Tuesday, June 07, 2005

Star Wars on the couch

How can a med student get a much-needed break during psychiatry clerkship? ReaLspace finds that a movie may offer no relief:
Watching Star Wars 3 (much better than the first two), I couldn’t help the train of thoughts running through my mind: Paranoid delusions. Grandiosity. Impulsivity. Inflexibility in thinking. Black and white thinking. Anger management issues. Issues with authority figures. Tendency to aggression and violence. Ambivalence. Labile. Poor coping style. Difficulty with trust. Psychomotor agitation. Lack of insight. Query psychosis. Query antisocial personality disorder, possibly psychopathic. Query borderline personality disorder. At very high risk of PTSD, depression. Management? Likelihood of medication compliance? Need for involuntary treatment order? We’d need a lot of backup...
Hat tip to Rebel Doctor, who adds his own assessment of Darth Vader:
I think Realspace is on the right track when he mentions the cluster B personality disorder diagnoses of antisocial personality disorder and borderline personality disorder, though I would vote for a diagnosis of narcissistic personality disorder (he has a grandiose sense of self-importance, is preoccupied with fantasies of unlimited power, believes that he is special and should only associate with other high-status people, requires excessive admiration, has a sense of entitlement, shows arrogance, and is often envious of others or believes that others are envious of him. He also lacks empathy, at least at the end of the movie)....
Managment: he might have been a candidate for intensive psychodynamic therapy before he went to the dark side; after that he was essentially untreatable. Don't think any mediction would have helped. I don't think anyone is powerful enough to enforce an involuntary treatment order on Vader, and it can be hard to get an involuntary treatment order for an axis 2 diagnosis in many jurisdictions.
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