Psychiatry, general practice and emergency clinicians get a balanced harm-reduction frame for psilocybin. It separates possible effects in depression or terminal illness anxiety from treatment-resistant uncertainty, contraindications, serotonergic medicine review, supervised dosing, integration therapy and persistent perceptual disturbance.

Trauma presentations with flashbacks, nightmares, persistent anxiety or low self-esteem may need more than symptom labelling. The EMDR guide is useful for understanding stabilisation, readiness for reprocessing, bilateral stimulation and the eight-phase model before considering accredited training.

Autistic young people may carry suicide risk even when supervision, routine or communication differences make distress harder to read. The emphasis is concrete language, processing time, collateral history and safety planning that includes sensory triggers, access to lethal means and family roles.

Gender-affirming care needs respectful assessment rather than pathologising identity. Document diagnosis, capacity, informed consent, comorbidity and social support, while separating reversible, partially reversible and irreversible interventions and making suicide-risk assessment visible.

Gender-affirming care is approached through critical appraisal of a flawed historical follow-up study. The teaching is to separate evidence quality from assumptions about social conformity, and to prioritise patient-reported distress, functioning and safety when services are discussed.

This psychiatry and critical appraisal item is specialist, but worth choosing when adolescent gender dysphoria outcomes or consent records are under review. It separates appearance satisfaction from broader mental health outcomes, then treats dextromethorphan augmentation in clozapine-resistant schizophrenia as an early, cautious signal.

Complex gender-related distress needs more than satisfaction data. The psychiatry appraisal stresses evidence limits, multidisciplinary assessment before irreversible treatment, external pressures around detransition, and ADHD reviews that focus on functional organisation rather than early stimulant energy.

Adolescent gender care becomes unsafe when diagnosis, comorbidity and expected benefit are blurred. Keep this for later unless you work in mental health or adolescent services; its main value is precise terms, body dysmorphic disorder caution, and honest consent and coordination before irreversible interventions.

Lithium is framed here as a long-term stabiliser rather than the fastest way to calm acute mania. The main bedside value is learning which bipolar history fits classic lithium response, when mixed features should lower expectations, and when blunting may mean the dose is simply too high.

Borderline personality disorder is approached here through assessment, treatment frame, and what happens in the room, not just a list of behaviours. The episode is most useful for the reminder that depression, self-harm, or substance misuse should not end the assessment before personality structure is explored.