Forgive me for leaping in at my first visit and when I haven't even finished reading the Otto case. I've never practised Psychiatry in the States, but have done for over 30 years in UK and I must have seen very different kinds of patients. I can't imagine admitting only 12 in the time -- I must have admitted hundreds (I've never calculated). On the evidence given in this case, I'm still left wondering why Otto was admitted -- it's not clear that he was seriously suicidal, for example. Admission is such a big step.......But the reason I couldn't restrain myself from jumping in to the discussion is the evident difference in terminology -- or conceptualisation. Nothing in the history so far would justify - in UK - using the word "psychosis" as here - "Brief Reactive Psychosis". Sorry -- I was just so flabbergasted -- if that word is allowed. But probably I should really finish reading - I hope you understand why I had to comment.