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Media commentators seem puzzled as they express hope that President Trump can remold himself into a national leader the country needs. Twenty-seven psychiatrists have weighed in by each contributing a chapter in a book compiled by Brandy Lee, MD, entitled, “The Dangerous Case of Donald Trump.” The book deals with the mental state of President Trump. It explains why there is poor understanding of the Trump mental and personality abnormality causing so much dysfunction in presidential leadership.

The psychiatric and mental health contributors justify a professional responsibility in their “duty to warn,” circumventing the Goldwater rule of the American Psychiatric Association code of ethics to not diagnose without examination. They conclude the president is dangerously unfit to lead the nation. The descriptions describing President Trump are “narcissistic personality disorder, antisocial personality disorder, paranoid personality disorder, delusional disorder, malignant narcissist, and solipsistic reality disorder.” The later term means embracing reality only about himself, excluding any empathy for others. The capacity for the human mind to become “derailed” is part of believing what is not true, resulting in lying, and ruling by decree like other dictators, no matter how unjust or immoral. Trump’s pervasive sense of entitlement to say and do whatever he pleases to women reinforces his self-image of superiority as an untouchable celebrity. The most disturbing character described in the book, linked to destructiveness and inhumanity, is identified as “malignant narcissism.” There is concern that no one will be able to control or restrain him in a national crisis. Ruling by fear, lies, and betrayal are expected to worsen as he becomes more isolated and paranoid.

The health professionals are convincing in their analysis of Trump’s character thought to be dangerous beyond imagination. They warn it is imperative that something be done about it, but exactly what is not revealed.

Richard A. Damon, MD

Bozeman

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