PsychEd: educational psychiatry podcast PsychEd

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the topic of cultural psychiatry with expert guest Dr. Eric Jarvis, Staff Psychiatrist and Director of the Cultural Consultation Service and the First Episode Psychosis Program at the Jewish General Hospital in Montreal, Quebec and Associate Professor in the Department of Psychiatry at McGill University.
 
The learning objectives for this episode are as follows:
 
By the end of this episode, you should be able to…
Define culture Describe how culture affects psychiatric care Outline the goal and structure of a Cultural Formulation Interview Evaluate clinical scenarios to determine whether to employ the Cultural Formulation Interview or seek a cultural consultation Define the three types of cultural concepts of distress, and compare these with DSM-5 nosology Discuss the concept of cultural competency  Explore the role of advocacy in psychiatric practice  
Guest expert: Dr. Eric Jarvis
Hosts: Dr. Sarah Hanafi (PGY3), Audrey Le (CC4)
Audio editing by Dr. Sarah Hanafi (PGY3)
Show notes by Dr. Sarah Hanafi (PGY3)
 
Interview Content:
Introductions: 0:28 Learning objectives: 3:01 Definition of cultural psychiatry: 3:52 Definition of culture: 6:50 Disparities in mental health outcomes 12:48 The Cultural Formulation Interview (CFI) 15:59 Cultural concepts of distress 34:28 Cultural competency 40:46 Role of advocacy in psychiatry 48:04 Tips for those interested and training opportunities 51:26 Closing 61:01  
Resources:
McGill Summer Program in Social and Cultural Psychiatry McGill Advanced Study Institute in Cultural Psychiatry Society for the Study of Psychiatry and Culture Cultural Psychiatry Day  
References:
Cultural Formulation. (2017). In Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA: American Psychiatric Association. Kirmayer, L. J., Fung, K., Rousseau, C., Lo, H. T., Menzies, P., Guzder, J., . . . Mckenzie, K. (2020). Guidelines for Training in Cultural Psychiatry. The Canadian Journal of Psychiatry, 070674372090750. doi:10.1177/0706743720907505 Kirmayer, L. J., Kronick, R., & Rousseau, C. (2018). Advocacy as Key to Structural Competency in Psychiatry. JAMA Psychiatry, 75(2), 119. doi:10.1001/jamapsychiatry.2017.3897  Kirmayer, L.J., Rousseau, C., Jarvis, G.E. and Guzder, J. (2008). The Cultural Context of Clinical Assessment. In Psychiatry (eds A. Tasman, J. Kay, J.A. Lieberman, M.B. First and M. Maj). doi:10.1002/9780470515167.ch4   
CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association.

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Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Immigrant and Refugee mental health with not one, not two but three experts in the field: Dr. Lisa Andermann, Dr. Clare Pain, and Norma Hannant.
 
The learning objectives for this episode are as follows:
 
By the end of this episode, you should be able to:
Explore the social, political and legal context of refugees and immigrants presenting with mental health concerns: Appreciate the specific mental health needs of refugee and immigrant populations in Canada. Describe the clinical approach to providing mental health care for this population:



Produced and Hosted by: Dr. Sarah Hanafi (PGY 3), Weam Sieffien (CC3), and Shaoyuan (Randi) Wang (CC3)
 
Produced by: Dr. Sarah Hanafi (PGY 3), Weam Sieffien (CC3), and Shaoyuan (Randi) Wang (CC3)
 
Guest experts: Dr. Lisa Andermann, Dr. Clare Pain, Norma Hannant 



Resources: 
Immigrant and Refugee Mental Health Project (courses, community of practice and toolkits) Listen to Weam’s hands-on impressions of this resource in the post-credits of this episode


References 
Edmonston, B. (2016). Canadian immigration trends and patterns. Canadian Studies in Population, 43(1-2), 78-116.  Duffin, E. (2020). Immigration in Canada - Statistics & Facts. Statista. Retrieved 2020-06-16 from https://www.statista.com/topics/2917/immigration-in-canada/ Statistics Canada. (2019). Classification of admission category of immigrant. Retrieved 2020-06-16 from https://www23.statcan.gc.ca/imdb/p3VD.pl?Function=getVD&TVD=323293&CVD=323294&CLV=0&MLV=4&D=1 Robert, A. & Gilkinson, T. (2012). Mental health and well-being of recent immigrants in Canada: Evidence from the Longitudinal Survey of Immigrants to Canada. Citizenship and Immigration Canada. Retrieved 2020-06-16 from https://novascotia.cmha.ca/wp-content/uploads/2020/01/mental-health.pdf Ng, E. (2015). The healthy immigrant effect and mortality rates. Statistics Canada. Retrieved 2020-06-16 from https://www150.statcan.gc.ca/n1/pub/82-003-x/2011004/article/11588-eng.htm Immigrant and Refugee Mental Health Project. (n.d.). Retrieved from https://irmhp-psmir.camhx.ca/ Stats Canada 2016 Stats Canada 2017 Blair AH, Schneeberg A. Changes in the ‘healthy migrant effect’ in Canada: are recent immigrants healthier than they were a decade ago?. Journal of immigrant and minority health. 2014 Feb 1;16(1):136-42 Vang Z, Sigouin J, Flenon A, Gagnon A. The healthy immigrant effect in Canada: A systematic review. Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail. 2015;3(1):4. Close C, Kouvonen A, Bosqui T, Patel K, O’Reilly D, Donnelly M. The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews. Globalization and health. 2016 Dec;12(1):47. Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K. Common mental health problems in immigrants and refugees: general approach in primary care. Cmaj. 2011 Sep 6;183(12):E959-67 Betancourt, J.R., Green, A.R., Carrillo, J.E., & Ananeh-Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118, 293-302. Harris, M. & Fallot, R.D. (2001). Envisioning a Trauma-informed service system: A vital paradigm shift. New Directions in Mental Health Services, 89, 3-22. Chen AW, Kazanjian A, Wong H. Why do Chinese Canadians not consult mental health services: health status, language or culture?. Transcultural psychiatry. 2009 Dec;46(4):623-41. Durbin A, Lin E, Moineddin R, Steele LS, Glazier RH. Use of mental health care for nonpsychotic conditions by immigrants

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.
 
In this episode, we begin to explore the neurobiology of the serotonin system — along with key pharmacological agents (SSRIs and classical psychedelics) that act on this system — with guest expert Dr. Robin Carhart-Harris, a neuroscientist and head of the Centre for Psychedelic Research at Imperial College London.
 
Our discussion is more theoretical than directly clinically relevant, striving to provide a mechanistic understanding of how serotonin functions within the brain and how serotonin-modulating drugs influence this system. The episode was inspired by a review published by our guest expert and Dr. David Nutt called “Serotonin and brain function: a tale of two receptors” (cited below). If you are interested in the topic, you might consider reading this review in full! Please note that the figures referenced during this episode can be accessed at https://journals.sagepub.com/doi/figure/10.1177/0269881117725915.
 
The learning objectives for this episode are as follows: 
 
By the end of this episode, you should be able to…
 
Understand the general anatomy and function of the serotonin system, with a focus on the purported activity of the more common serotonin receptors and transporters. Describe the effects of serotonin reuptake inhibitors and how they lead to symptom improvement in mood and anxiety disorders, in addition to the mechanism of action of other serotonergic medications. Consider the two-pronged serotonin system conceptualized by Dr. Carhart-Harris, and understand how serotonergic agents (including SSRIs and classic psychedelics) and the concepts of active and passive coping fit within this theory.  
Guest: Dr. Robin Carhart-Harris, a neuroscientist and head of the Centre for Psychedelic Research at Imperial College London.
 
Produced and hosted by: Dr. Chase Thompson (PGY3), Dr. Lucy Chen (Psychiatrist), Dr. Nikhita Singhal (PGY2)
 
Audio editing by: Dr. Chase Thompson
 
Infographic by: Dr Chase Thompson, Dr Nikhita Singhal
 
Interview Content:
 
00:18 - Introductions 3:00 - Learning objectives 4:10 - Introduction to serotonin 10:30 - 5HT1A receptors 24:30 - 5HT2A receptors 30:20 - Serotonin system operation under normal conditions 35:00 - Introduction of bipartite model / two divergent methods for addressing depression 42:20 - Parallels between psychological destabilization (through therapy) and the psychedelic effect  46:20 - Who should not have a psychedelic experience? Are psychedelics intrinsically psychotherapeutic or facilitative in nature? 50:20 - Brief discussion of the neuroimaging correlates of psychotherapeutic benefits from psychedelic experiences 58:40 - Discussion of why 2A agonists cause psychedelic effects but high serotonin release does not  
Resources:
 
Carhart-Harris RL, Nutt DJ. Serotonin and brain function: a tale of two receptors. J Psychopharmacol. 2017;31(9):1091-1120. https://doi.org/10.1177/0269881117725915 Artigas F, Nutt DJ, Shelton R. Mechanism of action of antidepressants. Psychopharmacol Bull. 2002;36 Suppl 2:123-132. Antidepressants. In: Stahl SM. Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 4th ed. Cambridge University Press; 2013:284-369. Beliveau V, Ganz M, Feng L, et al. A High-Resolution In Vivo Atlas of the Human Brain's Serotonin System. J Neurosci. 2017;37(1):120-128. https://doi.org/10.1523/JNEUROSCI.2830-16.2016 Carhart-Harris RL, Bolstridge M, Rucker J, et al. Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. Lancet Psychiatry. 2016;3(7):619-627. https://doi.org/10.1016/S2215-0366(16)30065-7 Carhart-Harris RL, Leech R, Hellyer PJ, et al. The entropic brain: a theory of conscious states informed by neuroimaging research with

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers nutritional psychiatry with expert guest Dr. Laura LaChance, Staff Psychiatrist and Director of Outpatient Psychiatry at St. Mary’s Hospital Centre in Montreal, Quebec and Faculty Lecturer in the Department of Psychiatry at McGill University.
 
The learning objectives for this episode are as follows:
 
By the end of this episode, you should be able to…
 
1)      Define nutritional psychiatry
2)      Understand the mechanisms, common misconceptions, challenges, and current evidence supporting the role for nutrition in mental health
3)      Apply this understanding to clinical cases in psychiatry
 
Guest: Dr. Laura LaChance
Hosts: Dr. Sarah Hanafi (PGY2), Dr. Nima Nahiddi (PGY2), Gray Meckling (CC3)
Audio editing by Dr. Alex Raben (PGY5)
Show notes by Gray Meckling
 
Interview Content:
 
·       Introduction and learning objectives – 0:35
·       Dr. Laura LaChance’s professional background – 1:50
·       Definition of nutritional psychiatry and history of the field – 3:35
·       Putative mechanisms through which nutrition is implicated in mental health – 7:00
·       Common misconceptions surrounding the role for nutrition in mental health – 11:45
·       Current evidence supporting the role for nutrition in the management of psychiatric illness – 16:00
·       Case-based examples of nutrition in clinical psychiatry – 23:35
·       Challenges to capitalizing on this mode of intervention in psychiatry – 32:30
·       Taking a dietary history in the context of mental health – 34:50
·       Future directions in the field of nutritional psychiatry – 41:20
·       The gut-microbiome – 43:00
·       Tips for those interested and how to get involved – 48:00
·       Closing – 50:15
 
Resources:
 
·       International Society for Nutritional Psychiatry Research
·       The Food & Mood Centre at Deakin University
·       Future Learn Online Course – Food and Mood: Improving Mental Health Through Diet and Nutrition
·       The Brain Food Academy
·       Dr. Drew Ramsey
·       Food as Medicine Update – Conference
 
Articles:
 
·       Nutritional Psychiatry: The Gut-Brain Connection (Psychiatric Times)
·       Nutritional Psychiatry: Your Brain on Food (Harvard Health Publishing)
 
References:
 
·       Adan, R. A., van der Beek, E. M., Buitelaar, J. K., Cryan, J. F., Hebebrand, J., Higgs, S., ... & Dickson, S. L. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European Neuropsychopharmacology.
·       Auction, Monique & LaChance, Laura & Cooley, Kieran & Kidd, Sean. (2019). Diet and Psychosis: A Scoping Review. Advances in Integrative Medicine. 6. S101. 10.1016/j.aimed.2019.03.292.
·       Firth J, Veronese N, Cotter J, Shivappa N, Hebert J, Ee C, Smith L, Stubbs B, Jackson S, Sarris J. What is the role of dietary inflammation in severe mental illness? a review of observational and experimental findings. Frontiers in psychiatry. 2019;10:350.
·       Firth, J., Carney, R., Stubbs, B., Teasdale, S. B., Vancampfort, D., Ward, P. B., ... & Sarris, J. (2018). Nutritional deficiencies and clinical correlates in first-episode psychosis: a systematic review and meta-analysis. Schizophrenia bulletin, 44(6), 1275-1292.
·       Francis HM, Stevenson RJ, Chambers JR, Gupta D, Newey B, Lim CK. A brief diet intervention can reduce symptoms of depression in young adults–A randomised controlled trial. PloS one. 2019;14(10).
·       Guu TW, Mischoulon D, Sarris J, Hibbeln J, McNamara RK, Hamazaki K, Freeman MP

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.
In this episode, we explore Attachment Theory, a key foundational framework in psychiatry which concerns relationships and the ways in which infants seek proximity to caregivers in development.
Our guest expert is Dr. Diane Philipp, a child and adolescent psychiatrist at the Sick kids Center for Community Mental Health in Toronto and Assistant Professor at the University of Toronto. She has developed a family therapy method called Reflective Family Play, a model of therapy which aims to improve parent-child dynamics, and more specifically attachment. She currently practices reflective family play and also teaches this method locally and internationally.
Produced and Hosted by Dr. Chase Thompson (PGY2) and Dr. Lucy Chen (PGY5)
Audio Editing by Dr. Alex Raben (PGY5)
The learning objectives for this episode are as follows: 
    Define attachment theory     Review the history of attachment theory and how the field developed     Briefly review the evolutionary basis, and functional role of attachment in infants     Briefly review the neurobiological perspectives of attachment     Outline and describe different types of attachment and attachment disorders     Learn how infant attachment is assessed in contemporary psychiatry/psychology     Learn how attachment disorders impact adult relationships and child rearing Some sources for further reading:
Ainsworth, Mary S. “Infant-mother attachment” American psychologist 34.10 (1979): 932
Bowlby, J. "Lecture 2: The origins of attachment theory." A secure base (1988): 20-38.
Cicchetti, Dante, Fred A. Rogosch, and Sheree L. Toth. "Fostering secure attachment in infants in maltreating families through preventive interventions." Development and psychopathology 18.3 (2006): 623-649.
Cohen, Nancy J., et al. "Watch, wait, and wonder: Testing the effectiveness of a new approach to mother–infant psychotherapy." Infant Mental Health Journal: Official Publication of The World Association for Infant Mental Health 20.4 (1999): 429-451.
Collins, Nancy L. "Working models of attachment: Implications for explanation, emotion, and behavior." Journal of personality and social psychology 71.4 (1996): 810.
Feeney, Judith A., and Patricia Noller. "Attachment style as a predictor of adult romantic relationships." Journal of personality and Social Psychology 58.2 (1990): 281.
George, Carol, Nancy Kaplan, and Mary Main. "Adult attachment interview." (1996). 
Insel, Thomas R., and Larry J. Young. “The neurobiology of attachment.” Nature Reviews Neuroscience 2.2 (2001):129
Main, Mary. "Introduction to the special section on attachment and psychopathology: 2. Overview of the field of attachment." Journal of consulting and clinical psychology 64.2 (1996): 237.
Simpson, Jeffry A., et al. "Attachment and the experience and expression of emotions in romantic relationships: A developmental perspective." Journal of personality and social psychology 92.2 (2007): 355.
Sroufe, L. Alan, et al. "Implications of attachment theory for developmental psychopathology." Development and psychopathology 11.1 (1999): 1-13.
CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association.
 
For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodast@gmail.com For more information visit our website: psychedpodcast.org.
 

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers medical trainee wellness during the COVID-19 pandemic with expert guest Dr. Deanna Chaukos, Staff Psychiatrist at Mount Sinai Hospital in Toronto and Wellness Lead for the Psychiatry Residency program at the University of Toronto. 
 
The learning objectives for this episode are as follows:
 
By the end of this episode, you should be able to…
Define wellness and burnout and their importance in medical education/psychiatry Understand strategies on how to maintain our own wellness and prevent burnout Understand strategies to help others maintain their wellness and deal with burnout *All through the lens of the COVID-19 pandemic
 
Hosts: Dr. Alex Raben (PGY5), Gray Meckling (CC3), Shaoyuan (Randi) Wang (CC3), Weam Sieffien (CC3)
 
Guest Staff Psychiatrist: Dr. Deanna Chaukos (Sinai Health Systems, Toronto)
 
Resources
COVID-19 Resources for Residents, infographic prepared by residents at the University of Toronto, including team member of PsychEd Nikhita Singhal Resources for MD Wellness Improving Mental Health During COVID-19 University of Toronto Office of Health Professions Student Affairs OHPSA University of Toronto Postgraduate Wellness Office at UofT Gerstein Crisis Centre CAMH: COVID-19 Information for Healthcare Workers CAMH self-referral for healthcare workers to access mental health services UofT Faculty of Medicine: COVID-19 Wellness Resources for Faculty and Trainees Canadian Psychiatric Association - COVID-19 American Psychiatric Association Well-being Resources Seven tips for staying grounded as the world grapples with COVID-19: UofT Expert AMA: 6 ways to address physician stress during COVID-19 pandemic UBC - COVID-19 Resident Wellness Resources Youtube video: Three steps to coping with anything (including COVID-19) MHCC: Resource Hub: Mental health and wellness during the COVID-19 pandemic CMHA: COVID-19 and mental health  
Articles
CMA: Maintaining Your and Your Family’s Well-being During a Pandemic BMJ Opinion: COVID-19 - the impact on our medical students will be far-reaching AAMC: “A terrifying privilege”: Residency during the COVID-19 Outbreak AMA: Residency in a pandemic: How COVID-19 is affecting trainees CMAJ: Medical education needs reform to improve student well-being and reduce burnout, say experts  
Examples of Medical Student Initiatives
UofT News: As COVID-19 battle escalates, U of T students offer busy health-care workers help on the home front UofT News: Medical students collect personal protective gear for front line health-care workers, donate through U of T UofT News: 'We care and are here for them': U of T students help seniors cope with distancing during COVID-19 COVID-19 Central Making a difference: UBC students help frontline medical workers during COVID-19 McGill students rally their peers to provide support to frontline workers U of A medical students offering emergency child care to physicians and front-line health workers UCalgary medical and nursing students quickly answer the call for COVID-19 help News: Medical students providing support during COVID-19 containment effort (Schulich School of Medicine & Dentistry, Western University) Queen's students volunteer to help Kingston's medical professionals UOttawa MD students pitch in to help frontline health workers during COVID-19 McMaster med students help their future colleagues during COVID-19  
References 
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. Eckleberry-Hunt, J., Van Dyke, A., Lick, D., & Tucciarone, J. (2009). Changing the conversation from burnout to wellness: physician well-bei