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This podcast is written and produced by psychiatry residents at the University of Toronto and is aimed at medical students and residents. Listeners will learn about fundamental and more advanced topics in psychiatry as our resident team explore these topics with world-class psychiatrists at U of T and abroad.

PsychEd: educational psychiatry podcas‪t‬ PsychEd

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This podcast is written and produced by psychiatry residents at the University of Toronto and is aimed at medical students and residents. Listeners will learn about fundamental and more advanced topics in psychiatry as our resident team explore these topics with world-class psychiatrists at U of T and abroad.

    PsychEd Episode 33: Treating Borderline Personality Disorder with Dr. Robert Biskin and Dr. Ronald Fraser

    PsychEd Episode 33: Treating Borderline Personality Disorder with Dr. Robert Biskin and Dr. Ronald Fraser

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.
    This episode covers the treatment of borderline personality disorder with expert guests:
    Dr. Robert Biskin, Associate Professor in the Department of Psychiatry at McGill University, and inpatient psychiatrist at the Borderline Personality Disorder Clinic at the McGill University Health Centre, as well as the inpatient psychiatrist at the Jewish General Hospital. Dr. Ronald Fraser, Associate Professor in the Department of Psychiatry at McGill University, Adjunct Professor at Dalhousie University, and head of the Inpatient Detoxification Services and Addictions Unit, as well as director of the Extended Care Borderline Personality Disorder Clinic at the McGill University Health Centre. The learning objectives for this episode are as follows: 
    By the end of this episode, you should be able to…
    Understand the frame and principles of care for the treatment of individuals with borderline personality disorder. Explore the approach to the treatment of individuals with borderline personality disorder: On presentation in crisis to the emergency department. During an inpatient psychiatric admission. In the context of psychiatric outpatient care. Understand the use of psychotherapy in the treatment of individuals with borderline personality disorder. Understand the use of pharmacotherapy in the treatment of individuals with borderline personality disorder Guest: Dr. Robert Biskin and Dr. Ronald Fraser
    Hosts: Dr. Sarah Hanafi (PGY3), Dr. Nima Nahiddi (PGY3), Audrey Le (CC4)
    Audio editing by Audrey Le
    Show notes by Dr. Nima Nahiddi
    Interview Content:
     Introduction – 0:00 Learning objectives – 0:35 Principles of care for treatment of BPD – 1:16 The therapeutic frame – 5:40  Approach to the management of emergency department presentations – 9:10 Dialectical behaviour therapy (DBT) – 16:15 Suicidality and self-harm in BPD diagnosis – 21:05 Pharmacotherapy for symptom treatment – 22:40 Treatment of co-morbid disorders – 32:35  Management of safety risk – 39:30 Stigma in treatment of BPD – 46:05 Closing remarks – 52:00 Resources/Articles:
    The Treatment of Borderline Personality Disorder: Implications of Research on Diagnosis, Etiology, and Outcome | Annual Review of Clinical Psychology (annualreviews.org) Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis | Psychiatry | JAMA Psychiatry | JAMA Network National Education Alliance for Borderline Personality Disorder References:
     
    Cristea I.A., Gentili C, Cotet CD, Palomba D, Barbui C, Cuijpers P. (2017) Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis. JAMA Psychiatry. 74(4):319–328. doi:10.1001/jamapsychiatry.2016.4287 Ingenhoven T, Lafay P, Rinne T, Passchier J, Duivenvoorden H  J. (2010) Effectiveness of pharmacotherapy for severe personality disorders: meta-analyses of randomized controlled trials. Clin Psychiatry. 71(1):14.  Paris J. (2009). The Treatment of Borderline Personality Disorder: Implications of Research on Diagnosis, Etiology, and Outcome. Review of Clinical Psychology. 5:1, 277-290 Stoffers J, Vollm BA, Rucker G, Timmer A, Huband N. (2010) Pharmacological interventions for borderline personality disorder. Cochrane Database of Systematic Reviews, Issue 6. Art. No.: CD005653. DOI: 10.1002/14651858.CD005653 Storebø  OJ, Stoffers-Winterling  JM, Völlm  BA, Kongerslev  MT, Mattivi  JT, Jørgensen  MS, Faltinsen  E, Todorovac  A, Sales  CP, Callesen  HE, Lieb  K, Simonsen  E.  (2020) Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD012955. DOI: 10.1002/14651858.CD012955.pub2  
     
    CPA Note: The views expressed in this p

    • 54 Min.
    PsychEd Episode 32: Diagnosing Borderline Personality Disorder with Dr. Robert Biskin and Dr. Ronald Fraser

    PsychEd Episode 32: Diagnosing Borderline Personality Disorder with Dr. Robert Biskin and Dr. Ronald Fraser

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.
    This episode covers the diagnosis of borderline personality disorder with expert guests:
    Dr. Robert Biskin, Associate Professor in the Department of Psychiatry at McGill University, psychiatrist at the Borderline Personality Disorder Clinic at the McGill University Health Centre, as well as inpatient psychiatrist at the Jewish General Hospital. Dr. Ronald Fraser, Associate Professor in the Department of Psychiatry at McGill University, Adjunct Professor at Dalhousie University, head of the Inpatient Detoxification Services and Addictions Unit, as well as director of the Extended Care Borderline Personality Disorder Clinic at the McGill University Health Centre.  
    By the end of this episode, you should be able to…
    List the DSM-5 diagnostic criteria of borderline personality disorder. Recall the epidemiology of borderline personality disorder. Consider the risk factors and posited causal mechanisms for borderline personality disorder, including developmental and neurobiological mechanisms.  Discuss the clinical presentation of borderline personality in different clinical settings, including the Emergency and Outpatient settings.  Recognize the differential diagnoses for patients presenting with borderline personality disorder. List the common comorbid psychiatric and general medical conditions with borderline personality disorder. Discuss the common diagnostic challenges and pitfalls. Explore the stigma surrounding the diagnosis of borderline personality disorder, and discuss a therapeutic approach to providing psychoeducation to patients with this diagnosis.   
    Guests: Dr. Robert Biskin and Dr. Ronald Fraser.
    Hosts: Dr. Sarah Hanafi (PGY3), Dr. Nima Nahiddi (PGY3), Audrey Le (CC4).
    Audio editing by Audrey Le.
    Show notes by Dr. Nima Nahiddi.
     
    Interview Content:
    Introduction – 0:00 Learning objectives – 2:03 DSM-5 definition of personality disorder, and borderline personality disorder (BPD) – 3:00 Other associated features of BPD – 4:36 Distinguishing BPD from other psychiatric and co-morbid conditions – 5:55 Epidemiology of BPD – 13:48 BPD over the lifecycle – 18:05 Explanatory models for the development of BPD – 21:20 Differences in the presentation of BPD – 26:00 Approach to a BPD diagnosis in the emergency department – 31:05 Stigma surrounding BPD diagnosis and disclosure of diagnosis – 33:51 Clinical pearls for screening of BPD – 41:11 Evidenced based screening tools or scales for BPD diagnosis – 46:22 Closing – 48:40 Resources:
    MSI-BDP: MacLean Screening Index for BPD Diagnostic Interview for BPD – Revised (DIB-R): https://psycnet.apa.org/record/1990-11356-001 Articles: Diagnosing borderline personality disorder | CMAJ
     
    References:
    Biskin, R.S., Paris, J. (2012). Diagnosing borderline personality disorder. CMAJ. 184 (16), 1789-1794. Zanarini, M. C., Gunderson, J. G., Frankenburg, F. R., & Chauncey, D. L. (1989). The revised Diagnostic Interview for Borderlines: Discriminating BPD from other Axis II disorders. Journal of Personality Disorders, 3(1), 10–18. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596  
    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), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    • 50 Min.
    PsychEd Episode 31: Understanding Psychodynamic Therapy with Dr. Rex Kay

    PsychEd Episode 31: Understanding Psychodynamic Therapy with Dr. Rex Kay

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers psychodynamic psychotherapy with Dr. Rex Kay. Dr. Kay is a staff psychiatrist at Mount Sinai Hospital, assistant professor and modality lead for dynamic psychotherapy at the University of Toronto, as well as a faculty member at the Toronto Institute for Contemporary Psychoanalysis. 
     
    The learning objectives for this episode are as follows:
     
    By the end of this episode, you should be able to…
    Define psychodynamic psychotherapy.  Describe the core concepts of psychodynamic therapy.  Determine who may be an appropriate patient for psychodynamic psychotherapy.  Describe the evidence base for psychodynamic psychotherapy.  Compare and contrast psychodynamic therapy to other psychotherapies.   
    Guest: Dr. Rex Kay
     
    Produced and Hosted by: Jordan Bawks and Anita Corsini
     
    Audio editing by: Anita Corsini
     
    Resources:
    Ars Medica: A Journal of Medicine, the Arts, and Humanities Canadian Institute for Child and Adolescent Psychoanalytic Psychotherapy  Narrative Competence Psychotherapy Group at Mount Sinai Hospital Toronto Institute for Contemporary Psychoanalysis Toronto Institute of Psychoanalysis   


    References:
    Black, M. & Mitchell, S. (2016). Freud and beyond: A history of modern psychoanalytic thought. Basic Books. 
    Cabaniss, D. L., Cherry, S., Douglas, C. J., & Schwartz, A. R. (2017). Psychodynamic psychotherapy: A clinical manual. Wiley.  
    Driessen, E., Hegelmaier, L. M., Abbass, A. A., Barber, J. P., Dekker, J. J., Van, H. L., Jansma, E. P., & Cuijpers, P. (2015). The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis update. Clinical Psychology Review, 42, 1-15. doi: 10.1016/j.cpr.2015.07.004
    Eppel, A. (2018). Short-term psychodynamic psychotherapy. Springer. 
    Karen, R. (1994). Becoming attached: First relationships and how they shape our capacity to love. Oxford. 
    Safran, J. D. (2012). Psychoanalysis and Psychoanalytic Therapies. American Psychological Association. 
    Summers, R. F. & Barber, J. P. (2010). Psychodynamic Therapy: A Guide to Evidence-Based Practice. Guilford.




    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), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    • 1 Std. 11 Min.
    PsychEd Episode 30: Anti-black Racism and Mental Health with Dr. Kwame McKenzie

    PsychEd Episode 30: Anti-black Racism and Mental Health with Dr. Kwame McKenzie

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers anti-black racism and mental health with Dr. Kwame McKenzie. Dr. McKenzie is an international expert on the social causes of illness, suicide and the development of effective, equitable health systems. He is a Professor of Psychiatry at University of Toronto and a staff psychiatrist and Director of Health Equity at the Centre of Addiction and Mental Health.
     
    The learning objectives:
     
    By the end of this episode, you should be able to…
    Understand the history and legacy of racism and mental health in the black community Understand the current state of racism towards black people and the impacts on their mental health. Explore how healthcare workers can be anti-racist in providing mental health care and how the system can change to improve the mental health of black people.  
    Host(s): Anita Corsini (social worker), Dr. Alex Raben (staff psychiatrist), and Rebecca Marsh (CC4)
     
    Produced by: Anita Corsini, Rebecca Marsh, Randi Wang (CC4), and Dr. Alex Raben
     
    Guest experts: Dr. Kwame McKenzie, staff psychiatrist
     
    Resources:
     
    Manual for Cognitive-Behavioural Therapy for English-Speaking People of Caribbean Origin
    The City of Toronto has curated a list of Mental Health Resources for Black Communities. Organizations include:
    Across Boundaries Black Creek Community Health Centre Caribbean African Canadian Social Services Rexdale Community Health Centre TAIBU Community Health Centre The Black Health Alliance Women’s Health in Women’s Hands Community Health Centre  
    References:
     
    Adelman, J. (2003). Study in Blue and Grey, Police Interventions with People with Mental Illness: A Review of Challenges and Responses [Ebook]. Canadian Mental Health Association. Retrieved 7 October 2020, from https://cmha.bc.ca/wp-content/uploads/2016/07/policereport.pdf. Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: current perspectives. Neuropsychiatric disease and treatment, 15, 603–609. https://doi.org/10.2147/NDT.S128584 Bor, J., Venkataramani, A., Williams, D., & Tsai, A. (2018). Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study. The Lancet, 392(10144), 302-310. https://doi.org/10.1016/s0140-6736(18)31130-9 Bresnahan, M., Begg, M., Brown, A., Schaefer, C., Sohler, N., & Insel, B. et al. (2007). Race and risk of schizophrenia in a US birth cohort: another example of health disparity?. International Journal Of Epidemiology, 36(4), 751-758. https://doi.org/10.1093/ije/dym041 Chakraborty, A., McKenzie, K., & King, M. (2009). Discrimination, ethnicity and psychosis — a qualitative study. Ethnicity And Inequalities In Health And Social Care, 2(1), 18-29. https://doi.org/10.1108/17570980200900004 Fernando, S. (2014). Racism in psychiatry. In R. Moodley & M. Ocampo (Eds.), Critical Psychiatry and Mental Health: Exploring the Work of Suman Fernando in Clinical Practice (pp. 22-32). Taylor & Francis.   Kirkmayer, L. J. (2014). Critical psychiatry in Canada. In R. Moodley & M. Ocampo (Eds.), Critical Psychiatry and Mental Health: Exploring the Work of Suman Fernando in Clinical Practice (pp. 170-181). Taylor & Francis.   Kuper, A. (2018). Cultural Safety & Equity [Lecture PDF]. Retrieved from University of Toronto Faculty of Medicine.  Maynard, R. (2017). Policing Black Lives: State Violence in Canada from Slavery to the Present. Fernwood. McKenzie, K. (2002). Does racial discrimination cause mental illness?. European Psychiatry, 17, 84. https://doi.org/10.1016/s0924-9338(02)80385-6 McKenzie, K., & Bhui, K. (2007). Institutional racism in mental health care. BMJ, 334(7595), 649-650. https://doi.org/10.1136/bmj.39163.395972.80 MCRRT - St. Joseph's Healthcare Hamilton. St. Joseph's He

    • 1 Std. 4 Min.
    PsychEd Episode 29: Cultural Psychiatry with Dr. Eric Jarvis

    PsychEd Episode 29: Cultural Psychiatry with Dr. Eric Jarvis

    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.

    For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information visit our website at psychedpodcast.org.

    • 1 Std. 2 Min.
    PsychEd Episode 28: Newcomer mental health with Dr. Lisa Andermann, Dr. Clare Pain, and Norma Hannant

    PsychEd Episode 28: Newcomer mental health with Dr. Lisa Andermann, Dr. Clare Pain, and Norma Hannant

    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

    • 44 Min.

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