PsychEd: educational psychiatry podcast

PsychEd
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PsychEd: educational psychiatry podcast

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.

  1. HACE 5 D

    PsychEd Episode 65: Psychotherapy in Youth with Dr. Laurence Katz

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers psychotherapy in youth with Dr. Laurence Katz, a professor of child and adolescent psychiatry at the University of Manitoba. Dr. Katz received his medical and adult psychiatric training at the University of Manitoba and his child and adolescent psychiatry training at the Albert Einstein College of Medicine, Bronx N.Y. He is an adjunct scientist at the Manitoba Centre for Health Policy and has published numerous papers using the population health administrative database in mental health outcomes. He has held and been part of numerous grants funded by CIHR, PHAC, and other national funding agencies related to work with First Nations communities. Dr. Katz is widely published in particular in the areas of suicide and suicidal behaviour. His other research interests include Dialectical Behaviour Therapy, pharmacoepidemiology, and implementation of complex interventions. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Outline which psychotherapeutic modalities are commonly used in youth Identify which youth may benefit/should be referred for psychotherapy Discuss important considerations in delivering psychotherapy to youth Guest: Dr. Laurence Katz Hosts: Wendy MacMillan-Wang, Shaoyuan Wang, Kate Braithwaite, and Sara Abrahamson Audio editing by: Angad Singh Show notes by: Kate Braithwaite Interview content: Introduction - 0:04 Guest introduction - 00:44 Learning objectives - 05:25 Definitions - 06:00 Types of psychotherapy in youth - 07:44 Evolution of psychotherapy in youth over time - 13:10 Psychotherapy in suicide prevention/risk mitigation - 16:24 Challenges in research: decrease in effect sizes over time - 18:32 Conditions responding best to psychotherapy - 22:01 Youth specific modalities - 26:44 Summary of learning objective 1 - 29:49 Indications and contraindications - 30:23 Consent - 37:31 Group therapy - 39:31 Summary of learning objective 2 - 46:27 Differences in psychotherapy in youth compared to adults in practice - 47:10 Techniques for engagement of youth - 53:32 Family involvement - 58:21 Confidentiality - 1:02:39 Use of mobile apps/internet-based therapies - 1:07:20 Summary of learning objective 3 - 1:11:17 Other considerations - 1:12:35 End credits - 1:16:52 References: Agostino, H., & Toulany, A. (2023). Considerations for privacy and confidentiality in adolescent health care service delivery. Paediatrics & Child Health, 28(3), 172–183. https://doi.org/10.1093/pch/pxac117 American Academy of Child and Adolescent Psychiatry. (2019, April). Psychotherapies for children and adolescents: different types. Facts for Families Guide. Retrieved from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychotherapies-For-Children-And-Adolescents-086.aspx Bailin, A., Cho, E., Sternberg, A., & others. (2023). Principle-guided psychotherapy for children and adolescents (FIRST): Study protocol for a randomized controlled effectiveness trial in outpatient clinics. Trials, 24, Article 682. https://doi.org/10.1186/s13063-023-07717-y Bhide, A., & Chakraborty, K. (2020). General principles for psychotherapeutic interventions in children and adolescents. Indian Journal of Psychiatry, 62(Suppl 2), S299–S318. CADDRA - Canadian ADHD Resource Alliance. (2020). Canadian ADHD practice guidelines (4.1 ed.). Toronto, ON: CADDRA. Christner, R. W., Stewart, J. L., & Mulligan, C. A. (Eds.). (2024). Handbook of cognitive-behavior group therapy with children and adolescents: Specific settings and presenting problems (2nd ed.). Routledge. Campisi, S. C., Ataullahjan, A., Baxter, J. B., Szatmari, P., & Bhutta, Z. A. (2022). Mental health interventions in adolescence. Current Opinion in Psychology, 48. https://doi.org/10.1016/j.copsyc.2022.101492 Katzman, M. A., Bleau, P., Blier, P., & others. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress, and obsessive-compulsive disorders. BMC Psychiatry, 14(Suppl 1), S1. https://doi.org/10.1186/1471-244X-14-S1-S1 Kendall, P. C., Ney, J. S., Maxwell, C. A., Lehrbach, K. R., Jakubovic, R. J., McKnight, D. S., & Friedman, A. L. (2023). Adapting CBT for youth anxiety: Flexibility within fidelity in different settings. Frontiers in Psychiatry, 14, Article 1067047. https://doi.org/10.3389/fpsyt.2023.1067047 Kernberg, P. F., Ritvo, R., Keable, H., & American Academy of Child an Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI) (2012). Practice Parameter for psychodynamic psychotherapy with children. Journal of the American Academy of Child and Adolescent Psychiatry, 51(5), 541–557. https://doi.org/10.1016/j.jaac.2012.02.015 Lam, R. W., Kennedy, S. H., Adams, C., & others. (2024). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 update on clinical guidelines for management of major depressive disorder in adults: Réseau canadien pour les traitements de l’humeur et de l’anxiété (CANMAT) 2023: Mise à jour des lignes directrices cliniques pour la prise en charge du trouble dépressif majeur chez les adultes. The Canadian Journal of Psychiatry, 69(9), 641–687. https://doi.org/10.1177/07067437241245384 Oetzel, K. B., & Scherer, D. G. (2003). Therapeutic engagement with adolescents in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 40(3), 215–225. https://doi.org/10.1037/0033-3204.40.3.215 Wergeland, G. J., Fjermestad, K. W., Marin, C. E., Haugland, B. S., Bjaastad, J. F., Oeding, K., Bjelland, I., Silverman, W. K., Öst, L. G., Havik, Ø. E., & Heiervang, E. R. (2014). An effectiveness study of individual versus group cognitive behavioral therapy for anxiety disorders in youth. Behaviour Research and Therapy, 57, 1–12. https://doi.org/10.1016/j.brat.2014.03.007 Witt, K. G., Hetrick, S. E., Rajaram, G., Hazell, P., Taylor Salisbury, T. L., Townsend, E., & Hawton, K. (2021). Interventions for self-harm in children and adolescents. Cochrane Database of Systematic Reviews, 3, Article CD013667. https://doi.org/10.1002/14651858.CD013667.pub2 Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., Alda, M., MacQueen, G., Milev, R. V., Ravindran, A., O'Donovan, C., McIntosh, D., Lam, R. W., Vazquez, G., Kapczinski, F., McIntyre, R. S., Kozicky, J., Kanba, S., Lafer, B., Suppes, T., Calabrese, J. R., Vieta, E., Malhi, G., Post, R. M., & Berk, M. (2018). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders, 20(2), 97–170. https://doi.org/10.1111/bdi.12609 For more PsychEd, follow us on Instagram (@psyched.podcast), X (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    1 h 18 min

  2. 2 NOV · CONTENIDO EXTRA

    Upcoming Book Club: Mind Fixers

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This is a special episode in a new series — the PsychEd Book Club, a forum where we'll introduce and discuss books of interest to psychiatry learners from a variety of disciplines, moving beyond epidemiology and clinical practice to look at science, history, culture, and more. We'll also invite you to read along and discuss with us as we read! Our book club episodes will start with a short introductory episode (like this one) sharing the book title and why we picked it. A few months later, we plan to release an episode debriefing our thoughts on the book. If there are specific things you want us to talk about, email us at psychedpodcast@gmail.com or reach out to us on social media and we will try to include them in our debrief! The first book we'll be covering is Anne Harrington's Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness. This is a new history of psychiatry, from the later nineteenth century to the present, with a focus on biological explanations and treatments for mental illness — the way that these approaches have gained and lost ground in the profession over time, clashing and collaborating with other understandings. It offers a wide-ranging overview of many defining figures, discoveries, and shifts within modern mental healthcare, unified by a single narrative which gives the book momentum and makes its portraits memorable, and often stinging. It's a polemical history, which prompts us to reconsider some of the field's most automatic self-conceptions, and to recognize the social, political, and cultural forces that have shaped and reshaped it over time. Hosts: Drs Kate Braithwaite, Wendy MacMillan-Wang, Alastair Morrison, and Gaurav Sharma Audio editing by: Dr Angad Singh For more PsychEd, follow us on Instagram (@psyched.podcast), X (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    8 min

  3. 30 AGO

    PsychEd Episode 64: Introduction to Consultation-Liaison Psychiatry with Dr. Raed Hawa and Dr. Alan Wai

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers an introduction to consultation-liaison psychiatry with Dr. Raed Hawa and Dr. Alan Wai, both from the University of Toronto. Dr. Raed Hawa is an esteemed CL psychiatrist and educator. Dr Hawa's interests are in the areas of undergraduate, postgraduate, and continuing medical education. He also practices general sleep medicine with particular clinical interest in the areas of insomnia, co-morbid psychiatric and medical illnesses, and sleep-related movement disorders. He currently serves as the President of the Canadian Academy of Consultation-Liaison Psychiatry (CACLP) and holds the position of Professor at the Faculty of Medicine, University of Toronto. Additionally, Dr. Hawa is the Deputy Psychiatrist-in-Chief at the Centre for Mental Health, University Health Network. Dr. Hawa has earned American Board Certification in Psychiatry, with subspecialty certifications in Sleep Medicine and Psychosomatic Medicine (Consultation-Liaison Psychiatry). His expertise and contributions to the field have been recognized through his designation as a Distinguished Fellow of both the American Psychiatric Association (APA) and the Canadian Psychiatric Association (CPA). Dr. Alan Wai is a psychiatrist at the University Health Network in Toronto and an Assistant Professor in the Department of Psychiatry at the University of Toronto. He provides inpatient CL psychiatry care and mental health and psychiatric care embedded in the Immunodeficiency Clinic at Toronto General Hospital, where he sees both persons living with and at risk of HIV. He received his medical degree from the University of British Columbia and completed his psychiatric residency training at the University of Toronto. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Outline the history and evolution of CL psychiatry Define the role and scope of CL psychiatrists in diverse medical settings Identify and assess common psychiatric disorders in CL settings Provide differential diagnoses and a general approach to a CL patient through a sample case Guests: Dr. Raed Hawa and Dr. Alan Wai Hosts: Annie Yu (PGY3), Sena Gok (MD), and Matthew Cho (CC3) Audio editing by: Sena Gok Show notes by: Sena Gok Interview content: Introduction - 00:13 Learning objectives - 01:09 First guest introduction - 01:36 History of CL psychiatry - 03:18 Subspecialties within CL psychiatry - 10:33 Collaborative care of CL psychiatry - 14:00 Preparation for CL Rotation - 20:03 Bariatric clinic and CL psychiatry - 22:32 Future of CL psychiatry, AFC Certification - 27:45 Second guest introduction - 33:29 Role and scope of CL psychiatry - 34:18 A day in CL psychiatry - 39:32 Cultural competence in CL psychiatry - 44:08 Introduction to patients in CL clinics - 47:53 Resources for CL psychiatry rotation - 50:14 Clinical vignette - 53:08 CL psychiatric assessment approach - 01:00:25 Agitation management in CL psychiatry - 01:09:24 Closing - 01:13:51 End credits - 01:15:05 Resources: Massachusetts General Hospital Handbook of General Hospital Psychiatry: https://www.sciencedirect.com/book/9781437719277/massachusetts-general-hospital-handbook-of-general-hospital-psychiatry Academy of CL Psychiatry (ACLP) educational resources: https://www.clpsychiatry.org/educationcareers/ AFC (Area of Focused Competence) in CL Psychiatry: https://news.royalcollege.ca/en/eligibility-and-exams/areas-of-focused-competence.html Canadian Academy of Consultation-Liaison Psychiatry website: https://www.clpsychiatry.ca Our previous CL psychiatry-related episodes: PsychEd Episode 22: Psycho-Oncology Assessments with Dr. Elie Isenberg-Grzeda PsychEd Episode 35: Pain Psychiatry with Dr. Leon Tourian PsychEd Episode 36: Understanding Eating Disorders with Dr. Randy Staab PsychEdEpisode 37: Treating Eating Disorders with Dr. Randy Staab

    1 h 15 min

  4. 31 JUL

    PsychEd Episode 63: Balancing Perspectives on Safety and Involuntary Hospitalization with Jesse Mangan and Dr. Jim McQuaid

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we discuss the practice of involuntary hospitalization (also referred to as involuntary commitment or certification) with two special guests and fellow podcast creators — Jesse Mangan and Dr. Jim McQuaid. Their podcast, Committable, focuses on the topic of involuntary commitment and features stories from people with lived experience as a window into complex conversations with attorneys, physicians, psychologists, and more. Jesse Mangan is the producer of Committable and someone who has experienced involuntary hospitalization. Dr. Jim McQuaid is an Associate Professor of Sociology at Framingham University. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Appreciate the individual and societal functions of involuntary hospitalization Understand the potential benefits and risks associated with involuntary hospitalization from the perspective of health care professionals as well as service users and the community at large Describe actions you can take as a practitioner (who has the power to certify) that may better serve your community and those you care for Identify meaningful ways to continue the conversation about these issues in medical education or training and beyond *This episode was recorded in 2021. Through a saga involving lost and recovered audio files, we’re thrilled to finally be able to release it, and believe that the topic is just as timely and relevant as ever! Guests: Jesse Mangan and Dr. Jim McQuaid Hosts: Anita Corsini, Nikhita Singhal, Gray Meckling, and Alex Raben Audio editing by: Nikhita Singhal Show notes by: Nikhita Singhal Interview content: Introduction - 00:34 Committable podcast trailer - 01:52 Guest introductions - 04:26 Learning objectives - 07:22 Defining terms and setting the context - 08:11 Jesse’s experience - 12:03 Exploring the functions of involuntary hospitalization - 23:06 Power differentials and the importance of humility - 41:05 Training considerations - 45:18 False divide between patients and providers - 51:39 Primary prevention and public health - 55:57 Professional identity formation - 57:57 Societal functions and processes - 01:05:00 Building trust - 01:11:57 Legal safeguards - 01:20:20 Alternative approaches/systems - 01:30:11 Rosenhan experiment - 01:37:12 Final thoughts - 01:39:21 End credits - 1:43:50 Resources: Committable podcast website: https://sensiblenonsense.squarespace.com PsychEd Episode 18: Assessing Suicide Risk with Dr. Juveria Zaheer On Being Sane in Insane Places References: Jaeger S, Hüther F, Steinert T. Refusing medication therapy in involuntary inpatient treatment—a multiperspective qualitative study. Front Psychiatry. 2019 May 9;10:295. https://doi.org/10.3389%2Ffpsyt.2019.00295 Johansson IM, Lundman B. Patients' experience of involuntary psychiatric care: good opportunities and great losses. J Psychiatr Ment Health Nurs. 2002 Dec;9(6):639-47. https://doi.org/10.1046/j.1365-2850.2002.00547.x McGuinness D, Murphy K, Bainbridge E, Brosnan L, Keys M, Felzmann H, Hallahan B, McDonald C, Higgins A. Individuals' experiences of involuntary admissions and preserving control: qualitative study. BJPsych Open. 2018 Nov 16;4(6):501-509. https://doi.org/10.1192%2Fbjo.2018.59 Ontario Hospital Association. A Practical Guide to Mental Health and the Law, Fourth Edition. Toronto: Ontario Hospital Association; 2023. Available from: https://www.oha.com/Legislative%20and%20Legal%20Issues%20Documents1/A%20Practical%20Guide%20to%20Mental%20Health%20and%20the%20Law%2c%20Fourth%20Edition%2c%202023.pdf Paksarian D, Mojtabai R, Kotov R, Cullen B, Nugent KL, Bromet EJ. Perceived trauma during hospitalization and treatment participation among individuals with psychotic disorders. Psychiatr Serv. 2014 Feb 1;65(2):266-9. https://doi.org/10.1176%2Fappi.ps.201200556 Rosenhan DL. On bein

    1 h 45 min

  5. 29 JUN

    PsychEd Episode 62: Antipsychotic Side Effects with Dr. Alex Raben

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Antipsychotic Side Effects with our very own expert Dr Alex Raben, a staff psychiatrist in chronic care at the Centre for Addiction and Mental Health in Toronto. Dr. Raben graduated from medical school and completed residency at the University of Toronto. His academic interests include teaching and medical education scholarship with a particular interest in novel modalities of knowledge translation within the field of psychiatry. He is a founding member and Executive Director of PsychEd, this educational psychiatry podcast which aims to empower medical learners to seek out current knowledge from mental health experts to share with their colleagues around the world. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Outline the side effects of antipsychotics and their known/potential mechanisms Discuss management options for the different side effects Identify which antipsychotics are more likely to cause certain side effects Guest: Dr Alex Raben Hosts: Angad Singh and Kate Braithwaite Audio editing by: Angad Singh Show notes by: Angad Singh and Kate Braithwaite Interview Content: Introduction - 0:00 Primer on antipsychotics - 1:54 Anti-dopamine side effects - 5:04 Drug potency as it relates to side effects - 38:46 Anticholinergic side effects - 41:37 Antiadrenergic side effects - 47:30 Metabolic side effects - 50:29 Sedation - 56:46 Please note that this episode does not include a discussion of the life threatening side effects of antipsychotics. These include neuroleptic malignant syndrome, torsades de pointes, laryngospasm, and seizure. Resources: PsychEd Episode 10: Treatment of Schizophrenia Part II with Dr. Albert Wong — PsychEd Podcast PsychEd Episode 60: Metabolic Psychiatry with Dr. Cindy Calkin – Psyched Podcast AIMSExtendedSample - YouTube Anticholinergic Mnemonics: Toxicology Mnemonic Challenge • LITFL • Toxicology Conundrum References: de Silva VA, Suraweera C, Ratnatunga SS, Dayabandara M, Wanniarachchi N, Hanwella R. Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis. BMC psychiatry. 2016;16:1-0. Migirov A, Datta AR. Physiology, Anticholinergic Reaction. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546589/ Miller DD. Atypical antipsychotics: sleep, sedation, and efficacy. Prim Care Companion J Clin Psychiatry. 2004;6(Suppl 2):3-7. PMID: 16001094; PMCID: PMC487011. Roerig JL, Steffen KJ, Mitchell JE. Atypical antipsychotic-induced weight gain: insights into mechanisms of action. CNS drugs. 2011;25:1035-59. Stahl SM. Stahl's essential psychopharmacology: neuroscientific basis and practical applications. Cambridge university press; 2021. Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018;17(3):341-56. For more PsychEd, follow us on Instagram (@psyched.podcast), Twitter (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

    59 min

  6. 29 MAY

    PsychEd Episode 61: Introduction to Forensic Psychiatry with Dr. Amina Ali

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers an introduction to forensic psychiatry with Dr. Amina Ali, a forensic psychiatrist at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada. Dr. Ali joined the Forensic Division at CAMH in 2018. She is an Assistant Professor in the Department of Psychiatry at the University of Toronto. Prior to joining CAMH, Dr. Ali received her Doctor of Medicine at the American University of the Caribbean, completed her Psychiatry residency at the Icahn School of Medicine at Mount Sinai in New York, and fellowship in Forensic Psychiatry at the Albert Einstein College of Medicine. Dr. Ali's leadership experience includes serving as Chief resident during her residency, for which she was bestowed a Residency Leadership Award from the Bronx Lebanon Hospital Center. She is a Competence By Design coach to residents and serves on the Psychiatry Competency Committee and as a CaRMS file reviewer for the University of Toronto General Psychiatry Residency Program. She is also a supervisor for forensic residents and sits on the subspecialty resident committees. Within the forensic division, Dr. Ali has contributed to the organization and implementation of the Summer Studentship in Forensic Psychiatry Program and is our Medical Education and Wellness Lead. Internationally, Dr. Ali was appointed to serve on the American Academy of Psychiatry and the Law Education Committee and most recently recruited to Chair their Civil Commitment and Consent to Treatment Working Group. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Describe the role of forensic psychiatry and its relation to the Ontario Review Board. Outline the criteria for fitness to stand trial. Describe the function and possible outcomes of a treatment order. Outline the criteria for not criminally responsible on account of a mental disorder. Distinguish between the disposition options available under the Ontario Review Board. Demonstrate an enhanced ability to advocate for and support patients in navigating the forensic psychiatric system. Guest: Dr. Amina Ali Hosts: Alexander Simmons (PGY3), Kate Braithwaite (MD), and Rhys Linthorst (PGY5) Audio editing by: Gaurav Sharma (PGY5) Show notes by: Alexander Simmons (PGY3) References: Crocker, A. G., Nicholls, T. L., Seto, M. C., Charette, Y., Cote, G., Caulet, M. (2015). The National Trajectory Project of individuals found not criminally responsible on account of mental disorder in Canada. Part 2: the people behind the label. The Canadian Journal of Psychiatry, 60(3), 106-116. Prpa, T., Moulden, H. M., Taylor, L., Chaimowitz, G. A. (2018). A review of patient-level factors related to the assessment of fitness to stand trial in Canada. International Journal of Risk and Recovery, 1(2), 16-22. Carroll, A., McSherry, B., Wood, D., & Yannoulidis, LLB, S. (2008). Drug‐associated psychoses and criminal responsibility. Behavioral sciences & the law, 26(5), 633-653. Watts, J. (2013). Updating toxic psychosis into 21st-century Canadian: Bouchard-Lebrun v. R. Journal of the American Academy of Psychiatry and the Law Online, 41(3), 374-381. Crocker, AG, Nicholls, TL, Seto, MC, Cote, G, Charette, Y, Caulet, M. The national trajectory project of individuals found not criminally responsible on account of a mental disorder in Canada, Part 1: Context and methods. Canadian Journal of Psychiatry. 2015;60(3):98-105. Schneider, RD. Mental health courts. Current Opinion in Psychiatry. 2008;21:510-513. https://www.orb.on.ca/scripts/en/about.asp#dispositions For more PsychEd, follow us on X (@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

  7. 29 ABR

    PsychEd Episode 60: Metabolic Psychiatry with Dr. Cindy Calkin

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode introduces the field of metabolic psychiatry, with a focus on patients with severe mental illness and metabolic syndrome. Our guest is Dr. Cindy Calkin, an Associate Professor in the Department of Psychiatry and Department of Neuroscience at Dalhousie University in Nova Scotia. Dr. Calkin has been a pioneer in the field of metabolic and neuroendocrine disorders in patients with bipolar disorder. Her research interests include examining the effects of obesity, insulin resistance and type II diabetes on the clinical course and outcomes in bipolar disorder. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to…  Describe the burden of metabolic syndrome in the population with severe mental illnesses Explain reasons for the comorbidity between metabolic syndrome and severe mental illness Identify biopsychosocial strategies to prevent or treat metabolic conditions in this population Guest: Dr. Cindy Calkin Hosts: Angad Singh, Gaurav Sharma, and Sara Abrahamson Audio editing by: Gaurav Sharma Show notes by: Sara Abrahamson & Gaurav Sharma  Conflicts of interest: Neither our guest nor hosts for this episode have declared any conflicts of interest related to this topic. Interview content: 0:00 - Introduction 00:54 - Learning objectives 01:37 - Dr. Calkin’s career trajectory 9:45 - Describing the burden of metabolic syndrome in severe mental illness 14:16 - What is the relationship between metabolic syndrome and severe mental illness 25:23 - Why is metabolic syndrome underdiagnosed in severe mental illness 27:56 - How to measure and monitor insulin resistance in clinical practice 32:44 - How stigma impacts treatment of metabolic syndrome in the mentally ill 34:02 - Lifestyle interventions for metabolic syndrome in the mentally ill 37:06 - Medication interventions for metabolic syndrome in the mentally ill 39:44 - Directions for future research in the metabolic psychiatry 41:48 - Episode summary References: Bai, Y.-M., Li, C.-T., Tsai, S.-J., Tu, P.-C., Chen, M.-H., & Su, T.-P. (2016). Metabolic syndrome and adverse clinical outcomes in patients with bipolar disorder. BMC Psychiatry, 16(1), 448–448. https://doi.org/10.1186/s12888-016-1143-8 Calkin, C., Kamintsky, L., & Friedman, A. (2022). Reversal of insulin resistance is associated with repair of blood-brain barrier dysfunction and remission in a patient with treatment-resistant bipolar depression. Bipolar Disorders, 24(5), 553-555. https://doi.org/10.1111/bdi.13199 Calkin, C. V., Ruzickova, M., Uher, R., Hajek, T., Slaney, C. M., Garnham, J. S., ... & Alda, M. (2015). Insulin resistance and outcome in bipolar disorder. The British Journal of Psychiatry, 206(1), 52-57. https://doi.org/10.1192/bjp.bp.114.152850 Giménez-Palomo, A., Gomes-da-Costa, S., Dodd, S., Pachiarotti, I., Verdolini, N., Vieta, E., & Berk, M. (2022). Does metabolic syndrome or its component factors alter the course of bipolar disorder? A systematic review. Neuroscience and Biobehavioral Reviews, 132, 142–153. https://doi.org/10.1016/j.neubiorev.2021.11.026 Ho, C. S., Zhang, M. W., Mak, A., & Ho, R. C. (2014). Metabolic syndrome in psychiatry: advances in understanding and management. Advances in psychiatric treatment, 20(2), 101-112. https://doi.org/10.1192/apt.bp.113.011619 Leboyer, M., Godin, O., Llorca, P. M., Aubin, V., Bellivier, F., Belzeaux, R., Courtet, P., Costagliola, D., Dubertret, C., M’Bailara, K., Haffen, E., Henry, C., Laouamri, H., Passerieux, C., Pelletier, A., Polosan, M., Roux, P., Schwan, R., Samalin, L., … Etain, B. (2022). Key findings on bipolar disorders from the longitudinal FondaMental Advanced Center of Expertise-Bipolar Disorder (FACE-BD) cohort. Journal of Affective Disorders, 307, 149–156. https://doi.org/10.1016/j.jad.2022.03.053 Stog

    45 min

  8. 01/11/2023

    PsychEd Episode 59: Critical Psychiatry with Dr. Elia Abi-Jaoude and Lucy Costa

    Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the field of critical psychiatry with Dr. Elia Abi-Jaoude and Lucy Costa. Dr. Abi-Jaoude is a staff psychiatrist at The Hospital for Sick Children and Assistant Professor and Clinician Investigator in the Department of Psychiatry at the University of Toronto in Toronto, Canada. Lucy Costa is Deputy Executive Director of the Empowerment Council, a voice for clients of mental health and addiction services primarily at the Centre for Addiction and Mental Health in Toronto.   While this topic could be very philosophical and expansive, we are going to focus our discussion by considering the practical implications of this field on psychiatric practice. What do you need to know about critical psychiatry as a trainee, and how might it impact your clinical practice?   The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Define the term critical psychiatry and describe how the field has evolved over time Review core principles of critical psychiatry and apply them to a clinical situation Understand the potential benefits and harms of critical psychiatry and where the field is headed   Guests: Dr. Eila Abi-Jaoude and Lucy Costa   Hosts: Dr. Gaurav Sharma (PGY5), Dr. Nikhita Singhal (PGY5), Dr. Monisha Basu (PGY2), and Saja Jaberi (IMG)   Audio editing by: Gaurav Sharma   Show notes by: Gaurav Sharma and Nikhita Singhal   Conflicts of interest: Neither of our guests nor hosts have declared any conflicts of interest related to this topic. Interview content: Introduction - 00:13 Learning objectives - 02:35 Defining critical psychiatry - 03:33 How our experts got involved in critical psychiatry and incorporate it into their work - 04:50 What are some of the questions critical psychiatry tries to answer? - 15:07 Why care about critical psychiatry and “holding truths lightly”? - 23:55 Principles of critical psychiatry - 24:55 Applying critical psychiatry principles to a case - 32:40 Potential benefits and harms of a critical psychiatry approach - 41:49 Future directions for critical psychiatry - 58:29 Review of learning objectives and summary - 1:01:30 End credits - 1:03:17   Resources: Critical Psychiatry Textbook Restoring Study 329  Psych Debate 14 | Critical Psychiatry and Diagnosis   References: Barkil-Oteo A. Collaborative care for depression in primary care: how psychiatry could "troubleshoot" current treatments and practices. Yale J Biol Med. 2013 Jun 13;86(2):139-46. Craddock N, Mynors-Wallis L. Psychiatric diagnosis: impersonal, imperfect and important. The British Journal of Psychiatry. 2014;204(2):93-95. doi:10.1192/bjp.bp.113.133090 Kirsch I. The emperor's new drugs: medication and placebo in the treatment of depression. Handb Exp Pharmacol. 2014;225:291-303. doi:10.1007/978-3-662-44519-8_16 Middleton H, Moncrieff J. Critical psychiatry: a brief overview. BJPsych Advances. 2019;25(1):47-54. doi:10.1192/bja.2018.38 O'Donoghue T, Crossley J. A critical narrative analysis of psychiatrists' engagement with psychosis as a contentious area. Int J Soc Psychiatry. 2020 Nov;66(7):724-730. doi: 10.1177/0020764020934516 Samara MT, Dold M, Gianatsi M, et al. Efficacy, Acceptability, and Tolerability of Antipsychotics in Treatment-Resistant Schizophrenia: A Network Meta-analysis. JAMA Psychiatry. 2016;73(3):199–210. doi:10.1001/jamapsychiatry.2015.2955   Important figures in the history of anti-psychiatry and critical psychiatry (discussion edited from episode for length): Anti-Psychiatrists: R. D. Laing (UK) Thomas Szasz (USA) Michel Foucault (France)   Critical Psychiatrists: Joanna Moncrieff (UK) Suman Fernando (UK) Sami Tamini (UK) Pat Bracken (UK) Derek Summerfield (UK) Sandra Steinguard (USA) Critical Psychiatry

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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.

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