PsychPearls by Psychiatric Times PsychPearls by Psychiatric Times

In this episode of Psych Pearls, Amir Inamdar MBBS, DNB (Psych), MFPM, talks about the latest research in the field of psychedelics as a new tool for supporting patients with psychiatric disorders.

Scare tactics don’t work. But scientific education might. Here are tips for talking with teenaged patients about keeping themselves and their friends safe. 

Last month we taught you how evening light can worsen mood. Today, we teach you how to fix that.

[Note: this is the second half of the Psych Pearls interview with James L. Knoll IV, MD. In the first half of the conversation, Knoll discussed the challenges of treating patients with traits like psychopathy or anti-social personality disorders. – Ed] 




Forensic psychiatrists have emotionally taxing jobs: They spend countless hours studying acts of violence and the individuals who commit them. How could anyone endure this job for more than a few years? 




James L. Knoll IV, MD, has survived decades in the field. In this edition of Psych Pearls, Knoll talks about how he maintains his mental well-being. He also reveals the childhood obsession that set him on his career path, reflects on how forensic psychiatry has changed over time, and looks forward to how it might change for the better in the future.  




In this conversation, Psychiatric Times and Knoll cover:




1.     His childhood fascination with the Jonestown murder-suicide.

2.     How he got interested in forensic psychiatry. 

3.     The risk of burnout in forensic psychiatry (or any other psychiatric specialty).

4.     How the arts and other creative endeavors can help psychiatrists stay mentally and physically well. 

5.     The tension at the heart of the forensic psychiatrist’s identity: are they primarily treaters of mental illnesses, or expert witnesses? 

6.     The new importance of social media for forensic investigations. 

7.     Why it’s important not to judge patients—no matter how difficult they may be.








Dr Knoll is professor of psychiatry and director of forensic psychiatry at SUNY Upstate Medical University in Syracuse, New York, and clinical director of Central New York Psychiatric Center in Marcy, New York. He is Emeritus Editor-in-Chief of the Psychiatric Times and President-elect of the American Academy of Psychiatry and the Law (2022-23).

Psychiatrists are not strangers to difficult and even potentially dangerous patients, but James L. Knoll IV, MD, has made these populations one of his specialties. With decades of experience in forensic psychiatry, Knoll takes listeners deep into the US criminal justice system, where he treats both inmates suffering from detention-related psychiatric disorders and an especially challenging group that he has dubbed morally objectionable patients. 




In this conversation, Psychiatric Times and Knoll cover:




1.     What he means by the term morally objectionable patients. 

2.     How prisons’ strict social hierarchies can contribute to psychiatric illnesses. 

3.     The high prevalence of bipolar disorder and schizophrenia in corrections—and their potential causes. 

4.     The different challenges of treating patients in prisons vs jails. 

5.     Why inmates with psychiatric illnesses end up in the correctional system for longer than those without psychiatric illnesses.

6.     The role of mental health courts in improving psychiatric care in the correctional system.

7.     The challenges of treating patients who are high in psychopathy or have anti-social personality disorders.  




This is the first half of the Psych Pearls podcast with Dr Knoll. Stay tuned for the second half later in the week. 





Dr Knoll is professor of psychiatry and director of forensic psychiatry at SUNY Upstate Medical University in Syracuse, New York, and clinical director of Central New York Psychiatric Center in Marcy, New York. He is Emeritus Editor-in-Chief of the Psychiatric Times and President-elect of the American Academy of Psychiatry and the Law (2022-23).