Thinking In Psychiatry

The Academy by Psych Scene
  • 5.0 (1)
  • Medicine

Thinking in Psychiatry is an Academy by Psych Scene podcast featuring short, high-signal audio episodes you can listen to on the go. Each week we break down emerging evidence, evolving clinical frameworks, and complex cases across the lifespan – from psychopharmacology and neurobiology to formulation, systems thinking, and metabolic and sleep psychiatry. Designed for busy clinicians, every episode is grounded in evidence, reviewed by faculty, and focused on one question: how can we practise better psychiatry, starting today?

Episodes

  1. Jun 13

    Why is Alzheimer’s More Common in Women?

    Access the mentioned paper here: Trying to Unravel Why Alzheimer Disease Is More Common in Women By Rita Rubin, MA https://jamanetwork.com/journals/jama/article-abstract/2839498#  Access mentioned courses here: Women’s Mental Health Course: https://psychscene.co/41RwJx2 Alzheimer’s Disease Course: https://psychscene.co/4vNaeqH  In this episode, Dr Sanil Rege examines why Alzheimer’s disease is more common in women and what this means for clinical assessment, prevention, and treatment. The discussion reviews a 2025 JAMA medical news feature (https://jamanetwork.com/journals/jama/article-abstract/2839498#) on sex differences in Alzheimer’s disease and outlines a life-course model showing how sex-related vulnerability may shape disease onset, progression, and clinical expression. This video provides clinicians with a sex-informed clinical framework for assessing Alzheimer’s risk in women through the lens of hormonal transitions, cognitive reserve, and later-life neurodegenerative expression. Chapters: 00:21 Alzheimer’s Disease in Women 02:59 Beyond Longevity 03:40 Survival Differences After Dementia Diagnosis 04:34 Tau Pathology and Steeper Later Decline 06:00 Menopause and Hormonal Vulnerability 08:11 Modifiable Midlife Risk Factors in Women 13:18 A Sex-Informed Life-Course Formulation1 #Alzheimer's #Psychiatry #Dementia

    14 min

  2. Jun 4

    Why the Brain Is Never Really “At Rest”

    Here are the links to the papers mentioned: Parkinson’s disease as a somato-cognitive action network disorder Ren et. al. https://psychscene.co/4vQKgmc  The brain’s action-mode network Dosenbach et. al. https://psychscene.co/4ts1pRr  Access mentioned courses here: Advanced Psychiatric Formulation and Strategic Management: https://psychscene.co/4sG214L  ADHD Masterclass: https://psychscene.co/4sJ1GOS  In this video, Dr Sanil Rege examines the Action Mode Network as a unifying clinical framework for understanding how the brain regulates action, arousal, body state, and cognition. He explores the counterbalance between action mode and default mode, showing how impaired initiation, hyperarousal, poor state shifting, and social withdrawal may be better understood as disturbances of mode regulation rather than isolated symptom categories. This session provides clinicians with a neurobiological framework for refining psychiatric formulation through the lens of state regulation, brain–body integration, and network-based clinical reasoning. Chapters: 01:32 – Introducing the Action Mode Network 03:17 – The Brain as an Organ Organised for Action 05:48 – Action Mode vs Default Mode 07:18 – Psychiatric Syndromes as Mode-Switching Disorders 09:48– Overcoming the False Dichotomy of Mind and Body 12:25 – The PACES Model in Clinical Formulation 14:48 – Translating State Regulation into Clinical Practice #ActionModeNetwork #Psychiatry #Brain

    17 min

  3. Feb 19

    Have We Been Thinking About Sleep Wrong? (Motor Theory Explained)

    Access the mentioned courses here: Sleep And Psychiatry: https://psychscene.co/46d0T09 ADHD and Sleep Dysfunction: https://psychscene.co/4rrE9Cc In this episode, Dr Sanil Rege explores the "how and why" of sleep by analysing a 2025 Neuron perspective paper (https://pubmed.ncbi.nlm.nih.gov/40961940/) detailing the interplay between sleep, motor circuits, and catecholamine biology. The discussion unpacks the motor theory of sleep, in which sleep control is embedded within somatic and autonomic motor circuits, and the catecholamine hypothesis, which posits that a core biological function of sleep is the inactivation of dopamine, noradrenaline, and adrenaline. This podcast provides clinicians with a neuroscientific framework for understanding sleep as an active state transition involving a global downshift of somatic and autonomic motor systems. #Sleep #Neuropsychiatry #Insomnia

    9 min

  4. Feb 5

    Do ADHD Stimulants ‘Cause’ Psychosis?

    Access mentioned course here: https://psychscene.co/46iAaiI In this episode, Consultant Psychiatrist, Dr Sanil Rege examines the complex relationship between ADHD pharmacotherapy and the emergence of psychotic symptoms. By analysing synthesis data from The Lancet Psychiatry (https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00248-2/abstract), the podcast distinguishes between drug-induced events and baseline neurobiological vulnerabilities inherent in ADHD populations. This podcast provides clinicians with a neuroscientific framework for differentiating between protopathic bias and true medication-induced psychotic phenomena, as well as a step-wise screening pathway for risk-guided prescribing using validated at-risk mental state (ARMS) triage tools. To get access to the complete podcast catalog and material like this plus over 150 hours of interactive CPD education on psychiatry, check out The Academy using the link below: https://psychscene.co/45M67jh

    18 min

  5. Jan 29

    Did Ketamine 'Fail' or Are We Asking The Wrong Questions? *Full Study Review*

    Access mentioned courses here: Clinical Audit On Cognitive Aspects of Depression:  https://psychscene.co/3Z2EdvH The Aggregation of Marginal Gains as a Philosophy of Clinical Care with Prof Michael Berk:  https://psychscene.co/4rqS62V In this episode, Dr Sanil Rege examines the KARMA-Dep 2 trial, a randomised controlled trial comparing adjunctive serial ketamine infusions to midazolam for patients with Treatment-Resistant Depression (TRD) in an inpatient setting. Based on a JAMA Psychiatry article titled “Serial Ketamine Infusions as Adjunctive Therapy to Inpatient Care for Depression,” the discussion explores why statistically insignificant differences between ketamine and psychoactive comparators necessitate a shift in how clinicians evaluate rapid-acting antidepressants, detailing the "wow effect" of early symptomatic drops and the subsequent plateauing of recovery curves. This podcast provides clinicians with a clinical framework for differentiating between acute symptomatic response and long-term functional recovery in TRD. Chapters: 00:22 - The KARMA-Dep 2 Trial Headlines 03:44 - Primary Outcomes: Ketamine vs. Midazolam Results04:26 - Analysing the Curves: The "Wow Effect" vs. Sustained Recovery08:50 - Neurobiology of Response vs. Neurobiology of Recovery09:21 - Why Improvement Stalls: The Role of Neuroadaptation10:47 - Clinical Implications for Inpatient Care To get access to more materials like this plus over 150 hours of interactive CPD education on psychiatry, check out The Academy using the link below: https://psychscene.co/4rl6pFV

    16 min

  6. Jan 22

    The 3 Types of Hunger Clinicians Need to Know For Medication Side Effects

    Access the mentioned course ‘Antipsychotic Induced Weight Gain and Metabolic Syndrome (MetS)’ here:  https://psychscene.co/4a62kQa In this episode Consultant Psychiatrist, Dr Sanil Rege, explores the complex neurobiology of appetite regulation, diving deep into the nuances of the brain-gut-microbiome system. Based on a recent New England Journal of Medicine (NEJM) review titled “The Physiology of Hunger,” the discussion examines hunger not as a matter of willpower, but as a sophisticated interaction between the brain, gut, and microbiome. This podcast provides clinicians with a pathophysiological framework for differentiating between energy balance systems, reward-based drives, and microbial metabolites to better manage obesity, anorexia nervosa, and the cautious implementation of GLP-1 receptor agonists. To get access to more material like this plus over 150 hours of interactive CPD education on psychiatry, check out The Academy using the link below: https://psychscene.co/4t8d6gy #HungerPhysiology #Neuroscience #MetabolicHealth

    11 min

  7. Jan 14

    Why Pharmacotherapy Alone May 'Fail' in Complex TRD (Treatment-Resistant Depression)

    To access the full episode and over 150+ hours of cutting-edge, interactive courses on Psychiatry subscribe to The Academy: https://psychscene.co/4qfNAny In this episode, Consultant Psychiatrist, Dr Sanil Rege looks at treatment refractory mood disorders through a psychodynamic lens using a naturalistic study from the Austen Riggs Centre.  A subset of what most see as Treatment-Resistant Depression (TRD) isn't just pharmacological non-response; it's depression embedded within personality organisation, trauma-related aspects, attachment, and unconscious patterns.  This podcast provides clinicians with a psychodynamic perspective to understand how clinical refractoriness to standard pharmacotherapy can be sustained by meaning, defences, and relational patterns, not just neurotransmitters.

    14 min

  8. 12/03/2025

    The How and Why of Sleep: Motor Theory and Catecholamine Hypothesis

    To access all episodes plus 150+ hours of advanced psychiatric education, join the Academy today. Get access here: https://www.academy.psychscene.com/ In this episode, we explore a groundbreaking 2025 Neuron paper that reframes how sleep is generated in the brain, and why we sleep at all. Instead of a single “sleep centre,” sleep emerges from a distributed network embedded within motor and autonomic circuits. The authors also propose a unifying “catecholamine hypothesis” explaining sleep’s restorative functions across brain, immune, and metabolic systems. We break down what this means for clinicians, how it updates classic models of sleep–wake regulation, and why dysfunction in these systems manifests across psychiatry. To access all episodes of this podcast plus 150+ hours of advanced psychiatric education, join the Academy today. Get access here: https://www.academy.psychscene.com/

    10 min

  9. 11/30/2025

    Why Alzheimer Disease Is More Common in Women

    To access all episodes plus 150+ hours of advanced psychiatric education join the Academy today. Get access here: https://www.academy.psychscene.com/ Why is Alzheimer’s disease more common in women? In this episode, we break down what current research reveals about sex differences in Alzheimer’s biology — including hormonal changes, tau progression, genetics, and how women often compensate on early cognitive testing, delaying diagnosis. We also discuss how these differences shape clinical assessment, treatment responses to emerging anti-amyloid therapies, and why midlife risk modification is especially important. Key Points Women show faster tau accumulation once amyloid appears.Cognitive compensation can lead to later diagnosis in women.Estrogen decline at menopause influences inflammation, synaptic resilience, and neuroprotection.APOE-ε4 confers greater Alzheimer’s risk in women.Sex-specific risk factors require tailored prevention and assessment.To access all episodes plus 150+ hours of advanced psychiatric education join the Academy today. Get access here: https://www.academy.psychscene.com/

    8 min
  • 9 Episodes

About

Thinking in Psychiatry is an Academy by Psych Scene podcast featuring short, high-signal audio episodes you can listen to on the go. Each week we break down emerging evidence, evolving clinical frameworks, and complex cases across the lifespan – from psychopharmacology and neurobiology to formulation, systems thinking, and metabolic and sleep psychiatry. Designed for busy clinicians, every episode is grounded in evidence, reviewed by faculty, and focused on one question: how can we practise better psychiatry, starting today?

Information

  • Creator
    The Academy by Psych Scene
  • Years Active
    2025 - 2026
  • Episodes
    9
  • Rating
    Clean
  • Copyright
    © 2025 Psych Scene Pty Ltd
  • Show Website
    Thinking In Psychiatry

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