PsychEd: educational psychiatry podcast

PsychEd Episode 5: Diagnosing Schizophrenia with Dr. Andrew Lustig and Dr. Jason Joannou

Jan 17, 2018
Dr. Andrew Lustig and Dr. Jason Joannou, both inpatient psychiatrists at CAMH, dive deep into the intriguing world of schizophrenia. They unravel the DSM V diagnostic criteria and discuss the real-life impacts of the disorder, highlighting its complex nature. The conversation navigates the intricate relationship between cannabis use and schizophrenia, while also emphasizing effective strategies for interviewing paranoid patients. Additionally, they address patient rights concerning involuntary admission under the Mental Health Act, advocating for a more compassionate, holistic approach to treatment.
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ANECDOTE

Misdiagnosis and Epival

  • Dr. Joannou treated a misdiagnosed "treatment-resistant" schizophrenia patient.
  • Increasing the patient's Epival dosage resolved visual hallucinations, suggesting a seizure disorder.
ADVICE

Collateral Information

  • Always gather collateral information from family and friends.
  • This helps determine illness onset, prodromal periods, and provides more reliable diagnostic information.
ADVICE

Engaging with Patients Lacking Insight

  • Align with patients, especially those lacking insight.
  • Emphasize shared goals like improved health and acknowledge their distress.
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