American Journal of Psychiatry Audio

Dr. Giovanna Punzi and Dr. Daniel Weinberger (Lieber Institute for Brain Development, Baltimore, Maryland) discuss findings from their new paper, “Genetics and Brain Transcriptomics of Completed Suicide,” which looks at differences in the brains of those who die by violent versus less violent means of suicide.  Afterwards, Journal Editor-in-Chief Dr. Ned Kalin discusses what pulls the March issue of AJP together. Punzi and Weinberger interview [00:43] What made the two categories distinct? [02:28] Aggression as a factor [03:43] Differences in genetic factors [04:58] Potential heterogeneity of suicide [06:28] Counterintuitive conclusions [07:42] Clinical implications for those at risk for suicide [11:00] Next steps for research [11:43] Kalin interview [12:56] McMahon [13:58] Jacquemont et al. [14:22] Mancini et al. [15:53] Mahjani et al. [18:40] Leckman [21:22] Punzi et al. [21:48] Ecker et al. [25:38] Summary [28:45]   Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org  

Dr. Margaret Sibley (University of Washington, Seattle, WA) joins the podcast this month to discuss an article from the February issue of the Journal looking at patterns of remission in attention deficit hyperactivity disorder in children.  Dr. Ned Kalin, Editor-in-Chief of AJP will join us afterwards to discuss the rest of the February issue of the Journal. Sibley interview [00:51] What does “full remission” from ADHD mean? [01:54] Variable patterns of remission in children with ADHD [02:33] The DSM definition of ADHD and the impact of ADHD symptoms [04:10] Advantages and disadvantages of using longitudinal data [06:50] What does the pattern of intermittent remission mean for treatment of ADHD? [09:39] What does this suggest for further research into ADHD diagnosis and treatment? [11:08] How does this affect treatment going forward? [12:48] Kalin interview [15:25] Flavin et al. [16:04] Sibley et al. [16:45] Markowitz et al. [18:20] Tadmon and Olfson [19:07] Manfredi et al. [20:30] Morgan et al. [22:39] Cole et al. [24:57] In conclusion [29:03]   Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

In this month’s AJP Audio, Dr Margert Haney (Director of the Cannabis Research Laboratory at Columbia Psychiatry) discusses her new review from the January issue of the American Journal of Psychiatry, “Cannabis Use and the Endocannabinoid System: A Clinical Perspective,” and the questions around the legal status of cannabis research.  Afterward, Dr. Ned Kalin, Editor-in-Chief of the Journal discusses the January 2022 issue of AJP. Haney interview: How does cannabis interact with our brains? [00:30] CBD and how it’s different [01:26] Impact of state legalization of cannabis on research [02:08] Federal attitudes towards cannabis legalization [03:43] A single source of cannabis for research [04:57] Limitations on research and an expanding, unexamined market [06:11] Marketing of other cannabinoids [06:38] Consequences of cannabis legalization [08:06] Cannabis use disorder [08:36] What happens with daily cannabis use – and abrupt cessation? [09:27] What happens to your endocannabinoid system with daily use? [10:36] A proliferating market and constrained research [11:56] Patients foregoing FDA-approved medication in favor of cannabis products [12:14] There’s a reason we have randomized controlled clinical trials with placebo [12:37] Changes in cannabis use and abuse [13:31] Public perception of cannabis use disorder [14:26] What’s next for cannabis research? [15:20] Loosening of cannabis sources [16:03] No US source for CBD to study [16:36] Future changes in the status quo? [17:24] Importance of the endogenous cannabinoid system [18:41] Potential consequences during vulnerable times in brain development: in utero and adolescence [19:08] Marketing cannabis to pregnant women [19:45] Kalin interview [20:30] Alcohol and cannabis use disorders [20:39] Haney [21:43] Browne et al. [22:34] Livne et al. [23:31] Mellentin et al. [25:38] Mallard et al. [27:39] In sum [28:30]   Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org  

In this month’s AJP Audio, Dr. Samuel Wilkinson (Yale University, Associate Director of the Yale Depression Research Program) discusses a study looking at the association of electro-convulsive therapy or ECT on all-cause mortality and suicide in Medicare patients with mood and bipolar disorders.  Following that, Dr. Ned Kalin, Editor-in-Chief of the Journal discusses the December issue of AJP. Wilkinson interview: Effects of ECT on older patients with mood disorders [00:50] A brief history of ECT [01:20] A troubled history [02:00] A backlash against ECT [02:24] Improved techniques and practices [03:32] Limitations of past research into ECT [04:20] Strength of the study [05:33] How patients were matched [05:59] Limitations of the present study [07:17] Treatment of patients going forward [08:18] Difficulties in administering and accessing ECT [09:49] Next steps in research into ECT and patients with elevated suicide risk [11:14] All-cause mortality and ECT [11:57] Kalin interview: The December issue of AJP [13:02] Major depressive and bipolar disorders [13:13] “Neuromodulation Strategies for the Treatment of Depression” [13:42] “Association of ECT With Risks of All-Cause Mortality and Suicide in Older Medicare Patients” [14:19] “Efficacy and Safety of Lumateperone for Major Depressive Episodes Associated with Bipolar I or Bipolar II Disorder: A Phase 3 Randomized Placebo-Controlled Trial” [15:29] Ostacher editorial [17:44] “Association Between Systemic Inflammation and Individual Symptoms of Depression: A Pooled Analysis of 15 Population-Based Cohort Studies” [18:18] Pariante editorial [20:42] “Coordinate-Based Network Mapping of Brain Structure in Major Depressive Disorder in Younger and Older Adults: A Systematic Review and Meta-Analysis” [21:23] Putting the issue into context [23:00]   Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org  

Dr. Jennifer Stevens (Assistant Professor of Psychiatry and Behavioral Sciences, Emory University) discusses a technique to classify trauma victims into discrete biotypes in the immediate aftermath of trauma, with the hope of providing insight into the groups that could guide treatment, and American Journal of Psychiatry Editor-in-Chief Dr. Ned Kalin puts the November, 2021 issue of AJP into context.   Stevens interview [00:44] Using brain imaging data to understand how people respond to trauma [01:07] Patient enrollment [01:21] AURORA Study [01:42] Can patterns of brain activity help map different responses to trauma? [02:12] Biotypes [02:48] Structure of the study [03:40] Neuroimaging and fMRI tasks [04:11] Limitations [05:44] Biotypes definitions [07:30] Highest risk group [09:10] Most resilient group [09:51] What does this mean for treating trauma patients going forward? [10:17] Next steps [11:31] Kalin interview: looking at trauma and suicide [12:37] Stevens et al. look at neuroimaging and trauma [13:16] Edwards et al. look at genetic and environmental factors in suicide [14:11] McKibben et al. look at suicidal ideation and attempts in U.S. soldiers [16:12] Taken together [18:20] Keding et al. on brain development [19:26] Kumar et al. look at biomarkers and Alzheimer’s disease [20:22]   Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the May 2021 issue. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Lara N. Coughlin, Ph.D., and Lewei Allison Lin, M.D., M.S., about their article on the provision of guideline-concordant depression treatment to patients with and without substance use disorders. Dr. Lara Coughlin is an assistant professor in the Department of Psychiatry and an adjunct assistant professor of psychology at the University of Michigan. She is also a licensed clinical psychologist. Her research aims to find new ways to use behavioral economic frameworks to improve outcomes among individuals with substance use disorders. In particular, she is interested in decision making around health behaviors, such as choosing between sooner and smaller rewards, like substance use, and delayed and larger rewards, like overall health or career development. Her current work looks at the delivery and evaluation of care for underserved and rural populations. Dr. Allison Lin is an addiction psychiatrist, an assistant professor in the Department of Psychiatry at the University of Michigan, and a research scientist in the Department of Veterans Affairs Ann Arbor Healthcare System. How the authors became interested in their areas of research [2:28] How often does depression co-occur with other disorders? [5:05] Current recommendations or best practices for the treatment of these conditions [5:33] Objective of the study [6:55] Description of study participants [7:27] Measures used to collect and analyze data [9:15] Main results of the study [11:20] Were there significant differences between disorders with respect to receipt of appropriate treatment? [12:10] Did any demographic characteristics, medical comorbidities, or other variables affect the findings? [13:25] Other notable or surprising results [14:03] Do the findings of the study extend to patients in the general population? [14:50] Study limitations [15:28] Patient or structural factors that may contribute to inequity in guideline-concordant care [16:13] How can we improve depression care for patients with comorbid substance use disorders? [19:01] Key points that researchers, clinicians, and other mental health professionals should take away from the article [22:12] Recommendations for further research in this area [23:32] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the May 2021 issue. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Karen L. Bierman, Ph.D., about her article on reducing adolescent psychopathology in socioeconomically disadvantaged children with a preschool intervention. Dr. Karen Bierman is the Evan Pugh University Professor, Professor of Psychology, Professor of Human Development and Family Studies, and Director of the Child Study Center at Penn State University. Her research looks at the design and evaluation of programs for social and emotional learning within schools and communities. She has also developed and evaluated group interventions for peer-rejected children. How the author became interested in this area of research [1:58] What we know about how exposure to chronic or unpredictable negative circumstances disturbs a developing brain [3:21] Why the intersection of growing up in adverse conditions and the beginning of formal schooling is significant in the life of a child [6:41] Objective of the study [7:54] Outline of the Head Start REDI program [9:26] Description of study participants [11:26] How the authors collected and analyzed data [13:20] How well did the intervention work in terms of reducing conduct problems, emotional symptoms, and peer problems among students? [14:31] Other key findings of the study [17:21] Did any results surprise the authors? [18:45] Study limitations [20:26] How this work fits in to the overall literature on this subject [22:21] Implications this work has for public health policy [24:49] Key points that researchers, clinicians, and other mental health professionals should take away from the article [26:31] Recommendations for further research in this area [27:37] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the April 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Ayana Jordan, M.D., Ph.D., and Christina Mangurian, M.D., M.A.S., about their article on psychiatry diversity leadership in academic medicine. Dr. Ayana Jordan is an associate program director of the adult psychiatry training program and an assistant professor of psychiatry at the Yale University School of Medicine. She is a member of the APA Board of Trustees, and she serves on the Early-Career Psychiatrist Advisory Committee for the journal Psychiatric Services. Her research is concentrated on increasing access to care for minoritized populations with substance use problems. Dr. Christina Mangurian is a professor of psychiatry, epidemiology, and biostatistics in the School of Medicine at the University of California, San Francisco (UCSF). She is also vice chair for diversity and health equity at the UCSF Department of Psychiatry and Behavioral Sciences and a former chair of the APA Council on Minority Mental Health and Health Disparities. Her primary research program focuses on promoting mental health equity for patients and the workforce. The authors’ background and how they became involved in their work [2:50] How the authors’ roles in the workplace and in the community changed over the course of the past few years [7:51] Description of the case vignette presented in the article [14:23] The overall landscape for diversity leaders at psychiatry departments [18:40] Comparisons with other fields of medicine and academia [22:20] Three unique challenges faced by individuals who hold diversity, equity, and inclusion (DEI) roles [24:44] Initial steps that can help leaders in DEI positions [28:42] What people with institutional power can do to make sure that the experiences of BIPOC individuals are not ignored [34:40] Best practices to effectively support DEI leadership efforts in psychiatry [37:18] How scholarly research can adapt to help advance these efforts [42:39] Are the authors optimistic that we can overcome barriers and make real progress in efforts to expand diversity, equity, and inclusion throughout our community and workplaces? [46:11] Photo (from top): Helena Hansen, M.D., Ph.D., Christina Mangurian, M.D., M.A.S., Carolyn I. Rodriguez, M.D., Ph.D., Ayana Jordan, M.D., Ph.D., Ruth S. Shim, M.D., M.P.H., Altha J. Stewart, M.D. (Image courtesy of Dr. Mary Kay Smith.) Full author list of the article: Ayana Jordan, M.D., Ph.D. (Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.) Ruth S. Shim, M.D., M.P.H. (Department of Psychiatry, University of California, Davis) Carolyn I. Rodriguez, M.D., Ph.D. (Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif.) Eraka Bath, M.D. (Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, Los Angeles) Jean-Marie Alves-Bradford, M.D. (Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York) Lisa Eyler, Ph.D. (Department of Psychiatry, University of California, San Diego, and Desert-Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare Center, San Diego) Nhi-Ha Trinh, M.D. (Department of Psychiatry, Massachusetts General Hospital and Harvard University School of Medicine, Boston) Helena Hansen, M.D., Ph.D. (Departments of Psychiatry and Anthropology, New York University, New York) Christina Mangurian, M.D., M.A.S. (Department of Psychiatry and Behavioral Sciences and Department of Biostatistics and Epidemiology, University of California, San Francisco (UCSF), UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General, and UCSF Philip R. Lee Institute for Health Policy Studies, San Francisco) Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the March 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Glenn Verner, M.P.H., and Sonja Entringer, Ph.D., about their article on the relationship between maternal psychological resilience during pregnancy and newborn telomere length. Ms. Glenn Verner is a doctoral candidate in medical psychology at Charité University Medicine in Berlin. She is interested in studying the biological mechanisms that underpin maternal and fetal health. Dr. Sonja Entringer is a professor of medical psychology at Charité University Medicine in Berlin. She is also an associate professor in the Health and Disease Research Program at the University of California, Irvine. Her research interests broadly include how developmental programming affects health and disease risk. In particular, she is interested in how stress during pregnancy affects offspring development. How the authors became interested in this area of research [2:10] Overview of the telomere system [4:35] Aims of the study, which examined how positive maternal psychological conditions during pregnancy affect newborn telomere settings [7:40] Characteristics of study participants [10:44] The various data collected during pregnancies [12:26] How resilience and positivity were quantified [13:58] Relationship between newborn telomere length and maternal resilience [15:18] Results that stood out to the authors [16:37] How clinical features or demographic characteristics of the participants affected the study outcome [17:26] Limitations that may have affected the study results [18:43] How this work fits in to the overall literature on this subject [19:51] Implications the work has for the understanding of how maternal health affects infant health and disease risk [20:42] Key points for researchers, clinicians, and other mental health professionals [22:43] Recommendations for further research [23:59] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the February 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Luke J. Norman, Ph.D., and Kate D. Fitzgerald, M.D., about their article examining whether brain activity is associated with treatment response to cognitive-behavioral therapy (CBT) in adolescents and adults with obsessive-compulsive disorder (OCD), and whether any associations are treatment specific relative to an active control psychotherapy (stress management therapy; SMT). Dr. Luke Norman was recently a neuroscience postdoctoral fellow at the University of Michigan. He is now affiliated with the National Institutes of Health. His research has looked at treatment for obsessive-compulsive disorder and attention deficit hyperactivity disorder. Dr. Kate Fitzgerald is the Phil F. Jenkins Research Professor of Depression and associate professor in the Department of Psychiatry at the University of Michigan. She is the academic director for child and adolescent psychiatry and co-director of the Pediatric Anxiety Disorders Clinic. She is also an adjunct associate professor in the Department of Psychology. Her work has examined pediatric anxiety and obsessive-compulsive disorders, and currently, she is interested in looking for biomarkers of pediatric anxiety disorders that may represent options for novel, targeted treatments. She also has done work focusing on the use of cognitive-behavioral therapy in schools. How the authors became interested in this area of research [2:42] How prevalent obsessive-compulsive disorder (OCD) is among the general population, and its conventional treatment approaches [5:50] Comparing cognitive-behavioral therapy (CBT) with a control psychotherapy called stress management therapy (SMT) [8:42] Details about two neural networks that have been implicated in OCD (the cingulo-opercular network and the orbito-striato-thalamic network) [12:04] Makeup of study participants, and methods the authors used to analyze the data [14:07] Comparison of symptom change between the group who received CBT relative to the group who received SMT [17:39] Details from functional MRI scans [18:23] Differences by age [20:40] Other notable study results [21:25] Limitations of the study [22:21] Implications that this work has for the understanding and treatment of OCD [23:30] Key points for researchers, clinicians, and other mental health professionals [24:50] Recommendations for further research [26:07] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the January 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org