The Carlat Psychiatry Podcast

Explore the intriguing world of narcissism in therapy, discussing strategies like mirroring and confrontation. Learn about the contrasting methods of Otto Kernberg and Heinz Kohut, focusing on empathetic engagement. Delve into the risks of AI technology mirroring beliefs, potentially escalating mental health issues. The conversation highlights alarming outcomes from AI therapy, raising awareness about its dangers while contrasting safer options. Get ready for a thought-provoking discussion on how these concepts interconnect in today's society.

An intriguing discussion uncovers the 'placebo flip' phenomenon, where patients find unexpected relief after stopping medications. The dialogue dives into the complexities of tapering off drugs like lithium, highlighting the risk of delayed relapses. Psychological factors influencing patient experiences during medication discontinuation are also examined. Additionally, the conversation sheds light on the underdiagnosis of tardive dyskinesia in chronic depression patients and introduces an AI tool, TD Screen, poised to revolutionize detection methods.

The complexity of the placebo effect is explored, shedding light on its varying impact across psychiatric disorders. Historical examples illustrate how patient responses can often skew perceptions of treatment efficacy. The discussion also touches on the importance of tapering medications during crises and alarming trends in recreational drug use, particularly ketamine and psilocybin. The rising popularity of these psychedelics among those facing mental health challenges raises important concerns, especially with recent data from poison control centers.

Discover how AI is revolutionizing medical diagnostics, boasting a 92% accuracy that outshines human experts. Delve into the advantages of AI in psychiatric assessments, addressing biases inherent in human judgment. Explore how AI can enhance decision-making in psychiatry and the transformative potential it holds. Learn about the historical evolution of medical knowledge and the role of AI in evolving research practices, including the FDA's initiatives to integrate AI into scientific reviews.

Determining the best treatment for teens facing substance use can be complex. The discussion covers outpatient therapy versus intensive programs based on severity and family support. Challenges like marijuana addiction and the risks of fentanyl are explored, emphasizing the need for innovative treatment approaches. The role of Partial Hospitalization and Intensive Outpatient Programs is examined, alongside the importance of teen communication and involvement in treatment. Effective strategies for aligning teen behaviors with their values are highlighted, showcasing motivational interviewing techniques.

Joshua Feder, an expert in child psychiatry and co-author of notable texts on child medication, discusses the unique challenges faced by young adults with developmental disabilities at 18. The conversation focuses on empowering decision-making while balancing autonomy and necessary support. Key topics include assessing decision-making capacity, the role of guardianship, and the importance of clear communication. Feder highlights the significance of involving trusted advisors and listening to the voices of individuals with disabilities to foster informed choices.

Families face significant hurdles in finding effective OCD treatment for children, from a lack of specialized therapists to long waitlists. Online cognitive behavioral therapy is emerging as a viable alternative, showing promising results in reducing OCD symptoms. Listeners learn about the strong preference for remote care and the necessity for further research into its long-term effectiveness. Additionally, the importance of building a strong therapeutic relationship before transitioning to online treatment is discussed, highlighting the challenges of fostering trust in virtual settings.

Delve into the complexities of diagnosing ADHD in preschoolers and the quandary of using stimulant medications. Explore the risks associated with medication, including side effects on growth and appetite. Discover the importance of a holistic care approach that encompasses nutrition and support systems. Learn how collaborative efforts between parents, educators, and healthcare providers enhance treatment plans. This episode tackles the critical question of how to balance medical intervention with essential non-pharmacological strategies for young children.

The discussion centers around the MTHFR gene and its variants, which play a crucial role in mental health, particularly in depression. Testing for MTHFR's impact on treatment with methylfolate is analyzed, revealing important links to clinical outcomes. The effectiveness of SAMe as a depression treatment is evaluated, showcasing mixed trial results. Additionally, the podcast emphasizes the significance of folate and its affordable options, highlighting its historical importance and benefits in mental health treatment. It's a fascinating dive into genetics and psychiatry!

Dive into the fascinating link between low folate levels and depression, tracing discoveries back to the 1930s. Discover how folate impacts neurotransmitter production and cognitive health. Unearth the advantages of L-methylfolate over traditional folic acid, revealing its unique ability to cross the blood-brain barrier. Learn about the effects of folate deficiency on mental health, especially in relation to obesity and inflammation. This discussion highlights the evolving strategies in depression treatment and the emerging importance of affordable folate options.