PsychEd: Educational Psychiatry Podcast

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode from our EPA mini-series on clinical skills, we comprehensively review the risk factors and management of aggression in the Psychiatric Emergency context. Our guest expert is Dr. Jodi Lofchy. She is the Chair of the Canadian Psychiatric Association’s Section of Emergency Psychiatry, and Interim Chief and Medical Program Director for the Department of Psychiatry at St. Joseph’s Health Centre. Dr. Lofchy has presented and published many works on Best Practice in Emergency Psychiatry and has been tremendously involved in Medical Education.  The learning objectives for this episode are as follows: Identify risk factors for violence in the ER, static and dynamic risks Know how to take a history for violence, and communicate risk Describe the indications for non-chemical interventions in the management of the agitated patient Describe pharmacologic interventions in managing the agitated patient How to apply legislation regarding risk of violence Recommended Readings: Emergency Psychiatry: Clinical and Training Approaches Jodi Lofchy, MD, FRCPC1; Peter Boyles, MD, FRCPC2; Justin Delwo, MD, FRCPC3 http://www.cpa-apc.org/wp-content/uploads/Emergency-Psychiatry-2004%E2%80%9344-R1-EN-FIN-web.pdf   CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website: psychedpodcast.org.  

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we comprehensively review the diagnosis and treatment of PTSD, and explore the psychological and physiological underpinnings of trauma.   Our guest expert is Dr. Dana Ross. She is a psychiatrist in the Trauma Therapy Program at Women’s College Hospital in Toronto, Canada. She is also a founder of Trauma Education Essentials Inc. which provides trauma-focused educational webinars, online courses, and workshops to health professionals and organizations   The learning objectives for this episode are as follows:   Know the prevalence and incidence rates of Posttraumatic Stress Disorder (PTSD) Recognize the clinical features of PTSD using DSM-5 diagnostic criteria List 5 common risk factors for the development of PTSD Identify 3 neurophysiological mechanisms underlying PTSD Differentiate the three stages of trauma therapy Describe evidence-based pharmacological and psychological treatments for   Recommended Readings by Dr. Ross:   The Body Keeps the Score by Bessel Van der Kolk, MD Treating the Trauma Survivor: An Essential Guide to Trauma-Informed Care by Clark, Classen, Fourt, & Shetty Trauma and Recovery by Judith Herman, MD The Deepest Well: Healing the Long-Term Effects of Childhood Adversity by Nadine Burke Harris, MD   CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website:psychedpodcast.org.  

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Psychiatric Rehabilitation with guest Dr. Abraham Rudnick, who is currently a Professor in the Department of Psychiatry at the University of Dalhousie. In this episode, Aarti and Alex learn about Psychiatric Rehabilitation, also known as Psychosocial Rehabilitation (PSR), a rarely discussed or taught “4th branch” of mental health intervention. Join our residents as they discover the definition, purpose, history, process, character, and possibilities of psychiatric rehabilitation from a world expert. The learning objectives for this episode are as follows:   By the end of this episode, the listener will be able to Define psychiatric rehabilitation (PSR) Differentiate clinical and personal recovery Understand how PSR supports personal recovery Differentiate psychiatric rehabilitation from other mental health interventions Identify key areas of overlap with psychotherapy Identify key concepts within the process of PSR: readiness assessment and development, skills, supports, environment of choice, lack of coercion, maintenance of hope Locate resources to further their own knowledge and skills in PSR*   As referenced in the podcast*:   Online PSR training courses: https://www.mohawkcollege.ca/ce/programs/health-and-nursing/psychosocial-rehabilitation-016   https://www.douglascollege.ca/programs-courses/faculties/humanities-social-sciences/psychology/psychosocial-rehabilitation   Books/Journals: 1) Psychiatric Rehabilitation Journal 2) Work of Dr. William Anthony 3) Dr. Patrick Corrigan’s Principles and Practice of Psychiatric Rehabilitation   Guest staff psychiatrist: Dr. Abraham Rudnick, BMedSc, MD, MPsych, PhD, CPRP, FRCPC, CCPE, DFESPCH, FCPA, CSLI, CPRRP   CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website: psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode is our fourth and final episode in our mini-series on schizophrenia. In this episode, we take an advanced look at the clinical management of schizophrenia, including a discussion of treatment-resistant schizophrenia and clozapine. Warning: this content in this episode is a little bit more advanced than usual, but also ultra interesting.     Our guest expert is Dr. Gary Remington. He is a researcher, psychiatrist, Chief of the Schizophrenia Division at CAMH and an author of the 2017 Canadian schizophrenia guidelines    The learning objectives for this episode are as follows:    By the end of this episode, the listener will be able to… Have an approach to treating a first episode psychosis of schizophrenia Understand the important components of maintenance treatment in schizophrenia Understand the concept of treatment-resistant schizophrenia (TRS) Know when to initiate clozapine List some of the psychosocial interventions involved in treating schizophrenia   References: Remington, G., Addington, D., Honer, W., Ismail, Z., Raedler, T., & Teehan, M. (2017). Guidelines for the pharmacotherapy of schizophrenia in adults. The Canadian Journal of Psychiatry, 62(9), 604-616. Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., ... & Severe, J. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1209-1223. Kapur, S., Remington, G., Jones, C., & Wilson, A. (1996). High levels of dopamine D2 receptor occupancy with low-dose haloperidol treatment: a PET study. The American journal of psychiatry, 153(7), 948.   CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website: psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers community treatment orders (CTOs) and assertive community treatment (ACT) teams in the context of schizophrenia treatment with Dr. Arash Nakhost a staff psychiatrist who works on the FOCUS ACT team at St. Michael’s Hospital. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Provide a brief description of the history of ACT teams and CTOs, as well as the challenges in establishing evidence for their use Compare and contrast ACT teams with intensive case management teams in terms of their composition, methods, and respective strengths and weaknesses Describe the array of services that an ACT team can help provide to its clients as well as some of the challenges and drawbacks of ACT teams Outline the major reasons someone might be put on a community treatment order and describe how a CTO is applied and enforced Outline the major challenges in using CTOs as a treatment tool Guest staff psychiatrist: Dr. Arash Nakhost (St. Michael’s Hospital, Toronto) References: Ontario Hospital Association. (2016). A practical guide to mental health and the law in Ontario. Government of Ontario, Health Care Consent Act. Kisely, S. R., Campbell, L. A., & O'Reilly, R. (2017). Compulsory community and involuntary outpatient treatment for people with severe mental disorders. Cochrane database of systematic reviews, (3). Maughan, D., Molodynski, A., Rugkåsa, J., & Burns, T. (2014). A systematic review of the effect of community treatment orders on service use. Social psychiatry and psychiatric epidemiology, 49(4), 651-663. Aubry, T., Goering, P., Veldhuizen, S., Adair, C. E., Bourque, J., Distasio, J., ... & Tsemberis, S. (2015). A multiple-city RCT of housing first with assertive community treatment for homeless Canadians with serious mental illness. Psychiatric Services, 67(3), 275-281. Bromley, E., Mikesell, L., Whelan, F., Hellemann, G., Hunt, M., Cuddeback, G., ... & Young, A. S. (2017). Clinical factors associated with successful discharge from assertive community treatment. Community mental health journal, 53(8), 916-921. CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website: psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode is part II in the treatment of schizophrenia series with our expert Dr. Albert Wong, a psychiatrist and research scientist who is an expert in schizophrenia at the Centre for Addiction and Mental Health (CAMH) and professor at the University of Toronto. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to…   Conceptualize antipsychotic drugs categories in in different and clinically relevant ways Have an approach for choosing an antipsychotic medication for a patient and be able to consent them by going over the benefits and limitations of the medications Understand the limitations of our understanding of schizophrenia and our current treatments and some of the problems that remain to be solved in this area of psychiatry    References: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Robinson, D. J. (1997). Brain calipers: A guide to a successful mental status exam. Fort Gratiot, Mich., USA: Rapid Psychler Press. Kuipers, E., Yesufu-Udechuku, A., Taylor, C., & Kendall, T. (2014). Management of psychosis and schizophrenia in adults: summary of updated NICE guidance. BMJ: British Medical Journal (Online), 348. CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com. For more information visit our website:psychedpodcast.org.

Dr. Jason Joannou and Dr. Andrew Lustig, both inpatient staff psychiatrists at CAMH and assistant professors at the University of Toronto, delve into the nuances of schizophrenia treatment. They discuss the complexities of antipsychotic medications, emphasizing their mechanisms, side effects, and the significance of long-acting injectables. The conversation highlights the challenges of treatment-resistant schizophrenia, underlining the importance of personalized care and integrating psychosocial interventions for better patient outcomes. Ethical considerations and family-centered approaches to communication are also explored.

Please take our 5-minute RESEARCH SURVEY. (more details below)   Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. We apologize that we don't have a new episode for you this month but we are working hard behind the scenes both on new episodes and on medical education research into podcasting. Don't fear, new episodes are on the way! In the meantime, we have a favour to ask. We have started a research project to improve PsychEd and to better understand how medical learners use podcasts. We are asking for our listeners help in completing this brief 5-minute RESEARCH SURVEY. Your input will help us improve this podcast and provide more insight into why and how podcasts are used in medical education. And remember you’ll also be given a chance to win a $250 gift card of your choice/pre-paid visa in addition to the good you’ll be doing. We look forward to listening to all of you for a change! CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website: psychedpodcast.org.

  Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the diagnosis and treatment of Obsessive Compulsive Disorder (OCD) with Dr. Nik Grujich, a staff psychiatrist at Sunnybrook Hospital, associate of the Frederick W. Thompson Anxiety Disorders Centre and award-winning educator at the University of Toronto. In this episode, Jordan Bawks (PGY2 resident) and Aarti Rana (PGY1 resident) sit down with Dr. Grujich to talk about OCD. Together, they discuss the phenomenology of OCD (with a focus on differentiating it from Obsessive Compulsive Personality Disorder, OCPD), the epidemiology and natural course of the disorder, the DSM-5 diagnostic criteria, interview techniques to elicit and differentiate OCD from other psychiatric disorders and the pharmacological and psychological treatments for the disorder. By the end of this episode, the listener will be able to… Recognize the clinical features of OCD using DSM-5 criteria Appreciate the differential diagnosis and how to use specific interviewing questions and the mental status to aid clinical judgment Describe the evidence-based pharmacological and psychological treatments for OCD and their relative efficacy CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association. For more PsychEd, follow us on Twitter (@psychedpodcast) and Facebook. You can provide feedback by email at psychedpodcast@gmail.com For more information visit our website: psychedpodcast.org.

Dr. Jared Peck from Mount Sinai Hospital in Toronto discusses the treatment of Generalized Anxiety Disorder with lifestyle changes, recommended medications (SSRIs, SNRIs, Pregabalin, TCAs), and psychotherapies like CBT. They explore the effectiveness of different treatments and dive into the cognitive model of CBT for managing GAD.