PsychEd: educational psychiatry podcast

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.

Dr. Jared Peck, Staff Psychiatrist at Mount Sinai Hospital in Toronto, discusses diagnosing Generalized Anxiety Disorder. Topics include DSM-5 criteria, using standardized scales for assessment, navigating differential diagnosis, substance use in coping with anxiety, and distinguishing normal vs. pathological anxiety.

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.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers treatment of bipolar disorder with Dr. Roger McIntyre, Professor of Psychiatry and Pharmacology at University of Toronto and Head of the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto, Canada. In this episode, we follow the case of Devon, a 28 year old male who presents to the ER with acute mania and is diagnosed with bipolar disorder. Our team of psychiatry residents from University of Toronto guide you through Devon’s trajectory with reference to CANMAT guidelines and expertise from Dr. McIntyre. We discuss how to manage acute mania and acute depression and what management looks like for outpatients (pharmacological and non-pharmacological). Special topics include treating severe agitation on the inpatient ward and things to consider for lithium treatment.  The Learning Objectives for this episode are as follows: By the end of this episode, the listener will be able to… Treat acute mania and depression in bipolar disorder  Prevent relapse in bipolar disorder through maintenance pharmacotherapy Prevent relapse through nonpharmacological interventions Obtain informed consent for and initiate lithium treatment Guest staff psychiatrist: Dr. Roger McIntyre (University Health Network, Toronto) 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 of bipolar disorder in ther depressive episodes, and a phenomenon termed "episodes with mixed features", with guest Dr. Ariel Shafro, a staff psychiatrist at Trillium Health Partners.  Bipolar disorder is an illness characterized by manic and depressive episodes; patients in fact spend more time in a depressed state than a manic state. The criteria for diagnosing a bipolar depression is the same as unipolar depression (or major depressive disorder).  When patients present with a depressive episode, it is important to consider bipolar disorder as a possible differential diagnosis. In addition, we discuss certain features that can point to an increased likelihood of bipolarity in a patient presenting with depression: this includes a strong family of bipolar disorder; previous subthreshold mania and cyclothymic features;atypical depression, psychomotor retardation (and/or catatonia), and psychotic features; and atypical reaction to antidepressants.  Lastly, we talk about the phenomenon of "episodes with mixed features", where people can present with simultaneous symptoms of depression and mania. We discuss the relevance of recognizing such episodes, including increased vigilance for features of bipolarity and considerations for treatments that have effect in both unipolar and bipolar depression. The learning objectives for this episode are as follows. By the end of this episode, the listener will be able to: Describe criteria for bipolar depression (it's the same as unipolar depression!) List features suggestive of bipolarity in a presentation of depression Know the DSM-V criteria of and recognize episodes with mixed features Describe the relevance of diagnosing episodes with mixed features Guest Staff Psychiatrist: Dr. Ariel Shafro (Trillium Health Partners, Mississauga) 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.