PsychEd: Educational Psychiatry Podcast

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.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the diagnosis of Bipolar Disorder (Type 1 and 2), with insights from guest Dr. Mark Sinyor, Staff Psychiatrist at Sunnybrook Health Sciences Centre.  Bipolar disorder is characterized by depressive and manic episodes. This episode focuses on the diagnostic criteria and assessment in mania, and presents a fictional case of a patient with a first manic episode. We discuss the epidemiology of bipolar disorder, and a plain-English description of manic episodes. We then explore the DSM-5 diagnostic criteria for manic episodes using the mnemonic GSTPAID. Relating the criteria back to the case, we will talk with Dr. Sinyor about practical methods and tips for assessing a person who presents with manic symptoms. Some common mental status exam terms and findings in mania will be explained. We then discuss common differential diagnoses for bipolar disorder, including schizoaffective disorder, schizophrenia, borderline personality disorder, and substance intoxication/substance-induced mania.  Lastly, we will differentiate between mania and hypomania, and Bipolar Disorder Type 1 and Type 2. Through the examination of the concept of “bipolar spectrum”, we will discuss some challenges and limitations of the DSM-5 and the current understanding of Bipolar Disorder.  The Learning Objectives for this episode are as follows. By the end of this episode, the listener will be able to: Cite the prevalence and incidence rates of bipolar affective disorder Describe the natural history of bipolar disorder including its cyclical nature, and relative ratio of times in mania vs depression Know the DSM-V criteria for mania, hypomania Suggested mnemonic GSTPAID Perform an effective diagnostic interview for manic symptoms Perform a differential diagnosis for bipolar disorder including borderline personality disorder and psychotic disorders Guest Staff Psychiatrist: Dr. Mark Sinyor (Sunnybrook Health Sciences Centre, 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.

Dr. Sidney Kennedy, a leading psychiatrist and founding chair of CANMAT, sheds light on the evolution of treatment guidelines for Major Depressive Disorder. He discusses the critical role of evidence-based therapies like CBT and interpersonal therapy, emphasizing the importance of tailoring treatment to individual patient needs. The conversation dives into the efficacy of combining psychotherapy with pharmacotherapy, explores neurostimulation options, and addresses misconceptions about treatments like electroconvulsive therapy. A wealth of insights for anyone interested in mental health!

Welcome to PsychEd, the educational psychiatry podcast for medical learners, by medical learners. This episode covers the diagnosis of major depressive disorder (MDD), leveraging experience from Dr. Ilana Shawn, Staff Emergency and Outpatient Psychiatrist at St. Michael’s Hospital in Toronto. In this episode we talk about a hypothetical case of someone presenting for the first time with a depressive illness. Using the metric of DALY (disability-adjusted life-years), we highlight the high global disease burden of depression. We then briefly discuss the purpose and limitations of using a diagnostic manual. We describe in depth the symptoms of depression using the mnemonic MSIGECAPS, including Dr. Shawn’s thoughts on how the they can be elicited more naturally in an assessment. We talk about common challenges in performing a suicide assessment, and the misconception that asking about suicide increases the risk of suicide. Finally, we highlight other medical and psychiatric conditions that can mimic depression. The Learning Objectives for this episode are as follows. By the end of this episode, the listener will be able to: Understand the societal impact of depression Describe the diagnostic criteria of MDD Describe strategies to elicit depression symptoms Apply Mental State Exam findings to support or a diagnosis of depression Understand the limitations of the Diagnostic and Statistical Manual (DSM) Perform a differential diagnosis of major depression Guest Staff Psychiatrist: Dr. Ilana Shawn (St. Michael’s Hospital, 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.