Psyched: Educational Psychiatry Podcast

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 pro

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 inte

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 chall

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.). A

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the treatment of schizophrenia with Dr. Jason Joannou and Dr. Andrew Lustig, two inpatient staff psychiatrists at the Centre for Addiction and Mental Health (CAMH) and assistant professors 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… Articulate the basic psychopharmacology of antipsychotics Create a basic treatment presenting with a first episode of schizophrenia, based on the 2017 Guidelines for the Pharmacotherapy of Schizophrenia in Adults Summarize principles of longitudinal treatment, which includes treatment-resistant schizophrenia and psychosocial approaches to the illness. 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. No

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 Ca

  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 an

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the treatment of generalized anxiety disorder with Dr. Jared Peck, a Staff Psychiatrist at Mount Sinai Hospital in Toronto. In this episode, Jordan Bawks (PGY2 resident) and Bruce Fage (PGY4 resident) reunite with Dr. Peck to talk about the bio-psycho-social management of GAD. They cover recommended lifestyle changes for people with GAD, evidence-based pharmacotherapies, including SSRIs, SNRIs, Pregabalin, Quetiapine, TCAs and benzodiazepines, and how to choose between them, and psychotherapeutic treatments with a focus on CBT and a quick overview of some of the third wave cognitive models. By the end of this episode, the listener will be able to… List the lifestyle changes recommended for people with GAD Describe the first line and second line medication therapies for GAD and the rationale supporting each agent's place in the treatment hierarchy  Appreciate the key elements of CBT that make it effective

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the diagnosis of generalized anxiety disorder with Dr. Jared Peck, a Staff Psychiatrist at Mount Sinai Hospital in Toronto.   In this episode, Jordan Bawks (PGY2 resident) and Bruce Fage (PGY4 resident) sit down with Dr. Peck to help them understand the clinical construct of generalized anxiety disorder (GAD). In addition to understanding how to make the diagnosis they also cover the epidemiology natural course, differential diagnosis and routine investigations for GAD.      By the end of this episode, the listener will be able to… Recognize the clinical features of GAD using DSM-5 diagnostic criteria Appreciate the differential diagnosis and how to conduct assessments to help clinical judgment   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 fe

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Schizophrenia, which guest speakers Dr. Jason Joannou and Dr. Andy Lustig from the CAMH inpatient psychiatry unit. In this episode we discuss schizophrenia, with the following objectives: 1.      The DSM V diagnostic criteria of schizophrenia 2.      The impact of the disease and its trajectory 3.      The differential diagnosis of schizophrenia 4.      Clinical approach to patients with schizophrenia 5.      The Mental Health Act and involuntary admission By the end of this episode, the listener will be able to… 1.       Know the DSM V diagnostic criteria of schizophrenia and specific manifestations of the disease 2.      Know some of the epidemiology, triggers and impact of the disease 3.      Know the differential diagnosis of schizophrenia and its subtypes 4.      Know how to elicit a good history and how to approach patients with schizophrenia 5.      Know the Mental Health Act and the legalities aro

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 t

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 psycho

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, borderl

Welcome to PsychED, the educational psychiatry podcast for medical learners, by medical learners. This episode covers the approach to treating Major Depressive Disorder, as described by the CANMAT (Canadian Network for Mood and Anxiety Treatments) Guidelines. We discuss with Dr. Sid Kennedy, the founding chair of CANMAT, the past president of International Society for Affective Disorders, as well as a staff psychiatrist and scientist at Toronto Western and St. Michael’s Hospitals in Toronto. In this episode, Dr. Kennedy discusses the origins of the CANMAT and how the guidelines are structured and constructed. We talk briefly about consideration of specifiers and symptoms in tailoring treatment. We then approach psychotherapy, pharmacotherapy, electrostimulation, and complementary and alternative therapies as treatment options, using the case from the previous episode on the diagnosis of depression. Evidence-based psychotherapies for depression include cognitive behavioral therapy (CBT), interpersonal therapy

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. T