Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers psychiatry and ethics in the Ontario context with Dr. Suze Berkhout, a clinician investigator and practicing psychiatrist working in acute inpatient psychiatry at University Health Network. She is an Associate Professor at the University of Toronto in the department of psychiatry and affiliate faculty with the Institute for the History & Philosophy of Science and Technology. Her research draws on critical creative methods in ethnography, art-science collaborations, and feminist science and technology studies, to consider the politics of diagnosis and social lives of interventions and emerging technologies in biomedicine. She works with artists, service users, clinicians and scientists to understand how serious illness experiences impact our sense of identity and our social roles, and she studies the impacts of novel and emerging technologies on experiences in healthcare settings. Suze loves coffee and finding new ways to think with stories.

The learning objectives are as follows:

1. Gain familiarity with key ethical concepts in psychiatry, including how ethics differs from law and the major ethical frameworks used in clinical reasoning.

2.  Identify and analyze common ethical challenges in psychiatric practice, such as autonomy, confidentiality, boundaries, and justice.

3. Apply practical strategies for ethical decision-making in clinical encounters.

Guest: Dr. Suze Berkhout

Hosts: Dr. Matthew Cho (PGY1), Dr. Annie Yu (PGY4) and Sena Gok (MD)

Audio Editing: Angad Singh (PGY2)

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of sleep hygiene.

Hosts: Jo Kikukawa (MS2) and Grant Yao (MS4)

Audio editing: Grant Yao

Timestamps:

(0:33) - Background

(2:07) - Core principles and strategies

(5:37) - Counselling on sleep

(6:18) - When to get help with sleep

(7:29) - Summary

References:

• Centre for Addiction and Mental Health. Sleep disorders. CAMH.
• Harvard Health Publishing. Sleep hygiene: Simple practices for better rest. Harvard Health.
• Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–133.
• Sleep Foundation. Sleep hygiene. SleepFoundation.org.
• Spielman AJ, Caruso LS, Glovinsky PB. Behavioral treatment of insomnia: A clinical case series. Sleep. 1987;10(1):87–92.

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers Types of Substances

Hosts: Sara Abrahamson, Shaoyuan Wang and Kate Braithwaite.

Audio Editing: Kate Braithwaite

References:

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5, text revision (DSM-5-TR). 5th ed. Washington, D.C.: American Psychiatric Association Publishing; 2022.

CAMH. (2013). Inhalants. Inhalants | CAMH

CAMH. (2010). Cocaine and Crack. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/cocaine

CAMH. (2012). Amphetamines. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/amphetamines#:~:text=Chronic%20use%20of%20amphetamines%20can,can%20also%20cause%20amphetamine%20psychosis.

Chae J, Marsden J and Sutherland A. (2024, August 21). Benzodiazepine Withdrawal. Emergency Care BC. Benzodiazepine Withdrawal : Emergency Care BC

ChildHealthBC. (2023, September 21). Common Street names for Substances. https://childhealthbc.ca/mhsu/common_streetnames_substances/printfile

Jauch EC. (2023, January 18) Inhalants Clinical Presentation. Medscape. Inhalants Clinical Presentation: History, Physical, Causes

Kaye, AD, Staser, AN, Mccollins, TS, Zheng, J, Berry, FA, Burroughs, CR, Heisler, M, Mouhaffel, A, Ahmadzadeh, S, Kaye, AM, Shekoohi, S, & Varrassi, G. (2024). Delirium Tremens: A Review of Clinical Studies. Cureus, 16(4), e57601. https://doi.org/10.7759/cureus.57601

Long N. (2020, November 3). GHB toxicity. Life in the Fast Lane. GHB toxicity • LITFL • Toxicology Library Toxicant

Medx. (2025, November 26). Understanding What is the MOA of Alcohol: A Pharmacological Perspective. What is the MOA of Alcohol? Explained: Receptors and Effects

Mendelson, J. H., & Mello, N. K. (1996). Management of cocaine abuse and dependence. The New England journal of medicine, 334(15), 965–972. https://doi.org/10.1056/NEJM199604113341507

Nichols DE. Hallucinogens. Pharmacol Ther. 2004 Feb;101(2):131-81. doi: 10.1016/j.pharmthera.2003.11.002.

Nickson C. (2024, December 18). Sedative toxidrome. Life in the Fast Lane. Sedative Toxidrome • LITFL • CCC Toxicology

Porter RS, Kaplan JL, Homeier BP, editors. The Merck manual of diagnosis and therapy. 20th ed. Kenilworth (NJ): Merck Sharp & Dohme; 2018.

PsychDB. (2021, March). Opioid Intoxication. Opioid Intoxication - PsychDB

PsychDB. (2023, October). Opioid Withdrawal. Opioid Withdrawal - PsychDB

PsychDB. (2023 February). Cannabis Withdrawal. Cannabis Withdrawal - PsychDB

Roth BL, Gumpper RH. Psychedelics as Transformative Therapeutics. Am J Psychiatry. 2023 May 1;180(5):317-20.

Vollenweider FX, Kometer M. The neurobiology of psychedelic drugs: implications for the treatment of mood disorders. Nat Rev Neurosci. 2010 Sep;11(9):642-51. doi: 10.1038/nrn2884.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers the psychiatric case presentation with Dr. Justin Delwo, a staff psychiatrist at Toronto Western Hospital where he works in the emergency department and urgent care settings.

The learning objectives for this episode are as follows:

1. What is the goal of a psychiatric case presentation?
2. What are some ground rules for a case presentation?
3. What are the key sections of a case presentation and what should you include under each? 
4. How can you tailor your case presentation to the setting

Guest: Dr. Justin Delwo

Hosts: Dr. Matt Cho (PGY1), Dr. Daamoon Ghahari (PGY2), and Dr. Angad Singh (PGY2)

Audio editing: Dr. Angad Singh (PGY2)

Episode evaluation: Shelly Palchik (MS4)

Time Stamps:

(1:50) - Goals of a case presentation

(4:49) - Ground rules for presenting

(7:56) - General overview

(19:44) - Identifying Data

(23:16) - Chief complaint and reason for referral

(25:42) - History of presenting illness

(38:38) - Review of systems

(42:16) - Safety

(49:42) - Past psychiatric history

(53:54) - Medications

(55:55) - Past medical history

(59:14) - Allergies

(1:00:13) - Family psychiatric history

(1:02:07) - Personal history

(1:06:23) -  Mental status exam

(1:09:45) - Impression

(1:14:20) - Plan

(1:18:43) - Tailoring to different settings

For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website atpsychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers how to take a substance use history

Hosts: Dr. Andrew Nguyen, Dr. Zakia Hussain, Jo Kikukawa, and Dr. Kate Braithwaite.

Audio editing: Dr. Kate Braithwaite

Resources:

1. Chapter 4: Substance Use and Addictive Disorders. In Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences

2. Meta:Phi Resource Library

3. Ten Domains of De-escalation to Prevent Behavioural Emergencies (from Alberta Health Services)

References:

• American Psychiatric Association Publishing. (2022). Substance-Related and Addictive Disorders. In Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition, Text Revision: DSM-5-TR (5th ed., pp. 481-590). American Psychiatric Association Publishing. 

• Boland, R.J., Verduin, M.L., & Ruiz, P. (2022). Chapter 4: Substance Use and Addictive Disorders. In Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences, Clinical Psychiatry (12th ed., pp. 269 - 336). Wolters Kluwer. 

• Porter, L.D. Getting to the Good Part: How to Take an Engaging SUD History. [Presentation Transcript]. University of California, Los Angeles Integrated Substance Use and Addictions Programs. https://www.uclaisap.org/clinicalproviderquicktips/docs/La-Donna-Porter/Porter_LD_Transcript_Clean.pdf 

• Welsh, C.J. “Trapped”: A Mnemonic for Taking a Substance Use History. Acad Psychiatry 27, 289 (2003). https://doi.org/10.1176/appi.ap.27.4.289

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode covers Functional Neurological Disorder with Dr. Patricia Rosebush. Dr. Rosebush is a Professor in the Department of Psychiatry & Behavioural Neurosciences at McMaster University. She is the distinguished author of numerous articles on clinical neuroscience, including considerable work on mitochondrial disorders in mental illness and over 30 papers on catatonia, and practices consultation-liaison psychiatry at St. Joseph’s Healthcare Hamilton.

The learning objectives for this episode are as follows:

1. Provide a definition and conceptual approach to FND

2. Identify clinical signs and patient histories relevant to a diagnosis of FND

3. Describe an approach to the treatment of FND

4. Understand the special challenges of communication and collaboration in this illness

Guest: Dr. Patricia Rosebush

Hosts: Dr. Alastair Morrison, Dr. Kate Braithwaite

Audio editing: Dr. Alastair Morrison

Show notes: Dr. Kate Braithwaite

Interview content:

(02:39) Learning objectives

(03:09) Conceptualization of FND

(08:30) Underlying psychological processes

(09:35) Difference between FND and factitious disorder/malingering

(14:54) Alexithymia

(16:51) Common symptomatic presentations

(18:00) Types of underlying stressors

(19:17) Other risk factors for FND

(22:12) Communicating with patients to address stigma

(24:32) Psychotherapy in FND

(29:36) Referral pathways for patients with FND

(31:15) Prognosis of FND

(33:09) Social media and FND

Resources:

• Functional Neurological Disorder Society. Functional Neurological Disorder Society (FNDS). Includes a podcast and courses for physicians

• Functional Neurological Disorder (FND) – A Patient's Guide to FND

References:

• Hull, M., & Parnes, M. (2021). Tics and TikTok: Functional Tics Spread Through Social Media. Movement disorders clinical practice, 8(8), 1248–1252. https://doi.org/10.1002/mdc3.13267

• National Institute for Neurological Disorders and Stroke. (2024, July.) Functional Neurological Disorder.  U.S. Department of Health and Human Services, National Institutes of Health. Functional Neurologic Disorder | National Institute of Neurological Disorders and Stroke

• PsychDB. (2024, April). Conversion Disorder (Functional Neurological Disorder. Conversion Disorder (Functional Neurological Disorder) - PsychDB

• Rosebush, P. I., & Mazurek, M. F. (2011). Treatment of conversion disorder in the 21st century: have we moved beyond the couch?. Current treatment options in neurology, 13(3), 255–266. https://doi.org/10.1007/s11940-011-0124-y

• Scamvougeras, A., & Castle, D. (2024). Functional Neurological Disorders: Challenging the Mainstream Agnostic Causative Position. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 69(7), 487–492. https://doi.org/10.1177/07067437241245957

For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers metabolic monitoring for patients on antipsychotic medications.

Hosts: Grant Yao (MS4) and Dr. Angad Singh (PGY2)

Audio editing: Dr. Angad Singh (PGY2)

Timestamps:

(0:21) - Background

(2:22) - Monitoring for metabolic side effects

(6:16) - Managing metabolic side effects

(9:50) - Summary

References:

Agarwal, S. M., Stogios, N., Faulkner, G. E., & Hahn, M. (2023). Pharmacological interventions for the prevention of antipsychotic-induced weight gain in people with schizophrenia: A Cochrane systematic review and meta-analysis. Schizophrenia Bulletin, 49(4), 833-835.

Carolan, A., Hynes-Ryan, C., Agarwal, S. M., Bourke, R., Cullen, W., Gaughran, F., ... & O’Donoghue, B. (2024). Metformin for the prevention of antipsychotic-induced weight gain: guideline development and consensus validation. Schizophrenia bulletin, sbae205.

Cooper, S. J., Reynolds, G. P., With expert co-authors (in alphabetical order):, Barnes, T. R. E., England, E., Haddad, P. M., ... & Smith, J. (2016). BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. Journal of Psychopharmacology, 30(8), 717-748.

DeJongh, B. M. (2021). Clinical pearls for the monitoring and treatment of antipsychotic induced metabolic syndrome. Mental Health Clinician, 11(6), 311-319.

Stogios, N., Humber, B., Agarwal, S. M., & Hahn, M. (2023). Antipsychotic-induced weight gain in severe mental illness: risk factors and special considerations. Current Psychiatry Reports, 25(11), 707-721.

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.

This episode is part of the PsychEd Book Club, a forum where we discuss books of interest to psychiatry learners from a variety of disciplines. We invite you to read along with us and contribute to our discussion.

This short introductory episode gives you a heads-up about our upcoming book club on Healing: Our Path from Mental Illness to Mental Health by Thomas Insel. Stay tuned for a longer episode in a few months where we’ll share our thoughts on the book.

If you’d like to share your thoughts or questions about the book, email us at [email protected] or reach out on social media.

Hosts: Dr. Kate Braithwaite, Dr. Sophie Gregoire-Mitha, Dr. Gaurav Sharma

Audio editing by: Dr. Gaurav Sharma

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers goals of care conversations.

Our guest for this episode is Dr. Tavis Apramian, a clinician-investigator in the Department of Family & Community Medicine (DFCM) at the University of Toronto and scientist in the Office of Education Scholarship. He works as a palliative care physician at St. Michael’s Hospital and at Kensington Hospice. His largely qualitative program of research is focused on advance care planning; workplace-based learning and assessment; palliative care in family medicine; medical assistance in dying; and inequity in end-of-life care. His primary focus is on telling rich stories of learner and patient experiences to spark conversation about socioculturally complex educational and clinical problems in serious illness.

The learning objectives for this episode are as follows:

1. Describe a palliative approach to care and its relevance across different contexts

2. Demonstrate a structured and compassionate approach to goals of care conversations

3. Apply effective communication strategies to build therapeutic alliance, navigate difficult conversations, and involve multiple actors in the palliative context

4. Recognize and manage challenges in goals of care conversations

Guest: Dr. Tavis Apramian

Hosts: Dr. Daamoon Ghahari (PGY2) and Dr. Angad Singh (PGY2)

Audio editing: Dr. Angad Singh (PGY2)

Timestamps:

(1:07) - Journey to palliative care

(5:07) - What is palliative care

(14:47) - Understanding patient values

(33:47) - Structuring goals of care conversations

(44:16) - Communication strategies

(57:05) - Navigating family meetings

(77:25) - Reflections on MAiD for sole mental illness

Resources:

Roth, H. (2024). Hearing the unspoken. Canadian Family Physician, 70(10), 642-642. https://pmc.ncbi.nlm.nih.gov/articles/PMC11477260/pdf/0700642.pdf

References:

Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: a review and synthesis of best practices. JAMA internal medicine, 174(12), 1994-2003.

Gross, J., & Koffman, J. (2024). Examining how goals of care communication are conducted between doctors and patients with severe acute illness in hospital settings: A realist systematic review. PLoS One, 19(3), e0299933.

Scheunemann, L. P., Ernecoff, N. C., Buddadhumaruk, P., Carson, S. S., Hough, C. L., Curtis, J. R., ... & White, D. B. (2019). Clinician-family communication about patients’ values and preferences in intensive care units. JAMA internal medicine, 179(5), 676-684.

You, J. J., Downar, J., Fowler, R. A., Lamontagne, F., Ma, I. W., Jayaraman, D., ... & Canadian Researchers at the End of Life Network (CARENET). (2015). Barriers to goals of care discussions with seriously ill hospitalized patients and their families: a multicenter survey of clinicians. JAMA Internal Medicine, 175(4), 549-556.

For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of electroconvulsive therapy.

Hosts: Ravi Bhindi (CC3), Dr. Angad Singh (PGY2)

Audio Editing: Dr. Angad Singh (PGY2)

Show Notes: Dr. Angad Singh (PGY2)

Time Stamps:

(0:36) - What is ECT?

(2:18) - Indications and efficacy

(4:35) - Treatment course

(4:32) - Combination treatment

(6:33) - Medications to discontinue

(8:16) - Contraindications

(9:40) - Side effects

(11:52) - Procedure

(16:03) - Summary

Resources:

• https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/electroconvulsive-therapy
• https://sunnybrook.ca/content/?page=psychiatry-electroconvulsive-therapy-ect-faq

References:

• Andrade, C., Arumugham, S. S., & Thirthalli, J. (2016). Adverse Effects of Electroconvulsive Therapy. The Psychiatric clinics of North America, 39(3), 513–530.

• Brakemeier, E. L., Merkl, A., Wilbertz, G., Quante, A., Regen, F., Bührsch, N., van Hall, F., Kischkel, E., Danker-Hopfe, H., Anghelescu, I., Heuser, I., Kathmann, N., & Bajbouj, M. (2014). Cognitive-behavioral therapy as continuation treatment to sustain response after electroconvulsive therapy in depression: a randomized controlled trial. Biological psychiatry, 76(3), 194–202.

• Espinoza, R. T., & Kellner, C. H. (2022). Electroconvulsive therapy. New England Journal of Medicine, 386(7), 667-672.

• Gill, S., Hussain, S., Purushothaman, S., Sarma, S., Weiss, A., Chamoli, S., ... & Loo, C. K. (2023). Prescribing electroconvulsive therapy for depression: Not as simple as it used to be. Australian & New Zealand Journal of Psychiatry, 57(9), 1202-1207.

• Janjua, A. U., Dhingra, A. L., Greenberg, R., & McDonald, W. M. (2020). The efficacy and safety of concomitant psychotropic medication and electroconvulsive therapy (ECT). CNS Drugs, 34(5), 509-520.

• Jelovac, A., Kolshus, E., & McLoughlin, D. M. (2013). Relapse following successful electroconvulsive therapy for major depression: a meta-analysis. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 38(12), 2467–2474.

• Kolshus, E., Jelovac, A., & McLoughlin, D. M. (2017). Bitemporal v. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials. Psychological Medicine, 47(3), 518-530.

• Lam, R. W., Kennedy, S. H., Adams, C., Bahji, A., Beaulieu, S., Bhat, V., ... & Milev, R. V. (2024). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults: Réseau canadien pour les traitements de l'humeur et de l'anxiété (CANMAT) 2023: Mise à jour des lignes directrices cliniques pour la prise en charge du trouble dépressif majeur chez les adultes. The Canadian Journal of Psychiatry, 69(9), 641-687.

• Luchini, F., Medda, P., Mariani, M. G., Mauri, M., Toni, C., & Perugi, G. (2015). Electroconvulsive therapy in catatonic patients: Efficacy and predictors of response. World journal of psychiatry, 5(2), 182–192.

• Tess, A. V., & Smetana, G. W. (2009). Medical evaluation of patients undergoing electroconvulsive therapy. New England Journal of Medicine, 360(14), 1437-1444.

• Zolezzi M. (2016). Medication management during electroconvulsant therapy. Neuropsychiatric disease and treatment, 12, 931–939.

For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.