Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode is about counselling patients on antidepressant medications.

Hosts: Matthew Cho and Angad Singh

Audio editing: Angad Singh

Time Stamps:

2:03 - Steps to antidepressant counselling

7:31 - Frequently asked questions about antidepressants

Related Episodes:

PsychEd Episode 1: Diagnosis of Depression with Dr. Ilana Shawn

PsychEd Episode 2: Treatment of Depression with Dr. Sidney Kennedy

PsychEd Episode 58: Depression in Children and Adolescents with Dr. Darren Courtney

Patient Education:

UpToDate resource on ‘Medicines for Depression’: https://www.uptodate.com/contents/medicines-for-depression-the-basics

CAMH resource on ‘Antidepressant Medications’:

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/antidepressant-medications

Kelty Mental Health resource on ‘Selective Serotonin Reuptake Inhibitors’: https://keltymentalhealth.ca/sites/default/files/resources/SSRI_MedicationSheet2022.pdf, 

References:

PsychDB. (2024, January 11). Introduction to Antidepressants. https://www.psychdb.com/meds/antidepressants/home

Lam RW, Kennedy SH, Adams C, Bahji A, Beaulieu S, Bhat V, Blier P, Blumberger DM, Brietzke E, Chakrabarty T, Do A. 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. 2024 Sep;69(9):641-87.

Contact:

For more about PsychEd follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), and X (@psychedpodcast). 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 is our inaugural book club episode centred around the book Mind Fixers by Anne Harrington.

Mind Fixers is by the Harvard historian Anne Harrington, and came out from Norton in 2022. It reframes the “biological turn” in later twentieth century psychiatry with a history of the discipline from the later nineteenth century forward. Harrington argues that the biological turn had relatively little to do with new scientific advances, and came instead from a need to separate psychiatry from the increasingly unpopular public image of the discipline’s previous, “Freudian” age. 

To make this argument, she starts with the anatomic research of turn-of-the-century figures like Kraepelin, and how this generally failed to explain important mental illnesses. She traces the emergence of “Freudian” or psychological approaches to mental illness to the high point of their dominance in the mid twentieth century, and then their decline, as their inadequacy with respect to things like bipolar disorder and schizophrenia became increasingly clear, and their emphasis on childhood experience stigmatized families. Biological psychiatry is then a way to restore the fields’s respectability as as branch of medicine, but according to Harrington, there is not much transformative innovation to go along with this rebrand; and she emphasizes that the psychopharmacology revolution which gave us the first antipsychotics, MAOIS, tricyclics, and the receptor model of mental illness, actually happened during the heyday of psychoanalysis.

The members of our team involved in this discussion are:

Sara Abrahamson - MS2 at the University of Toronto

Dr. Kate Braithwaite - Medical Doctor from South Africa

Dr. Wendy MacMillan-Wang - PGY4 psychiatry resident at the University of Manitoba

Dr. Alastair Morrison - PGY1 psychiatry resident at McMaster University

Dr. Gaurav Sharma - Staff psychiatrist working in Nunavut, Canada

This episode was edited by Dr. Angad Singh - PGY1 psychiatry resident at the University of Toronto 

Our discussion was structured around four themes:

(03:15) - Psychiatry and Economic Incentives

(19:33) - Psychiatry and Parenting

(28:40) - Biological Psychiatry and its Alternatives

(52:05) - Psychiatry and Social Control

If you enjoyed this episode, consider listening to our episodes about:

History of Psychiatry with Dr. David Castle

Critical Psychiatry with Dr. Elia Abi-Jaoude and Lucy Costa

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

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

This primer covers the differential diagnosis of dementia.

Hosts: Dr. Alastair Morrison (PGY-1) and Dr. Angad Singh (PGY-1)

Audio editing by: Dr. Angad Singh (PGY-1)

Resources:

• MoCA: https://dementia.talkbank.org/protocol/materials/MOCA.pdf
• MMSE: https://meded.temertymedicine.utoronto.ca/sites/default/files/assets/resource/document/mini-mental-state-examinationmmse.pdf
• Beers Criteria: American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults
• PsychEd Episode 49: Dementia Assessment with Dr. Lesley Wiesenfeld

References:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  
• Francis, J. & Young, B. (2022). Diagnosis of delirium and confusional states. UpToDate. Retrieved January 31, 2025, from https://www.uptodate.com/contents/delirium-and-acute-confusional-states-prevention-treatment-and-prognosis
• Larson, E. B. (2022). Evaluation of cognitive impairment and dementia. UpToDate. Retrieved January 31, 2025, from https://www.uptodate.com/contents/evaluation-of-cognitive-impairment-and-dementia
• PsychDB. (2022, Oct 3). Introduction to Dementia. Retrieved January 31, 2025, from https://www.psychdb.com/geri/dementia/home
• PsychDB. (2024, Feb 1). Delirium. Retrieved January 31, 2025, from https://www.psychdb.com/cl/1-delirium
• PsychDB. (2024, Feb 9). Alzheimer’s Disease. Retrieved January 31, 2025, from https://www.psychdb.com/geri/dementia/alzheimers
• PsychDB. (2023, Oct 12). Vascular Dementia. Retrieved January 31, 2025, from https://www.psychdb.com/geri/dementia/vascular
• PsychDB. (2024, Jan 23). Frontotemporal Dementia. Retrieved January 31, 2025, from https://www.psychdb.com/geri/dementia/frontotemporal
• PsychDB. (2024, Feb 5). Dementia with Lewy Bodies. Retrieved January 31, 2025, from https://www.psychdb.com/geri/dementia/lewy-body

For more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), and X (@psychedpodcast). 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 ADHD in youth with Dr. Daniel Gorman, an Associate Professor in the Department of Psychiatry at the University of Toronto and a Staff Psychiatrist at The Hospital for Sick Children. Dr Gorman’s clinical and academic interests include ADHD, Tourette syndrome, obsessive-compulsive disorder, child psychopharmacology, psychiatric education, and narrative medicine. He is highly involved in resident teaching and clinical supervision, and from 2014 to 2022 he was the Program Director for the Child and Adolescent Psychiatry subspecialty program at the University of Toronto.

Dr. Gorman has given over 85 invited presentations and authored or co-authored over 35 peer-reviewed articles and book chapters, mainly related to childhood neuropsychiatric disorders and their pharmacological management. He also contributed to several Canadian guidelines, including guidelines on cardiac risk assessment before the use of stimulants, management of tic disorders, pharmacotherapy for childhood disruptive and aggressive behaviour, and pharmacogenetic testing for children treated with psychiatric medications.

The learning objectives for this episode are as follows:

By the end of this episode, the listener will be able to…

1. Review diagnostic criteria for ADHD
2. Describe important considerations in making the diagnosis of ADHD
3. Describe psychosocial aspects of management of ADHD
4. Outline the pharmacological management of ADHD

Guest: Dr. Daniel Gorman

Hosts: Dr. Kate Braithwaite, Dr. Shaoyuan Wang (PGY-4), Matthew Cho (MS-4)

Audio editing by: Dr. Angad Singh (PGY-1)

Resources:

• CADDRA - Canadian ADHD Resource Alliance: Canadian ADHD Practice Guidelines, 4.1 Edition, Toronto ON; CADDRA, 2020.

References:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  
• Biederman, J., DiSalvo, M., Fried, R., Woodworth, K. Y., Biederman, I., & Faraone, S. V. (2019). Quantifying the protective effects of stimulants on functional outcomes in attention-deficit/hyperactivity disorder: A focus on number needed to treat statistic and sex effects. Journal of Adolescent Health, 65(6), 784–789. https://doi.org/10.1016/j.jadohealth.2019.06.016
• Peterson, B. S., Trampush, J., Brown, M., Maglione, M., Bolshakova, M., Rozelle, M., Miles, J., Pakdaman, S., Yagyu, S., Motala, A., & Hempel, S. (2024). Tools for the diagnosis of ADHD in children and adolescents: A systematic review. Pediatrics, 153(4), e2024065854. https://doi.org/10.1542/peds.2024-065854
• Fedder, D., Patel, H., & Saadabadi, A. (2018). Atomoxetine. StatPearls. Retrieved January 31, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK493234/
• Canadian Pediatric Society. (2022). Mental health: Screening tools and rating scales. Canadian Pediatric Society. Retrieved January 31, 2025, from https://cps.ca/mental-health-screening-tools

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

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

This episode covers psychotherapy in youth with Dr. Laurence Katz, a professor of child and adolescent psychiatry at the University of Manitoba. Dr. Katz received his medical and adult psychiatric training at the University of Manitoba and his child and adolescent psychiatry training at the Albert Einstein College of Medicine, Bronx N.Y. He is an adjunct scientist at the Manitoba Centre for Health Policy and has published numerous papers using the population health administrative database in mental health outcomes. He has held and been part of numerous grants funded by CIHR, PHAC, and other national funding agencies related to work with First Nations communities. Dr. Katz is widely published in particular in the areas of suicide and suicidal behaviour. His other research interests include Dialectical Behaviour Therapy, pharmacoepidemiology, and implementation of complex interventions.

The learning objectives for this episode are as follows:

By the end of this episode, the listener will be able to…

1. Outline which psychotherapeutic modalities are commonly used in youth
2. Identify which youth may benefit/should be referred for psychotherapy
3. Discuss important considerations in delivering psychotherapy to youth

Guest: Dr. Laurence Katz

Hosts: Wendy MacMillan-Wang, Shaoyuan Wang, Kate Braithwaite, and Sara Abrahamson

Audio editing by: Angad Singh

Show notes by: Kate Braithwaite

Interview content:

• Introduction - 0:04
• Guest introduction - 00:44
• Learning objectives - 05:25
• Definitions - 06:00
• Types of psychotherapy in youth - 07:44
• Evolution of psychotherapy in youth over time - 13:10
• Psychotherapy in suicide prevention/risk mitigation - 16:24
• Challenges in research: decrease in effect sizes over time - 18:32
• Conditions responding best to psychotherapy - 22:01
• Youth specific modalities - 26:44
• Summary of learning objective 1 - 29:49
• Indications and contraindications - 30:23
• Consent - 37:31
• Group therapy - 39:31
• Summary of learning objective 2 - 46:27
• Differences in psychotherapy in youth compared to adults in practice - 47:10
• Techniques for engagement of youth - 53:32
• Family involvement - 58:21
• Confidentiality - 1:02:39
• Use of mobile apps/internet-based therapies - 1:07:20
• Summary of learning objective 3 - 1:11:17
• Other considerations - 1:12:35
• End credits - 1:16:52
  

References:

• Agostino, H., & Toulany, A. (2023). Considerations for privacy and confidentiality in adolescent health care service delivery. Paediatrics & Child Health, 28(3), 172–183. https://doi.org/10.1093/pch/pxac117
• American Academy of Child and Adolescent Psychiatry. (2019, April). Psychotherapies for children and adolescents: different types. Facts for Families Guide. Retrieved from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychotherapies-For-Children-And-Adolescents-086.aspx
• Bailin, A., Cho, E., Sternberg, A., & others. (2023). Principle-guided psychotherapy for children and adolescents (FIRST): Study protocol for a randomized controlled effectiveness trial in outpatient clinics. Trials, 24, Article 682. https://doi.org/10.1186/s13063-023-07717-y
• Bhide, A., & Chakraborty, K. (2020). General principles for psychotherapeutic interventions in children and adolescents. Indian Journal of Psychiatry, 62(Suppl 2), S299–S318.
• CADDRA - Canadian ADHD Resource Alliance. (2020). Canadian ADHD practice guidelines (4.1 ed.). Toronto, ON: CADDRA.
• Christner, R. W., Stewart, J. L., & Mulligan, C. A. (Eds.). (2024). Handbook of cognitive-behavior group therapy with children and adolescents: Specific settings and presenting problems (2nd ed.). Routledge.
• Campisi, S. C., Ataullahjan, A., Baxter, J. B., Szatmari, P., & Bhutta, Z. A. (2022). Mental health interventions in adolescence. Current Opinion in Psychology, 48. https://doi.org/10.1016/j.copsyc.2022.101492
• Katzman, M. A., Bleau, P., Blier, P., & others. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress, and obsessive-compulsive disorders. BMC Psychiatry, 14(Suppl 1), S1. https://doi.org/10.1186/1471-244X-14-S1-S1
• Kendall, P. C., Ney, J. S., Maxwell, C. A., Lehrbach, K. R., Jakubovic, R. J., McKnight, D. S., & Friedman, A. L. (2023). Adapting CBT for youth anxiety: Flexibility within fidelity in different settings. Frontiers in Psychiatry, 14, Article 1067047. https://doi.org/10.3389/fpsyt.2023.1067047
• Kernberg, P. F., Ritvo, R., Keable, H., & American Academy of Child an Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI) (2012). Practice Parameter for psychodynamic psychotherapy with children. Journal of the American Academy of Child and Adolescent Psychiatry, 51(5), 541–557. https://doi.org/10.1016/j.jaac.2012.02.015
• Lam, R. W., Kennedy, S. H., Adams, C., & others. (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. https://doi.org/10.1177/07067437241245384
• Oetzel, K. B., & Scherer, D. G. (2003). Therapeutic engagement with adolescents in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 40(3), 215–225. https://doi.org/10.1037/0033-3204.40.3.215
• Wergeland, G. J., Fjermestad, K. W., Marin, C. E., Haugland, B. S., Bjaastad, J. F., Oeding, K., Bjelland, I., Silverman, W. K., Öst, L. G., Havik, Ø. E., & Heiervang, E. R. (2014). An effectiveness study of individual versus group cognitive behavioral therapy for anxiety disorders in youth. Behaviour Research and Therapy, 57, 1–12. https://doi.org/10.1016/j.brat.2014.03.007
• Witt, K. G., Hetrick, S. E., Rajaram, G., Hazell, P., Taylor Salisbury, T. L., Townsend, E., & Hawton, K. (2021). Interventions for self-harm in children and adolescents. Cochrane Database of Systematic Reviews, 3, Article CD013667. https://doi.org/10.1002/14651858.CD013667.pub2
• Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., Alda, M., MacQueen, G., Milev, R. V., Ravindran, A., O'Donovan, C., McIntosh, D., Lam, R. W., Vazquez, G., Kapczinski, F., McIntyre, R. S., Kozicky, J., Kanba, S., Lafer, B., Suppes, T., Calabrese, J. R., Vieta, E., Malhi, G., Post, R. M., & Berk, M. (2018). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders, 20(2), 97–170. https://doi.org/10.1111/bdi.12609

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

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This is a special episode in a new series — the PsychEd Book Club, a forum where we'll introduce and discuss books of interest to psychiatry learners from a variety of disciplines, moving beyond epidemiology and clinical practice to look at science, history, culture, and more. We'll also invite you to read along and discuss with us as we read!

Our book club episodes will start with a short introductory episode (like this one) sharing the book title and why we picked it. A few months later, we plan to release an episode debriefing our thoughts on the book. If there are specific things you want us to talk about, email us at [email protected] or reach out to us on social media and we will try to include them in our debrief!

The first book we'll be covering is Anne Harrington's Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness. This is a new history of psychiatry, from the later nineteenth century to the present, with a focus on biological explanations and treatments for mental illness — the way that these approaches have gained and lost ground in the profession over time, clashing and collaborating with other understandings. It offers a wide-ranging overview of many defining figures, discoveries, and shifts within modern mental healthcare, unified by a single narrative which gives the book momentum and makes its portraits memorable, and often stinging. It's a polemical history, which prompts us to reconsider some of the field's most automatic self-conceptions, and to recognize the social, political, and cultural forces that have shaped and reshaped it over time.

Hosts: Drs Kate Braithwaite, Wendy MacMillan-Wang, Alastair Morrison, and Gaurav Sharma

Audio editing by: Dr Angad Singh

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

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers an introduction to consultation-liaison psychiatry with Dr. Raed Hawa and Dr. Alan Wai, both from the University of Toronto.

Dr. Raed Hawa is an esteemed CL psychiatrist and educator. Dr Hawa's interests are in the areas of undergraduate, postgraduate, and continuing medical education. He also practices general sleep medicine with particular clinical interest in the areas of insomnia, co-morbid psychiatric and medical illnesses, and sleep-related movement disorders. He currently serves as the President of the Canadian Academy of Consultation-Liaison Psychiatry (CACLP) and holds the position of Professor at the Faculty of Medicine, University of Toronto. Additionally, Dr. Hawa is the Deputy Psychiatrist-in-Chief at the Centre for Mental Health, University Health Network. Dr. Hawa has earned American Board Certification in Psychiatry, with subspecialty certifications in Sleep Medicine and Psychosomatic Medicine (Consultation-Liaison Psychiatry). His expertise and contributions to the field have been recognized through his designation as a Distinguished Fellow of both the American Psychiatric Association (APA) and the Canadian Psychiatric Association (CPA).

Dr. Alan Wai is a psychiatrist at the University Health Network in Toronto and an Assistant Professor in the Department of Psychiatry at the University of Toronto. He provides inpatient CL psychiatry care and mental health and psychiatric care embedded in the Immunodeficiency Clinic at Toronto General Hospital, where he sees both persons living with and at risk of HIV. He received his medical degree from the University of British Columbia and completed his psychiatric residency training 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…

1. Outline the history and evolution of CL psychiatry

2. Define the role and scope of CL psychiatrists in diverse medical settings

3. Identify and assess common psychiatric disorders in CL settings

4. Provide differential diagnoses and a general approach to a CL patient through a sample case

Guests: Dr. Raed Hawa and Dr. Alan Wai

Hosts: Annie Yu (PGY3), Sena Gok (MD), and Matthew Cho (CC3)

Audio editing by: Sena Gok

Show notes by: Sena Gok

Interview content:

• Introduction - 00:13
• Learning objectives - 01:09
• First guest introduction - 01:36
• History of CL psychiatry - 03:18
• Subspecialties within CL psychiatry - 10:33
• Collaborative care of CL psychiatry - 14:00
• Preparation for CL Rotation - 20:03
• Bariatric clinic and CL psychiatry - 22:32
• Future of CL psychiatry, AFC Certification - 27:45
• Second guest introduction - 33:29
• Role and scope of CL psychiatry - 34:18
• A day in CL psychiatry - 39:32
• Cultural competence in CL psychiatry - 44:08
• Introduction to patients in CL clinics - 47:53
• Resources for CL psychiatry rotation - 50:14
• Clinical vignette - 53:08
• CL psychiatric assessment approach - 01:00:25
• Agitation management in CL psychiatry - 01:09:24
• Closing - 01:13:51
• End credits - 01:15:05

Resources:

• Massachusetts General Hospital Handbook of General Hospital Psychiatry: https://www.sciencedirect.com/book/9781437719277/massachusetts-general-hospital-handbook-of-general-hospital-psychiatry
• Academy of CL Psychiatry (ACLP) educational resources: https://www.clpsychiatry.org/educationcareers/
• AFC (Area of Focused Competence) in CL Psychiatry: https://news.royalcollege.ca/en/eligibility-and-exams/areas-of-focused-competence.html
• Canadian Academy of Consultation-Liaison Psychiatry website: https://www.clpsychiatry.ca
• Our previous CL psychiatry-related episodes:
  • PsychEd Episode 22: Psycho-Oncology Assessments with Dr. Elie Isenberg-Grzeda
  • PsychEd Episode 35: Pain Psychiatry with Dr. Leon Tourian
  • PsychEd Episode 36: Understanding Eating Disorders with Dr. Randy Staab
  • PsychEdEpisode 37: Treating Eating Disorders with Dr. Randy Staab
  • PsychEd Episode 57: HIV Psychiatry with Dr. Adriana Carvalhal and Dr. Leigh van den Heuvel

References:

• Ali, S., Ernst, C., Pacheco, M., & Fricchione, G. (2006). Consultation-liaison psychiatry: How far have we come? Current Psychiatry Reports, 8(3), 215–222. https://link.springer.com/article/10.1007/s11920-006-0026-y
• Beran, C., & Sowa, N. A. (2021). Adaptation of an Academic Inpatient Consultation-Liaison Psychiatry Service During the SARS-CoV-2 Pandemic: Effects on Clinical Practice and Trainee Supervision. Journal of the Academy of Consultation-Liaison Psychiatry, 62(2), 186–192. https://pubmed.ncbi.nlm.nih.gov/33288272
• Lipowski, Z. J. (1974). Consultation-Liaison Psychiatry: An Overview. American Journal of Psychiatry, 131(6), 623–630. https://doi.org/10.1176/ajp.131.6.623
• Lipowski, Z. J. (1992). Consultation-liaison psychiatry at century’s end. Psychosomatics, 33(2), 128–133. https://doi.org/10.1016/S0033-3182(92)71988-4
• Swenson, J. R., Abbey, S., & Stewart, D. E. (1993). Consultation-liaison psychiatry as a subspecialty. A Canadian survey. General Hospital Psychiatry, 15(6), 386–391. https://doi.org/10.1016/0163-8343(93)90007-b
• Taylor, G., & Doody, K. (1979). Psychiatric Consultations in a Canadian General Hospital. The Canadian Journal of Psychiatry, 24(8), 717–723. https://doi.org/10.1177/070674377902400803

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

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we discuss the practice of involuntary hospitalization (also referred to as involuntary commitment or certification) with two special guests and fellow podcast creators — Jesse Mangan and Dr. Jim McQuaid. Their podcast, Committable, focuses on the topic of involuntary commitment and features stories from people with lived experience as a window into complex conversations with attorneys, physicians, psychologists, and more. Jesse Mangan is the producer of Committable and someone who has experienced involuntary hospitalization. Dr. Jim McQuaid is an Associate Professor of Sociology at Framingham University.

The learning objectives for this episode are as follows:

By the end of this episode, the listener will be able to…

1. Appreciate the individual and societal functions of involuntary hospitalization

2. Understand the potential benefits and risks associated with involuntary hospitalization from the perspective of health care professionals as well as service users and the community at large

3. Describe actions you can take as a practitioner (who has the power to certify) that may better serve your community and those you care for

4. Identify meaningful ways to continue the conversation about these issues in medical education or training and beyond

*This episode was recorded in 2021. Through a saga involving lost and recovered audio files, we’re thrilled to finally be able to release it, and believe that the topic is just as timely and relevant as ever!

Guests: Jesse Mangan and Dr. Jim McQuaid

Hosts: Anita Corsini, Nikhita Singhal, Gray Meckling, and Alex Raben

Audio editing by: Nikhita Singhal

Show notes by: Nikhita Singhal

Interview content:

• Introduction - 00:34
• Committable podcast trailer - 01:52
• Guest introductions - 04:26
• Learning objectives - 07:22
• Defining terms and setting the context - 08:11
• Jesse’s experience - 12:03
• Exploring the functions of involuntary hospitalization - 23:06
• Power differentials and the importance of humility - 41:05
• Training considerations - 45:18
• False divide between patients and providers - 51:39
• Primary prevention and public health - 55:57
• Professional identity formation - 57:57
• Societal functions and processes - 01:05:00
• Building trust - 01:11:57
• Legal safeguards - 01:20:20
• Alternative approaches/systems - 01:30:11
• Rosenhan experiment - 01:37:12
• Final thoughts - 01:39:21
• End credits - 1:43:50

Resources:

• Committable podcast website: https://sensiblenonsense.squarespace.com
• PsychEd Episode 18: Assessing Suicide Risk with Dr. Juveria Zaheer
• On Being Sane in Insane Places

References:

• Jaeger S, Hüther F, Steinert T. Refusing medication therapy in involuntary inpatient treatment—a multiperspective qualitative study. Front Psychiatry. 2019 May 9;10:295. https://doi.org/10.3389%2Ffpsyt.2019.00295
• Johansson IM, Lundman B. Patients' experience of involuntary psychiatric care: good opportunities and great losses. J Psychiatr Ment Health Nurs. 2002 Dec;9(6):639-47. https://doi.org/10.1046/j.1365-2850.2002.00547.x
• McGuinness D, Murphy K, Bainbridge E, Brosnan L, Keys M, Felzmann H, Hallahan B, McDonald C, Higgins A. Individuals' experiences of involuntary admissions and preserving control: qualitative study. BJPsych Open. 2018 Nov 16;4(6):501-509. https://doi.org/10.1192%2Fbjo.2018.59
• Ontario Hospital Association. A Practical Guide to Mental Health and the Law, Fourth Edition. Toronto: Ontario Hospital Association; 2023. Available from: https://www.oha.com/Legislative%20and%20Legal%20Issues%20Documents1/A%20Practical%20Guide%20to%20Mental%20Health%20and%20the%20Law%2c%20Fourth%20Edition%2c%202023.pdf
• Paksarian D, Mojtabai R, Kotov R, Cullen B, Nugent KL, Bromet EJ. Perceived trauma during hospitalization and treatment participation among individuals with psychotic disorders. Psychiatr Serv. 2014 Feb 1;65(2):266-9. https://doi.org/10.1176%2Fappi.ps.201200556
• Rosenhan DL. On being sane in insane places. Science. 1973 Jan 19;179(4070):250-8. https://doi.org/10.1126/science.179.4070.250
• Sposini FM. Confinement and certificates: consensus, stigma and disability rights. CMAJ. 2020 Nov 30;192(48):E1642-E1643. https://doi.org/10.1503/cmaj.201750

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

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Antipsychotic Side Effects with our very own expert Dr Alex Raben, a staff psychiatrist in chronic care at the Centre for Addiction and Mental Health in Toronto.

Dr. Raben graduated from medical school and completed residency at the University of Toronto. His academic interests include teaching and medical education scholarship with a particular interest in novel modalities of knowledge translation within the field of psychiatry. He is a founding member and Executive Director of PsychEd, this educational psychiatry podcast which aims to empower medical learners to seek out current knowledge from mental health experts to share with their colleagues around the world.

The learning objectives for this episode are as follows:

By the end of this episode, the listener will be able to…

1. Outline the side effects of antipsychotics and their known/potential mechanisms
2. Discuss management options for the different side effects
3. Identify which antipsychotics are more likely to cause certain side effects

Guest: Dr Alex Raben

Hosts: Angad Singh and Kate Braithwaite

Audio editing by: Angad Singh

Show notes by: Angad Singh and Kate Braithwaite

Interview Content:

• Introduction - 0:00
• Primer on antipsychotics - 1:54
• Anti-dopamine side effects - 5:04
• Drug potency as it relates to side effects - 38:46
• Anticholinergic side effects - 41:37
• Antiadrenergic side effects - 47:30
• Metabolic side effects - 50:29
• Sedation - 56:46

Please note that this episode does not include a discussion of the life threatening side effects of antipsychotics. These include neuroleptic malignant syndrome, torsades de pointes, laryngospasm, and seizure.

Resources:

• PsychEd Episode 10: Treatment of Schizophrenia Part II with Dr. Albert Wong — PsychEd Podcast
• PsychEd Episode 60: Metabolic Psychiatry with Dr. Cindy Calkin – Psyched Podcast
• AIMSExtendedSample - YouTube
• Anticholinergic Mnemonics: Toxicology Mnemonic Challenge • LITFL • Toxicology Conundrum
  

References:

• de Silva VA, Suraweera C, Ratnatunga SS, Dayabandara M, Wanniarachchi N, Hanwella R. Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis. BMC psychiatry. 2016;16:1-0.
• Migirov A, Datta AR. Physiology, Anticholinergic Reaction. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546589/
• Miller DD. Atypical antipsychotics: sleep, sedation, and efficacy. Prim Care Companion J Clin Psychiatry. 2004;6(Suppl 2):3-7. PMID: 16001094; PMCID: PMC487011.
• Roerig JL, Steffen KJ, Mitchell JE. Atypical antipsychotic-induced weight gain: insights into mechanisms of action. CNS drugs. 2011;25:1035-59.
• Stahl SM. Stahl's essential psychopharmacology: neuroscientific basis and practical applications. Cambridge university press; 2021.
• Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018;17(3):341-56.

For more PsychEd, follow us on Instagram (@psyched.podcast), Twitter (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at [email protected]. For more information, visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers an introduction to forensic psychiatry with Dr. Amina Ali, a forensic psychiatrist at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada. Dr. Ali joined the Forensic Division at CAMH in 2018. She is an Assistant Professor in the Department of Psychiatry at the University of Toronto. Prior to joining CAMH, Dr. Ali received her Doctor of Medicine at the American University of the Caribbean, completed her Psychiatry residency at the Icahn School of Medicine at Mount Sinai in New York, and fellowship in Forensic Psychiatry at the Albert Einstein College of Medicine.

Dr. Ali's leadership experience includes serving as Chief resident during her residency, for which she was bestowed a Residency Leadership Award from the Bronx Lebanon Hospital Center. She is a Competence By Design coach to residents and serves on the Psychiatry Competency Committee and as a CaRMS file reviewer for the University of Toronto General Psychiatry Residency Program. She is also a supervisor for forensic residents and sits on the subspecialty resident committees. Within the forensic division, Dr. Ali has contributed to the organization and implementation of the Summer Studentship in Forensic Psychiatry Program and is our Medical Education and Wellness Lead. Internationally, Dr. Ali was appointed to serve on the American Academy of Psychiatry and the Law Education Committee and most recently recruited to Chair their Civil Commitment and Consent to Treatment Working Group.

The learning objectives for this episode are as follows:

By the end of this episode, the listener will be able to…

1. Describe the role of forensic psychiatry and its relation to the Ontario Review Board.

2. Outline the criteria for fitness to stand trial.

3. Describe the function and possible outcomes of a treatment order.

4. Outline the criteria for not criminally responsible on account of a mental disorder.

5. Distinguish between the disposition options available under the Ontario Review Board.

6. Demonstrate an enhanced ability to advocate for and support patients in navigating the forensic psychiatric system.

Guest: Dr. Amina Ali

Hosts: Alexander Simmons (PGY3), Kate Braithwaite (MD), and Rhys Linthorst (PGY5)

Audio editing by: Gaurav Sharma (PGY5)

Show notes by: Alexander Simmons (PGY3)

References:

1. Crocker, A. G., Nicholls, T. L., Seto, M. C., Charette, Y., Cote, G., Caulet, M. (2015). The National Trajectory Project of individuals found not criminally responsible on account of mental disorder in Canada. Part 2: the people behind the label. The Canadian Journal of Psychiatry, 60(3), 106-116.

2. Prpa, T., Moulden, H. M., Taylor, L., Chaimowitz, G. A. (2018). A review of patient-level factors related to the assessment of fitness to stand trial in Canada. International Journal of Risk and Recovery, 1(2), 16-22.

3. Carroll, A., McSherry, B., Wood, D., & Yannoulidis, LLB, S. (2008). Drug‐associated psychoses and criminal responsibility. Behavioral sciences & the law, 26(5), 633-653.

4. Watts, J. (2013). Updating toxic psychosis into 21st-century Canadian: Bouchard-Lebrun v. R. Journal of the American Academy of Psychiatry and the Law Online, 41(3), 374-381.

5. Crocker, AG, Nicholls, TL, Seto, MC, Cote, G, Charette, Y, Caulet, M. The national trajectory project of individuals found not criminally responsible on account of a mental disorder in Canada, Part 1: Context and methods. Canadian Journal of Psychiatry. 2015;60(3):98-105.

6. Schneider, RD. Mental health courts. Current Opinion in Psychiatry. 2008;21:510-513.

7. https://www.orb.on.ca/scripts/en/about.asp#dispositions

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