PsychEd: Educational Psychiatry Podcast

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers anti-black racism and mental health with Dr. Kwame McKenzie. Dr. McKenzie is an international expert on the social causes of illness, suicide and the development of effective, equitable health systems. He is a Professor of Psychiatry at University of Toronto and a staff psychiatrist and Director of Health Equity at the Centre of Addiction and Mental Health.

The learning objectives:

By the end of this episode, you should be able to…

1. Understand the history and legacy of racism and mental health in the black community
2. Understand the current state of racism towards black people and the impacts on their mental health.
3. Explore how healthcare workers can be anti-racist in providing mental health care and how the system can change to improve the mental health of black people.

Host(s): Anita Corsini (social worker), Dr. Alex Raben (staff psychiatrist), and Rebecca Marsh (CC4)

Produced by: Anita Corsini, Rebecca Marsh, Randi Wang (CC4), and Dr. Alex Raben

Guest experts: Dr. Kwame McKenzie, staff psychiatrist

Resources:

Manual for Cognitive-Behavioural Therapy for English-Speaking People of Caribbean Origin

The City of Toronto has curated a list of Mental Health Resources for Black Communities. Organizations include:

• Across Boundaries
• Black Creek Community Health Centre
• Caribbean African Canadian Social Services
• Rexdale Community Health Centre
• TAIBU Community Health Centre
• The Black Health Alliance
• Women’s Health in Women’s Hands Community Health Centre

References:

• Adelman, J. (2003). Study in Blue and Grey, Police Interventions with People with Mental Illness: A Review of Challenges and Responses [Ebook]. Canadian Mental Health Association. Retrieved 7 October 2020, from https://cmha.bc.ca/wp-content/uploads/2016/07/policereport.pdf.
• Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: current perspectives. Neuropsychiatric disease and treatment, 15, 603–609. https://doi.org/10.2147/NDT.S128584
• Bor, J., Venkataramani, A., Williams, D., & Tsai, A. (2018). Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study. The Lancet, 392(10144), 302-310. https://doi.org/10.1016/s0140-6736(18)31130-9
• Bresnahan, M., Begg, M., Brown, A., Schaefer, C., Sohler, N., & Insel, B. et al. (2007). Race and risk of schizophrenia in a US birth cohort: another example of health disparity?. International Journal Of Epidemiology, 36(4), 751-758. https://doi.org/10.1093/ije/dym041
• Chakraborty, A., McKenzie, K., & King, M. (2009). Discrimination, ethnicity and psychosis — a qualitative study. Ethnicity And Inequalities In Health And Social Care, 2(1), 18-29. https://doi.org/10.1108/17570980200900004
• Fernando, S. (2014). Racism in psychiatry. In R. Moodley & M. Ocampo (Eds.), Critical Psychiatry and Mental Health: Exploring the Work of Suman Fernando in Clinical Practice (pp. 22-32). Taylor & Francis.  
• Kirkmayer, L. J. (2014). Critical psychiatry in Canada. In R. Moodley & M. Ocampo (Eds.), Critical Psychiatry and Mental Health: Exploring the Work of Suman Fernando in Clinical Practice (pp. 170-181). Taylor & Francis.  
• Kuper, A. (2018). Cultural Safety & Equity [Lecture PDF]. Retrieved from University of Toronto Faculty of Medicine. 
• Maynard, R. (2017). Policing Black Lives: State Violence in Canada from Slavery to the Present. Fernwood.
• McKenzie, K. (2002). Does racial discrimination cause mental illness?. European Psychiatry, 17, 84. https://doi.org/10.1016/s0924-9338(02)80385-6
• McKenzie, K., & Bhui, K. (2007). Institutional racism in mental health care. BMJ, 334(7595), 649-650. https://doi.org/10.1136/bmj.39163.395972.80
• MCRRT - St. Joseph's Healthcare Hamilton. St. Joseph's Healthcare Hamilton. (2020). Retrieved 7 October 2020, from https://www.stjoes.ca/health-services/mental-health-addiction-services/mental-health-services/coast/mcrrt.
• Richardson, L. (2019). Diversity and Advocacy [Lecture PDF]. Retrieved from University of Toronto Faculty of Medicine. 

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 [email protected].  For more information visit our website: psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the topic of cultural psychiatry with expert guest Dr. Eric Jarvis, Staff Psychiatrist and Director of the Cultural Consultation Service and the First Episode Psychosis Program at the Jewish General Hospital in Montreal, Quebec and Associate Professor in the Department of Psychiatry at McGill University.

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1. Define culture
2. Describe how culture affects psychiatric care
3. Outline the goal and structure of a Cultural Formulation Interview
4. Evaluate clinical scenarios to determine whether to employ the Cultural Formulation Interview or seek a cultural consultation
5. Define the three types of cultural concepts of distress, and compare these with DSM-5 nosology
6. Discuss the concept of cultural competency 
7. Explore the role of advocacy in psychiatric practice

Guest expert: Dr. Eric Jarvis

Hosts: Dr. Sarah Hanafi (PGY3), Audrey Le (CC4)

Audio editing by Dr. Sarah Hanafi (PGY3)

Show notes by Dr. Sarah Hanafi (PGY3)

Interview Content:

• Introductions: 0:28
• Learning objectives: 3:01
• Definition of cultural psychiatry: 3:52
• Definition of culture: 6:50
• Disparities in mental health outcomes 12:48
• The Cultural Formulation Interview (CFI) 15:59
• Cultural concepts of distress 34:28
• Cultural competency 40:46
• Role of advocacy in psychiatry 48:04
• Tips for those interested and training opportunities 51:26
• Closing 61:01

Resources:

• McGill Summer Program in Social and Cultural Psychiatry
• McGill Advanced Study Institute in Cultural Psychiatry
• Society for the Study of Psychiatry and Culture
• Cultural Psychiatry Day

References:

• Cultural Formulation. (2017). In Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA: American Psychiatric Association.
• Kirmayer, L. J., Fung, K., Rousseau, C., Lo, H. T., Menzies, P., Guzder, J., . . . Mckenzie, K. (2020). Guidelines for Training in Cultural Psychiatry. The Canadian Journal of Psychiatry, 070674372090750. doi:10.1177/0706743720907505
• Kirmayer, L. J., Kronick, R., & Rousseau, C. (2018). Advocacy as Key to Structural Competency in Psychiatry. JAMA Psychiatry, 75(2), 119. doi:10.1001/jamapsychiatry.2017.3897 
• Kirmayer, L.J., Rousseau, C., Jarvis, G.E. and Guzder, J. (2008). The Cultural Context of Clinical Assessment. In Psychiatry (eds A. Tasman, J. Kay, J.A. Lieberman, M.B. First and M. Maj). doi:10.1002/9780470515167.ch4 

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), 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.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Immigrant and Refugee mental health with not one, not two but three experts in the field: Dr. Lisa Andermann, Dr. Clare Pain, and Norma Hannant.

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to:

1. Explore the social, political and legal context of refugees and immigrants presenting with mental health concerns:
2. Appreciate the specific mental health needs of refugee and immigrant populations in Canada.
3. Describe the clinical approach to providing mental health care for this population:

Produced and Hosted by: Dr. Sarah Hanafi (PGY 3), Weam Sieffien (CC3), and Shaoyuan (Randi) Wang (CC3)

Produced by: Dr. Sarah Hanafi (PGY 3), Weam Sieffien (CC3), and Shaoyuan (Randi) Wang (CC3)

Guest experts: Dr. Lisa Andermann, Dr. Clare Pain, Norma Hannant 

Resources: 

• Immigrant and Refugee Mental Health Project (courses, community of practice and toolkits)
• • Listen to Weam’s hands-on impressions of this resource in the post-credits of this episode

References 

1. Edmonston, B. (2016). Canadian immigration trends and patterns. Canadian Studies in Population, 43(1-2), 78-116. 
2. Duffin, E. (2020). Immigration in Canada - Statistics & Facts. Statista. Retrieved 2020-06-16 from https://www.statista.com/topics/2917/immigration-in-canada/
3. Statistics Canada. (2019). Classification of admission category of immigrant. Retrieved 2020-06-16 from https://www23.statcan.gc.ca/imdb/p3VD.pl?Function=getVD&TVD=323293&CVD=323294&CLV=0&MLV=4&D=1
4. Robert, A. & Gilkinson, T. (2012). Mental health and well-being of recent immigrants in Canada: Evidence from the Longitudinal Survey of Immigrants to Canada. Citizenship and Immigration Canada. Retrieved 2020-06-16 from https://novascotia.cmha.ca/wp-content/uploads/2020/01/mental-health.pdf
5. Ng, E. (2015). The healthy immigrant effect and mortality rates. Statistics Canada. Retrieved 2020-06-16 from https://www150.statcan.gc.ca/n1/pub/82-003-x/2011004/article/11588-eng.htm
6. Immigrant and Refugee Mental Health Project. (n.d.). Retrieved from https://irmhp-psmir.camhx.ca/
7. Stats Canada 2016
8. Stats Canada 2017
9. Blair AH, Schneeberg A. Changes in the ‘healthy migrant effect’ in Canada: are recent immigrants healthier than they were a decade ago?. Journal of immigrant and minority health. 2014 Feb 1;16(1):136-42
10. Vang Z, Sigouin J, Flenon A, Gagnon A. The healthy immigrant effect in Canada: A systematic review. Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail. 2015;3(1):4.
11. Close C, Kouvonen A, Bosqui T, Patel K, O’Reilly D, Donnelly M. The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews. Globalization and health. 2016 Dec;12(1):47.
12. Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K. Common mental health problems in immigrants and refugees: general approach in primary care. Cmaj. 2011 Sep 6;183(12):E959-67
13. Betancourt, J.R., Green, A.R., Carrillo, J.E., & Ananeh-Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118, 293-302.
14. Harris, M. & Fallot, R.D. (2001). Envisioning a Trauma-informed service system: A vital paradigm shift. New Directions in Mental Health Services, 89, 3-22.
15. Chen AW, Kazanjian A, Wong H. Why do Chinese Canadians not consult mental health services: health status, language or culture?. Transcultural psychiatry. 2009 Dec;46(4):623-41.
16. Durbin A, Lin E, Moineddin R, Steele LS, Glazier RH. Use of mental health care for nonpsychotic conditions by immigrants in different admission classes and by refugees in Ontario, Canada. Open Medicine. 2014;8(4):e136.
17. Hansson, E., Tuck, A., Lurie, S., and McKenzie, K. for the Task Group of the Services Systems Advisory Committee, Mental Health Commission of Canada.  (2010). Improving mental health services for immigrant, refugee, ethno-cultural and racialized groups: Issues and options for service improvement. Available: http://www.mentalhealthcommission.ca/English/document/457/improving-mental-health-services-immigrant-refugee-ethno-cultural-and-racialized-groups
18. Paniagua, F. (2014). Assessing and Treating Culturally Diverse Clients: A Practical Guide. Thousand Oaks, California: Sage

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 [email protected].  For more information visit our website: psychedpodcast.org.

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

In this episode, we begin to explore the neurobiology of the serotonin system — along with key pharmacological agents (SSRIs and classical psychedelics) that act on this system — with guest expert Dr. Robin Carhart-Harris, a neuroscientist and head of the Centre for Psychedelic Research at Imperial College London.

Our discussion is more theoretical than directly clinically relevant, striving to provide a mechanistic understanding of how serotonin functions within the brain and how serotonin-modulating drugs influence this system. The episode was inspired by a review published by our guest expert and Dr. David Nutt called “Serotonin and brain function: a tale of two receptors” (cited below). If you are interested in the topic, you might consider reading this review in full! Please note that the figures referenced during this episode can be accessed at https://journals.sagepub.com/doi/figure/10.1177/0269881117725915.

The learning objectives for this episode are as follows: 

By the end of this episode, you should be able to…

1. Understand the general anatomy and function of the serotonin system, with a focus on the purported activity of the more common serotonin receptors and transporters.
2. Describe the effects of serotonin reuptake inhibitors and how they lead to symptom improvement in mood and anxiety disorders, in addition to the mechanism of action of other serotonergic medications.
3. Consider the two-pronged serotonin system conceptualized by Dr. Carhart-Harris, and understand how serotonergic agents (including SSRIs and classic psychedelics) and the concepts of active and passive coping fit within this theory.

Guest: Dr. Robin Carhart-Harris, a neuroscientist and head of the Centre for Psychedelic Research at Imperial College London.

Produced and hosted by: Dr. Chase Thompson (PGY3), Dr. Lucy Chen (Psychiatrist), Dr. Nikhita Singhal (PGY2)

Audio editing by: Dr. Chase Thompson

Infographic by: Dr Chase Thompson, Dr Nikhita Singhal

Interview Content:

• 00:18 - Introductions
• 3:00 - Learning objectives
• 4:10 - Introduction to serotonin
• 10:30 - 5HT1A receptors
• 24:30 - 5HT2A receptors
• 30:20 - Serotonin system operation under normal conditions
• 35:00 - Introduction of bipartite model / two divergent methods for addressing depression
• 42:20 - Parallels between psychological destabilization (through therapy) and the psychedelic effect 
• 46:20 - Who should not have a psychedelic experience? Are psychedelics intrinsically psychotherapeutic or facilitative in nature?
• 50:20 - Brief discussion of the neuroimaging correlates of psychotherapeutic benefits from psychedelic experiences
• 58:40 - Discussion of why 2A agonists cause psychedelic effects but high serotonin release does not

Resources:

• Carhart-Harris RL, Nutt DJ. Serotonin and brain function: a tale of two receptors. J Psychopharmacol. 2017;31(9):1091-1120. https://doi.org/10.1177/0269881117725915
• Artigas F, Nutt DJ, Shelton R. Mechanism of action of antidepressants. Psychopharmacol Bull. 2002;36 Suppl 2:123-132.
• Antidepressants. In: Stahl SM. Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 4th ed. Cambridge University Press; 2013:284-369.
• Beliveau V, Ganz M, Feng L, et al. A High-Resolution In Vivo Atlas of the Human Brain's Serotonin System. J Neurosci. 2017;37(1):120-128. https://doi.org/10.1523/JNEUROSCI.2830-16.2016
• Carhart-Harris RL, Bolstridge M, Rucker J, et al. Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. Lancet Psychiatry. 2016;3(7):619-627. https://doi.org/10.1016/S2215-0366(16)30065-7
• Carhart-Harris RL, Leech R, Hellyer PJ, et al. The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs. Front Hum Neurosci. 2014;8:20. https://doi.org/10.3389/fnhum.2014.00020
• Carhart-Harris RL, Friston KJ. REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics. Pharmacol Rev. 2019;71(3):316-344. https://doi.org/10.1124/pr.118.017160
• Griffiths RR, Johnson MW, Carducci MA, et al. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol. 2016;30(12):1181-1197. https://doi.org/10.1177/0269881116675513
• Griffiths RR, Richards WA, McCann U, Jesse R. Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology (Berl). 2006;187(3):268-292. https://doi.org/10.1007/s00213-006-0457-5

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), 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.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers nutritional psychiatry with expert guest Dr. Laura LaChance, Staff Psychiatrist and Director of Outpatient Psychiatry at St. Mary’s Hospital Centre in Montreal, Quebec and Faculty Lecturer in the Department of Psychiatry at McGill University.

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1)      Define nutritional psychiatry

2)      Understand the mechanisms, common misconceptions, challenges, and current evidence supporting the role for nutrition in mental health

3)      Apply this understanding to clinical cases in psychiatry

Guest: Dr. Laura LaChance

Hosts: Dr. Sarah Hanafi (PGY2), Dr. Nima Nahiddi (PGY2), Gray Meckling (CC3)

Audio editing by Dr. Alex Raben (PGY5)

Show notes by Gray Meckling

Interview Content:

·       Introduction and learning objectives – 0:35

·       Dr. Laura LaChance’s professional background – 1:50

·       Definition of nutritional psychiatry and history of the field – 3:35

·       Putative mechanisms through which nutrition is implicated in mental health – 7:00

·       Common misconceptions surrounding the role for nutrition in mental health – 11:45

·       Current evidence supporting the role for nutrition in the management of psychiatric illness – 16:00

·       Case-based examples of nutrition in clinical psychiatry – 23:35

·       Challenges to capitalizing on this mode of intervention in psychiatry – 32:30

·       Taking a dietary history in the context of mental health – 34:50

·       Future directions in the field of nutritional psychiatry – 41:20

·       The gut-microbiome – 43:00

·       Tips for those interested and how to get involved – 48:00

·       Closing – 50:15

Resources:

·       International Society for Nutritional Psychiatry Research

·       The Food & Mood Centre at Deakin University

·       Future Learn Online Course – Food and Mood: Improving Mental Health Through Diet and Nutrition

·       The Brain Food Academy

·       Dr. Drew Ramsey

·       Food as Medicine Update – Conference

Articles:

·       Nutritional Psychiatry: The Gut-Brain Connection (Psychiatric Times)

·       Nutritional Psychiatry: Your Brain on Food (Harvard Health Publishing)

References:

·       Adan, R. A., van der Beek, E. M., Buitelaar, J. K., Cryan, J. F., Hebebrand, J., Higgs, S., ... & Dickson, S. L. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European Neuropsychopharmacology.

·       Auction, Monique & LaChance, Laura & Cooley, Kieran & Kidd, Sean. (2019). Diet and Psychosis: A Scoping Review. Advances in Integrative Medicine. 6. S101. 10.1016/j.aimed.2019.03.292.

·       Firth J, Veronese N, Cotter J, Shivappa N, Hebert J, Ee C, Smith L, Stubbs B, Jackson S, Sarris J. What is the role of dietary inflammation in severe mental illness? a review of observational and experimental findings. Frontiers in psychiatry. 2019;10:350.

·       Firth, J., Carney, R., Stubbs, B., Teasdale, S. B., Vancampfort, D., Ward, P. B., ... & Sarris, J. (2018). Nutritional deficiencies and clinical correlates in first-episode psychosis: a systematic review and meta-analysis. Schizophrenia bulletin, 44(6), 1275-1292.

·       Francis HM, Stevenson RJ, Chambers JR, Gupta D, Newey B, Lim CK. A brief diet intervention can reduce symptoms of depression in young adults–A randomised controlled trial. PloS one. 2019;14(10).

·       Guu TW, Mischoulon D, Sarris J, Hibbeln J, McNamara RK, Hamazaki K, Freeman MP, Maes M, Matsuoka YJ, Belmaker RH, Jacka F. International Society for Nutritional Psychiatry Research Practice Guidelines for Omega-3 Fatty Acids in the Treatment of Major Depressive Disorder. Psychotherapy and psychosomatics. 2019;88(5):263-73.

·       Jacka, F. N. (2017). Nutritional psychiatry: where to next?. EBioMedicine, 17, 24-29.

·       Jacka F, O’Neil A, Opie R, et al. A randomized controlled trial of dietary improvement for adults with major depression (the SMILES trial). BMC Med. 2017; 15:23.

·       LaChance, L. R., & Ramsey, D. (2018). Antidepressant foods: An evidence-based nutrient profiling system for depression. World journal of psychiatry, 8(3), 97–104. https://doi.org/10.5498/wjp.v8.i3.97

·       Lachance, L., & Ramsey, D. (2015). Food, mood, and brain health: Implications for the modern clinician. Missouri medicine, 112(2), 111.

·       Marx W, Moseley G, Berk M, Jacka F. Nutritional psychiatry: the present state of the evidence. Proc Nutr Soc. 2017;76: 427-436.

·       Lakhan, S. E., & Vieira, K. F. (2010). Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutrition journal, 9(1), 42.

·       Mörkl S, Butler MI, Holl A, Cyran JF, Dinan TG. Probiotics and the Microbiota-Gut-Brain Axis: Focus on Psychiatry. Current Nutrition Reports. 2020 May 13.

·       Mörkl, S., Wagner-Skacel, J., Lahousen, T., Lackner, S., Holasek, S. J., Bengesser, S. A., ... & Reininghaus, E. (2020). The role of nutrition and the gut-brain axis in psychiatry: a review of the literature. Neuropsychobiology, 79(1-2), 80-88.

·       Parletta N, Zarnowiecki D, Cho J, Wilson A, Bogomolova S, Villani A, Itsiopoulos C, Niyonsenga T, Blunden S, Meyer B, Segal L. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED). Nutritional neuroscience. 2019 Jul 3;22(7):474-87.

·       Sarris J, Logan AC, Akbaraly TN, et al. Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry. 2015;2: 271-274.

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), 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.

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

In this episode, we explore Attachment Theory, a key foundational framework in psychiatry which concerns relationships and the ways in which infants seek proximity to caregivers in development.

Our guest expert is Dr. Diane Philipp, a child and adolescent psychiatrist at the Sick kids Center for Community Mental Health in Toronto and Assistant Professor at the University of Toronto. She has developed a family therapy method called Reflective Family Play, a model of therapy which aims to improve parent-child dynamics, and more specifically attachment. She currently practices reflective family play and also teaches this method locally and internationally.

Produced and Hosted by Dr. Chase Thompson (PGY2) and Dr. Lucy Chen (PGY5)

Audio Editing by Dr. Alex Raben (PGY5)

The learning objectives for this episode are as follows: 

1.     Define attachment theory
2.     Review the history of attachment theory and how the field developed
3.     Briefly review the evolutionary basis, and functional role of attachment in infants
4.     Briefly review the neurobiological perspectives of attachment
5.     Outline and describe different types of attachment and attachment disorders
6.     Learn how infant attachment is assessed in contemporary psychiatry/psychology
7.     Learn how attachment disorders impact adult relationships and child rearing

Some sources for further reading:

Ainsworth, Mary S. “Infant-mother attachment” American psychologist 34.10 (1979): 932

Bowlby, J. "Lecture 2: The origins of attachment theory." A secure base (1988): 20-38.

Cicchetti, Dante, Fred A. Rogosch, and Sheree L. Toth. "Fostering secure attachment in infants in maltreating families through preventive interventions." Development and psychopathology 18.3 (2006): 623-649.

Cohen, Nancy J., et al. "Watch, wait, and wonder: Testing the effectiveness of a new approach to mother–infant psychotherapy." Infant Mental Health Journal: Official Publication of The World Association for Infant Mental Health 20.4 (1999): 429-451.

Collins, Nancy L. "Working models of attachment: Implications for explanation, emotion, and behavior." Journal of personality and social psychology 71.4 (1996): 810.

Feeney, Judith A., and Patricia Noller. "Attachment style as a predictor of adult romantic relationships." Journal of personality and Social Psychology 58.2 (1990): 281.

George, Carol, Nancy Kaplan, and Mary Main. "Adult attachment interview." (1996). 

Insel, Thomas R., and Larry J. Young. “The neurobiology of attachment.” Nature Reviews Neuroscience 2.2 (2001):129

Main, Mary. "Introduction to the special section on attachment and psychopathology: 2. Overview of the field of attachment." Journal of consulting and clinical psychology 64.2 (1996): 237.

Simpson, Jeffry A., et al. "Attachment and the experience and expression of emotions in romantic relationships: A developmental perspective." Journal of personality and social psychology 92.2 (2007): 355.

Sroufe, L. Alan, et al. "Implications of attachment theory for developmental psychopathology." Development and psychopathology 11.1 (1999): 1-13.

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 [email protected] For more information visit our website: psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers medical trainee wellness during the COVID-19 pandemic with expert guest Dr. Deanna Chaukos, Staff Psychiatrist at Mount Sinai Hospital in Toronto and Wellness Lead for the Psychiatry Residency program at the University of Toronto. 

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1. Define wellness and burnout and their importance in medical education/psychiatry
2. Understand strategies on how to maintain our own wellness and prevent burnout
3. Understand strategies to help others maintain their wellness and deal with burnout

*All through the lens of the COVID-19 pandemic

Hosts: Dr. Alex Raben (PGY5), Gray Meckling (CC3), Shaoyuan (Randi) Wang (CC3), Weam Sieffien (CC3)

Guest Staff Psychiatrist: Dr. Deanna Chaukos (Sinai Health Systems, Toronto)

Resources

1. COVID-19 Resources for Residents, infographic prepared by residents at the University of Toronto, including team member of PsychEd Nikhita Singhal
2. Resources for MD Wellness
3. Improving Mental Health During COVID-19
4. University of Toronto Office of Health Professions Student Affairs OHPSA
5. University of Toronto Postgraduate Wellness Office at UofT
6. Gerstein Crisis Centre
7. CAMH: COVID-19 Information for Healthcare Workers
8. CAMH self-referral for healthcare workers to access mental health services
9. UofT Faculty of Medicine: COVID-19 Wellness Resources for Faculty and Trainees
10. Canadian Psychiatric Association - COVID-19
11. American Psychiatric Association Well-being Resources
12. Seven tips for staying grounded as the world grapples with COVID-19: UofT Expert
13. AMA: 6 ways to address physician stress during COVID-19 pandemic
14. UBC - COVID-19 Resident Wellness Resources
15. Youtube video: Three steps to coping with anything (including COVID-19)
16. MHCC: Resource Hub: Mental health and wellness during the COVID-19 pandemic
17. CMHA: COVID-19 and mental health

Articles

1. CMA: Maintaining Your and Your Family’s Well-being During a Pandemic
2. BMJ Opinion: COVID-19 - the impact on our medical students will be far-reaching
3. AAMC: “A terrifying privilege”: Residency during the COVID-19 Outbreak
4. AMA: Residency in a pandemic: How COVID-19 is affecting trainees
5. CMAJ: Medical education needs reform to improve student well-being and reduce burnout, say experts

Examples of Medical Student Initiatives

• UofT News: As COVID-19 battle escalates, U of T students offer busy health-care workers help on the home front
• UofT News: Medical students collect personal protective gear for front line health-care workers, donate through U of T
• UofT News: 'We care and are here for them': U of T students help seniors cope with distancing during COVID-19
• COVID-19 Central
• Making a difference: UBC students help frontline medical workers during COVID-19
• McGill students rally their peers to provide support to frontline workers
• U of A medical students offering emergency child care to physicians and front-line health workers
• UCalgary medical and nursing students quickly answer the call for COVID-19 help
• News: Medical students providing support during COVID-19 containment effort (Schulich School of Medicine & Dentistry, Western University)
• Queen's students volunteer to help Kingston's medical professionals
• UOttawa MD students pitch in to help frontline health workers during COVID-19
• McMaster med students help their future colleagues during COVID-19

References 

1. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet.
2. Eckleberry-Hunt, J., Van Dyke, A., Lick, D., & Tucciarone, J. (2009). Changing the conversation from burnout to wellness: physician well-being in residency training programs. Journal of Graduate Medical Education, 1(2), 225-230.
3. Eckleberry-Hunt, J., Lick, D., Boura, J., Hunt, R., Balasubramaniam, M., Mulhem, E., & Fisher, C. (2009). An exploratory study of resident burnout and wellness. Academic Medicine, 84(2), 269-277.
4. Dewey, C., Hingle, S., Goelz, E., & Linzer, M. (2020). Supporting clinicians during the COVID-19 pandemic. Annals of Internal Medicine.
5. Drolet, B. C., & Rodgers, S. (2010). A comprehensive medical student wellness program—design and implementation at Vanderbilt School of Medicine. Academic Medicine, 85(1), 103-110.
6. Dyrbye, L. N., Burke, S. E., Hardeman, R. R., Herrin, J., Wittlin, N. M., Yeazel, M., ... & Satele, D. V. (2018). Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians. Jama, 320(11), 1114-1130.
7. Kealy, D., Halli, P., Ogrodniczuk, J. S., & Hadjipavlou, G. (2016). Burnout among Canadian psychiatry residents: a national survey. The Canadian Journal of Psychiatry, 61(11), 732-736.
8. Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., ... & Tan, H. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open, 3(3), e203976-e203976.
9. Lebensohn, P., Dodds, S., Benn, R., Brooks, A. J., & Birch, M. (2013). Resident wellness behaviors. Fam. Med, 45, 541-549.
10. Santarone

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Autism Spectrum Disorder (ASD) with not one, not two but THREE experts in the field: Dr. Melanie Penner (Developmental Pediatrician at Holland-Bloorview), Dr. Mitesh Patel (Forensic and Child Psychiatrist at CAMH) and Dr. Yona Lunsky (Psychologist at CAMH)

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1. Have an understanding of the neurobiology and epidemiology of autism
2. Tailor their diagnostic interview for autism in a way that improves accuracy and is empathic
3. Have familiarity with the impact of autism on people and their families and the interdisciplinary and biopsychosocial approaches involved in caring for people with autism

Host(s): Dr. Alex Raben (PGY5), Dr. Sabrina Agnihotri (PGY1) 

Produced by: Dr. Alex Raben (PGY5), Dr. Sabrina Agnihotri (PGY1), Weam Sieffien (CC3) and Dr. Gurnaam Kasbia

Guest experts: Dr. Melanie Penner, Dr. Mitesh Patel and Dr. Yona Lunsky

Episode infographic by Weam Sieffien (CC3) and Dr. Nikhita Singhal (PGY1)

Resources:

• https://cpa.ca/docs/File/Psynopsis/2020-Vol42-1/index.html
• https://autismcanada.org/#home-row-1
• Clinical guide for front line staff to support the management of patients with a learning disability, autism or both during the coronavirus pandemic
• Magnetoencephalographic (MEG) Brain Activity During a Mental Flexibility Task Suggests Some Shared Neurobiology in Children With Neurodevelopmental Disorders
• Books:
• • Look Me in the Eye: My Life with Asperger's
  • Neurotribes
  •  

References 

• American Academy of Pediatrics. Management of Children With Autism Spectrum Disorder. Pediatrics. 2007 Nov;120(5):1183-1215.
• Bartlo P, Klein PJ. Physical activity benefits and needs in adults with intellectual disabilities: systematic review of the literature. Am J Intellect Dev Disabil. 2011 May. 116(3):220-32.
• Bazzano AT, Zeldin AS, Diab IR, Garro NM, Allevato NA, Lehrer D. The Healthy Lifestyle Change Program: a pilot of a community-based health promotion intervention for adults with developmental disabilities. Am J Prev Med. 2009 Dec. 37(6 Suppl 1):S201-8.
• Lyall, K., Croen, L., Daniels, J., Fallin, M. D., Ladd-Acosta, C., Lee, B. K., ... & Windham, G. C.  (2017). The changing epidemiology of autism spectrum disorders. Annual review of public health, 38, 81-102.
• Maulik, P. K., Mascarenhas, M. N., Mathers, C. D., Dua, T., & Saxena, S. (2011). Prevalence of intellectual disability: a meta-analysis of population-based studies. Research in developmental disabilities, 32(2), 419-436.
• McPheeters ML, Warren Z, Sathe N, Bruzek JL, Krishnaswami S, Jerome RN, et al. A systematic review of medical treatments for children with autism spectrum disorders. Pediatrics. 2011 May. 127(5):e1312-21.
• Rubin IL, Crocker AC. Medical care for children and adults with developmental disabilities. Second edition. Baltimore, MD: Paul H Brookes Publishing Co, Inc; 2006.
• Rueda JR, Ballesteros J, Tejada MI. Systematic review of pharmacological treatments in fragile X syndrome. BMC Neurol. 2009 Oct 13. 9:53.
• Taylor, L. E., Swerdfeger, A. L., & Eslick, G. D. (2014). Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Vaccine, 32(29), 3623-3629.
• Taylor, L. E., Swerdfeger, A. L., & Eslick, G. D. (2014). Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Vaccine, 32(29), 3623-3629.
• Thapar, A., Cooper, M., & Rutter, M. (2017). Neurodevelopmental disorders. The Lancet Psychiatry, 4(4), 339-346

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 [email protected].  For more information visit our website: psychedpodcast.org.

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

This episode is an introduction to the subspeciality of psychosocial oncology, focusing on 10 key content areas that you want to supplement your general psychiatric interview with. Along the way, we discuss the history of the field, contemporary controversies and useful interviewing techniques that can help with history collection, therapeutic alliance, and formulation. 

Learning objectives:

1. Gain familiarity with unique content areas to include in the assessment of patients with cancer
2. Learn interview techniques to facilitate accurate and efficient history taking in this patient population 
3. Increase knowledge around the concept of cancer-related distress and how it informs patient formulation, intervention, and DSM-5 Diagnosis

Host: Dr. Jordan Bawks, PGY4 in Psychiatry at the University of Toronto

Guest: Dr. Elie Isenberg-Grzeda, Psychiatrist at Sunnybrook Health Sciences Centre and Assistant Professor at the University of Toronto

Timestamps for Content: 

4-11minutes - History of Psycho-Oncology

11- 14minutes –Distress Screening

14- 16minutes – Overview of specific content areas in psychosocial oncology assessments

15:50 – Cancer history

20:10- Beliefs about illness

24:00- Physical symptoms

26:00- Body Image

33:55- Coping

38:30- Family Supports &

41:00- Counseling on Cancer Disclosure to Family Members

49:30- Work Disruption

52:00- Religion & Spirituality

57:30- Death, Dying, Prognosis

1:04:45- Diagnostic dilemmas

1:10:30- Closing thoughts 

 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 [email protected]. For more information visit our website: psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Motivational Interviewing (MI) with Dr. Wiplove Lamba (staff psychiatrist), Dr. Anees Bahji (PGY5 resident), and Dr. Marlon Danilewitz (PGY5 resident) who we caught up with after their workshop on MI at the CPA annual conference in Quebec City. In addition to learning the basics about MI, Alex also volunteered to do a real-play with Dr. Lamba to demonstrate some MI techniques (and all in one take!).

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1. Define MI and its utility
2. Appreciate some of the techniques that are used in MI to increase motivation
3. Start to use some of these techniques with your patients

Guest staff psychiatrist: Dr. Wiplove Lamba

Episode infographic by Nikhita Singhal

Resources:

• MITI scale (available through google search)

• Rollnick, S., Butler, C. C., Kinnersley, P., Gregory, J., & Mash, B. (2010). Motivational interviewing. Bmj, 340, c1900.

• BMJ Learning: Motivational Interviewing Module

• Youtube video of Carl Rogers interviewing Gloria 

• Motivational Interviewing: Helping People Change by Miller and Rollnick (textbook) 

• MINT (Motivational Interviewing Network of Trainers)

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 [email protected].  For more information visit our website: psychedpodcast.org.