Dr. John C. Markowitz, Professor of Clinical Psychiatry at Columbia University, introduces us to supportive psychotherapy. We discuss the principles that underpin supportive psychotherapy and "common factors" in psychotherapy. Dr. Markowitz helps us to understand where supportive psychotherapy fits into modern psychiatric practice, and provides clinical wisdom about building a therapeutic alliance and pursuing affect.

What is Supportive Psychotherapy? (Markowitz 2014)

Brief Supportive Psychotherapy (2022)

Psychiatrist Effects in the Psychopharmacological Treatment of Depression (McKay 2006)

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Dr. Allen Frances, Chair of the DSM-IV Task Force and Chair Emeritus at Duke University returns to kick off Season 3. We discuss the unique role of consultation-liaison psychiatry in today's healthcare system, and Dr. Frances provides us with a framework for understanding and helping each individual patient during a medical hospitalization. Dr. Frances provides wisdom and encouragement to set the stage for our journey into the world of consultation-liaison psychiatry.

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Dr. Sameer Jauhar, Senior Clinical Lecturer in Affective Disorders and Psychosis at the Institute of Psychiatry, Psychology and Neuroscience, King's College, London, and as a Consultant Psychiatrist at Maudsley NHS Foundation Trust, introduces us to schizophrenia. Explore core clinical features of schizophrenia and what is known about the neuroscience of schizophrenia. We'll also discuss psychopharmacological and psychosocial treatment approaches, rooted in Dr. Jauhar's humanistic approach.

This episode is intended to supplement Dr. Jauhar's Lancet Seminar on Schizophrenia (2022).

Connect with Dr. Jauhar: @SameerJauhar

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Dr. Laura Watkins, Clinical Psychologist and Assistant Professor of Psychiatry at Emory University School of Medicine, introduces us to post-traumatic stress disorder (PTSD).

We walk though the diagnostic criteria and discuss how these symptoms can impact a person's day-to-day life. We then learn to conceptualize PTSD in terms of both classical and operant conditioning. Finally, we explain evidence based psychotherapies for PTSD and conclude with a primer on psychopharmacology for PTSD.

Essential references:

1) Osser Psychopharmacology Algorithm for PTSD

2) Clinical Guidelines for PTSD (United States Department of Veteran's Affairs and Department of Defense)

3) This American Life: Ten Sessions

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Dr. John Walkup, Chair of the Pritzker Department of Psychiatry and Behavioral Health at Ann and Robert H. Lurie Children’s Hospital of Chicago, Professor of Psychiatry at Northwestern Feinberg School of Medicine, and president-elect of the American Academy of Child and Adolescent Psychiatry, introduces us to anxiety disorders.

We discuss the phenomenon of normal, adaptive anxiety and contrast this with symptomatology that may warrant a diagnosis of an anxiety disorder. We learn to appreciate anxiety disorders from a developmental lens, discuss clinical pearls for building a therapeutic alliance with anxious patients, and explore psychotherapies for anxiety disorders. We also discuss psychopharmacological considerations for both SSRIs and benzodiazapines.

Dr. Roger McIntyre, Professor of Psychiatry and Pharmacology at the University of Toronto and Head of the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto, Canada, returns to introduce depressive disorders.

We differentiate normal "low mood" from conditions that warrant a psychiatric diagnosis. We discuss historical subtypes of depression and the current DSM specifiers for major depressive disorder. We review epidemiology, discuss the neurophysiology of depressive disorders, and then dive into treatment options.

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Dr. Lois Choi-Kain, Director of the Gunderson Personality Disorders Institute at McLean Hospital and Associate Professor of Psychiatry at Harvard Medical School, introduces us to borderline personality disorder (BPD).

We discuss the prevalence, naturalistic course, and treatments for BPD. We explore BPD using the “Good Psychiatric Management” (GPM) model, which is intended to empower clinicians of all disciplines to manage patients with BPD effectively. We discuss the principles of GPM and walk through some examples of how it might be used in the clinical setting. 

Book: Applications of Good Psychiatric Management for Borderline Personality Disorder: A Practical Guide (Check your academic library!) 

References: 

1. (11:30) Grant BF, Chou SP, Goldstein RB, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2008;69(4):533-545. 
2. (12:30) Trull TJ, Jahng S, Tomko RL, Wood PK, Sher KJ. Revised NESARC personality disorder diagnoses: gender, prevalence, and comorbidity with substance dependence disorders. J Pers Disord. 2010;24(4):412-426. 
3. (15:00) Gregory R, Sperry SD, Williamson D, Kuch-Cecconi R, Spink GL Jr. High Prevalence of Borderline Personality Disorder Among Psychiatric Inpatients Admitted for Suicidality. J Pers Disord. 2021;35(5):776-787. 
4. (20:45) Kernberg O. Borderline personality organization. J Am Psychoanal Assoc. 1967;15(3):641-685. 
5. (29:30) Choi-Kain LW, Finch EF, Masland SR, Jenkins JA, Unruh BT. What Works in the Treatment of Borderline Personality Disorder. Curr Behav Neurosci Rep. 2017;4(1):21-30. 
6. (33:00) Skodol AE, Gunderson JG, Shea MT, et al. The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications. J Pers Disord. 2005;19(5):487-504.
7. (33:00) Temes CM, Zanarini MC. The Longitudinal Course of Borderline Personality Disorder. Psychiatr Clin North Am. 2018;41(4):685-694. 

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Dr. Roger McIntyre,  Professor of Psychiatry and Pharmacology at the University of Toronto and Head of the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto, Canada, introduces us to bipolar disorders.

We discuss the key clinical features of bipolar disorders, the relationship between bipolar disorders and circadian rhythm, known pathogenesis, and some first line treatment options. We also contextualize the difference between "type I" and "type II" bipolar disorder, and explore the relationship between bipolar disorder and traumatic life experiences.

For more: Bipolar Disorders (Lancet Seminar

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Dr. Steve Delisi, Chief Medical Officer at YourPath Inc., Associate Director at UC-Irvine School of Medicine's "Train New Trainers" Primary Care - Training and Education in Addiction Medicine Fellowship, Adjunct Professor at Hazelden Betty Ford Graduate School of Addiction Studies, walks through the fundamentals of substance use disorder. We discuss the neurobiology of substance use disorder and explore the clinical use of "translational neuroscience." You'll also learn about the relationship between trauma and substance use, hear best practices for building a therapeutic alliance with this patient population, and catch a glimpse into future research on substance use disorders.

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