PsychEd: educational psychiatry podcast

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode introduces the field of metabolic psychiatry, with a focus on patients with severe mental illness and metabolic syndrome. Our guest is Dr. Cindy Calkin, an Associate Professor in the Department of Psychiatry and Department of Neuroscience at Dalhousie University in Nova Scotia. Dr. Calkin has been a pioneer in the field of metabolic and neuroendocrine disorders in patients with bipolar disorder. Her research interests include examining the effects of obesity, insulin resistance and type II diabetes on the clinical course and outcomes in bipolar disorder. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Describe the burden of metabolic syndrome in the population with severe mental illnesses Explain reasons for the comorbidity between metabolic syndrome and severe mental illness Identify biopsychosocial strategies to prevent or treat metabolic conditions in this population Guest: Dr. Cindy Calkin Hosts: Angad Singh, Gaurav Sharma, and Sara Abrahamson Audio editing by: Gaurav Sharma Show notes by: Sara Abrahamson & Gaurav Sharma Conflicts of interest: Neither our guest nor hosts for this episode have declared any conflicts of interest related to this topic. Interview content: 0:00 - Introduction 00:54 - Learning objectives 01:37 - Dr. Calkin’s career trajectory 9:45 - Describing the burden of metabolic syndrome in severe mental illness 14:16 - What is the relationship between metabolic syndrome and severe mental illness 25:23 - Why is metabolic syndrome underdiagnosed in severe mental illness 27:56 - How to measure and monitor insulin resistance in clinical practice 32:44 - How stigma impacts treatment of metabolic syndrome in the mentally ill 34:02 - Lifestyle interventions for metabolic syndrome in the mentally ill 37:06 - Medication interventions for metabolic syndrome in the mentally ill 39:44 - Directions for future research in the metabolic psychiatry 41:48 - Episode summary References: Bai, Y.-M., Li, C.-T., Tsai, S.-J., Tu, P.-C., Chen, M.-H., & Su, T.-P. (2016). Metabolic syndrome and adverse clinical outcomes in patients with bipolar disorder. BMC Psychiatry, 16(1), 448–448. https://doi.org/10.1186/s12888-016-1143-8 Calkin, C., Kamintsky, L., & Friedman, A. (2022). Reversal of insulin resistance is associated with repair of blood-brain barrier dysfunction and remission in a patient with treatment-resistant bipolar depression. Bipolar Disorders, 24(5), 553-555. https://doi.org/10.1111/bdi.13199 Calkin, C. V., Ruzickova, M., Uher, R., Hajek, T., Slaney, C. M., Garnham, J. S., ... & Alda, M. (2015). Insulin resistance and outcome in bipolar disorder. The British Journal of Psychiatry, 206(1), 52-57. https://doi.org/10.1192/bjp.bp.114.152850 Giménez-Palomo, A., Gomes-da-Costa, S., Dodd, S., Pachiarotti, I., Verdolini, N., Vieta, E., & Berk, M. (2022). Does metabolic syndrome or its component factors alter the course of bipolar disorder? A systematic review. Neuroscience and Biobehavioral Reviews, 132, 142–153. https://doi.org/10.1016/j.neubiorev.2021.11.026 Ho, C. S., Zhang, M. W., Mak, A., & Ho, R. C. (2014). Metabolic syndrome in psychiatry: advances in understanding and management. Advances in psychiatric treatment, 20(2), 101-112. https://doi.org/10.1192/apt.bp.113.011619 Leboyer, M., Godin, O., Llorca, P. M., Aubin, V., Bellivier, F., Belzeaux, R., Courtet, P., Costagliola, D., Dubertret, C., M’Bailara, K., Haffen, E., Henry, C., Laouamri, H., Passerieux, C., Pelletier, A., Polosan, M., Roux, P., Schwan, R., Samalin, L., … Etain, B. (2022). Key findings on bipolar disorders from the longitudinal FondaMental Advanced Center of Expertise-Bipolar Disorder (FACE-BD) cohort. Journal of Affective Disorders, 307, 149–156. https://doi.org/10.1016/j.jad.2022.03.053 Stogios, N., Humber, B., Agarwal, S. M., & Hahn, M. (2023)....

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the field of critical psychiatry with Dr. Elia Abi-Jaoude and Lucy Costa. Dr. Abi-Jaoude is a staff psychiatrist at The Hospital for Sick Children and Assistant Professor and Clinician Investigator in the Department of Psychiatry at the University of Toronto in Toronto, Canada. Lucy Costa is Deputy Executive Director of the Empowerment Council, a voice for clients of mental health and addiction services primarily at the Centre for Addiction and Mental Health in Toronto. While this topic could be very philosophical and expansive, we are going to focus our discussion by considering the practical implications of this field on psychiatric practice. What do you need to know about critical psychiatry as a trainee, and how might it impact your clinical practice? The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Define the term critical psychiatry and describe how the field has evolved over time Review core principles of critical psychiatry and apply them to a clinical situation Understand the potential benefits and harms of critical psychiatry and where the field is headed Guests: Dr. Eila Abi-Jaoude and Lucy Costa Hosts: Dr. Gaurav Sharma (PGY5), Dr. Nikhita Singhal (PGY5), Dr. Monisha Basu (PGY2), and Saja Jaberi (IMG) Audio editing by: Gaurav Sharma Show notes by: Gaurav Sharma and Nikhita Singhal Conflicts of interest: Neither of our guests nor hosts have declared any conflicts of interest related to this topic. Interview content: Introduction - 00:13 Learning objectives - 02:35 Defining critical psychiatry - 03:33 How our experts got involved in critical psychiatry and incorporate it into their work - 04:50 What are some of the questions critical psychiatry tries to answer? - 15:07 Why care about critical psychiatry and “holding truths lightly”? - 23:55 Principles of critical psychiatry - 24:55 Applying critical psychiatry principles to a case - 32:40 Potential benefits and harms of a critical psychiatry approach - 41:49 Future directions for critical psychiatry - 58:29 Review of learning objectives and summary - 1:01:30 End credits - 1:03:17 Resources: Critical Psychiatry Textbook Restoring Study 329 Psych Debate 14 | Critical Psychiatry and Diagnosis References: Barkil-Oteo A. Collaborative care for depression in primary care: how psychiatry could "troubleshoot" current treatments and practices. Yale J Biol Med. 2013 Jun 13;86(2):139-46. Craddock N, Mynors-Wallis L. Psychiatric diagnosis: impersonal, imperfect and important. The British Journal of Psychiatry. 2014;204(2):93-95. doi:10.1192/bjp.bp.113.133090 Kirsch I. The emperor's new drugs: medication and placebo in the treatment of depression. Handb Exp Pharmacol. 2014;225:291-303. doi:10.1007/978-3-662-44519-8_16 Middleton H, Moncrieff J. Critical psychiatry: a brief overview. BJPsych Advances. 2019;25(1):47-54. doi:10.1192/bja.2018.38 O'Donoghue T, Crossley J. A critical narrative analysis of psychiatrists' engagement with psychosis as a contentious area. Int J Soc Psychiatry. 2020 Nov;66(7):724-730. doi: 10.1177/0020764020934516 Samara MT, Dold M, Gianatsi M, et al. Efficacy, Acceptability, and Tolerability of Antipsychotics in Treatment-Resistant Schizophrenia: A Network Meta-analysis. JAMA Psychiatry. 2016;73(3):199–210. doi:10.1001/jamapsychiatry.2015.2955 Important figures in the history of anti-psychiatry and critical psychiatry (discussion edited from episode for length): Anti-Psychiatrists: R. D. Laing (UK) Thomas Szasz (USA) Michel Foucault (France) Critical Psychiatrists: Joanna Moncrieff (UK) Suman Fernando (UK) Sami Tamini (UK) Pat Bracken (UK) Derek Summerfield (UK) Sandra Steinguard (USA) Critical Psychiatry Network (International Email List) For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers depression in children and adolescents with Dr. Darren Courtney, a scientist with the Cundill Centre for Child and Youth Depression and the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and a staff psychiatrist in the Youth Addictions and Concurrent Disorders Service at the Centre for Addiction and Mental Health (CAMH) in Toronto. He is also an associate professor in the Department of Psychiatry at the University of Toronto. Dr. Courtney earned his MD in 2004 at Queen’s University and completed psychiatry residency in 2009 at the University of Ottawa. He was the clinical director of the Youth Inpatient Unit at the Royal Ottawa Mental Health Centre from 2009 to 2014 and moved to Toronto in 2014, where he worked on the Concurrent Youth Inpatient Unit at the Centre for Addiction and Mental Health until 2017 and where his clinical work with concurrent disorders continues now with outpatient youth. Dr. Courtney's research focus is on the treatment of adolescent depression through the use of an integrated care pathway — a collaboratively developed treatment algorithm based on high-quality clinical practice guidelines. Through his research, he works on identifying quality practice guidelines and corresponding multi-disciplinary care pathways to facilitate evidence-based and measurement-based care for adolescents with depression. He has also participated in a systematic review and quality appraisal of clinical practice guidelines for psychiatric disorders in children and adolescents. Additionally, he has an interest in the management of concurrent disorders, where young people are affected by both primary psychiatric disorders and substance use disorders. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Outline the prevalence and risk factors for depression in children and adolescents Explain how children and adolescents with depression present in clinical practice Discuss the use of screening tools for depression in this population Describe an approach to the management of depression in children and adolescents Outline the management of an adolescent with suicidal thoughts or behaviours Guest: Dr. Darren Courtney Hosts: Kate Braithwaite (MD) and Nikhita Singhal (PGY5) Audio editing by: Nikhita Singhal Show notes by: Kate Braithwaite and Nikhita Singhal Interview Content: Introduction - 0:00 Learning objectives - 02:11 Prevalence of depression in youth - 03:11 Risk factors for depression in youth - 06:25 Diagnosing depression in youth - 08:30 Screening tools - 14:24 Approach to taking a history from youth - 19:45 Management of depression in youth - 30:12 Psychotherapies - 33:20 Medications - 37:37 Assessing and managing suicidality in youth - 44:00 Measurement based care - 51:00 Final thoughts - 55:10 Resources: Previous PsychEd episodes: PsychEd Episode 1: Diagnosis of Depression with Dr. Ilana Shawn PsychEd Episode 2: Treatment of Depression with Dr. Sidney Kennedy PsychEd Episode 18: Assessing Suicide Risk with Dr. Juveria Zaheer ICHOM Set of Patient-Centered Outcome Measures for Children & Young People with Depression & Anxiety Screening tools/rating scales: Revised Children's Anxiety and Depression Scale (RCADS) Mood and Feelings Questionnaire (MFQ) NICE guideline: Depression in children and young people: identification and management NICE guideline: Self-harm: assessment, management and preventing recurrence The CARIBOU Pathway by CAMH: A youth-centered program for the treatment of depression Includes links to download free clinician-specific and youth-specific resources co-developed with youth and mental health clinicians Clinical Innovations and Tools | Cundill Centre for Child and Youth Depression | CAMH Includes links to various tools for health care providers, researchers,...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers HIV/AIDS psychiatry with special guests from two international settings to provide complementary perspectives on HIV psychiatry. Dr. Adriana Carvalhal, HIV Psychiatrist and Staff Psychiatrist at Scarborough Health Network in Canada and Dr. Leigh Van Den Heuvel, Psychiatrist and Associate Professor in the Department of Psychiatry, at Stellenbosch University in South Africa. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Understand the unique mental health needs of people living with HIV and the bidirectional relationship between HIV and mental health Identify HIV-specific mental health disorders and how to screen for these conditions Outline the overall approach to treatment for HIV patients with mental health disorders Guests: Dr. Adriana Carvalhal and Dr Leigh Van Den Heuvel Produced by: Saja Jaberi (MD), Kate Braithwaite (MD) and Gaurav Sharma (PGY5) Hosts: Kate Braithwaite (MD) and Gaurav Sharma (PGY5) Audio editing by: Gaurav Sharma (PGY5) Show notes by: Saja Jaberi (MD) and Gaurav Sharma (PGY5) Conflicts of Interest: Neither of our guests nor hosts have declared any conflicts of interest related to this topic. Generic names are used for all medications referenced. Contents: Introduction - 0:19 Learning objectives - 3:52 The bidirectional relationship between HIV and psychiatric illness - 4:24 Prevalence of psychiatric illness in HIV - 9:56 Screening for psychiatric illness in HIV populations - 12:11 HIV Associated Neurocognitive Disorder (HAND) - 19:27 Diagnostic Criteria - 20:19 Clinical Presentation & Etiology - 23:03 Risk Factors - 26:56 Screening Tools - 32:06 Treatment - 36:59 HIV Psychiatry case example - 39:48 Navigating the differential diagnosis - 41:44 Initial management & addressing comorbidities - 44:30 Drug-drug interactions between antiretroviral and psychiatric medications - 48:04 Review of learning objectives & final thoughts - 52:04 Outro - 55:55 Resources: Clinical Care Guidelines for Adults and Adolescents Living with HIV in Ontario, Canada (occguidelines.com) Estimates of HIV incidence, prevalence and Canada’s progress on meeting the 90-90-90 HIV targets, 2020 - Canada.ca HIV and Clinical Depression https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/HIV-Psychiatry/FactSheet-Anxiety-2012.pdf https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/HIV-Psychiatry/FactSheet-CognitiveDisorder-2012.pdf International HIV Dementia Scale (IHDS) - Mental Health Screening - National HIV Curriculum (uw.edu)/ Liverpool HIV Interactions (hiv-druginteractions.org) References: Angelovich TA, Churchill MJ, Wright EJ, Brew BJ. New Potential Axes of HIV Neuropathogenesis with Relevance to Biomarkers and Treatment. Curr Top Behav Neurosci. 2021;50:3-39. doi: 10.1007/7854_2019_126. PMID: 32040843. Angelovich TA, Churchill MJ, Wright EJ, Brew BJ. New Potential Axes of HIV Neuropathogenesis with Relevance to Biomarkers and Treatment. Curr Top Behav Neurosci. 2021;50:3-39. doi: 10.1007/7854_2019_126. PMID: 32040843. Awori V, Mativo P, Yonga G, Shah R. The association between asymptomatic and mild neurocognitive impairment and adherence to antiretroviral therapy among people living with human immunodeficiency virus. South Afr J HIV Med. 2018 Apr 12;19(1):674. doi: 10.4102/sajhivmed.v19i1.674. PMID: 29707383; PMCID: PMC5913780. Bloch M, Kamminga J, Jayewardene A, Bailey M, Carberry A, Vincent T, Quan D, Maruff P, Brew B, Cysique LA. A Screening Strategy for HIV-Associated Neurocognitive Disorders That Accurately Identifies Patients Requiring Neurological Review. Clin Infect Dis. 2016 Sep 1;63(5):687-693. doi: 10.1093/cid/ciw399. Epub 2016 Jun 19. PMID: 27325690; PMCID: PMC4981762. Clinical Care Guidelines for Adults and Adolescents living with HIV in...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers trauma and addictions with Dr. Gabor Maté, a retired physician who, after 20 years of family practice and palliative care experience, worked for over a decade in Vancouver’s Downtown East Side with patients challenged by drug addiction and mental illness. The bestselling author of five books published in thirty languages, including the award-winning In the Realm of Hungry Ghosts: Close Encounters with Addiction, Dr. Maté is an internationally renowned speaker highly sought after for his expertise on addiction, trauma, childhood development, and the relationship of stress and illness. For his groundbreaking medical work and writing he has been awarded the Order of Canada, his country’s highest civilian distinction, and the Civic Merit Award from his hometown, Vancouver. His fifth book, The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture was released on September 13, 2022. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Understand the connection between trauma and the development of addictions and other mental illnesses Critically reflect on current diagnostic and treatment paradigms Apply principles of trauma-informed care to psychiatric assessment and the provision of mental health services Guest: Dr Gabor Maté Hosts: Sena Gok, Rhys Linthorst, Angad Singh, Nikhita Singhal, and Alex Raben Audio editing by: Sena Gok Show notes by: Nikhita Singhal Interview Content: Introduction - 0:00 Learning objectives - 01:43 Defining trauma - 02:14 Current dominant views of addiction - 07:27 Defining addiction - 11:05 Relationship between trauma and addiction - 16:15 Neurobiology of addiction - 17:20 Brain development - 25:48 Genetic susceptibility - 36:10 Trauma-informed approach to treatment - 39:45 Importance of therapeutic relationships - 44:10 Societal barriers - 48:15 Harm reduction - 54:32 Closing comments - 01:00:14 Resources: Books: In the Realm of Hungry Ghosts (Gabor Maté) The Myth of Normal (Gabor Maté) The Body Keeps The Score (Bessel van der Kolk) The Archaeology of Mind: Neuroevolutionary Origins of Human Emotions (Jaak Pansepp, Lucy Biven) Dr Gabor Maté’s website: https://www.drgabormate.com Adverse Childhood Experiences (ACEs) study: https://doi.org/10.1016/s0749-3797(98)00017-8 More information on ACEs from Harvard University’s Center on the Developing Child: What Are ACEs? And How Do They Relate to Toxic Stress? Compassionate Inquiry (psychotherapeutic approach developed by Dr Gabor Maté) References: Brown, T., Berman, S., McDaniel, K., Radford, C., Mehta, P., Potter, J., & Hirsh, D. A. (2021). Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context. Academic medicine: journal of the Association of American Medical Colleges, 96(5), 661–667. https://doi.org/10.1097/ACM.0000000000003587 Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/ Colon-Rivera Hector, A., Aoun, E. & Vaezazizi, L. M. (2023). Addiction Psychiatric Medicine: A Comprehensive Board Review. Elsevier. Dugosh, K.L. & Cacciola J. (2022). Clinical assessment of substance use disorders. In J. A. Melin (Ed.), UpToDate. Retrieved from https://www.uptodate.com/contents/clinical-assessment-of-substance-use-disorders Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Medical Assistance in Dying (MAiD) and mental illness as a sequel to our previous episode on MAiD with our guest experts, Dr. Sonu Gaind and Dr. Jeffrey Kirby. This episode was originated by Dr. Urvashi Prasad for her Grand Rounds. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Gain an understanding of the current state of Medical Assistance in Dying for primarily mental illness in Canada Evaluate the arguments in support of and against implementation of Medical Assistance in Dying for primarily Mental Illness Understand next steps and future directions of Medical Assistance in Dying for primarily mental illness in Canada Discuss the possible impact that Medical Assistance in Dying might have on the profession of psychiatry Guest Experts: Dr. Sonu Gaind who is a Professor in the Faculty of Medicine at the University of Toronto (U of T) and Chief of Psychiatry at Sunnybrook Health Sciences Centre, and clinically works as a psycho-oncology consultant. As Medical Assistance in Dying (MAiD) policies have been evolving in Canada, Dr. Gaind has testified in front of numerous expert, parliamentary and senate committees on issues relevant to mental health and mental illness that need to be considered in the MAiD framework. Dr. Gaind chaired the time-limited Canadian Psychiatric Association Task Force on Assisted Dying, was selected to sit on the Council of Canadian Academies Expert Panel on Mental Disorders and Assisted Dying, was retained by the former Attorney General of Canada as an expert in the Truchon and Lamb cases, and chaired his former hospitals MAiD team. He has spoken across the country and internationally on the subject. Dr. Jeffrey Kirby is a (retired) Professor in the Department of Bioethics, Faculty of Medicine, Dalhousie University. He has an educational background and professional experience in medicine, philosophy and health care ethics. Dr. Kirby has published a set of academic papers in high-impact, international, bioethics journals on a variety of MAID-related topics including: assisted dying for suffering arising from mental health conditions, morally-relevant distinctions between paradigm and non-paradigm MAID circumstances, meso- and macro-level (MAID-related) health policy development, and organ donation after MAID and institutional conscientious objection to MAID. He made several, virtual and written, Bill C-7 related submissions to the Senate Committee on Legal and Constitutional Affairs regarding matters/issues of relevance to the potential consideration of mental health disorders as sole-qualifying conditions for MAID in Canada. He is a former member of the Expert Panel on MAiD and Mental Illness. Grand Rounds Presenter: Dr. Urvashi Prasad (PGY4) Produced by: Dr. Urvashi Prasad (PGY4) and Dr. Alex Raben (staff psychiatrist) Hosts: Dr. Urvashi Prasad (PGY4) and Dr. Alex Raben (Staff Psychiatrist) Peer Reviewer: David Eapen-John (MS4) Audio editing by: Dr. Urvashi Prasad (PGY4) Show notes by: Dr. Urvashi Prasad (PGY4) Resources: Canada, Health. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 27 Mar. 2023, https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html. References: Government of Ontario, Ministry of Health and Long-Term Care. “Medical Assistance in Dying.” Health Care Professionals - MOH, Government of Ontario, Ministry of Health and Long-Term Care, 13 May 2021, https://www.health.gov.on.ca/en/pro/programs/maid/. Tabitha Marshall. “Assisted Suicide in Canada.” The Canadian Encyclopedia, 3 Dec. 2021, https://www.thecanadianencyclopedia.ca/en/article/assisted-suicide-in-canada. Canada, Health. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 27 Mar. 2023, https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html. Canada, Health....

Welcome to PsychEd - the psychiatry podcast for medical learners, by medical learners. This episode covers the relationship between cannabis and psychotic disorders, as well as the potential impact of cannabis legalization in Canada, with our special guest Dr. Nitin Chopra. This episode was originated by Dr. Luke Fraccaro for his Grand Rounds. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Briefly summarize the effects of cannabis on mental health and cognition, with a focus on psychosis. Appreciate the evidence for cannabis use as a potential cause of persistent psychotic disorders. Discuss the possible impact that recent cannabis legislation may have had on cannabis use and psychosis in Canada. Guest Expert Dr. Nitin Chopra is an addictions psychiatrist at the Centre for Addiction and Mental Health (CAMH) and is an Assistant Professor in the Department of Psychiatry at the University of Toronto. He has an interest in concurrent disorders and is a staff psychiatrist on the Concurrent Addictions Inpatient Treatment Service and Concurrent Outpatient Medical and Psychosocial Addiction Support Service. Through his work on the Psychiatry Addictions Capacity Building and Consultation Service (PACCS) at CAMH and the Addiction Medicine and Psychosocial Addictions ECHO program, he is evolving into a leader in capacity building and education for addictions treatment. Furthermore, Dr. Chopra also works on the Early Psychosis Unit at CAMH and has extensive clinical experience working with patients experiencing psychosis, often with comorbid cannabis and other substance use. Grand Rounds Presenter: Dr. Luke Fraccaro (PGY3) Produced by: Dr. Luke Fraccaro (PGY3), Dr. Alex Raben (staff psychiatrist), and Josh Benchaya (MS4) Hosts: Dr. Luke Fraccaro (PGY3), Dr. Alex Raben (staff psychiatrist), and Josh Benchaya (MS4) Audio Editing by: Dr. Luke Fraccaro (PGY3) Show notes by: Dr. Luke Fraccaro (PGY3) Conflicts of Interest: There are no known conflict of interests to report Topics: 0:00 - Introduction 2:50 - Objectives 3:55 - Case example 7:25 - Overview of cannabis effects of mental health 10:45 - Differentiating clinically between cannabis-induced psychosis and a primary psychotic disorder 13:11 - Cannabis causing acute psychotic symptoms 14:15 - Back to the case 16:05 - Overlapping risk factors for cannabis use and psychotic disorders 18:14 - Cannabis use as a potential cause of persistent psychotic disorders (Reviewing the evidence) 30:14 - Summary of the relationship between cannabis and psychosis and how to apply it clinically 35:20 - Cannabis legalization in Canada 39:45 - Canadian studies on potential impact of cannabis legalization on psychosis 44:33 - Brief review of American studies on potential impact of cannabis legalization on psychosis. 46:35 - Summary of potential impact of legalization 47:42 - Questions and discussion 1:06:15 - Summary and Outro Resources: Canada’s Lower-Risk Cannabis Use Guideline: https://www.camh.ca/-/media/files/lrcug_professional-pdf.pdf Cannabis legalization and regulation in Canada: https://www.canada.ca/en/health-canada/programs/engaging-cannabis-legalization-regulation-canada-taking-stock-progress/document.html References: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Arlington, VA: American Psychiatric Association, 2022. Tourjman SV, Buck G, Jutras-Aswad D, Khullar A, McInerney S, Saraf G, Pinto JV, Potvin S, Poulin MJ, Frey BN, Kennedy SH, Lam RW, MacQueen G, Milev R, Parikh SV, Ravindran A, McIntyre RS, Schaffer A, Taylor VH, van Ameringen M, Yatham LN, Beaulieu S. Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: A Systematic Review and Recommendations of Cannabis use in Bipolar Disorder and Major Depressive Disorder. Can J...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers the Journey Through Stages of Sleep with Dr. Michael Mak, Assistant Professor in the Department of Psychiatry at the University of Toronto, and an Adjunct Research Professor at Western University. The learning objectives for this episode are as follows: Understand the basics of sleep physiology, including the stages of sleep Recognize the clinical features of insomnia disorder using the ICSD-3 and DSM-5-TR criteria Develop an approach to the assessment of insomnia Identify the pharmacological and non-pharmacological treatments for insomnia disorder Guest: Dr. Michael Mak (Staff Psychiatrist) Hosts: Dr. Vanessa Aversa (PGY4), Andreea Chiorean (CC4), Sena Gok (IMG) Audio editing by: Sena Gok Show notes by: Sena Gok Contents: Introduction: 0:16 Learning Objectives: 01:49 Definition and Clinical features of insomnia (ICSD-3 and DSM-5-TR criteria): 02:39 Insomnia prevalence, cost effects: 05:25 Sleep physiology: 10:05 Stages of Sleep: 11:37 Changes in Sleep stages during Insomnia: 14:35 Melatonin/Orexin systems: 15:45 Assessment and diagnosis of Insomnia: 21:00 Risk Factors of Insomnia: 30:12 CBT for Insomnia (CBT-I): 31:35 Relaxation-based techniques: 40:25 Contraindication for Insomnia: 42:15 Pharmacological treatments of insomnia: 45:15 Summary: 1:11:10 Resources: 1. Wainberg M, Jones SE, Beaupre LM, Hill SL, Felsky D, Rivas MA, et al. Association of accelerometer-derived sleep measures with lifetime psychiatric diagnoses: A cross-sectional study of 89,205 participants from the UK Biobank. PLOS Med. 2021 Oct 12;18(10):e1003782. 2. Morin CM, Vallières A, Guay B, Ivers H, Savard J, Mérette C, et al. Cognitive Behavioral Therapy, Singly and Combined With Medication, for Persistent Insomnia: A Randomized Controlled Trial. JAMA. 2009 May 20;301(19):2005–15. : 3. Crescenzo FD, D’Alò GL, Ostinelli EG, Ciabattini M, Franco VD, Watanabe N, et al. Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis. The Lancet. 2022 Jul 16;400(10347):170–84. 4. Watanabe Y, Kuroki T, Ichikawa D, Ozone M, Uchimura N, Ueno T. Effect of smartphone-based cognitive behavioral therapy app on insomnia: a randomized, double-blind study. Sleep. 2023 Mar 1;46(3):zsac270. 5. Erland LAE, Saxena PK. Melatonin Natural Health Products and Supplements: Presence of Serotonin and Significant Variability of Melatonin Content. J Clin Sleep Med. 13(02):275–81. 6. Sweetman A, McEvoy RD, Smith S, Catcheside PG, Antic NA, Chai-Coetzer CL, et al. The effect of cognitive and behavioral therapy for insomnia on week-to-week changes in sleepiness and sleep parameters in patients with comorbid insomnia and sleep apnea: a randomized controlled trial. Sleep. 2020 Jul 13;43(7):zsaa002. 7. Origins of Sleep Medicine: Dr. Nathaniel Kleitman,, Dr. Mark Mahowald, Dr. Carlos Schenck https://aasm.org/mark-mahowald-md-and-carlos-schenck-md-to-receive-william-c-dement-award/ 8. CBT-Insomnia lab at the Toronto Metropolitan University: https://drcolleencarney.com/lab/ 9. CBT-Insomnia Applications: https://www.sleepio.com/ https://www.ptsd.va.gov/appvid/mobile/cbticoach_app_public.asp https://www.blackdoginstitute.org.au/research-projects/sleep-ninja/ https://www.somryst.com/ 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 psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

Welcome to PsychEd — the psychiatry podcast for medical learners, by medical learners. This episode is an introduction to the use and monitoring of lithium in bipolar disorder. Join Tingting Yan (CC4) and Dr. Alex Raben (staff psychiatrist at CAMH and lecturer at the University of Toronto) for a lively case-based discussion. Learning Objectives The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Describe the indications and process for starting lithium Monitor and interpret serum lithium levels List short and long-term adverse effects of lithium Produced by: Tingting Yan CC4, Dr. Alex Raben (staff psychiatrist) Hosts: Tingting Yan, Alex Raben Audio editing by: Alex Raben Show notes by: Alex Raben Contents: Learning objectives: 00:44 Lithium background and brief history: 2:48 Women’s health and lithium: 5:28 Underutilization of lithium: 8:02 Baseline blood work for lithium: 11:32 Choosing a lithium starting dose: 14:32 Lithium serum levels: 16:17 Lithium titration: 20:46 Lithium toxicity: 23:48 Lithium side effects: 26:52 Summary: 32:11 References Baastrup PC, Poulsen JC, Schou M, Thomsen K, Amdisen A. Prophylactic lithium: double blind discontinuation in manic-depressive and recurrent-depressive disorders. Lancet. 1970;2(7668):326-330. doi:10.1016/s0140-6736(70)92870-9 Bauer LA. Chapter 17. Lithium. In: Bauer LA. eds. Applied Clinical Pharmacokinetics, 2e. McGraw Hill; 2008. Accessed March 16, 2023. https://accesspharmacy.mhmedical.com/content.aspx?bookid=510&sectionid=40843106 Chokhawala K, Lee S, Saadabadi A. Lithium. StatPearls. Davis J, Desmond M, Berk M. Lithium and nephrotoxicity: a literature review of approaches to clinical management and risk stratification. BMC nephrology. 2018 Dec;19:1-7. Draaisma D. Lithium: the gripping history of a psychiatric success story. Nature. 2019 Aug 1;572(7769):584-6. Hedya SA, Avula A, Swoboda HD. Lithium toxicity. Malhi GS, Bell E, Outhred T, Berk M. Lithium therapy and its interactions. Australian Prescriber. 2020 Jun;43(3):91. Malhi GS, Gessler D, Outhred T. The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines. J Affect Disord. 2017;217:266-280. doi:10.1016/j.jad.2017.03.052 McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet. 2012;379(9817):721-728. doi:10.1016/S0140-6736(11)61516-X Patorno E, Huybrechts KF, Bateman BT, Cohen JM, Desai RJ, Mogun H, Cohen LS, Hernandez-Diaz S. Lithium use in pregnancy and the risk of cardiac malformations. New England Journal of Medicine. 2017 Jun 8;376(23):2245-54. Tondo L, Alda M, Bauer M, Bergink V, Grof P, Hajek T, Lewitka U, Licht RW, Manchia M, Müller-Oerlinghausen B, Nielsen RE. Clinical use of lithium salts: guide for users and prescribers. International journal of bipolar disorders. 2019 Dec;7(1):1-0. Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, Sharma V, Goldstein BI, Rej S, Beaulieu S, Alda M. 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. 2018 Mar;20(2):97-170. 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 psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

Welcome to PsychEd — the psychiatry podcast for medical learners, by medical learners. This episode covers the “big picture” relationship between violence and severe mental illnesses such as schizophrenia and bipolar spectrum disorders. Our guest experts in this episode are Dr. Robert McMaster, Assistant Professor of Forensic Psychiatry at the University of Toronto and Dr. Ragy R. Girgis, Associate Professor of Clinical Psychiatry at Columbia University in New York. This episode is a good companion to Episode 15: Managing Aggression and Agitation with Dr. Jodi Lofchy, which covers how to identify and manage acute risk of violence in a clinical setting. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Describe the epidemiology of violence in severe mental illness (rates of perpetration vs. victimization, risk factors, quality of evidence) Understand and critique how society currently addresses violence in those with severe mental illness Discuss this topic with patients, caregivers and the public, and address common myths Guests: Dr. Robert McMaster - Assistant Professor of Forensic Psychiatry at the University of Toronto Dr. Ragy R. Girgis - Associate Professor of Clinical Psychiatry at Columbia University in New York Hosts: Dr. Alex Raben (Staff Psychiatrist), Dr. Gaurav Sharma (PGY4), Sena Gok(IMG), Josh Benchaya (CC4) Audio editing by: Gaurav Sharma Show notes by: Josh Benchaya, Gaurav Sharma, Sena Gok Interview Content: Learning Objectives: 02:29 Perceptions of Violence and Mental Illness: 03:53 Mental illness & Violence Link Evidence: 06:48 Violence Perpetration & Victimisation: 10:10 Risk of Violence Assessment (HCR 20 Model): 17:00 Mass Shootings & Mental Illness & Predictions: 20:30 Violence Risk Prediction: 25:25 Severe Mental Illness & Violence Risk Treatments: 29:40 Society’s approach to Severe Mental Illness & Violence Misperceptions: 38:30 Mental Illness and Violence Stigma: 45:03 Case Vignette & Approach: 46:44 Summary of the episode: 58:00 References: de Mooij, L.D., Kikkert, M., Lommerse, N.M., Peen, J., Meijwaard, S.C., Theunissen, J., Duurkoop, P.W., Goudriaan, A.E., Van, H.L., Beekman, A.T. and Dekker, J.J., 2015. Victimization in adults with severe mental illness: prevalence and risk factors. The British Journal of Psychiatry, 207(6), pp.515-522. Desmarais, S. L., Van Dorn, R. A., Johnson, K. L., Grimm, K. J., Douglas, K. S., & Swartz, M. S. (2014). Community violence perpetration and victimization among adults with mental illnesses. American journal of public health, 104(12), 2342-2349. Metzl, J.M., Piemonte, J. and McKay, T., 2021. Mental illness, mass shootings, and the future of psychiatric research into American gun violence. Harvard review of psychiatry, 29(1), p.81. Buchanan, A., Sint, K., Swanson, J. and Rosenheck, R., 2019. Correlates of future violence in people being treated for schizophrenia. American Journal of Psychiatry, 176(9), pp.694-701. Rund, B.R., 2018. A review of factors associated with severe violence in schizophrenia. Nordic journal of psychiatry, 72(8), pp.561-571. Markowitz FE. Mental illness, crime, and violence: Risk, context, and social control. Aggress Violent Behav. 2011 Jan 1;16(1):36–44. Pescosolido BA, Manago B, Monahan J. Evolving Public Views On The Likelihood Of Violence From People With Mental Illness: Stigma And Its Consequences. Health Aff Proj Hope. 2019 Oct;38(10):1735–43. Ross AM, Morgan AJ, Jorm AF, Reavley NJ. A systematic review of the impact of media reports of severe mental illness on stigma and discrimination, and interventions that aim to mitigate any adverse impact. Soc Psychiatry Psychiatr Epidemiol. 2019 Jan 1;54(1):11–31. Srivastava K, Chaudhury S, Bhat PS, Mujawar S. Media and mental health. Ind Psychiatry J. 2018;27(1):1–5. Stuart H. Media portrayal of mental illness and its treatments: what effect does it have on people with mental...

Welcome to PsychEd — the psychiatry podcast for medical learners, by medical learners. This episode covers the mental status examination and makes use of practical and fictional examples to delve deeper into the skills and concepts Learning Objectives: The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Explain the utility and purpose of the mental status examination in psychiatry Describe the major components of the mental status examination and be familiar with some of the common vocabulary used Incorporate the mental status in a way that respects patients in presentation, documentation and formulation in clinical practice Topics: 2:37 - Learning objectives 3:10 - Definition of the MSE 6:48 - History of the MSE 9:00 - Limitations of the MSE 15:37 - Strengths of the MSE 21:30 - ASEPTIC Mnemonic 23:04 - Appearance and Behaviour 37:42 - Speech 51:51 - Emotion (mood and affect) 1:03:51 - Perception 1:08:38 - Thought Form and Content 1:17:30 - Insight and Judgement 1:27:40 - Cognition Hosts: Andreea Chiorean (CC4), Saja Jaberi (IMG), Dr. Weam Seiffien (PGY2), Angad Singh (CC2), Dr. Annie Yu (PGY1), and Dr. Alex Raben, staff psychiatrist. Guest Experts: Us! Video clips: Speech: Mojo Jojo: https://youtu.be/y4qNWPPlYE4?t=48 Family guy video: no longer available Emotion Eeyore: https://youtu.be/7xPnUe6Xcbw?t=12 Squidward: https://youtu.be/FjrOWnywPok?t=195 Bubbles: https://youtu.be/rAC4W563Ayk?t=339 Perception A Beautiful Mind: https://youtu.be/vNa37tOB4rE Insight and Judgement Simpsons: no longer available Mr. Magoo: https://youtu.be/eWEnzLFd4P4?t=201 Cognition Still Alice: https://youtu.be/mhiXAJO8kBc?t=67 Resources: MSE template: https://www.therapistaid.com/therapy-worksheet/mental-status-exam Emotion wheel: https://feelingswheel.com/ MSE vocabulary: http://www.columbia.edu/itc/hs/medical/psychmed/1_2004/mental_status_exam.pdf References: Bell, R. (1977). The Mental Status Examination. 16(5).Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research, 12(3), 189-198. Donnelly, J., Rosenberg, M., & Fleeson, W. P. (1970). The evolution of the mental status—past and future. American Journal of Psychiatry, 126(7), 997-1002. Norris, D. R., Clark, M. S., & Shipley, S. (2016). The Mental Status Examination. 94(8). Norton, J. W., & Corbett, J. J. (2000, February). Visual perceptual abnormalities: hallucinations and illusions. In Seminars in neurology (Vol. 20, No. 01, pp. 0111-0122). Copyright© 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Notes, T. (2020). Comprehensive Medical Reference and Review for the Medical Council of Canada Qualifying Exam (MCCQE) Part I and the United States Medical Licensing Exam (USMLE) Step II 36th ed: Toronto Notes for Medical Students. Recupero, P. R. (2010). The Mental Status Examination in the Age of the Internet. The Journal of the American Academy of Psychiatry and the Law, 38(1). Robinson D. J. (2002). Mental status exam explained (2nd ed.). Rapid Psychler Press. Robinson D. J. (1998). Brain Calipers: a guide to a successful mental status exam. Rapid Psychler Press. Ross, C. A., & Leichner, P. (1988). Residents Performance on the Mental Status Examination. The Canadian Journal of Psychiatry, 33(2), 108–111. https://doi.org/10.1177/070674378803300207 Sadock, B. J., & Sadock, V. A. (2007). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry (10th ed.). Lippincott Williams & Wilkins Publishers. Segal, D. L. (Ed.). (2019). Diagnostic interviewing. Springer. Snyderman, D., & Rovner, B. (2009). Mental status examination in primary care: a review. American family physician, 80(8), 809-814. Spencer, R. J., Noyes, E. T., Bair, J. L., & Ransom, M. T. (2022)....

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we’ll explore a topic that we’re sure many listeners are eager to learn about: The Assessment of Major Neurocognitive Disorder, also known as dementia with Dr. Lesley Wiesenfeld who is a Geriatric Psychiatrist and Psychiatrist-in-Chief at Mount Sinai Hospital in Toronto, where she leads the Geriatric Consult Liaison Psychiatry Service. She is also an Associate Professor in the Department of Psychiatry at the University of Toronto. The learning objectives for this episode are as follows: Define Major Neurocognitive Disorder (aka Dementia) as per DSM-5 diagnostic criteria Identify differential diagnoses for cognitive decline and list differentiating clinical features Outline an approach to the assessment of a patient presenting with cognitive decline, including the role of a comprehensive history, psychometric tools and other investigations [ Relevant PMH/risk factors, ADLs/IADLs to cover on history, psychometric tools such as MMSE, MoCA and tie this back into major cognitive domains when to consider imaging, bloodwork including specialized testing such as ApoE genetic tests] Classify the major subtypes of Neurocognitive Disorders, their epidemiology, and clinical presentations [ Vascular dementia, Alzheimer’s, Frontotemporal, Lewy Body, Parkinson’s, Mixed dementia - Early onset dementia] Guest: Dr. Lesley Wiesenfeld ( Lesley.Wiesenfeld@sinaihealthsystem.ca ) Hosts: Dr. Luke Fraccaro (PGY-3), Dr. Mark Fraccaro (PGY-4), Sena Gok (international medical graduate) Audio editing by: Sena Gok Show notes by: Sena Gok Interview Content: Introduction: 0:13 Learning Objectives: 02:35 Diagnostic criteria of Major Neurocognitive Disorder: 03:20 Difference between Major and Mild Neurocognitive Disorder: 05:20 Red Flags of Cognitive Declines: 06:50 Normal Aging vs Major Neurocognitive Disorder: 10:00 Clinical Vignette – introduction: 11:35 Patient Assessment: 16:50 Past medical/family / Psychosocial history: 21:55 Clinical Vignette - Assessment: 37:45 Physical examination: 43:50 Investigations: 45:53 Role of genetic testing: 53:24 Clinical Vignette – Diagnosis: 57:50 References: American Psychiatric Association. (2022). Neurocognitive Disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Sadock, B. J., Sadock, V. A., Ruiz, P., & Kaplan, H. I. (2015). Neurocognitive Disorders. Kaplan and Sadock’s Synopsis of Psychiatry (11th ed.). Wolters Kluwer DSM-5-TR Fact Sheets (https://psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-tr-fact-sheets ) Gauthier S, Patterson C, Chertkow H, Gordon M, Herrmann N, Rockwood K, Rosa-Neto P, Soucy JP. Recommendations of the 4th Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD4). Can Geriatr J. 2012 Dec;15(4):120-6. doi: 10.5770/cgj.15.49. Epub 2012 Dec 4. PMID: 23259025; PMCID: PMC3516356. Gauthier S, Chertkow H, Theriault J, Chayer C, Ménard MC, Lacombe G, Rosa-Neto P, Ismail Z. CCCDTD5: research diagnostic criteria for Alzheimer's Disease. Alzheimers Dement (N Y). 2020 Aug 25;6(1):e12036. doi: 10.1002/trc2.12036. Erratum in: Alzheimers Dement (N Y). 2022 Feb 03;6(1):e12088. PMID: 32864413; PMCID: PMC7446944. 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 psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode delves into the history of psychiatry with Dr David Castle, the inaugural Scientific Director of the Centre for Complex Interventions at the Centre for Addictions and Mental Health and a Professor in the Department of Psychiatry at the University of Toronto. Prior to migrating to Canada in 2021, he spent 15 years as a Professor of Psychiatry at St Vincent’s Hospital and the University of Melbourne in Australia. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Gain an appreciation for the historical context of the field of psychiatryUnderstand how illness categories and treatments have been shaped by this history Compare and contrast how various past societies viewed and conceptualized mental illnessApply lessons learned from historical practices to appraise current approaches Guest: Dr David Castle Hosts: Dr Alex Raben (Staff Psychiatrist), Gaurav Sharma (PGY4), Nikhita Singhal (PGY4), Andreea Chiorean (CC4) Audio editing by: Dr Alex Raben Show notes by: Dr Nikhita Singhal Interview Content: 1:45 - Learning Objectives 3:25 - Ancient Times 14:42 - Middles Ages 23:56 - Renaissance to Enlightenment 34:55 - 19th-20th Centuries 47:55 - 20th-21st Centuries 1:00:48 - Final Thoughts Resources: Shrinks: The Untold Story of Psychiatry(Jeffrey A Lieberman) References: The Emotional Foundations of Personality: A Neurobiological and Evolutionary Approach(Kenneth L Davis, Jaak Panksepp) Illustration of Bedlam(William Hogarth) Pinel, médecin en chef de la Salpêtrière en 1795(Tony Robert-Fleury)Castle, D., Bassett, D., King, J., & Gleason, A. (2013).A primer of clinical psychiatry. Elsevier Health Sciences.de Leon J. DSM-5 and the research domain criteria: 100 years after Jaspers' General psychopathology. Am J Psychiatry. 2014 May;171(5):492-4.https://doi.org/10.1176/appi.ajp.2013.13091218Eisenberg L. Mindlessness and brainlessness in psychiatry. Br J Psychiatry. 1986 May;148:497-508.https://doi.org/10.1192/bjp.148.5.497Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977 Apr 8;196(4286):129-36.https://doi.org/10.1126/science.847460Kendell R, Jablensky A. Distinguishing between the validity and utility of psychiatric diagnoses. Am J Psychiatry. 2003 Jan;160(1):4-12.https://doi.org/10.1176/appi.ajp.160.1.4Robins E, Guze SB. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry. 1970 Jan;126(7):983-7.https://doi.org/10.1176/ajp.126.7.983Rosenhan DL. On being sane in insane places. Science. 1973 Jan 19;179(4070):250-8.https://doi.org/10.1126/science.179.4070.250Scheff TJ. The labelling theory of mental illness. Am Sociol Rev. 1974 Jun;39(3):444-52.https://doi.org/10.2307/2094300Szasz T. The myth of mental illness: 50 years later. The Psychiatrist. Cambridge University Press; 2011;35(5):179–182.https://doi.org/10.1192/pb.bp.110.031310 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 psychedpodcast@gmail.com. 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 present a focused summary of the latest changes in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) with our guest expert — Dr. Michael First, a Professor of Clinical Psychiatry at Columbia University, NY. Dr. First is an internationally recognized expert on psychiatric diagnosis and assessment issues, he is the editor and co-chair of the DSM-5 text revision project (DSM-5-TR), the editorial and coding Consultant for the DSM-5, the chief technical and editorial consultant on the World Health Organization ICD-11 revision project and was an external consultant to the NIMH Research Domain Criteria project (RDOC). The learning objectives for this episode are as follows: Understand the rationale for undertaking a DSM-5-TR as well as the revision process itself To become familiar with disorder, text and symptom code additions and modifications to the DSM-5-TR To understand the purpose and function of the DSM in its current form and be able to contemplate future directions Guest Expert: Dr. Michael First – staff psychiatrist and professor of clinical psychiatry at Columbia University, USA. Produced and hosted by: Dr. Alex Raben (staff psychiatrist) and Saja Jaberi (international medical graduate) Audio editing by: Dr. Alex Raben Show notes by: Saja Jaberi Interview Content: 2:53 - Learning objectives 3:34 - Brief description of the DSM and its history 4:54 – ICD vs. DSM 7:43 - Rationale behind the new revision 11:11 - Characteristics of the DSM-5-TR revision process and the people behind it 16:54 - Case presentation and Differential Diagnosis 23:07 - Prolonged Greif disorder 27:04 - Most important changes to the terminology used in the manual 39:34 - Pros and cons of the DSM 44:30 - A brief Comparison to the RDOC Framework 49:04 – Future Directions of the DSM References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. 2013. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Text Revision ed. 2022. DSM-5-TR Fact Sheets https://psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-tr-fact-sheets 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 psychedpodcast@gmail.com. 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 present a broad overview of antisocial personality disorder and psychopathy with our guest expert - Dr. Donald Lynam. Dr. Lynam is a clinical psychologist by training, and professor at Purdue university, where he heads the Purdue's Developmental Psychopathology, Psychopathy and Personality Lab. While there may be some disagreement in the field, Dr. Lynam and I discuss how ASPD and psychopathy are two diagnostic constructs that are attempting to outline the same psychopathology, with the main difference being the degree of severity - for this reason, we use the terms antisocial and psychopathic interchangeably. While not necessary, it may be of benefit for listeners to familiarize themselves with the DSM-V criteria for antisocial personality disorder, the psychopathy checklist (PCL), as well as the 5-factor model of personality. References for each are listed below in the references section, however, for a brief overview, one could do a quick google image search for each term (Wikipedia also has a succinct overview of the psychopathy checklist). The learning objectives for this episode are as follows: Develop a basic understanding of what is meant by antisocial personality and psychopathy Be aware of some of the classic traits and characteristics of antisocial/psychopathic personalities, and the general functions of these behaviors Describe the theoretical basis for the development of antisocial personalities Guest Expert: Dr. Donald Lynam - Clinical psychologist, Investigator at Purdue University, Indiana Produced and hosted by: Dr. Chase Thompson (PGY5 in Psychiatry) Episode guidance and feedback: Dr. Gaurav Sharma (PGY4 in Psychiatry) Interview Content: 0:50 - Learning objectives 1:40 - Dr. Lynam discusses his path to his current research interests 3:40 - Defining the terms antisocial personality disorder, sociopathy, psychopathy 8:30 - Discussing the possibility of antisocial behaviors without an antisocial personality 12:07 - Laying out the core features of antisocial individuals 18:20 - Antisocial personality from the perspective of the Big 5 personality model 22:00 - Discussion of the high-functioning psychopathy 25:06 - Prevalence of psychopathy 30:10 - Factors relevant to the development of psychopathy 39:30 - Prognosis and clinical trajectory 44:30 - Comorbid psychopathology 46:30 - Functions of antagonism or antisocial behaviours 49:30 - Treatment References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. 2013. Broidy LM, Nagin DS, Tremblay RE, Bates JE, Brame B, Dodge KA, Fergusson D, Horwood JL, Loeber R, Laird R, Lynam DR. Developmental trajectories of childhood disruptive behaviors and adolescent delinquency: a six-site, cross-national study. Developmental psychology. 2003 Mar;39(2):222. Babiak P, Hare RD, McLaren T. Snakes in suits: When psychopaths go to work. New York: Harper; 2007 May 8. Hare RD. The psychopathy checklist–Revised. Toronto, ON. 2003;412. Hare RD, Harpur TJ, Hakstian AR, Forth AE, Hart SD, Newman JP. The revised psychopathy checklist: reliability and factor structure. Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1990 Sep;2(3):338. Hare RD, Hart SD, Harpur TJ. Psychopathy and the DSM-IV criteria for antisocial personality disorder. Journal of abnormal psychology. 1991 Aug;100(3):391. Jones SE, Miller JD, Lynam DR. Personality, antisocial behavior, and aggression: A meta-analytic review. Journal of Criminal Justice. 2011 Jul 1;39(4):329-37. Lynam DR. Early identification of chronic offenders: Who is the fledgling psychopath?. Psychological bulletin. 1996 Sep;120(2):209. Miller JD, Lynam DR. Psychopathy and the five-factor model of personality: A replication and extension. Journal of personality assessment. 2003 Oct 1;81(2):168-78. CPA Note: The views expressed in...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers perinatal psychiatry with Dr. Tuong Vi Nguyen, Assistant Professor, Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University and Scientist and Scientist, RI-MUHC, Brain Repair and Integrative Neuroscience (BRaIN) Program, Centre for Outcomes Research and Evaluation. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Define the field of perinatal psychiatryDescribe the key issues that should be addressed in pre-conception psychiatric counselingDiscuss the management approach for prescribing medications during pregnancyRecognize the prevalence of mood disorders during the perinatal periodRecall the diagnostic criteria for postpartum depressionConsider the risk factors and explanatory models for postpartum depressionDiscuss the use of screening tools for postpartum depressionOutline the treatment for postpartum depressionDescribe the clinical presentation of postpartum psychosis and recognize the urgency of this conditionList important risk factors for postpartum psychosisDiscuss the management for postpartum psychosis Guest: Dr. Tuong Vi Nguyen Hosts: Nima Nahiddi (PGY4), Audrey Le (PGY1), and Arielle Geist (PGY2) Produced by: Nima Nahiddi (PGY4), Audrey Le (PGY1), Rebecca Marsh (PGY2) and Arielle Geist (PGY2) Audio editing by: Audrey Le Show notes by: Arielle Geist Interview content: Introduction - 00:00Learning objectives - 00:43Defining the field of perinatal psychiatry - 01:55Key issues to address in preconception counseling - 02:50Management approach for prescribing medications during pregnancy - 07:00Prevalence of mood disorders during the perinatal period - 12:11Diagnostic criteria for postpartum depression - 14:05Differentiating postpartum psychosis from postpartum depression - 16:52Risk factors and explanatory models for postpartum depression - 18:58Screening tools for postpartum depression - 20:15Treatment for postpartum depression - 22:13Pharmacotherapy - 22:20Psychotherapy - 27:34Clinical presentation of postpartum psychosis - 29:07Risk factors for postpartum psychosis - 30:43Postpartum psychosis prognosis and impacts on attachment- 32:57Management of postpartum psychosis -35:30Closing comments - 38:00 Resources: Bérard, A., Zhao, J. P., & Sheehy, O. (2017). Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort.BMJ open, 7(1), e013372. https://doi.org/10.1136/bmjopen-2016-013372Boukhris, T., Sheehy, O., Mottron, L., & Bérard, A. (2016). Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children.Jama Pediatrics, 170(2), 117-24. doi: 10.1001/jamapediatrics.2015.3356.Brown, A. S., Gyllenberg, D., Malm, H., McKeague, I. W., Hinkka-Yli-Salomäki, S., Artama, M., Gissler, M., Cheslack-Postava, K., Weissman, M. M., Gingrich, J. A., & Sourander, A. (2016). Association of Selective Serotonin Reuptake Inhibitor Exposure During Pregnancy With Speech, Scholastic, and Motor Disorders in Offspring.JAMA psychiatry, 73(11), 1163–1170. https://doi.org/10.1001/jamapsychiatry.2016.2594Cohen, J. , Hernández-Díaz, S. , Bateman, B. , Park, Y. , Desai, R. , Gray, K. , Patorno, E. , Mogun, H. & Huybrechts, K. (2017). Placental Complications Associated With Psychostimulant Use in Pregnancy.Obstetrics & Gynecology, 130(6), 1192-1201. doi: 10.1097/AOG.0000000000002362.Huybrechts, K. F., Hernández-Díaz, S., Patorno, E., Desai, R. J., Mogun, H., Dejene, S. Z., Cohen, J. M., Panchaud, A., Cohen, L., & Bateman, B. T. (2016). Antipsychotic Use in Pregnancy and the Risk for Congenital Malformations.JAMA psychiatry, 73(9), 938–946. https://doi.org/10.1001/jamapsychiatry.2016.1520Huybrechts, K. F., Palmsten, K., Avorn, J., Cohen, L. S., Holmes, L. B., Franklin, J. M., Mogun, H., Levin, R.,...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers perinatal psychiatry with Dr. Tuong Vi Nguyen, Assistant Professor, Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University and Scientist, RI-MUHC, Brain Repair and Integrative Neuroscience (BRaIN) Program, Centre for Outcomes Research and Evaluation. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Define the field of reproductive psychiatryDiscuss the possible neurobiological pathways impacting mood and cognition during the reproductive cycle of women. Discuss the influence of sociocultural gender roles on psychopathology. List the DSM-V diagnostic criteria of premenstrual dysphoric disorder.Recall the epidemiology of premenstrual dysphoric disorder.Describe the steps in the diagnostic evaluation for premenstrual dysphoric disorder.List lifestyle and psychopharmacologic interventions for premenstrual dysphoric disorder.Discuss common mental health concerns during the perimenopausal period. Guest: Dr. Tuong Vi Nguyen Hosts: Nima Nahiddi (PGY4), Audrey Le (PGY1), and Arielle Geist (PGY2) Audio editing by: Audrey Le Show notes by: Arielle Geist Interview content: Introduction - 00:00Learning objectives - 01:00Defining the field of perinatal psychiatry - 01:50Discussing neurobiological pathways impacting mood and cognition during the reproductive cycle - 02:47The influence of sociocultural gender roles on psychopathology -05:28DSM-V criteria of premenstrual dysphoric disorder - 11:18Epidemiology of premenstrual dysphoric disorder - 13:40Diagnostic evaluation of premenstrual dysphoric disorder - 14:38Management of premenstrual dysphoric disorder Pharmacologic - 17:45Lifestyle - 24:15Perimenopausal period - 24:45Closing comments - 31:39 Resources: Brzezinski, A., Brzezinski-Sinai, N.A., & Seeman, M.V. (2017). Treating schizophrenia during menopause.Menopause, 24(5), 582-588. doi: 10.1097/GME.0000000000000772.Epperson, C.N., Steiner, M., Hartlage, A., Eriksson, E., Schmidt, P.J., Jones, I., & Yonkers, K.A. (2012). Premenstrual dysphoric disorder: evidence for a new category for DSM-5.The American Journal of Psychiatry, 169(5), 465-475. DOI: 10.1176/appi.ajp.2012.11081302Marsh, W.K., Gershenson, B., & Rothschild, A.J. (2015). Symptom severity of bipolar disorder during the menopausal transition.International Journal of Bipolar Disorders, 3(1), 35. DOI: 10.1186/s40345-015-0035-zSoares, C.N., Almeida, O.P., Joffe, H., & Cohen, L.S. (2001). Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women a double-blind, randomized, placebo-controlled trial.Archives of General Psychiatry, 58(6), 529-534. doi:10.1001/archpsyc.58.6.529Weber, M.T., Maki, P.M., & McDermott, M.P. (2013). Cognition and mood in perimenopause: A systematic review and meta-analysis.The Journal of Steroid Biochemistry and Molecular Biology, 142, 90-98. https://doi.org/10.1016/j.jsbmb.2013.06.001 References: Kornstein S.G., & Clayton, A.H. (2004). Sex differenes in neuroendocrine and neurotransmitter systems. InWomen’s mental health: A comprehensive textbook (pp.3-30).Guilford Press. Chrisler, J. C., & Johnston-Robledo, I. (2002). Raging hormones?: Feminist perspectives on premenstrual syndrome and postpartum depression. In M. Ballou & L. S. Brown (Eds.), Rethinking mental health and disorder: Feminist perspectives (pp. 174–197). Guilford Press.American Psychiatric Association. (2013). Depressive disorders. InDiagnostic and statistical manual of mental disorders(5th ed.). https://doi.org/10.1176/appi.books.9780890425596. 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 psychedpodcast@gmail.com. For...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers psychedelic-assisted psychotherapy with Dr Emma Hapke and Dr Daniel Rosenbaum, both of whom are psychiatrists at the University Health Network in Toronto and co-founders of UHN’s Nikean Psychedelic Psychotherapy Research Centre (in addition to being lecturers in the Department of Psychiatry 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… Briefly describe the history of psychedelics in psychiatryList the four classes of psychedelic drugs and their mechanism of actionSummarize the evidence regardingpsychedelic-assisted psychotherapy for various psychiatric disordersDiscuss patient selection considerations for psychedelic-assisted psychotherapyDescribe the safety, tolerability and possible side effects of psychedelic-assisted psychotherapyUnderstand how a psychedelic-assisted psychotherapy session is practically carried out Guests: Dr Emma Hapke and Dr Daniel Rosenbaum Hosts: Dr Chase Thompson (PGY4), Dr Nikhita Singhal (PGY3), Jake Johnston (CC4), and Annie Yu (CC4) Audio editing by: Nikhita Singhal Show notes by: Nikhita Singhal Interview Content: Introduction - 0:00Learning objectives - 02:47Definitions/categories of psychedelics - 03:24Classic psychedelics - 04:15Empathogens (e.g. MDMA) - 07:15Etymology of the term “psychedelic” - 09:30Ketamine - 12:24Iboga - 13:28Brief history of psychedelic medicine - 17:51Current evidence and ongoing trials - 27:38MDMA and PTSD - 29:26Psilocybin and treatment-resistant depression - 32:24A word of caution - 34:29End-of-life care - 38:47Practical aspects of psychedelic-assisted psychotherapy sessions - 45:45Safety considerations - 01:04:04Future directions - 01:10:33Closing comments - 01:19:07 Resources: Books: How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence(Michael Pollan) The Doors of Perception(Aldous Huxley) The Human Encounter With Death(Stanislav Grof and Joan Halifax)Brainwashed podcast series (CBC): https://www.cbc.ca/listen/cbc-podcasts/440-brainwashedZendo Project (psychedelic peer support):https://zendoproject.orgNikean Psychedelic Psychotherapy Research Centre: https://www.uhn.ca/MentalHealth/Research/Nikean-Psychedelic-Psychotherapy-Research-CentreCalifornia Institute of Integral Studies (CIIS):https://www.ciis.eduMultidisciplinary Association for Psychedelic Studies (MAPS):https://maps.orgPsychEd Episode 27 - Serotonin Pharmacology: From SSRIs to Psychedelics with Dr Robin Carhart-Harris)PsychEd Episode 34 -Ketamine for Treatment-Resistant Depression with Dr Sandhya Prashad References: Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of Psilocybin versus Escitalopram for Depression. N Engl J Med. 2021;384(15):1402-1411.https://doi.org/10.1056/nejmoa2032994Carhart-Harris R, Nutt D. Serotonin and brain function: a tale of two receptors. Journal of Psychopharmacology. 2017;31(9):1091-1120.https://doi.org/10.1177/0269881117725915Davis AK, Barrett FS, May DG, et al. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021;78(5):481–489.https://doi.org/10.1001/jamapsychiatry.2020.3285Griffiths 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. dhttps://dx.doi.org/10.1177%2F0269881116675513Griffiths RR, Johnson MW, Richards WA, et al. Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors. J Psychopharmacol....

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers interpersonal psychotherapy (IPT) with Dr. Paula Ravitz, an Associate Professor of Psychiatry at the University of Toronto and Senior Clinician-Scientist at the Lunenfeld-Tanenbaum Research Institute of Mt Sinai Hospital. Dr. Ravitz held the Morgan Firestone Psychotherapy Chair at the Mount Sinai Hospital from 2011 to 2021 and is a past president of the International Society of Interpersonal Psychotherapy. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Define interpersonal psychotherapyDescribe the core principles and phases of IPTBecome familiarized with some psychological theories underpinning IPTList some patient selection considerations for IPTDescribe the efficacy and evidence base for IPT Understand how IPT is practically carried out Briefly compare and contrast IPT to other common psychotherapies Guest: Dr. Paula Ravitz (paula.ravitz@sinaihealthsystem.ca) Hosts: Jake Johnston and Sena Gok Audio editing by: Jake Johnston Show notes by: Jake Johnston Interview Content: Introduction - 00:00Learning objectives - 02:10Definition/overview of IPT - 02:53Core principles and phases - 07:20Psychological theories - 19:30Patient selection considerations - 24:42Contraindications - 35:57Evidence base and history - 38:10Practical components of IPT - 43:57Maintenance IPT - 59:52IPT vs other psychotherapies - 62:56 Closing comments - 71:17Online IPT course - 74:30 Resources: Summary of IPT written in layman's terms: https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/interpersonal-psychotherapyThe International Society of Interpersonal Psychotherapy (ISIPT) has a helpful overview of IPT and helpful resources for finding more information and IPT training opportunities: https://interpersonalpsychotherapy.org/‘Psychotherapy Essentials to Go’ book series mentioned during episode: https://www.penguinrandomhouse.ca/series/CNL/psychotherapy-essentials-to-goCourse for learning IPT mentioned at the end of the episode (email Dr. Ravitz atPaula.Ravitz@sinaihealth.cato inquire about access):www.learnipt.com References: Bernecker, S. L., Coyne, A. E., Constantino, M. J., & Ravitz, P. (2017). For whom does interpersonal psychotherapy work? A systematic review.Clinical psychology review, 56, 82–93.https://doi.org/10.1016/j.cpr.2017.07.001Chaimowitz, G., Weerasekera, P., & Ravitz, P. (2021). Psychotherapy in Psychiatry.The Canadian Journal of Psychiatry,66(11), 999–1004.https://doi.org/10.1177/07067437211040958Cuijpers, P., Donker, T., Weissman, M. M., Ravitz, P., & Cristea, I. A. (2016). Interpersonal Psychotherapy for Mental Health Problems: A Comprehensive Meta-Analysis.The American journal of psychiatry,173(7), 680–687.https://doi.org/10.1176/appi.ajp.2015.15091141 Dennis, C. L., Grigoriadis, S., Zupancic, J., Kiss, A., & Ravitz, P. (2020). Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: nationwide randomised controlled trial.The British journal of psychiatry : the journal of mental science,216(4), 189–196.https://doi.org/10.1192/bjp.2019.275 Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collins, J. F., Glass, D. R., Pilkonis, P. A., Leber, W. R., & Docherty, J. P. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatments.Archives of general psychiatry,46(11), 971–983.https://doi.org/10.1001/archpsyc.1989.01810110013002Klerman, G. L., Dimascio, A., Weissman, M., Prusoff, B., & Paykel, E. S. (1974). Treatment of depression by drugs and psychotherapy.The American journal of psychiatry,131(2), 186–191.https://doi.org/10.1176/ajp.131.2.186 MacQueen, G. M., Frey, B. N., Ismail, Z., Jaworska, N., Steiner, M., Lieshout, R. J., Kennedy, S. H., Lam, R. W., Milev, R. V., Parikh, S. V., Ravindran, A. V., & CANMAT...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Medical Assistance in Dying (MAiD) and mental illness with our guest expert Dr. Sonu Gaind. This episode was originated by Dr. Urvashi Prasad for her Grand Rounds. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… Briefly summarize the history of Medical Assistance in Dying in CanadaDefine the present policy on Medical Assistance in Dying and Mental Health in CanadaEvaluate the arguments in support of and against the implementation of Medical Assistance in Dying in Mental HealthDiscuss the possible impact that Medical Assistance in Dying might have on the profession of psychiatry Guest expert: Dr. Sonu Gaind is a Professor in the Faculty of Medicine at the University of Toronto (U of T) and Chief of Psychiatry at Humber River Hospital. Dr. Gaind has testified in front of the Federal External Panel on Options for a Legislative Response to Carter v. Canada, the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying, the Special Joint Commons/Senate Committee on Physician-Assisted Dying, and the Senate Committee on Legal and Constitutional Affairs on issues relevant to mental health and mental illness that need to be considered in the MAiD framework. Dr. Gaind chaired the time-limited Canadian Psychiatric Association Task Force on Assisted Dying, was selected to sit on the Council of Canadian Academies Expert Panel on Mental Disorders and Assisted Dying, and has spoken across the country and internationally on the subject. Grand Rounds Presenter: Dr. Urvashi Prasad (PGY3) Produced by: Dr. Urvashi Prasad (PGY3) and Dr. Alex Raben (staff psychiatrist) Hosts: David Eapen-John (MS2), Dr. Alex Raben (Staff Psychiatrist) Audio editing by: Dr. Alex Raben (Staff Psychiatrist) Show notes by: Dr. Urvashi Prasad (PGY3) Resources: Assisted Suicide in Canada https://www.thecanadianencyclopedia.ca/en/article/assisted-suicide-in-canada (Website) Council of Canadian Academies, 2018. The State of Knowledge on Medical Assistance in Dying Where a Mental Disorder Is the Sole Underlying Medical Condition. Ottawa (ON): The Expert Panel Working Group on MAID Where a Mental Disorder Is the Sole Underlying Medical Condition https://cca-reports.ca/wp-content/uploads/2018/12/The-State-of-Knowledge-on-Medical-Assistance-in-Dying-Where-a-Mental-Disorder-is-the-Sole-Underlying-Medical-Condition.pdf References: Government of Ontario, Ministry of Health and Long-Term Care. “Medical Assistance in Dying.”Health Care Professionals - MOH, Government of Ontario, Ministry of Health and Long-Term Care, 13 May 2021, https://www.health.gov.on.ca/en/pro/programs/maid/.Tabitha Marshall. “Assisted Suicide in Canada.”The Canadian Encyclopedia, 3 Dec. 2021, https://www.thecanadianencyclopedia.ca/en/article/assisted-suicide-in-canada.“Get the Facts: Canada's Medical Assistance in Dying Law.”Dying With Dignity Canada, https://www.dyingwithdignity.ca/get_the_facts_assisted_dying_law_in_canada#mental_illness.Jones, Roland M, and Alexander I F Simpson. “ Medical Assistance in Dying: Challenges for Psychiatry.”Frontiers in psychiatryvol. 9 678. 10 Dec. 2018, doi:10.3389/fpsyt.2018.00678Thienpont, Lieve et al. “Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study.” BMJ open vol. 5,7 e007454. 27 Jul. 2015, doi:10.1136/bmjopen-2014-007454 Gaind, KS. (2020). What does “irremediability” in mental illness mean? Canadian Journal of Psychiatry. Online first May 22, 2020. pp 1‐3. doi: 10.1177/0706743720928656 “Maid Volunteer Advocacy Council.”Mental Illness and MAID, https://sencanada.ca/content/sen/committee/432/LCJC/Briefs/MentalIllnessandMAID_e.pdf.Canada, Health. “Second Annual Report on Medical Assistance in Dying in Canada 2020.”Canada.ca, / Government of Canada Gouvernement...