NYU Langone Insights on Psychiatry

For the final episode of Season 2, we're joined by Dr. Samuele Cortese, Professor of Child and Adolescent Psychiatry at the University of Southampton (UK) and Adjunct Full Professor at NYU Langone. Together we explore the intersection of pediatric ADHD and precision psychiatry, including the disorder’s genetic underpinnings and evolving treatment options. 00:00 Introduction 00:54 Dr. Cortese's Research Journey 02:11 Global Perspectives and Challenges in ADHD Treatment 03:51 Advances in ADHD Diagnosis and Treatment 06:41 Role of Genetics in ADHD 09:33 Precision Treatment and Stratification 12:17 Treatment Adherence and Shared Decision-Making 23:55 Connection Between ADHD and Obesity 28:39 Non-Stimulant Alternatives and Future Directions in ADHD Treatment 32:16 Non-Pharmacological Treatments 37:28 Advice for Clinicians and Closing Thoughts Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Timothy Wilens is a Professor of Psychiatry at Harvard Medical School and Chief of the Division of Child and Adolescent Psychiatry at Massachusetts General Hospital. His research interest include the relationship between ADHD, bipolar disorder, and substance use disorders; ADHD pharmacotherapy; and stimulant medication misuse. On this episode, Dr. Wilens discusses the importance of early diagnosis and intervention in ADHD, as well as its lifelong implications. He takes us through the evolution of ADHD treatment, from behavioral therapies to modern pharmacological interventions, including stimulant and non-stimulant medications, and the application of digital therapeutics. The conversation also touches on the stigma surrounding ADHD, the role of precision medicine, and the future of ADHD research. 00:00 Introduction 02:50 Evolution of ADHD Treatment 04:43 Stigma and Misconceptions 12:18 Importance of Early Intervention 15:02 ADHD Symptoms and Treatment Approaches 30:02 Addressing Concerns About Stimulant Medications 35:50 Navigating the Complexities of ADHD Medication 41:22 Future of ADHD Research and Treatment 43:20 Conclusion Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Ira Glick is Professor Emeritus of Psychiatry and Behavioral Sciences at Stanford University Medical Center, where he has served as director of the Schizophrenia Research Clinic. On this episode, he discusses his research journey, which began in the 1960s and followed a shift from psychoanalysis to biological psychiatry. He addresses the broken social safety net for schizophrenia patients, including the controversial topic of treating some patients against their will, as well as the challenges of medication adherence, and the stigma surrounding severe mental illness. 00:00 Introduction 00:49 Evolution of Schizophrenia Treatment 04:34 Science Behind Schizophrenia Medications 07:39 Addressing the Public Health Challenges of Schizophrenia 11:15 Stigma and Misunderstanding of Severe Mental Illness 21:44 Innovative Treatment Approaches and the Future of Schizophrenia Care 31:36 Importance of Public Health Interventions and Political Will 35:45 Closing Remarks and Future Directions Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Christin Drake is Clinical Associate Professor and Vice Chair of Diversity and Equity in the Department of Psychiatry at NYU Grossman School of Medicine. On this episode, Dr. Drake discusses ongoing efforts to improve mental health equity, including by improving psychiatric services for underserved groups, gathering better data, and boosting diversity among health care providers. She also discusses the importance of integrating mental health care into perinatal services and challenges the conventional wisdom about stigma toward mental health care in the Black community. 00:00 Introduction 00:55 Dr. Drake's Vision for Equity in Mental Health Care 03:46 Addressing Racial Inequities in Psychiatry: A Critical Conversation 04:45 The Importance of Representation and Mentorship in Psychiatry 10:32 Building Foundations for Health Equity: Data and Systemic Change 22:16 Integrating Psychiatric Care into Perinatal Health 33:31 Rethinking Mental Health Stigma in the Black Community 38:08 Future Projects and Closing Thoughts Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. John Krystal is Chair of Psychiatry at the Yale School of Medicine. He is best known for leading the discovery of the rapid antidepressant effects of ketamine, which paved the way for the first major new antidepressant drug in decades. Here, Dr. Krystal talks about what we’ve learned in the five years since esketamine nasal spray was approved by the FDA, including efforts to predict treatment response, dosage and frequency, safety, and long-term impact. He also discusses advances in our understanding of alcohol use disorder and weighs in on the search for psychiatric biomarkers. 00:00 Introduction 01:01 Dr. Krystal's Research Journey 03:32 What We’ve Learned Since Esketamine’s FDA Approval 05:59 Avoiding Misuse 08:11 Optimizing Dosage 16:25 Predicting Treatment Outcomes 24:17 Ketamine vs. Psychedelics 25:48 Advances in the Treatment of Alcohol Use Disorder 32:33 Precision Psychiatry and Personalized Treatment Approaches 39:49 Psychiatric Biomarkers 41:03 The Future of Psychiatric Research and Treatment Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Robert Findling is Chair of the Department of Psychiatry at the Virginia Commonwealth University School of Medicine. Here he discusses recent advances in pediatric mental health, including his own research on aggression and schizophrenia in young people. Dr. Findling also shares his thoughts on the crisis of teen suicide, the lingering impact of COVID-19 on children’s mental health, and the need for early and collaborative interventions. 00:00 Introduction 00:46 Clinical and Research Journey 02:56 Aggression with impulsivity and reactivity (AIR) 06:48 Precision Pediatric Psychiatry 15:34 Schizophrenia 20:31 What Kids Need to Thrive 23:10 Teen Suicide 25:09 Role of Schools and Primary Care 30:58 Loneliness Epidemic Among Children 32:32 Improving Access to Pediatric Mental Health Care 40:00 Bipolar Disorder 43:24 Future Research and Hope for Young Patients 45:11 Conclusion: Importance of Early Intervention Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Charles Nemeroff is Chair of the Department of Psychiatry and Behavioral Sciences at the University of Texas-Austin's Dell Medical School. He is also co-director of the Center for Psychedelic Research and Therapy, and director of the Institute for Early Life Adversity Research. His research is focused on the pathophysiology of mood and anxiety disorders with a focus on the role of child abuse and neglect as a major risk factor. 00:00 Introduction 00:52 Dr. Nemeroff's Research Journey 01:55 Childhood Maltreatment as Risk Factor 04:53 Advances and Challenges in Precision Psychiatry 07:33 Psychedelic Medicine (incl. blinding issues and potential adverse events) 20:50 How Psychedelics Disrupt the "Circle of Hell" 30:00 Psilocybin as Potential Treatment for Anorexia Nervosa 38:32 Screening for Childhood Maltreatment 41:30 Transcranial Magnetic Stimulation (TMS) 44:14 Focused Ultrasound 46:32 Prescribing MAOIs 49:34 Conclusion Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Helen Riess is Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of Empathy Research and Training in the Psychotherapy Research Group at Massachusetts General Hospital. She is also Founder and Chief Executive Officer at Empathetics, a company that provides science-based empathy and interpersonal skills training for healthcare professionals. Her research focuses on improving empathy and relational skills in physicians. 00:00 Introduction 01:14 Defining Empathy 03:38 Empathy and Burnout 05:00 Care for the Caregiver 07:52 Exquisite Empathy and Burnout 09:18 Building Empathy and Avoiding Overburden 10:45 Developing Boundaries in Clinical Practice 11:45 Training and Teaching Empathy 13:42 Model for Recognizing Emotion in Others 15:11 Becoming Emotion Detectives 19:31 Leadership's Role in Creating Supportive Workplaces 23:22 Benefits of Empathy Training 29:07 Technology and Empathy Training 34:18 Research on MDMA-Assisted Psychotherapy 37:43 Building Empathy and Compassion 40:07 Taking Small Steps Towards Empathy 42:32 Resources for Building Empathy 43:28 Future of Empathy Training The Empathy Effect (Dr. Riess's book) The Power of Empathy (TEDx Talk) Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Christopher Pittenger is a Professor of Psychiatry at the Yale School of Medicine and Director of the Yale OCD Research Clinic. In this episode, he discusses the neurobiology, symptomology, and treatment of Obsessive-Compulsive Disorder (OCD), including potential new treatments such as psychedelics, neurofeedback, glutamate modulators, and transcranial magnetic stimulation (TMS). 00:00 Introduction 00:41 Why is OCD Underdiagnosed? 02:19 Impact of OCD on Individuals 03:40 Taboo Nature of OCD Thoughts 06:10 Biomarkers 08:06 Neurobiology 14:20 Serotonin 16:48 Heterogeneity of OCD 24:00 Glutamate Modulators 29:33 Ketamine 33:13 Psilocybin 38:23 Neurofeedback 44:01 Transcranial Magnetic Stimulation (TMS) 47:22 Relationship Between Depression and OCD 50:24 Future of OCD Treatment Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Richard Davidson is the William James and Vilas Professor of Psychology and Psychiatry at the University of Wisconsin–Madison and Founder & Director of the Center for Healthy Minds. In this episode, he discusses the current state of research on mindfulness and meditation as mental health interventions. 00:00 Introduction 02:15 Focus areas in current research 04:37 Well-being as a universal intervention 06:21 Beyond mindfulness: other forms of meditation 07:24 Four pillars of well-being: awareness, connection, insight, and purpose 13:04 Healthy Minds Program and the impact of short daily meditation practices 17:05 Comparison of Mindfulness-Based Stress Reduction (MBSR) and the Healthy Minds Program, focusing on accessibility and time commitment 20:55 The potential for structural changes in the brain with meditation 26:24 Integrating mindfulness and meditation into clinical practice 28:06 Micro-supports for everyday well-being 33:27 Mindfulness and social connection 35:06 Future research directions, including the concept of a flourishing city Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Ronald Kessler is the McNeil Family Professor of Health Care Policy at Harvard Medical School. His groundbreaking work on the social determinants of mental health, studied from an epidemiological perspective, has made him the most widely cited psychiatric researcher in the world. In this wide-ranging conversation, he talks about precision psychiatry's enormous potential and incremental development, delving into his own efforts to better identify at-risk patients and predict treatment efficacy. Dr. Kessler stresses the need for better data and bigger studies, and envisions a future of AI-supported clinicians. 00:00 Introduction 00:53 Dr. Kessler's Journey to Precision Psychiatry 02:45 The Importance of Data 04:14 Risk Factors and Treatment Optimization 10:42 Successes and Challenges 13:23 The Importance of Baseline Information 23:46 Machine Learning in Veterans Health 24:27 Determining Suicide Risk 25:35 Interventions and Cost-Effectiveness 26:16 Esketamine Trials and Response Prediction 27:07 Risk Models and Comparative Risk Models 27:15 Insomnia Treatment in Military Personnel 29:36 Cost-Benefit Analyses 35:45 AI in Medicine and Patient Response 42:21 Future of Precision Psychiatry 45:51 Closing Remarks Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Petros Levounis is President of the American Psychiatric Association and a leader in addiction research. He joins host Thea Gallagher, PsyD, to talk about the latest in addiction medicine, the state of the opioid crisis, the growing problem of technology addiction, and the promise and risks of psychedelic medicine. He also shares his hopes for the future of psychiatry, including better integration of diagnoses, treatments, and outcomes for people with mental health disorders. 00:00 Introduction to NYU Langone Insights on Psychiatry 00:16 Dr. Levounis's role and priorities as APA president 00:46 The State of Addiction Medicine 02:12 Neurobiology of Addiction 03:37 Interplay Between Mental Health and Addiction 06:03 Potential and Challenges of Psychedelic Medicine 08:37 Cannabis and Tech Addictions 10:11 Addressing the Opioid Crisis: Strategies and Solutions 15:28 Addressing Technological Addictions 28:55 The Future of Psychiatry: Goals and Aspirations 35:47 Conclusion and Final Thoughts Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Starting this fall, we're releasing 12 more conversations with the best minds in psychiatry. Subscribe wherever you're listening, so you won't miss an episode. Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Carla Nasca is an Assistant Professor in the Department of Psychiatry and the Department of Neuroscience and Physiology at NYU Langone, where she studies epigenetic mechanisms of neuroplasticity to stress. Dr. Nasca's work led to the discovery of acetyl-L-carnitine (LAC), a metabolite found in the mitochondria, as a promising biological marker of depression. Topics: More information: https://www.cdr.rfmh.org/research/nasca-lab/ Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Tanya Sippy is an Assistant Professor in the Department of Psychiatry and the Department of Neuroscience and Physiology at NYU Langone. She’s also Principal Investigator at the Sippy Lab and Associate Director of the Psychedelic Medicine Research Training Program. Her research explores the neural mechanisms that underlie how sensory stimuli become associated with goal-directed behavior. Topics: More information: https://www.sippylab.com/ Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Andrew Nierenberg is a Professor of Psychiatry at Harvard Medical School and Director of the MGH Dauten Family Center for Bipolar Treatment Innovation. He completed his residency in psychiatry at New York University/Bellevue Hospital. Topics: More information: https://brain.harvard.edu/?people=andrew-nierenberg Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Alan Schatzberg is a Professor of Psychiatry and Behavioral Sciences at Stanford Medicine, and Director of the Stanford Mood Disorders Center. His research examines the biology and psychopharmacology of depressive disorders. An NYU School of Medicine alumnus, Dr. Schatzberg was President of the American Psychiatric Association from 2009-2010. Topics: For more information: https://med.stanford.edu/profiles/alan-schatzberg Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Michael Bogenschutz is a Professor of Psychiatry at the NYU Grossman School of Medicine, and Director of the NYU Langone Center for Psychedelic Medicine. Topics: Cited: Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use DisorderFor more information: https://centerforpsychedelicmedicine.org/ Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Dr. Omonigho M. Bubu is an Assistant Professor of Psychiatry and Population Health at the NYU Grossman School of Medicine, where he studies the connection between sleep and neurodegenerative diseases, as well as social determinants of health as they relate to cognitive health. In this interview, he discusses the importance of sleep, especially for people at higher risk of developing Alzheimer’s disease. Topics: Cited: Obstructive sleep apnea, cognition and Alzheimer's disease: A systematic review integrating three decades of multidisciplinary researchSleep, Cognitive impairment, and Alzheimer’s disease: A Systematic Review and Meta-Analysis Visit our website for more information: https://physicianfocus.nyulangone.org/nyu-langone-insights-on-psychiatry-podcast/ Visit our website for more insights on psychiatry. Podcast producer: Jon Earle

Naomi Simon, MD, talks about her research into mindfulness-based stress reduction (MBSR) and yoga as treatments for anxiety disorders. Dr. Simon is a Professor in the Department of Psychiatry at the NYU Grossman School of Medicine, and Director of the Anxiety, Stress, and Prolonged Grief Program. Topics: Cited: Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders (Nov. 2022) Visit our website for more insights on psychiatry. Podcast producer: Jon Earle