PsychEd: educational psychiatry podcast

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

This episode covers catatonia with Dr. Patricia Rosebush. Dr. Rosebush is a Professor in the Department of Psychiatry & Behavioural Neurosciences at McMaster University. She is the distinguished author of numerous articles on clinical neuroscience, including considerable work on mitochondrial disorders in mental illness and over 30 papers on catatonia, and practices consultation-liaison psychiatry at St. Joseph’s Healthcare Hamilton.

The learning objectives for this episode are as follows:

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

1. Develop a conceptual understanding of catatonia
2. Have an approach for diagnosing catatonia
3. Have an approach for treating catatonia

Guest: Dr. Patricia Rosebush

Hosts: Dr. Alastair Morrison (PGY1), Dr. Angad Singh (PGY1)

Audio editing: Dr. Angad Singh

Show notes: Dr. Alastair Morrison

Interview content:

(01:20) Clinical features of catatonia (high level overview)

(04:15) Clinical anecdote - an index case of catatonia

(06:00) History of approaches to catatonia

(10:00) Approach to different catatonia phenotypes

(15:00) Categorization and ideas of mechanism

(18:00) Assessing clinical signs of catatonia 

(24:00) Preserved awareness in catatonia

(27:00) Investigations and differential diagnosis

(30:00) First interventions: benzodiazepines and benzodiazepine withdrawal

(41:30) Managing medical considerations in catatonia

(45:00) Treating other psychiatric illnesses in the catatonic patient

(49:00) Acute, chronic, and refractory treatments

References:

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

This short episode is about counselling patients on antidepressant medications.

Hosts: Matthew Cho and Angad Singh

Audio editing: Angad Singh

Time stamps:

(02:03) Steps to antidepressant counselling

(07:31) Frequently asked questions about antidepressants

Related episodes:

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

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

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

The members of our team involved in this discussion are:

• Sara Abrahamson - MS2 at the University of Toronto
• Dr. Kate Braithwaite - medical doctor from South Africa
• Dr. Wendy MacMillan-Wang - PGY4 psychiatry resident at the University of Manitoba
• Dr. Alastair Morrison - PGY1 psychiatry resident at McMaster University
• Dr. Gaurav Sharma - staff psychiatrist working in Nunavut, Canada

Audio editing by:

• Dr. Angad Singh - PGY1 psychiatry resident at the University of Toronto

Our discussion was structured around four themes:

(03:15) - Psychiatry and Economic Incentives

(19:33) - Psychiatry and Parenting

(28:40) - Biological Psychiatry and its Alternatives

(52:05) - Psychiatry and Social Control

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

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

This primer covers the differential diagnosis of dementia.

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

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

Resources:

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

This episode covers ADHD in youth with Dr. Daniel Gorman, an Associate Professor in the Department of Psychiatry at the University of Toronto and a Staff Psychiatrist at The Hospital for Sick Children. Dr Gorman’s clinical and academic interests include ADHD, Tourette syndrome, obsessive-compulsive disorder, child psychopharmacology, psychiatric education, and narrative medicine. He is highly involved in resident teaching and clinical supervision, and from 2014 to 2022 he was the Program Director for the Child and Adolescent Psychiatry subspecialty program at the University of Toronto.

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

The learning objectives for this episode are as follows:

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

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

Guest: Dr. Daniel Gorman

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

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

Resources: