PsychEd: educational psychiatry podcast

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers an introduction to consultation-liaison psychiatry with Dr. Raed Hawa and Dr. Alan Wai, both from the University of Toronto. Dr. Raed Hawa is an esteemed CL psychiatrist and educator. Dr Hawa's interests are in the areas of undergraduate, postgraduate, and continuing medical education. He also practices general sleep medicine with particular clinical interest in the areas of insomnia, co-morbid psychiatric and medical illnesses, and sleep-related movement disorders. He currently serves as the President of the Canadian Academy of Consultation-Liaison Psychiatry (CACLP) and holds the position of Professor at the Faculty of Medicine, University of Toronto. Additionally, Dr. Hawa is the Deputy Psychiatrist-in-Chief at the Centre for Mental Health, University Health Network. Dr. Hawa has earned American Board Certification in Psychiatry, with subspecialty certifications in Sleep Medicine and Psychosomatic Medicine (Consultation-Liaison Psychiatry). His expertise and contributions to the field have been recognized through his designation as a Distinguished Fellow of both the American Psychiatric Association (APA) and the Canadian Psychiatric Association (CPA). Dr. Alan Wai is a psychiatrist at the University Health Network in Toronto and an Assistant Professor in the Department of Psychiatry at the University of Toronto. He provides inpatient CL psychiatry care and mental health and psychiatric care embedded in the Immunodeficiency Clinic at Toronto General Hospital, where he sees both persons living with and at risk of HIV. He received his medical degree from the University of British Columbia and completed his psychiatric residency training at the University of Toronto. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Outline the history and evolution of CL psychiatry Define the role and scope of CL psychiatrists in diverse medical settings Identify and assess common psychiatric disorders in CL settings Provide differential diagnoses and a general approach to a CL patient through a sample case Guests: Dr. Raed Hawa and Dr. Alan Wai Hosts: Annie Yu (PGY3), Sena Gok (MD), and Matthew Cho (CC3) Audio editing by: Sena Gok Show notes by: Sena Gok Interview content: Introduction - 00:13 Learning objectives - 01:09 First guest introduction - 01:36 History of CL psychiatry - 03:18 Subspecialties within CL psychiatry - 10:33 Collaborative care of CL psychiatry - 14:00 Preparation for CL Rotation - 20:03 Bariatric clinic and CL psychiatry - 22:32 Future of CL psychiatry, AFC Certification - 27:45 Second guest introduction - 33:29 Role and scope of CL psychiatry - 34:18 A day in CL psychiatry - 39:32 Cultural competence in CL psychiatry - 44:08 Introduction to patients in CL clinics - 47:53 Resources for CL psychiatry rotation - 50:14 Clinical vignette - 53:08 CL psychiatric assessment approach - 01:00:25 Agitation management in CL psychiatry - 01:09:24 Closing - 01:13:51 End credits - 01:15:05 Resources: Massachusetts General Hospital Handbook of General Hospital Psychiatry: https://www.sciencedirect.com/book/9781437719277/massachusetts-general-hospital-handbook-of-general-hospital-psychiatry Academy of CL Psychiatry (ACLP) educational resources: https://www.clpsychiatry.org/educationcareers/ AFC (Area of Focused Competence) in CL Psychiatry: https://news.royalcollege.ca/en/eligibility-and-exams/areas-of-focused-competence.html Canadian Academy of Consultation-Liaison Psychiatry website: https://www.clpsychiatry.ca Our previous CL psychiatry-related episodes: PsychEd Episode 22: Psycho-Oncology Assessments with Dr. Elie Isenberg-Grzeda PsychEd Episode 35: Pain Psychiatry with Dr. Leon Tourian PsychEd Episode 36: Understanding Eating Disorders with Dr. Randy Staab PsychEdEpisode 37: Treating Eating Disorders with Dr. Randy Staab PsychEd Episode 57: HIV Psychiatry with Dr. Adriana Carvalhal and Dr. Leigh van den Heuvel References: Ali, S., Ernst, C., Pacheco, M., & Fricchione, G. (2006). Consultation-liaison psychiatry: How far have we come? Current Psychiatry Reports, 8(3), 215–222. https://link.springer.com/article/10.1007/s11920-006-0026-y Beran, C., & Sowa, N. A. (2021). Adaptation of an Academic Inpatient Consultation-Liaison Psychiatry Service During the SARS-CoV-2 Pandemic: Effects on Clinical Practice and Trainee Supervision. Journal of the Academy of Consultation-Liaison Psychiatry, 62(2), 186–192. https://pubmed.ncbi.nlm.nih.gov/33288272 Lipowski, Z. J. (1974). Consultation-Liaison Psychiatry: An Overview. American Journal of Psychiatry, 131(6), 623–630. https://doi.org/10.1176/ajp.131.6.623 Lipowski, Z. J. (1992). Consultation-liaison psychiatry at century’s end. Psychosomatics, 33(2), 128–133. https://doi.org/10.1016/S0033-3182(92)71988-4 Swenson, J. R., Abbey, S., & Stewart, D. E. (1993). Consultation-liaison psychiatry as a subspecialty. A Canadian survey. General Hospital Psychiatry, 15(6), 386–391. https://doi.org/10.1016/0163-8343(93)90007-b Taylor, G., & Doody, K. (1979). Psychiatric Consultations in a Canadian General Hospital. The Canadian Journal of Psychiatry, 24(8), 717–723. https://doi.org/10.1177/070674377902400803 For more PsychEd, follow us on Instagram (@psyched.podcast), X (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at [email protected]. For more information, visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. In this episode, we discuss the practice of involuntary hospitalization (also referred to as involuntary commitment or certification) with two special guests and fellow podcast creators — Jesse Mangan and Dr. Jim McQuaid. Their podcast, Committable, focuses on the topic of involuntary commitment and features stories from people with lived experience as a window into complex conversations with attorneys, physicians, psychologists, and more. Jesse Mangan is the producer of Committable and someone who has experienced involuntary hospitalization. Dr. Jim McQuaid is an Associate Professor of Sociology at Framingham University. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Appreciate the individual and societal functions of involuntary hospitalization Understand the potential benefits and risks associated with involuntary hospitalization from the perspective of health care professionals as well as service users and the community at large Describe actions you can take as a practitioner (who has the power to certify) that may better serve your community and those you care for Identify meaningful ways to continue the conversation about these issues in medical education or training and beyond *This episode was recorded in 2021. Through a saga involving lost and recovered audio files, we’re thrilled to finally be able to release it, and believe that the topic is just as timely and relevant as ever! Guests: Jesse Mangan and Dr. Jim McQuaid Hosts: Anita Corsini, Nikhita Singhal, Gray Meckling, and Alex Raben Audio editing by: Nikhita Singhal Show notes by: Nikhita Singhal Interview content: Introduction - 00:34 Committable podcast trailer - 01:52 Guest introductions - 04:26 Learning objectives - 07:22 Defining terms and setting the context - 08:11 Jesse’s experience - 12:03 Exploring the functions of involuntary hospitalization - 23:06 Power differentials and the importance of humility - 41:05 Training considerations - 45:18 False divide between patients and providers - 51:39 Primary prevention and public health - 55:57 Professional identity formation - 57:57 Societal functions and processes - 01:05:00 Building trust - 01:11:57 Legal safeguards - 01:20:20 Alternative approaches/systems - 01:30:11 Rosenhan experiment - 01:37:12 Final thoughts - 01:39:21 End credits - 1:43:50 Resources: Committable podcast website: https://sensiblenonsense.squarespace.com PsychEd Episode 18: Assessing Suicide Risk with Dr. Juveria Zaheer On Being Sane in Insane Places References: Jaeger S, Hüther F, Steinert T. Refusing medication therapy in involuntary inpatient treatment—a multiperspective qualitative study. Front Psychiatry. 2019 May 9;10:295. https://doi.org/10.3389%2Ffpsyt.2019.00295 Johansson IM, Lundman B. Patients' experience of involuntary psychiatric care: good opportunities and great losses. J Psychiatr Ment Health Nurs. 2002 Dec;9(6):639-47. https://doi.org/10.1046/j.1365-2850.2002.00547.x McGuinness D, Murphy K, Bainbridge E, Brosnan L, Keys M, Felzmann H, Hallahan B, McDonald C, Higgins A. Individuals' experiences of involuntary admissions and preserving control: qualitative study. BJPsych Open. 2018 Nov 16;4(6):501-509. https://doi.org/10.1192%2Fbjo.2018.59 Ontario Hospital Association. A Practical Guide to Mental Health and the Law, Fourth Edition. Toronto: Ontario Hospital Association; 2023. Available from: https://www.oha.com/Legislative%20and%20Legal%20Issues%20Documents1/A%20Practical%20Guide%20to%20Mental%20Health%20and%20the%20Law%2c%20Fourth%20Edition%2c%202023.pdf Paksarian D, Mojtabai R, Kotov R, Cullen B, Nugent KL, Bromet EJ. Perceived trauma during hospitalization and treatment participation among individuals with psychotic disorders. Psychiatr Serv. 2014 Feb 1;65(2):266-9. https://doi.org/10.1176%2Fappi.ps.201200556 Rosenhan DL. On being sane in insane places. Science. 1973 Jan 19;179(4070):250-8. https://doi.org/10.1126/science.179.4070.250 Sposini FM. Confinement and certificates: consensus, stigma and disability rights. CMAJ. 2020 Nov 30;192(48):E1642-E1643. https://doi.org/10.1503/cmaj.201750 For more PsychEd, follow us on Instagram (@psyched.podcast), X (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at [email protected]. For more information, visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers Antipsychotic Side Effects with our very own expert Dr Alex Raben, a staff psychiatrist in chronic care at the Centre for Addiction and Mental Health in Toronto. Dr. Raben graduated from medical school and completed residency at the University of Toronto. His academic interests include teaching and medical education scholarship with a particular interest in novel modalities of knowledge translation within the field of psychiatry. He is a founding member and Executive Director of PsychEd, this educational psychiatry podcast which aims to empower medical learners to seek out current knowledge from mental health experts to share with their colleagues around the world. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Outline the side effects of antipsychotics and their known/potential mechanisms Discuss management options for the different side effects Identify which antipsychotics are more likely to cause certain side effects Guest: Dr Alex Raben Hosts: Angad Singh and Kate Braithwaite Audio editing by: Angad Singh Show notes by: Angad Singh and Kate Braithwaite Interview Content: Introduction - 0:00 Primer on antipsychotics - 1:54 Anti-dopamine side effects - 5:04 Drug potency as it relates to side effects - 38:46 Anticholinergic side effects - 41:37 Antiadrenergic side effects - 47:30 Metabolic side effects - 50:29 Sedation - 56:46 Please note that this episode does not include a discussion of the life threatening side effects of antipsychotics. These include neuroleptic malignant syndrome, torsades de pointes, laryngospasm, and seizure. Resources: PsychEd Episode 10: Treatment of Schizophrenia Part II with Dr. Albert Wong — PsychEd Podcast PsychEd Episode 60: Metabolic Psychiatry with Dr. Cindy Calkin – Psyched Podcast AIMSExtendedSample - YouTube Anticholinergic Mnemonics: Toxicology Mnemonic Challenge • LITFL • Toxicology Conundrum References: de Silva VA, Suraweera C, Ratnatunga SS, Dayabandara M, Wanniarachchi N, Hanwella R. Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis. BMC psychiatry. 2016;16:1-0. Migirov A, Datta AR. Physiology, Anticholinergic Reaction. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546589/ Miller DD. Atypical antipsychotics: sleep, sedation, and efficacy. Prim Care Companion J Clin Psychiatry. 2004;6(Suppl 2):3-7. PMID: 16001094; PMCID: PMC487011. Roerig JL, Steffen KJ, Mitchell JE. Atypical antipsychotic-induced weight gain: insights into mechanisms of action. CNS drugs. 2011;25:1035-59. Stahl SM. Stahl's essential psychopharmacology: neuroscientific basis and practical applications. Cambridge university press; 2021. Stroup TS, Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018;17(3):341-56. For more PsychEd, follow us on Instagram (@psyched.podcast), Twitter (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at [email protected]. For more information, visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers an introduction to forensic psychiatry with Dr. Amina Ali, a forensic psychiatrist at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada. Dr. Ali joined the Forensic Division at CAMH in 2018. She is an Assistant Professor in the Department of Psychiatry at the University of Toronto. Prior to joining CAMH, Dr. Ali received her Doctor of Medicine at the American University of the Caribbean, completed her Psychiatry residency at the Icahn School of Medicine at Mount Sinai in New York, and fellowship in Forensic Psychiatry at the Albert Einstein College of Medicine. Dr. Ali's leadership experience includes serving as Chief resident during her residency, for which she was bestowed a Residency Leadership Award from the Bronx Lebanon Hospital Center. She is a Competence By Design coach to residents and serves on the Psychiatry Competency Committee and as a CaRMS file reviewer for the University of Toronto General Psychiatry Residency Program. She is also a supervisor for forensic residents and sits on the subspecialty resident committees. Within the forensic division, Dr. Ali has contributed to the organization and implementation of the Summer Studentship in Forensic Psychiatry Program and is our Medical Education and Wellness Lead. Internationally, Dr. Ali was appointed to serve on the American Academy of Psychiatry and the Law Education Committee and most recently recruited to Chair their Civil Commitment and Consent to Treatment Working Group. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Describe the role of forensic psychiatry and its relation to the Ontario Review Board. Outline the criteria for fitness to stand trial. Describe the function and possible outcomes of a treatment order. Outline the criteria for not criminally responsible on account of a mental disorder. Distinguish between the disposition options available under the Ontario Review Board. Demonstrate an enhanced ability to advocate for and support patients in navigating the forensic psychiatric system. Guest: Dr. Amina Ali Hosts: Alexander Simmons (PGY3), Kate Braithwaite (MD), and Rhys Linthorst (PGY5) Audio editing by: Gaurav Sharma (PGY5) Show notes by: Alexander Simmons (PGY3) References: Crocker, A. G., Nicholls, T. L., Seto, M. C., Charette, Y., Cote, G., Caulet, M. (2015). The National Trajectory Project of individuals found not criminally responsible on account of mental disorder in Canada. Part 2: the people behind the label. The Canadian Journal of Psychiatry, 60(3), 106-116. Prpa, T., Moulden, H. M., Taylor, L., Chaimowitz, G. A. (2018). A review of patient-level factors related to the assessment of fitness to stand trial in Canada. International Journal of Risk and Recovery, 1(2), 16-22. Carroll, A., McSherry, B., Wood, D., & Yannoulidis, LLB, S. (2008). Drug‐associated psychoses and criminal responsibility. Behavioral sciences & the law, 26(5), 633-653. Watts, J. (2013). Updating toxic psychosis into 21st-century Canadian: Bouchard-Lebrun v. R. Journal of the American Academy of Psychiatry and the Law Online, 41(3), 374-381. Crocker, AG, Nicholls, TL, Seto, MC, Cote, G, Charette, Y, Caulet, M. The national trajectory project of individuals found not criminally responsible on account of a mental disorder in Canada, Part 1: Context and methods. Canadian Journal of Psychiatry. 2015;60(3):98-105. Schneider, RD. Mental health courts. Current Opinion in Psychiatry. 2008;21:510-513. https://www.orb.on.ca/scripts/en/about.asp#dispositions For more PsychEd, follow us on X (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at [email protected]. For more information, visit our website at psychedpodcast.org.