Mdedge Psychcast

Ruth S. Shim, MD, MPH, joins Carol A. Bernstein, MD, to discuss how to understand systemic racism within psychiatric institutions and the implications for patient care. Dr. Shim is the Luke & Grace Kim Professor in Cultural Psychiatry in the department of psychiatry and behavioral sciences at the University of California, Davis. She has no disclosures. Dr. Bernstein, a past president of the American Psychiatric Association, is vice chair for faculty development and well-being at Montefiore Medical Center/Albert Einstein College of Medicine, New York. She has no disclosures. Take-home points Dr. Shim discusses her editorial published by statnews about why she left the APA, and describes her frustration about what she sees as the APA’s failure to prioritize mental health inequity and structural racism within the organization. Dr. Shim describes systemic racism and oppression as generational traumas that must be recognized and processed if our professional organizations and country are to move forward wi

The Beatles aren't the first group to write about sleep and surely won't be the last. In these next two programs, Dr. Kohanski shares some of her pearls, pharmacologic and nonpharmacologic, on those gymnastic, jumping sheep. Clinical Correlation is published every other Monday on the Psychcast feed. You can email the show at [email protected], and you can learn more about MDedge Psychiatry here: https://www.mdedge.com/podcasts/psychcast.

David H. Rosmarin, PhD, joins Lorenzo Norris, MD, to discuss how to think about the concept of denial and its role in the sociopolitical challenges of our society. Dr. Rosmarin is a clinical psychologist and director of the spirituality and mental health program at McLean Hospital in Belmont, Mass. He also is an assistant professor of psychiatry at Harvard Medical School, Boston. Dr. Rosmarin has no disclosures. Dr. Norris has no disclosures. Take-home points Denial is defined as a cognitive and emotional process by which a person avoids facing aspects of reality, especially when it is difficult to assimilate the details of reality into one’s current thinking. Arguably, denial is a coping or defense mechanism meant to address the tension that arises from trying to change an individual’s current way of thinking and understanding of reality. Another form of denial is choosing to focus only on one’s perception of reality and struggling to see the other side of an argument. We can see this form of denial play ou

Guest host Eva Ritvo, MD, interviews Dorothy Otnow Lewis, MD, about her more than 40-year career in studying death row inmates as examined in the HBO documentary “Crazy, Not Insane.” Dr. Lewis is clinical professor of psychiatry at Yale University, New Haven, Conn. She has no disclosures. Dr. Ritvo is a psychiatrist in private practice in Miami Beach, Fla. She has no disclosures. Take-home points Dr. Lewis has an extensive archive of taped interviews with death row inmates that she has used to inform her work as an expert witness. While doing her child psychiatry training at the Yale Child Study Center and sitting in at the juvenile court, she began to see that some of the children had psychiatric and neurologic problems that had not been addressed. The parents of these children sometimes had psychotic or bipolar disorders. After seeing these themes, Dr. Lewis started a clinic at the court. Dr. Lewis and her team were able to study approximately 15 inmates in four states, including Texas and Florida, both o

In this week's installment, Dr. Renee Kohanski explores the identity crisis facing many physicians today. Clinical Correlation is a bimonthly drop on the Psychcast feed. You can email the show at [email protected], and you can learn more about MDedge Psychiatry here: https://www.mdedge.com/podcasts/psychcast.

Regina James, MD, tells her personal story and discusses how to understand health equity with guest host Carol A. Bernstein, MD. Dr. James is deputy medical director and chief of the division of diversity and health equity at the American Psychiatric Association. She also serves on the advisory board of The PACT group (Pan African Clinical Trials) and receives no income from the group. Dr. Bernstein, a past president of the APA, is vice chair for faculty development and well-being at Montefiore Medical Center/Albert Einstein College of Medicine, New York. She has no disclosures. Take-home points The Robert Wood Johnson Foundation defines health equity as: “Everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.” Equity embraces the idea of inclusiveness and ev

As we begin 2021, Renee Kohanski, MD, muses about the roller coaster journey she and her listeners have been on during the challenging times of 2020. Clinical Correlation is a bimonthly drop on the Psychcast feed. You can email the show at [email protected], and you can learn more about MDedge Psychiatry here: https://www.mdedge.com/podcasts/psychcast.

Bradford L. Frank, MD, MPH, MBA, conducts a Masterclass on how to provide nursing home consultations for psychiatrists. The documents Dr. Frank refers to during this Masterclass are available at (https://bit.ly/3rWqfcK) Dr. Frank is a board-certified geriatric psychiatrist who provides consultations for more than 30 nursing homes in North Dakota. He has no disclosures. Take-home points Dr. Frank reviews practical information about documentation, prescribing, and diagnoses for psychiatric clinicians who treat individuals living in nursing homes. The Centers for Medicare & Medicaid Services has many rules and regulations governing the psychiatric treatment of individuals in nursing homes, including special mental status testing, a policy of gradual dose reduction, and restrictions on how long certain medications can be used. Documentation Even for geriatric patients who live in nursing homes, a full past psychiatric history, including substance abuse and social history, is essential to diagnosis and trea

Three of our favorite masterclasses back-to-back-to-back. The Psychcast will return with new content in 2021.  Bulimia nervosa (01:53) Episode 104  Telepsychiatry (12:58) Episode 111 Cannabis (39:17) Episode 137 Email the show at [email protected]

Richa Bhatia, MD, conducts a Masterclass on how to identify medical and neurologic illnesses that present with psychiatric symptoms and mimic psychiatric diagnoses. Dr. Bhatia is a board-certified general and child and adolescent psychiatrist in private practice. She has no disclosures. Take-home points Psychiatric diagnoses are diagnoses of exclusion. Psychiatric clinicians must maintain a high level of clinical suspicion for medical and neurologic illnesses that present with psychiatric symptoms and mimic psychiatric diagnoses. When patients have a “strange” presentation of their psychiatric illness, including being out of the usual age range, a fast progression, or an unusual constellation of symptoms, clinicians should pursue a medical work-up and think broadly about other diagnoses that might mimic the psychiatric diagnosis. Dr. Bhatia provides an overview of common medical and neurologic illnesses that mimic psychiatric diagnoses, including hypothyroidism, delirium, HIV/AIDS, Addison disease, autoimmune

In this week's installment of Clinical Correlation, Dr. Renee Kohanski reminds listeners of our inherent desire to help one another and problem solve while cautioning against those who would place our most vulnerable populations at risk. Clinical Correlation is a bimonthly drop on the Psychcast feed. You can email the show at [email protected], and you can learn more about MDedge Psychiatry here: https://www.mdedge.com/podcasts/psychcast.

Eliza W. Menninger, MD, spoke with Psychcast host Lorenzo Norris, MD, about how to help patients deal with anxiety related to the COVID-19 pandemic. Dr. Menninger is medical director of the behavioral health partial hospital program at McLean Hospital in Belmont, Mass. She treats patients with major depression, bipolar disorder, schizophrenia, and schizoaffective disorder. Dr. Menninger also treats patients in McLean’s Schizophrenia and Bipolar Disorder Outpatient Clinic. She has no disclosures. Dr. Norris has no disclosures. Take-home points Anxiety related to stress, fear, worry, and grief has spiked in all phases of the pandemic. Initially, we faced uncertainty not knowing how to adapt to restrictions, and we assumed that the adaptations would be short term. Six months into the pandemic, we’ve moved into questions about maintaining these adaptive processes over the long term. As the medical director of a partial hospitalization program, Dr. Menninger created an acronym, “MASK,” to help people cope with th

Oliver Freudenreich, MD, talks with Lorenzo Norris, MD, about principles of pandemic management among patients with serious mental illness. Dr. Freudenreich reported receiving grant or research support from Alkermes, Avanir, Janssen, and Otsuka. He has served as a consultant to the American Psychiatric Association, Alkermes, Janssen, Neurocrine, Novartis, and Roche. Dr. Norris has no disclosures. *  *  * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: [email protected]  

In this week's installment of Clinical Correlation, Dr. Renee Kohanski tackles the very difficult and painful realities of a postelection country. Clinical Correlation is a bimonthly drop on the Psychcast feed. You can email the show at [email protected], and you can learn more about MDedge Psychiatry here: https://www.mdedge.com/podcasts/psychcast.

This week, we revisit four shows that offer guidance to clinicians for addressing the mental health fallout from COVID-19. Lisa W. Coyne, PhD, founder of the McLean OCD Institute for Children and Adolescents in Belmont, Mass., focuses on helping children and adolescents with anxiety and obsessive-compulsive disorder. She disclosed receiving royalties from New Harbinger and Little Brown Publishing. Christine Moutier, MD, describes interventions that can prevent patients from ending their lives by suicide. She is chief medical officer of the American Foundation for Suicide Prevention. Dr. Moutier reported no disclosures. Sanjay Gupta, MD, offers a Masterclass on how to determine which medication works best for geriatric patients with symptoms of dementia. Dr. Gupta, chief medical officer at BryLin Hospital in Buffalo, N.Y., disclosed serving on the speakers’ bureaus of AbbVie, Acadia, Alkermes, Intra-Cellular Therapies, Janssen, and Otsuka. Peter Yellowlees, MBBS, MD, wraps up the podcast with perspective abou

Diana M. Martinez, MD, conducts a Masterclass on marijuana’s effects on psychiatric disorders. Dr. Martinez, a professor of psychiatry at Columbia University, New York, specializes in addiction research. She disclosed receiving medication (cannabis) from Tilray for one study and has no other financial relationships with this company. Take-home points The use of cannabis, recreationally and medically, has been a controversial topic for ages, and the classification of cannabis as a schedule I controlled substance has made it all the more difficult to research and meaningfully understand its harms and benefits. Based on information from the National Academies of Sciences publication Health Effects of Marijuana: An Evidence Review and Research Agenda, Dr. Martinez presents a sweeping overview of the role of cannabis in two domains: Its ability to worsen psychiatric symptoms, and its role in causing psychiatric disorders. The cannabis plant has 100 cannabinoids. The two most commonly studied are tetrahydrocannabi

In this week's installment of Clinical Correlation, Renée Kohanski, MD, ponders the loss of professional courtesy and the larger implications of medicine-shifting paradigms. Clinical Correlation is a bi-monthly drop on the Psychcast feed. You can email the show at [email protected], and you can learn more about MDedge Psychiatry here: https://www.mdedge.com/podcasts/psychcast.

Lisa W. Coyne, PhD, spoke with Psychcast host Lorenzo Norris, MD, about strategies that can be used to help children and adolescents deal with anxiety and obsessive-compulsive disorder amid COVID-19. Dr. Coyne, a clinical psychologist, is founder of the McLean OCD Institute for Children and Adolescents in Belmont, Mass. She also is director with the New England Center for OCD and Anxiety in Cambridge, Mass. Dr. Coyne disclosed receiving royalties from New Harbinger and Little Brown Publishing. Dr. Norris has no disclosures. Take-home points Much of the anxiety experienced by some children and adolescents is caused by uncertainty about the future. Some children and adolescents also are watching cases of COVID-19 tick up across the country and are concerned about the mixed messages they are receiving from adults. Different cultures exist around belief in science. Rates of anxiety in general are on the rise as are demands for more mental health services. Clinicians are supporting each other to support their

*** There is a transcript available for this episodes at https://www.medscape.com/viewarticle/940969 Yuan Chang Leong, PhD, spoke with Psychcast host Lorenzo Norris, MD, about his research into the neural underpinnings of right- and left-leaning individuals. Dr. Leong is a postdoctoral scholar in cognitive neuroscience at the University of California, Berkeley. He has no disclosures. Dr. Norris has no disclosures. Take-home points Dr. Leong and colleagues looked for further evidence of “neural polarization,” which is defined as divergent brain activity based on conversative versus liberal political attitudes. The prefrontal cortex is the part of the frontal lobe responsible for executive and higher-order brain function that makes sense and organizes what a person is seeing, hearing, and experiencing. Participants were shown news clips about immigration policy and their brain activity showed differences in activity of their dorsomedial prefrontal cortex (DMPFC), which is active in interpreting narrative conte

Renee Kohanski, MD, discusses managing difficult referrals from trusted colleagues. Clinical Correlation is a bi-monthly drop on the Psychcast feed. You can email the show at [email protected], and you can learn more about MDedge Psychiatry here: https://www.mdedge.com/podcasts/psychcast.