Cognitive Enhancers: The Brain on Chess
Play • 29 min

The Queen’s Gambit is Netflix’s critically acclaimed series about a chess prodigy who gets “a little help from her friends.” In this episode we find out what they got right, and wrong, about psychiatric meds and cognitive enhancement.

Published On: 1/11/2020

Duration: 29 minutes

Article Referenced: "The Queen's Gambit," The Carlat Psychiatry Report, January 2021

PsychEd: educational psychiatry podcast
PsychEd: educational psychiatry podcast
PsychEd
PsychEd Episode 31: Understanding Psychodynamic Therapy with Dr. Rex Kay
Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers psychodynamic psychotherapy with Dr. Rex Kay. Dr. Kay is a staff psychiatrist at Mount Sinai Hospital, assistant professor and modality lead for dynamic psychotherapy at the University of Toronto, as well as a faculty member at the Toronto Institute for Contemporary Psychoanalysis. The learning objectives for this episode are as follows: By the end of this episode, you should be able to… * Define psychodynamic psychotherapy. * Describe the core concepts of psychodynamic therapy. * Determine who may be an appropriate patient for psychodynamic psychotherapy. * Describe the evidence base for psychodynamic psychotherapy. * Compare and contrast psychodynamic therapy to other psychotherapies. Guest: Dr. Rex Kay Produced and Hosted by: Jordan Bawks and Anita Corsini Audio editing by: Anita Corsini Resources: * Ars Medica: A Journal of Medicine, the Arts, and Humanities * Canadian Institute for Child and Adolescent Psychoanalytic Psychotherapy * Narrative Competence Psychotherapy Group at Mount Sinai Hospital * Toronto Institute for Contemporary Psychoanalysis * Toronto Institute of Psychoanalysis References: Black, M. & Mitchell, S. (2016). Freud and beyond: A history of modern psychoanalytic thought. Basic Books. Cabaniss, D. L., Cherry, S., Douglas, C. J., & Schwartz, A. R. (2017). Psychodynamic psychotherapy: A clinical manual. Wiley. Driessen, E., Hegelmaier, L. M., Abbass, A. A., Barber, J. P., Dekker, J. J., Van, H. L., Jansma, E. P., & Cuijpers, P. (2015). The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis update. Clinical Psychology Review, 42, 1-15. doi: 10.1016/j.cpr.2015.07.004 Eppel, A. (2018). Short-term psychodynamic psychotherapy. Springer. Karen, R. (1994). Becoming attached: First relationships and how they shape our capacity to love. Oxford. Safran, J. D. (2012). Psychoanalysis and Psychoanalytic Therapies. American Psychological Association. Summers, R. F. & Barber, J. P. (2010). Psychodynamic Therapy: A Guide to Evidence-Based Practice. Guilford. 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.
1 hr 11 min
Psychcast
Psychcast
Medscape Professional Network
Treating patients with delusional infestation with Dr. John Koo and Dr. Scott Norton
John Koo, MD, and Scott A. Norton, MD, MPH, join host Lorenzo Norris, MD, for this special edition of the Psychcast. This is a crossover episode with our sister podcast, Dermatology Weekly. Dr. Koo is a psychiatrist and a dermatologist at the University of California, San Francisco. He has no disclosures. Dr. Norton is a dermatologist with the Uniformed Services University of the Health Sciences in Bethesda, Md., and with George Washington University, Washington. He has no disclosures. They are featured in an article on this topic online at MDedge.com/Psychiatry. Dr. Norris is associate dean of student affairs and administration at George Washington University. He has no disclosures. Take-home points * Delusional infestation or delusions of infestation, also known as delusional parasitosis, is a fixed false belief that one has an infestation of animate or inanimate pathogens, despite strong evidence against infestation. Common precipitants of delusional infestation include previous exposure to external or internal parasites, stress, and travel. The condition is more common among highly functional older women. * A recent study estimated the prevalence of delusional infestation as 1.9/100,000, though the condition is an area of limited study. Delusional infestation is poorly recognized by physicians, therapists, and families, which leads patients to search for an external cause of the symptoms and contributes to distress for patients and their loved ones. * Patients with delusional parasitosis often lack insight into their disease, and it can be difficult to persuade them to take the recommended treatment of antipsychotics. * Low-dose pimozide, a first-generation antipsychotic, is the most common treatment for delusional infestation, particularly because it does not have Food and Drug Administration approval as a treatment for psychosis. Therefore, patients are less biased against taking this medication. Summary * Delusions of infestation are a monosymptomatic hypochondriacal psychosis in which the only delusion present is one of infestation, and patients do not have other symptoms of psychotic spectrum illness. Secondary delusions of infestation may occur in individuals who use drugs, such as methamphetamine or cocaine, or who have a primary psychotic disorder, such as schizophrenia. * Delusions of infestation is related to Morgellons disease, which is defined as a skin condition characterized by the presence of “threads” or filaments that patients believe are embedded in their skin and might be accompanied by stinging and itching sensations. * Patients with delusions of infestation usually present to a primary care physician or ED with symptoms of abnormal sensations of their skin, including crawling sensations. In addition, patients usually bring personal proof of their condition, such as a small bag of “specimens,” including pieces of lint, threads, or scabs. Some patients also bring in journals detailing the timing and associated factors of their symptoms. * Dr. Norton advises that physicians treating the patients with delusions of infestation should mentally prepare themselves against initial bias and set aside time for longer visits or several follow-up visits. Dr. Norton starts with the premise that the patient has an actual infestation or other underlying cause of their pruritus and performs a thorough, full-body exam for dermatologic conditions, and examines the materials patients bring with them using a double-headed microscope – so that he and the patient can look at the specimens together. * Dr. Koo often tells patients that they have Morgellons disease because it does not include the stigmatizing term of “delusional.” He reframes Morgellons as an infestation that cannot be cured by internal or external antiparasitic medications. He then pivots away from etiology to validation of their emotions and eventually to treatment. * Dr. Koo usually often starts treatment with pimozide because it is an antipsychotic with FDA approval for Tourette syndrome – not schizophrenia. This perceived absence of a connection of the medication to psychiatric illness allows patients to be more open to taking the medication. * For primary delusional infestation, Dr. Koo starts with pimozide. The dose, which is daily and taken orally, starts low at 0.5 mg and goes up by 0.5 mg every 2-4 weeks. The aim is to get up to 3 mg per day. Low doses of pimozide and other antipsychotics lead to decreased sensation of itching and formication. Dr. Koo refers to his treatment plan as a “trapezoid-like dosage strategy.” Once he gets the patient to 3 mg, he continues the medication until all the symptoms disappear and then continues the medication for an additional 3 months. Dr. Koo then slowly tapers the dosage over an additional few months. * The keys to successful treatment include communicating with patients and working collaboratively with them. This approach builds trust and rapport. References Brown GE et al. J Clin Exp Dermatol Res. 2014;5:6. doi: 10.4172/2155-9554.1000241. Kohorst JJ et al. JAMA Dermatol. 2018 May 1;154(5):615-7. Lepping P et al. J Am Acad Dermatol. 2017 Oct;77(4):778-9. Middelveen MJ et al. Clin Cosmet Investig Dermatol. 2018;11:71-90. Lepping P et al. Acta Derm Venereol. 2020 Sep 16. doi: 10.2340/00015555-3625. Freudenmann RW et al. Br J Dermatol. 2012 Aug;167(2):247-51. Wolf RC et al. Neuropsychobiology. 2020;79:335-44. * * * Show notes by Jacqueline Posada, MD, associate producer of the Psychcast; assistant clinical professor in the department of psychiatry and behavioral sciences at George Washington University, Washington; and staff physician at George Washington Medical Faculty Associates, also in Washington. Dr. Posada has no conflicts of interest. For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com
57 min
American Journal of Psychiatry Audio
American Journal of Psychiatry Audio
American Journal of Psychiatry
February 2021: Maternal Psychological Resilience and Newborn Telomere Length
Executive Editor Michael Roy speaks with Glenn Verner, M.P.H., and Sonja Entringer, Ph.D., about their article on the relationship between maternal psychological resilience during pregnancy and newborn telomere length. Ms. Glenn Verner is a doctoral candidate in medical psychology at Charité University Medicine in Berlin. She is interested in studying the biological mechanisms that underpin maternal and fetal health. Dr. Sonja Entringer is a professor of medical psychology at Charité University Medicine in Berlin. She is also an associate professor in the Health and Disease Research Program at the University of California, Irvine. Her research interests broadly include how developmental programming affects health and disease risk. In particular, she is interested in how stress during pregnancy affects offspring development. * How the authors became interested in this area of research [2:10] * Overview of the telomere system [4:35] * Aims of the study, which examined how positive maternal psychological conditions during pregnancy affect newborn telomere settings [7:40] * Characteristics of study participants [10:44] * The various data collected during pregnancies [12:26] * How resilience and positivity were quantified [13:58] * Relationship between newborn telomere length and maternal resilience [15:18] * Results that stood out to the authors [16:37] * How clinical features or demographic characteristics of the participants affected the study outcome [17:26] * Limitations that may have affected the study results [18:43] * How this work fits in to the overall literature on this subject [19:51] * Implications the work has for the understanding of how maternal health affects infant health and disease risk [20:42] * Key points for researchers, clinicians, and other mental health professionals [22:43] * Recommendations for further research [23:59] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the February 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org
29 min
Inside Schizophrenia
Inside Schizophrenia
Healthline Media
Incarceration and Schizophrenia
The U.S. correctional system is responsible for having 10 times the number of mentally ill patients receiving treatment than any state psychiatric hospital. People with serious mental disorders are 4 times more likely to be incarcerated for minor charges, such as disorderly conduct. Inmates with schizophrenia also remain in prison longer than others. Host Rachel Star Withers and cohost Gabe Howard examine the effect prison has on people with schizophrenia and the connections between living with schizophrenia and incarceration. Guest Lloyd Hale joins us to discuss living with schizophrenia and his time in the correctional system after he was convicted of murder. Years later, he was found not guilty by reason of insanity. About Our Guest Lloyd Hale is a father, certified peer specialist, and the founder of RIDE 4 S.P.M.I. (Ride 4 Serious and Persistent Mental Illness), a 210-mile bike ride across South Carolina to raise awareness around mental illness. As someone living well with schizophrenia, Lloyd has devoted his life to sharing his story in the hopes that others will seek treatment and receive the help and support they need. Lloyd has partnered with SC SHARE (South Carolina Self Help Association Regarding Emotions) to champion the READY FOR LIFE project and THE DREAM TEAM PROJECT, which aims to start healthy conversations in rural areas with youths and their families about mental health and resources in their community. Featured in the Bevocalspeakup documentary “Beyond Silence” with executive producer, singer and songwriter Demi Lovato. In the documentary, Lloyd shares an unscripted journey with the camera through his recovery and current life. http://www.openeighty.com
1 hr 4 min
Bedside Rounds
Bedside Rounds
Adam Rodman, MD, MPH, FACP
60 - Santa's Salmonella
For a special holiday treat, we’re going to explore two tales of salmonella disease detectives -- the first about Mary Mallon (“Typhoid Mary”) and the birth of the genre; and the second about a mysterious salmonella outbreak at Massachusetts General Hospital solved with the assistance of a very jolly patient. Along the way, we’ll talk about clinical epidemiology, the long-lasting influence of Berton Roueché, and the joys of being an internist! You can sign up for the Digital Education conference at cmeregistration.hms.harvard.edu/digitaleducation. Sources: * Buckle GC, Fischer Walker CL, and Black RE, Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010.J Glob Health. 2012 Jun; 2(1): 010401. * Marineli F et al, Mary Mallon (1869-1938) and the history of typhoid fever.Ann Gastroenterol. 2013; 26(2): 132–134. * Soper GA, The Curious Career of Typhoid Mary, read on May 10, 1939 before the Section of Historical and Cultural Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911442/pdf/bullnyacadmed00595-0063.pdf * Norrington B, Cochineal: A Little Insect Goes a Long Way, UCSB Geography. * Roueche B, The Santa Claus Culture, The New Yorker, Aug 27, 1971. * Lang DJ et al, Carmine as a Source of Nosocomial Salmonellosis, NEJM. Apr 13, 1967. * You can buy Medical Detectives here: https://www.amazon.com/Medical-Detectives-Collection-Award-Winning-Investigative/dp/0452265886
38 min
Two Shrinks Pod
Two Shrinks Pod
Dr Hunter Mulcare & Amy Donaldson
68 - The Seven Deadly Sins
To kick off 2021, two shrinks is getting sinful. Thanks to a suggestion from psychiatrist Dr Jackie Rakov (@psychwrite on twitter), we’re taking a look at the psychology behind the seven deadly sins. Do we find people more attractive when we’re primed with lust? Does envy make us more likely to harm others? Is pride different from straight-up narcissism? Listen in to for a light-hearted but in depth look at whether the sins really are that bad. Timepoint/Articles: 05:30 Envy https://journals.sagepub.com/doi/10.1177/0146167219897660 14:30 Pride - https://europepmc.org/article/med/33180528 26:25 Gluttony - https://pubmed.ncbi.nlm.nih.gov/24411760/ 40:58 Sloth - https://www.prdb.pk/article/prevalence-of-academic-procrastination-and-reasons-for-acade-8348 47:30 Lust - https://www.tandfonline.com/doi/abs/10.1080/00224545.2014.933158 58:51 Wrath - https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1111/bjso.12357 01:14:27 Greed - https://www.sciencedirect.com/science/article/abs/pii/S0191886918305130 Media clips drawn from: Se7en (sins), Winnie the Pooh (gluttony), The Simpsons (Sloth), U2 (pride) Pride & Prejudice (pride), How I Met Your Mother (lust), Wallstreet (greed) and Star Trek II: Wrath of Khan (wrath) Hunter’s bonus I can’t believe it’s not sloth articles: (from 35:00-40:58 mins) Sloth bears: https://psycnet.apa.org/record/2019-05979-001 Bridges: https://www.sciencedirect.com/science/article/abs/pii/S1369847820304125
1 hr 27 min
BrainWaves: A Neurology Podcast
BrainWaves: A Neurology Podcast
Jim Siegler, MD | Neurologist | Father | Friend of dogs
#177 Agnosia
To quote Donald Rumsfeld, “there are things we know we know…. we know there are some things we do not know... But there are also unknown unknowns—the ones we don't know we don't know…it is the latter category that tends to be the difficult ones.” In neurology, the agnosias are not that dissimilar from Rumsfeld’s 'unknown unknowns.' In this week’s program, we discuss the nosology and nomenclature for the agnosias, the localization, and the importance of recognizing one. Produced by James E. Siegler. Music courtesy of Dr. Turtle, Grossman, Ewell and Grainger, Marco Trovatelli, and Purple Planet Music. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES * Milner AD, Perrett DI, Johnston RS, Benson PJ, Jordan TR, Heeley DW, Bettucci D, Mortara F, Mutani R, Terazzi E and et al. Perception and action in 'visual form agnosia'. Brain. 1991;114 ( Pt 1B):405-28. * Zeki S and Ffytche DH. The Riddoch syndrome: insights into the neurobiology of conscious vision. Brain. 1998;121 ( Pt 1):25-45. * Biran I and Coslett HB. Visual agnosia. Current neurology and neuroscience reports. 2003;3:508-12. * Coslett HB. Apraxia, Neglect, and Agnosia. Continuum (Minneap Minn). 2018;24:768-782. * Dhont S, Derom E, Van Braeckel E, Depuydt P and Lambrecht BN. The pathophysiology of 'happy' hypoxemia in COVID-19. Respir Res. 2020;21:198. * Li YC, Bai WZ and Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92:552-555. * Matschke J, Lutgehetmann M, Hagel C, Sperhake JP, Schroder AS, Edler C, Mushumba H, Fitzek A, Allweiss L, Dandri M, Dottermusch M, Heinemann A, Pfefferle S, Schwabenland M, Sumner Magruder D, Bonn S, Prinz M, Gerloff C, Puschel K, Krasemann S, Aepfelbacher M and Glatzel M. Neuropathology of patients with COVID-19 in Germany: a post-mortem case series. The Lancet Neurology. 2020;19:919-929.
15 min
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