Bedste PsyD-podcasts (2024)

1
WTF Cerebellum - Little Brain, Big Deal 32:58

6d ago32:58

32:58

I did not until recently even consider the cerebellum when thinking about psychiatric conditions, but the more I read, the more I wonder why the cerebellum is not considered a potential important player in nearly every psychiatric disorder. Although it can be said that all brain regions primarily function to make predictions, the cerebellum is espe…

1
WTF - Thalamus 22:32

16d ago22:32

22:32

The thalami are bilaterally symmetrical structures in the subcortical part of the brain that are cradled by the basal ganglia. They are major hubs of pretty much everything your brain does and all of the sensory information coming into the brain with the exception of smell. More primitive models of the brain visualized it as a bunch of relatively i…

1
Seroquel (Quetiapine) - Drugs, Sex, Money and Psychopharm 24:53

28d ago24:53

24:53

In this episode, I discuss a medication that patients who saw a psychiatrist or their primary care provider between about 1997 and 2015 were very likely to find themselves prescribed. More recently, it has been taken down a notch or two on prescribers lists of preferred meds. This medication is quetiapine, marketed as Seroquel by AstraZeneca in the…

1
In a Word - Confabulation 14:22

2M ago14:22

14:22

This episode continues an intermittent series called “In a Word.” Past episodes have explored words like Akathisia, Dissociation, Perseveration, and even the difference between Impulsive and Compulsive. This episode explores Confabulation, including some of the brain circuits involved, and what might differentiate confabulation from other kinds of …

1
How guilty are adolescents for their crimes? 29:31

2M ago29:31

29:31

In 2012 the Supreme Court heard two related cases involving adolescents convicted of murder and sentenced to life in prison without parole because of mandatory minimum sentencing guidelines in their states. One of the boys, Evan Miller along with an accomplice, had beat a man unconscious with a baseball bat after a fight that ensued when the man aw…

1
Serious Mental Illness in America with Dr. Zac Brooks 45:59

3M ago45:59

45:59

I am lucky today to be able to bring you an interview with Dr. Zac Brooks who is passionate about serious mental illness (SMI). “What is serious mental illness?” you might ask. That is one of the things we are going to discuss, and you may be surprised when Dr. Brooks explains how it was first formally defined. We also discuss the numerous ways the…

1
HIV, PrEP, and Mental Health with Dr. Jon Lindefjeld 46:48

3M ago46:48

46:48

PsyDactic welcomes Dr. Jon Lindefjeld for a discussion of the history of HIV and AIDS. In particular, we discuss the development of effective antiretroviral therapies, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), highlighting the CDC guidelines for use and monitoring, need to treat psychiatric com-morbidities, and …

1
Perspectives on the Borderline: The Most Disordered Personality 40:07

3M ago40:07

40:07

Dr. O'Leary discusses some of the history of the borderline personality, how different perspectives have attempted to explain its origin, how to treat it and how not to treat it. He starts in 1947 with some colorful descriptions of patients living with borderline personality disorder that would never get published today, and highlights some of the …

1
The Ghost of Personality Disorders Future 23:27

3M ago23:27

23:27

Our current diagnostic criteria for personality disorders have failed to demonstrate validity or reliability. The DSM 5 encouraged psychiatrists to start considering a broad range of personality features adapted from the Five Factor Model. These are combined with global functioning measures to build a personality inventory for any patient who is ha…

1
Tattoos, Stigma, Racists, and Psychiatry 26:11

4M ago26:11

26:11

Humans have a history of tattooing that stretches millennia into prehistory. The western ban on tattoos by the early church resulted in a systematic effort to paint tattooed individuals as pagan, primitive, vulgar, criminal, and mentally ill. Psychiatrists have historically contributed to this characterization but are in a position to help reframe …

1
Attractor Networks and the Bayesian Brain 58:06

4M ago58:06

58:06

The brain understands the world by building models that predict the future. One of the ways that it does this is by utilizing attractor networks. These small world networks are constantly trying to determine what is a true signal from the constant noise in the neural net. Dr. O'Leary explores how attractor networks have been hypothesized to explain…

1
Serotonin - Jack of All Trades, Master of None 32:44

4M ago32:44

32:44

When I started to make this episode, I thought I would try to do a comprehensive review of all of the various functions of serotonin across its 15 or more receptor types, but I soon found myself overwhelmed. More importantly, I found that some stories are more interesting to tell than others, so here I discuss serotonin and focus on how a few 5-HT …

1
Antipsychotics and their discontents 21:31

5M ago21:31

21:31

Frequently I have complained that the terms "typical and atypical" or "first generation and second generation" antipsychotics were not very helpful. When I give chalk talks to junior residents and interns about antipsychotics, this is one of the first things that I note. It is the medicines relative affinities for different receptors that appear to…

1
Extrapyramidal Side Effects and Tardive Dyskinesia for Super Nerds 37:22

5M ago37:22

37:22

This episode explores side effects of antipsychotics at the molecular level. It starts by exploring receptors and their ligands and takes a turn into the dorsal striatum where dopamine, acetylcholine, serotonin, and glutamate work together to help us dance the mamba. Dr. O'Leary explores what happens when the complex pathways of the cortico-striata…

1
The STAR*D Trial: Scientifically Flawed or Scientific Fraud? 22:02

5M ago22:02

22:02

The authors of the famous sequenced treatment alternatives to relieve depression trial or STAR*D reported that about two-thirds or 67% of patients had achieved remission after 4 trials of antidepressant medication. This remission rate has been questioned over the years and in October of 2023, the journal BMJ Open published an article that reports t…

1
Dopamine Networks and Psychosis 32:17

5M ago32:17

32:17

This episode is about dopamine. In episode 32, I discussed the pseudoscientific trend of the “dopamine detox” or "dopamine fasting." Instead of talking about pseudoscience in this episode, I discuss the actual science surrounding dopamine and its relationship with the neuroleptics or antipsychotics as they are more commonly known. The effects and s…

1
In a Word - Impulsive vs Compulsive 29:00

6M ago29:00

29:00

In this Episode, I continue an intermittent series called “In A Word.” The difference between prior episodes and this one is that today I have two words. I chose these words because I don’t really know the difference between them, and even after reading and trying to understand the difference, I am not sure that there is a clear difference. The two…

1
Traumatic Brain Injury - How Severe Was It? 24:34

7M ago24:34

24:34

I discuss something that is likely to present itself to a physician long after the fact: a single mild brain injury. This episode focuses on how to classify the severity of a single brain injury. While working in a brain injury unit, I noticed that some providers used the term severe brain injury when referring patients to neurology or neuropsychia…

1
The Medial Prefrontal Cortex 15:28

9M ago15:28

15:28

This episode continues a series on the prefrontal cortex, a complex region of the brain that gives us the ability to have the kinds of thoughts no other species on earth is known to have. The medial (or mesial) prefrontal cortex is especially important for emotional and autonomic regulation, attention and goal-directed behaviors (including addictio…

1
The Orbitofrontal Cortex - Our built-in Economist 25:30

10M ago25:30

25:30

In this episode, I am sliding down and under the front part of the brain and consider the orbital frontal cortex, that part of the brain right above and a little behind your eyes. It is much smaller than the lateral gyri on the prefrontal cortex, but appears to be an important probability generator in our brain when we need to consider different op…

1
The Dorsolateral Prefrontal Cortex - Our Executor and Speech Writer 36:15

10M ago36:15

36:15

We seem to understand the specializations of the the dorsolateral prefrontal cortex on the left better than the right side of our brain. That is because most of us do a lot more language processing on the left or dominant side. The more inferior and caudal parts of the dorsolateral PFC on the left side are more specialized for speech. The more supe…

1
The Prefrontal Cortex - An Introduction to What Makes Us Human 20:09

10M ago20:09

20:09

Besides being relatively hairless apes, there are some things about humans that make us special among animals. In the past we have noted things like, “We have big brains and we use tools,” or “We contemplate the future and our own mortality,” or “We use a truly complex language both verbal and written to communicate complex ideas.” These are things…

1
Psychological versus Neuropsychological Testing 40:23

10M ago40:23

40:23

This episode is about how to decide whether to send a patient to get neuropsychological or just psychological testing, and this decision is determined by at least two things. The first is the question that you are trying to answer. The second is, what can the service that I am referring to provide for the patient? In this episode, I will focus prim…

1
In a Word - Validity 25:50

10M ago25:50

25:50

Today I discuss the term “validity.” Let’s say we wanted to develop a test that identifies pathological character traits or quantifies depression symptom burden on a patient. A good test is going to do more than simply list the diagnostic criteria for various diagnoses and then ask the patient if they think that sounds like them. A test needs to ha…

1
Guns - Starting the Conversation 29:41

11M ago29:41

29:41

Today I talk about guns. More specifically, I talk about talking about guns. Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and shoul…

1
In a Word - Akathisia 23:17

12M ago23:17

23:17

Today I am continuing an intermittent series called, “In a Word,” and the word that I chose for today is akathisia. Akathisia is broadly defined as an inability to remain still. If you ask someone with Akathisia to stop moving, they will likely become very uncomfortable, but while they are moving, they experience at least some relief. Please leave …

1
Dopamine Detox and Pseudoscience 29:00

1y ago29:00

29:00

There is a narrative wave in popular psychology and neuroscience that has taken a small amount of very basic science and twisted it into a fantastic narrative of feast and famine. Its central character is dopamine. The Dopamine Detox also known as dopamine fasting is a pseudoscientific treatment that at best illustrates how magnificently strange an…

1
Artificial Intelligence and Psychiatry 26:45

1y ago26:45

26:45

I have recently added some artificial intelligence produced answers to psychiatry questions in my past episodes in an effort to try to understand what it is that AI text generators can do and what value they might add to my future as a psychiatrist versus what problems it might introduce into my practice. I realized that since I have opened this pa…

1
What is a placebo? 24:31

1y ago24:31

24:31

What is a placebo? You may already be thinking something like: A placebo is an imitation, fake, sham, decoy, or trick treatment that we give to people in studies to see if the treatment under investigation is any better or worse. Placebos are supposed to be both benign and inert, meaning they should neither harm nor help a patient beyond the patien…

1
In a Word - Dissociation 25:42

1y ago25:42

25:42

This episode is the second in an intermittent series I am calling In A Word. Psychiatry is full of terms that are either poorly defined or used in such broad ways that they are not very helpful by themselves. Trying to come to terms with terms we throw around can help us to understand the conditions we treat better, and hopefully will help us to co…

1
Adult ADHD and Bayesian Reasoning 21:56

1+ y ago21:56

21:56

Bayesian reasoning is likely operating in your mind whether you realize it or not, whether you can do the math or not. In this episode, Dr. O'Leary explores how to explicitly use Bayesian reasoning to put actual numbers to our inherent biases. Attention Deficit Hyperactivity Disorder (ADHD) seems like a good place to start. Please leave feedback at…

1
Psych GPT 15:13

1+ y ago15:13

15:13

You may have heard that Dr. Google now has some serious competition. It comes from artificial intelligence. Chat GPT is a text generating program that was trained to respond to prompts from users like you and me. What will it say to our psychiatry patients? I gave it some prompts to find out. Please leave feedback at https://www.psydactic.com. Refe…

1
Artificial Challenges for Physician Mental Health 14:23

1+ y ago14:23

14:23

Society is in upheaval in the way that it discusses mental health. There are many loud voices out there. Some of these advocate for more openness and less stigma with regard to how we treat people with behavioral and psychological disorders, and by "treat," I don’t mean with drugs or therapy, but with our words, actions, policies, laws, and inactio…

1
Neuropsychiatry - Huntington Disease 30:02

1+ y ago30:02

30:02

Dr. O'Leary reviews one of the most frustrating diseases that a patient and their family might approach a psychiatrist with: Huntington’s Disease. Huntington’s Disease is a neurodegenerative disorder, which means that over the course of the disease neurons die or cease to function correctly and this worsens over time. The death of neurons in the ca…

1
Neuronal Networks: Depression 29:12

1+ y ago29:12

29:12

It is unlikely that any model of major depressive disorder is likely to find universal signals among those diagnosed because the symptoms are so diverse. However, it does seem likely that models, such as brain-network models, will be able to identify common dysfunctions among those with similar symptom burdens (for example, those with primarily anh…

1
Treating Bipolar Depression with Dr. Tom DePietro 38:39

1+ y ago38:39

38:39

Bipolar disorder is a complex, often debilitating and potentially life threatening illness in which the patient goes from episodes of depression to episodes of mania or hypomania, most often with periods of relative euthymia in between these episodes. The most common way to conceptualize the treatment of bipolar disorder is by phase. The ideal goal…

1
Neuronal Networks: The Central Executive Network... and some philosophy 20:24

1+ y ago20:24

20:24

In previous episodes I have tried to draw pictures in your mind (using those fat crayons that babies like to chew on) of some of the brain networks that are important in many mental illnesses. We have talked specifically about the Default Mode Network (that is concerned with imaginal thoughts and self-referential thoughts and memories), the Dorsal …

1
Neuronal Networks: The Salience Network 14:16

1+ y ago14:16

14:16

What is salience? Fundamentally it is a value judgment that determines where your brain will place its limited resources. There are a lot of things that could draw our attention. The world is full of sights, sounds, smells, pressures, temperatures, stretches. Our mind is full of thoughts. Without a salience network, we wouldn’t know what matters an…

1
Neuronal Networks: The Attention Networks 12:38

1+ y ago12:38

12:38

Today, I am going to explore the Attention Networks, which are the parts of our brain that get really excited when, for example, we see something that we have never seen before, something that appears to be moving on its own volition (and might harm us), something that appears out of place (like an eyeball on the floor), or something that reminds u…

1
Neuronal Networks: The Default Mode Network 15:19

1+ y ago15:19

15:19

Behaviors are complex. We have networks of neurons functioning in systems, some of which ramp other systems up, and some of which dampen others down. This ballet of correlation (when increased activity in one network predicts increased activity in another) and anticorrelation (when increased activity in one network predicts decreased activity in an…

1
The Noradrenergic Paradox 17:08

2y ago17:08

17:08

One of the most influential models in psychiatry’s history for understanding brain dysfunction is the monoamine hypothesis. In short, it proposes that deficiencies or excess of certain neuromodulating agents, in particular the monoamines serotonin, dopamine, and norepinephrine (AKA noradrenaline) drive many psychiatric disorders. The paper I will p…

1
Gender Language and the DSM 5-TR 12:18

2y ago12:18

12:18

This is an episode to report updates in the DSM 5-TR that can be practice changing. I will also divulge a little about myself and how my philosophy and values have changed. In particular, I am reminded of how I have struggled to understand transgendered and other gendered individuals. Please leave feedback at https://www.psydactic.com. References a…

1
Bush Francis versus the DSM 20:39

2y ago20:39

20:39

I originally promised a review of the Bush Francis Catatonia Rating Scale, but while reviewing it, I came across some questions that I think are even more interesting. I will discuss Bush Francis, but I want to do it in a larger context of the challenges that Psychiatrists face with diagnosis in general. Please leave feedback at https://www.psydact…

1
Catatonic Signs - Echolalia, Echopraxia, and Agitation 13:15

2y ago13:15

13:15

Dr. O discusses the remaining hyperactive or “excited” signs of catatonia including echolalia, echopraxia, and agitation. In previous episodes, Dr. O discussed other hyperactive or “excited” signs, including mannerisms and stereotypy. All of these signs share the common feature that the patient is doing something odd, repetitive, or unexpected. Dr.…

1
Catatonic Signs - Catalepsy, Postering, Grimacing and Waxy Flexibility 12:23

2y ago12:23

12:23

In this episode, I discuss Catalepsy, Postering, Grimacing and Waxy Flexibility. I grouped the diagnostic signs that I am going to cover today because they are all similar. Your patient acts like a wax statue. Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcrip…

1
Catatonic Signs - Stupor, Mutism, and Negativism 10:07

2y ago10:07

10:07

Stupor, Mutism, and Negativism on the surface appear to have some overlapping features. Of all the features of catatonia that non-experts might be able to describe, stupor and mutism are like the ones. They are also the most common signs. A patient is not entirely unconscious, but they don’t move, they stare forward, they don’t talk, and they don’t…

1
Catatonic Signs - Stereotypy and Mannerisms 10:24

2y ago10:24

10:24

In the last episode, I promised [or threatened] to get into more of the nitty-gritty of the symptoms of catatonia. Well, like it or not, that is what I am going to do in this episode. Today I will focus on Mannerisms and Stereotypy, two of the potential signs of catatonia. Please leave feedback at https://www.psydactic.com. References and readings …

1
Catatonia - Introduction and Overview 23:14

2y ago23:14

23:14

In this episode, I introduce a diagnosis that is not a diagnosis. By that, I mean that it is a condition that we may find our patients in, but it is not considered to be a diagnosis by itself, like major depressive disorder or schizophrenia are considered to be diagnoses. I am talking about catatonia, a condition characterized by either a lack of i…

1
In a Word - Perseveration 9:48

2y ago9:48

9:48

This episode is a quick take in a new intermittent series I am calling “In a Word,” and in this series I hope to dig down into some neuropsychiatric terms that we use every day, but maybe don’t really understand very well. The first word I am taking on is PERSEVERATION. The reason I chose PERSEVERATION is because I see it written in psych notes by …

1
Those other obsessive and compulsive disorders 19:29

2y ago19:29

19:29

My last three episodes focussed on classical cases of Obsessive Compulsive Disorder, but the DSM 5 has included a few other related diagnoses in the same chapter including body dysmorphic disorder (BDD), hoarding disorder, trichotillomania, and excoriation disorder. Each of these have distinct obsessional components and compulsions, age of onset, d…

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