PsychPearls by Psychiatric Times

Amir Inamdar MBBS, DNB (Psych), MFPM

Scare tactics don't work. But scientific education might. Here are tips for talking with teenaged patients about keeping themselves and their friends safe. 

Last month we taught you how evening light can worsen mood. Today, we teach you how to fix that.

[Note: this is the second half of the Psych Pearls interview with James L. Knoll IV, MD. In the first half of the conversation, Knoll discussed the challenges of treating patients with traits like psychopathy or anti-social personality disorders. – Ed]  Forensic psychiatrists have emotionally taxing jobs: They spend countless hours studying acts of violence and the individuals who commit them. How could anyone endure this job for more than a few years?  James L. Knoll IV, MD, has survived decades in the field. In this edition of Psych Pearls, Knoll talks about how he maintains his mental well-being. He also reveals the childhood obsession that set him on his career path, reflects on how forensic psychiatry has changed over time, and looks forward to how it might change for the better in the future.   In this conversation, Psychiatric Times and Knoll cover: 1.     His childhood fascination with the Jonestown murder-suicide. 2.     How he got interested in forensic psychiatry.  3.     The risk of burnout in forensic psychiatry (or any other psychiatric specialty). 4.     How the arts and other creative endeavors can help psychiatrists stay mentally and physically well.  5.     The tension at the heart of the forensic psychiatrist's identity: are they primarily treaters of mental illnesses, or expert witnesses?  6.     The new importance of social media for forensic investigations.  7.     Why it's important not to judge patients—no matter how difficult they may be. Dr Knoll is professor of psychiatry and director of forensic psychiatry at SUNY Upstate Medical University in Syracuse, New York, and clinical director of Central New York Psychiatric Center in Marcy, New York. He is Emeritus Editor-in-Chief of the Psychiatric Times and President-elect of the American Academy of Psychiatry and the Law (2022-23).

Psychiatrists are not strangers to difficult and even potentially dangerous patients, but James L. Knoll IV, MD, has made these populations one of his specialties. With decades of experience in forensic psychiatry, Knoll takes listeners deep into the US criminal justice system, where he treats both inmates suffering from detention-related psychiatric disorders and an especially challenging group that he has dubbed morally objectionable patients.  In this conversation, Psychiatric Times and Knoll cover: 1.     What he means by the term morally objectionable patients.  2.     How prisons' strict social hierarchies can contribute to psychiatric illnesses.  3.     The high prevalence of bipolar disorder and schizophrenia in corrections—and their potential causes.  4.     The different challenges of treating patients in prisons vs jails.  5.     Why inmates with psychiatric illnesses end up in the correctional system for longer than those without psychiatric illnesses. 6.     The role of mental health courts in improving psychiatric care in the correctional system. 7.     The challenges of treating patients who are high in psychopathy or have anti-social personality disorders.   This is the first half of the Psych Pearls podcast with Dr Knoll. Stay tuned for the second half later in the week.  Dr Knoll is professor of psychiatry and director of forensic psychiatry at SUNY Upstate Medical University in Syracuse, New York, and clinical director of Central New York Psychiatric Center in Marcy, New York. He is Emeritus Editor-in-Chief of the Psychiatric Times and President-elect of the American Academy of Psychiatry and the Law (2022-23).

In this edition of PsychPearls, Hannah Simon, MD, introduces a new series on teen and tween mental health. Her first guest is Andrew Chen, MD, MS, the chief medical officer for USA Nordic, the national leadership organization for Nordic Combined and Ski Jumping in the United States. They discuss the importance of mental wellbeing for peak athletic performance, the programs available for Olympic athletes, and how health care providers can help students succeed—in everything from the big game to the big test.   In this podcast they cover: - Dr Chen's path from medical school to the Olympic Games - Simone Biles and fighting the stigma surrounding mental illness - The mental health challenges facing school-aged children during the pandemic - The importance of diet and nutrition for athletic performance and mental wellbeing - 5 personality attributes that Olympians share (and what psychiatrists can learn from them) Dr Simon is a child and adolescent psychiatry fellow at New York-Presbyterian Hospital.  Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present the Caring for Teens and Tweens podcast with experts in the field of psychiatry.

Lamotrigine was launched for bipolar disorder in 2003, but it was a quiet launch, and since then a few myths have gathered around it as if to fill that vacuum. Today, we will address 4 of them. 

Blue light is getting blamed for everything from eye strain to cancer lately, but what does it do to our patients with depression and bipolar disorder. A lot, as you will see in this podcast, but it depends on what time of day it is shining.

PSYCHPEARLS PODCAST Alzheimer disease (AD) remains one of the most dreaded diagnoses a patient can get. The US Food and Drug Administration (FDA) raised hopes when it approved aducanumab, which promised to be the first disease-modifying drug for AD. But the approval immediately proved controversial. Three FDA board members resigned, the FDA then narrowed its patient label, and in mid-July, major hospitals announced that they would not administer the drug.  In this edition of Psych Pearls, Helen Lavretsky, MD, MS clarifies the issues in the aducanumab debate and offers guidance for clinicians whose patients may ask about it. Going beyond pharmacology, she points out that other treatment options, including mind-body interventions and diet changes, have been shown to slow AD's progression.  In this conversation, Psychiatric Times and Lavretsky cover: 1.     The aducanumab controversy 2.     Advice for talking to patients and caregivers about aducanumab and other novel pharmacological options 3.     Mind-body and lifestyle interventions for AD 4.     AD prevention programs, including nutrition, exercise, and stress reduction 5.     Taking care of caregivers, including psychiatrists and other medical professionals 6.     How to prescribe joy  Dr Lavretsky is a professor in-residence in the Department of Psychiatry at the University of California, Los Angeles. Her work on geriatric depression and integrative mental health using mind-body interventions has received national attention, and she has won numerous grants supporting that work. A distinguished fellow of the American Psychiatric Association and a fellow of the American College of Neuropsychopharmacology, she is also on the board of Psychiatric Times.

Jonathan E. Alpert, MD, PhD PSYCHPEARLS PODCAST June is National Men's Health Month, a good time to consider the unique mental health needs of men. In this edition of PsychPearls, Jonathan E. Alpert, MD, PhD discusses mood disorders and the surprising symptoms that male patients may present.  In this conversation, Alpert also covers: 1. The etiology of major depressive disorder in men and women 2. Common comorbidities to depression among men 3. How to build a therapeutic alliance with men and encourage adherence 4. Effective pharmacological and psychotherapeutic interventions for men and women 5. Future directions for scientific research on mood disorders, including their connections to autoimmune, cardiac, and thyroid conditions.   Dr Alpert is the Dorothy and Marty Silverman Chair in in the department of Psychiatry and Behavioral Science, and professor of psychiatry, neuroscience, and pediatrics at Montefiore Medical Center and Albert Einstein College of Medicine. 

PSYCHPEARLS PODCAST The initial wave of COVID-19 cases flooded New York City hospitals with patients who urgently needed medical attention. Despite the potential dangers, psychiatrists and other physicians rushed to their aid. There were examples of inspiring teamwork and mutual support everywhere. At the same time, many physicians found themselves in new and unfamiliar roles, sometimes without the necessary mental health resources to cope with what they were seeing and doing.   In this edition of Psych Pearls, hots Angela Coombs, MD, and Jennifer Sotsky, MD, talk to Kasey Grewe, MD, and Niesha Voigt, MD, about their experiences in the early days of the pandemic.  Many physicians have undergone traumatic experiences during the COVID-19 pandemic. If you or anyone you know needs mental health resources, consider contacting the Substance Abuse and Mental Health Services Administration's national hotline (800-662-HELP) or the Physician Support Line (888-409-0141). Dr Grewe is an anesthesiology Critical Care Medicine Fellow at University of California, Los Angeles Health. Dr Voigt is a PGY 3 resident and co-chair of the Psychiatry Residents Diversity Alliance at Columbia University Medical Center.  About the hosts: Dr Coombs is a board-certified psychiatrist and assistant professor in Clinical Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute. She serves as the medical director and team psychiatrist at ONTrackNY Washington Heights Community Service clinic. She completed her public psychiatry fellowship and adult psychiatry residency at Columbia University where she was a chief resident and co-organized the curriculum on racial/ethnic mental health disparities. In addition to her clinical work in the public sector, she also works in Columbia's psychiatric emergency room and has a private practice in Upper Manhattan. Dr Sotsky is a fellow in consultation-liaison psychiatry at Columbia University Irving Medical Center with a part time private practice. She was formerly a chief resident at Columbia's psychiatry residency program. Before medical training, she received an MS in Narrative Medicine, an interdisciplinary field that studies illness through a humanities lens. She is co-author of Conquering Lyme Disease: Science Bridges the Great Divide and has interests in medical education, psychotherapy, and medical humanities.  Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present the Breakthrough Session podcast with experts in the field of psychiatry.

PSYCHPEARLS PODCAST The initial wave of COVID-19 cases flooded New York City hospitals with patients who urgently needed medical attention. Despite the potential dangers, psychiatrists and other physicians rushed to their aid. There were examples of inspiring teamwork and mutual support everywhere. At the same time, many physicians found themselves in new and unfamiliar roles, sometimes without the necessary mental health resources to cope with what they were seeing and doing.   In this edition of Psych Pearls, hots Angela Coombs, MD, and Jennifer Sotsky, MD, talk to Kasey Grewe, MD, and Niesha Voigt, MD, about their experiences in the early days of the pandemic.  Many physicians have undergone traumatic experiences during the COVID-19 pandemic. If you or anyone you know needs mental health resources, consider contacting the Substance Abuse and Mental Health Services Administration’s national hotline (800-662-HELP) or the Physician Support Line (888-409-0141). Dr Grewe is an anesthesiology Critical Care Medicine Fellow at University of California, Los Angeles Health. Dr Voigt is a PGY 3 resident and co-chair of the Psychiatry Residents Diversity Alliance at Columbia University Medical Center.  About the hosts: Dr Coombs is a board-certified psychiatrist and assistant professor in Clinical Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute. She serves as the medical director and team psychiatrist at ONTrackNY Washington Heights Community Service clinic. She completed her public psychiatry fellowship and adult psychiatry residency at Columbia University where she was a chief resident and co-organized the curriculum on racial/ethnic mental health disparities. In addition to her clinical work in the public sector, she also works in Columbia's psychiatric emergency room and has a private practice in Upper Manhattan. Dr Sotsky is a fellow in consultation-liaison psychiatry at Columbia University Irving Medical Center with a part time private practice. She was formerly a chief resident at Columbia’s psychiatry residency program. Before medical training, she received an MS in Narrative Medicine, an interdisciplinary field that studies illness through a humanities lens. She is co-author of Conquering Lyme Disease: Science Bridges the Great Divide and has interests in medical education, psychotherapy, and medical humanities.  Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present the Breakthrough Session podcast with experts in the field of psychiatry.

PSYCHPEARLS PODCASTAlthough lithium is a first-line treatment that ranks high on the list of patient’s favorites, it has fallen out of general use, particularly in the United States. When lithium works well, however, its benefits tend to last. It is among the top medications that prevent hospitalization.For the full transcript, see https://www.psychiatrictimes.com/view/dosing-tips-lithium-how-improve-tolerabilityAbout the hosts:Chris Aiken, MD, is the Mood Disorders Section Editor for Psychiatric Times, the Editor in Chief of The Carlat Psychiatry Report, and the Director of the Mood Treatment Center. He has written several books on mood disorders, most recently The Depression and Bipolar Workbook. He can be heard in the weekly Carlat Psychiatry Podcast with his cohost Kellie Newsome, PMH-NP. The author does not accept honoraria from pharmaceutical companies but receives royalties from PESI for The Depression and Bipolar Workbook and from W.W. Norton & Co. for Bipolar, Not So Much. Kellie L. Newsome, PMH-NP, is the cohost of the Carlat Psychiatry Podcast and is also a practicing Psychiatric Mental Health Nurse Practitioner in Winston Salem, NC, at the Mood Treatment Center. Raised in Tasmania, Australia, Kellie moved to the United States in 1998.

PSYCHPEARLS PODCAST During the first wave of COVID-19 cases in New York City, physicians of all kinds took on unfamiliar roles and, in many cases, potentially risked their lives to help their patients. In this edition of Psych Pearls, a quartet of doctors remember the early, uncertain days the pandemic. Hosts Angela Coombs, MD, and Jennifer Sotsky, MD, talk to Sara Nash, MD, MS, and David Chong, MD, about their personal experiences, how the challenges of the pandemic have evolved over time, what has kept them going throughout the year, and why preexisting social inequalities made the pandemic even deadlier in some communities.    Dr Nash is assistant professor of psychiatry at Columbia University Medical Center and program director of its fellowship in Psychosomatic Medicine. Dr Chong is associate professor of medicine and program director of the Internal Medicine Training Program at Columbia University Medical Center.  About the hosts: Dr Coombs is a board-certified psychiatrist and assistant professor in Clinical Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute. She serves as the medical director and team psychiatrist at ONTrackNY Washington Heights Community Service clinic. She completed her public psychiatry fellowship and adult psychiatry residency at Columbia University where she was a chief resident and co-organized the curriculum on racial/ethnic mental health disparities. In addition to her clinical work in the public sector, she also works in Columbia's psychiatric emergency room and has a private practice in Upper Manhattan. Dr Sotsky is a fellow in consultation-liaison psychiatry at Columbia University Irving Medical Center with a part time private practice. She was formerly a chief resident at Columbia’s psychiatry residency program. Before medical training, she received an MS in Narrative Medicine, an interdisciplinary field that studies illness through a humanities lens. She is co-author of Conquering Lyme Disease: Science Bridges the Great Divide and has interests in medical education, psychotherapy, and medical humanities. Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present the Breakthrough Session podcast with experts in the field of psychiatry.

May is Maternal Mental Health Month, and moms around the world could probably use a break. During the COVID-19 pandemic, they have done even more of the childcare and housework, while also, in many cases, keeping up with their careers. How has the pandemic affected their mental health—either by creating new problems or by exacerbating perennial concerns?    In this edition of Psych Pearls, Anita H. Clayton, MD, explores the wide and varied field of maternal mental health. Along with the effects of the pandemic, Clayton discusses pre-natal mental health care, new and emerging treatments for postpartum depression and psychosis, and how what she saw in a courtroom set her on a path to becoming a renowned expert on maternal wellness.     Dr Clayton is the David C. Wilson Professor and chair of the Department of Psychiatry and Neurobehavioral Sciences at the University of Virginia, with a secondary appointment as professor of clinical obstetrics and gynecology. She is the author of Satisfaction: Women, Sex, and the Quest for Intimacy, published by Ballantine Books in 2007, and an editor of the 2005 Women’s Mental Health: A Comprehensive Textbook. She is also a program co-chair of the Annual Psychiatric TimesTM World CME Conference.   

Even before the COVID-19 pandemic hit, many patients were already waiting months to see a psychiatrist. In this edition of Psych Pearls, we speak to James Phelps, MD, about the roots of the crisis and what psychiatrists can do to meet the nation’s mental health needs, especially through new models of collaborate care.  Phelps also reviews his long career treating bipolar and other mood disorders. He discusses some of the most exciting recent discoveries, including research on inflammation and circadian rhythm disturbance, and mood bias. He also reviews recent research on digital therapeutics, which may offer powerful new options for treatment.   Dr Phelps is research editor at the Psychopharmacology Institute, medical director at PsychEducation.org, and adjunct faculty at Samaritan Mental Health in Corvallis, Oregon. He is the bipolar disorder section editor for Psychiatric TimesTM and the author of A Spectrum Approach to Mood Disorders for clinicians and Bipolar, Not So Much for patients and their families.

In this episode of PsychPearls and the Columbia University Breakthrough Session, hosts Angela Coombs, MD, and Jennifer Sotsky, MD, discuss the possibilities and promise of psilocybin in treating psychiatric disorders and in enhancing everyday experiences with David Hellerstein, MD. Landmark studies and new research about the use of hallucinogens includes potential to treat: Advanced stage cancer & death anxiety Treatment-resistent depression Eating disorders Posttraumatic stress disorder Substance use disorders Psilocybin (mushrooms) and other hallucinogens from plants and some animal life generate perceptual changes and hallucinations, altered physical sensations, strong emotional reactions, and even dissolution of self. The question is whether these are wild rides or trips and whether they can result in lasting changes in the patient. Over time, some of the brain connections may become disrupted and new circuits may become activated. Dr Hellerstein is a professor of clinical psychiatry at Columbia University and is conducting clinical trials of psilocybin. His books include Heal Your Brain: How the New Neuropsychiatry Can Help You Go from Better to Well (Johns Hopkins University Press). About the hosts: Dr Coombs is a board-certified psychiatrist and assistant professor in Clinical Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute. She serves as the medical director and team psychiatrist at ONTrackNY Washington Heights Community Service clinic. She completed her public psychiatry fellowship and adult psychiatry residency at Columbia University where she was a chief resident and co-organized the curriculum on racial/ethnic mental health disparities. In addition to her clinical work in the public sector, she also works in Columbia's psychiatric emergency room and has a private practice in Upper Manhattan. Dr Sotsky is a fellow in consultation-liaison psychiatry at Columbia University Irving Medical Center with a part time private practice. She was formerly a chief resident at Columbia’s psychiatry residency program. Before medical training, she received an MS in Narrative Medicine, an interdisciplinary field that studies illness through a humanities lens. She is co-author of Conquering Lyme Disease: Science Bridges the Great Divide and has interests in medical education, psychotherapy, and medical humanities.Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present the Breakthrough Session podcast with experts in the field of psychiatry. 

PSYCHPEARLS PODCASTIn this installment of PsychPearls and the Columbia University Breakthrough Session, hosts Angela Coombs, MD, and Jennifer Sotsky, MD, discuss anxiety with Anne Marie Albano, PhD.  When does anxiety become a disorder? Anxiety as cultural phenomenon vs individual illness Self-care as a way to conquer anxiety Help-seeking as a sign of strength and self-knowledge Strategies to recognize anxiety The role of technology Dr Albano is professor of medical psychology (in Psychiatry) at Columbia University and director of the Columbia University Clinic for Anxiety and Related Disorders (CUCARD). She is a clinical psychologist and board-certified in clinical child and adolescent psychology. In addition to serving as director of CUCARD, she also conducts research and trains residents, fellows, and psychology postdoctoral fellows and interns. Her research is focused on the development and testing of psychosocial treatments for anxiety and mood disorders, and in understanding the impact of these disorders on the developing youth. Dr Albano devotes her career to the study and treatment of anxiety and mood disorders in children, adolescents, and young adults. She is an expert diagnostician and cognitive-behavioral therapist. Dr. Albano co-developed a cognitive behavioral treatment program for adolescents with social phobia. She has published more than 90 articles and chapters and is the coauthor of several cognitive behavioral treatment manuals, including Anxiety Disorders Interview Schedule (ADIS-IV) Child and Parent Interview Schedules.About the hosts: Dr Coombs is a board-certified psychiatrist and assistant professor in Clinical Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute. She serves as the medical director and team psychiatrist at ONTrackNY Washington Heights Community Service clinic. She completed her public psychiatry fellowship and adult psychiatry residency at Columbia University where she was a chief resident and co-organized the curriculum on racial/ethnic mental health disparities. In addition to her clinical work in the public sector, she also works in Columbia's psychiatric emergency room and has a private practice in Upper Manhattan. Dr Sotsky is a fellow in consultation-liaison psychiatry at Columbia University Irving Medical Center with a part time private practice. She was formerly a chief resident at Columbia’s psychiatry residency program. Before medical training, she received an MS in Narrative Medicine, an interdisciplinary field that studies illness through a humanities lens. She is co-author of Conquering Lyme Disease: Science Bridges the Great Divide and has interests in medical education, psychotherapy, and medical humanities.Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present the Breakthrough Session podcast with experts in the field of psychiatry. 

Body dysmorphic disorder (BDD) is a mental health disorder in which you cannot stop thinking about perceived defects or flaws in your appearance, flaws that are often minor or even invisible to others. This condition currently affects around 2-3% of the general population. In this edition of Psych Pearls, we speak to Katharine Phillips, MD, about how her pioneering research on BDD, she books on the topic, and options for treatment.   Dr Phillips is currently professor of psychiatry, DeWitt Wallace Senior Scholar, and Residency Research Director for the Department of Psychiatry at Weill Cornell Medicine. She is also an attending psychiatrist at New York-Presbyterian Hospital and adjunct professor of Psychiatry and Human Behavior at the Alpert Medical School of Brown University.

PSYCHPEARLSWhat is addiction, and how can psychiatrists best respond to the opioid (and other drug) epidemic? What have we done wrong about it in the medication and other effective treatments for addiction? What does addiction do to the brain?  Lloyd I Sederer, MD, a psychiatrist, public health expert, and writer provides key insights on what we can do to save more lives from overdose deaths.  Dr Sederer is adjunct professor at the Columbia University School of Public Health; director of Columbia Psychiatry Media; Chief Medical Officer of Bongo Media; and chair of The Advisory Board of Get Help. He has been chief medical officer of McLean Hospital; affiliated with Harvard; Mental Health Commissioner of New York City; and Chief Medical Officer of the New York State Office of Mental Health, the nation’s largest state mental health agency. The mission of Columbia Psychiatry is to find the causes of and cures for mental illness. Dr Sederer’s most recent book is Ink Stained for Life: Coming of Age in the 1950s. A Bronx Tale. His website is at www.askdrlloyd.com.About the hosts: Dr Coombs is a board-certified psychiatrist and assistant professor in Clinical Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute. She serves as the medical director and team psychiatrist at ONTrackNY Washington Heights Community Service clinic. She completed her public psychiatry fellowship and adult psychiatry residency at Columbia University where she was a chief resident and co-organized the curriculum on racial/ethnic mental health disparities. In addition to her clinical work in the public sector, she also works in Columbia's psychiatric emergency room and has a private practice in Upper Manhattan. Dr Sotsky is a fellow in consultation-liaison psychiatry at Columbia University Irving Medical Center with a part time private practice. She was formerly a chief resident at Columbia’s psychiatry residency program. Before medical training, she received an MS in Narrative Medicine, an interdisciplinary field that studies illness through a humanities lens. She is co-author of Conquering Lyme Disease: Science Bridges the Great Divide and has interests in medical education, psychotherapy, and medical humanities.Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present the Breakthrough Session podcast with experts in the field of psychiatry.  

Dr Drew Ramsey discusses the role of diet and nutrition in brain and mental health, promising areas of nutrition, and the importance of evidence-based treatment with food. Good nutrition is not a contest between zucchini and medications. Dr Ramsey is assistant clinical professor of psychiatry at Columbia University College of Physicians & Surgeons. His clinical work focuses on the treatment of depression and anxiety with a combination of psychotherapy, diet and lifestyle modification, and psychopharmacology. From 2005 to 2008, he directed the Audubon Continuing Day Treatment Program, a bi-lingual service for the severely mentally ill located in the Washington Heights area of Manhattan; a program of New York State Psychiatric Institute/Columbia Psychiatry. About the hosts:  Angela Coombs, MD, is a board-certified psychiatrist and assistant professor in Clinical Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute. She serves as the medical director and team psychiatrist at ONTrackNY Washington Heights Community Service clinic. She completed her public psychiatry fellowship and adult psychiatry residency at Columbia University where she was a chief resident and co-organized the curriculum on racial/ethnic mental health disparities. In addition to her clinical work in the public sector, she also works in Columbia's psychiatric emergency room and has a private practice in Upper Manhattan. Jennifer Sotsky, MD, MS, is a fellow in consultation-liaison psychiatry at Columbia University Irving Medical Center with a part time private practice. She was formerly a chief resident at Columbia’s psychiatry residency program. Before medical training, she received an MS in Narrative Medicine, an interdisciplinary field that studies illness through a humanities lens. She is co-author of Conquering Lyme Disease: Science Bridges the Great Divide and has interests in medical education, psychotherapy, and medical humanities.Acknowledgement: Thanks to Columbia University Department of Psychiatry for allowing us to present their Breakthrough Session podcast with experts in the field of psychiatry.

PSYCHPEARLS PODCAST Learn to Recognize and Treat Traumatic Brain Injury David Arciniengas, MD   March is brain injury awareness month. According to a study by the Centers for Disease Control, nearly 3 million individuals a year suffer a traumatic brain injury (TBI), and psychiatric disturbances are the most-common long-term effects of these injuries (https://www.psychiatrictimes.com/view/pharmacological-management-psychiatric-aspects-traumatic-brain-injury) . In this edition of Psych Pearls, we speak to David Arciniegas, MD, about how to spot TBI and its psychiatric sequalae—and how to give effective treatment.    Dr Arciniegas is professor and senior research neuropsychiatrist in the Department of Psychiatry and Behavioral Sciences at the University of New Mexico School of Medicine. He is director of research at the Marcus Institute for Brain health and editor of the Journal of Neuropsychiatry and Clinical Neurosciences.

PSYCHPEARLS PODCAST    LGBTQ issues are some of the most pressing and difficult topics facing psychiatrists today. In this podcast, Psychiatric Times interviews Michael F. Myers, MD, about gender and sexuality. Topics of discussion include:   1.     Current subjects in gender and sexuality, including gender dysmorphia 2.     How psychiatry’s understanding of sexuality and gender has changed over time 3.     His own experience as a doctor during the AIDS crisis   Find out more about Dr Myers and his experience treating patients during the AIDS crisis in his new memoir, Becoming a Doctors’ Doctor (https://www.amazon.com/Becoming-Doctors-Doctor-Michael-Myers/dp/B08HGTJNS2/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=) . Dr Myers is professor of Clinical Psychiatry and immediate past Vice-Chair of Education and Director of Training in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, NY.  

Psychiatric Times interviews Omar Reda, MD, about international medical graduates (IMG) and his own personal and professional journey. In this podcast he discusses:  1. His childhood and medical training in war-torn Libya 2. The challenges facing immigrants who want to become doctors in the United States 3. How his colleagues, and the American medical establishment at large, can help IMGs realize their dreams Dr Reda is a practicing psychiatrist, Providence Healthcare System, Portland, OR. See more podcasts at PsychPearls by Psychiatric Times (https://www.psychiatrictimes.com/psychpearls-podcast) .

Psychiatric Times interviews Charles Figley, PhD (https://www.psychiatrictimes.com/view/when-war-comes-home) , about his work in the area of PTSD, trauma, and disaster. In this podcast he discusses:  1. Female combat medics 2. What the military is (and is not) doing to help veterans with PTSD 3. His own experiences as a marine in Vietnam   Dr Figley is the Paul Henry Kurzweg, MD Distinguished Chair in Disaster Mental Health at Tulane University and founder and director of the Tulane Traumatology Institute (https://tulanetraumatologyinstitute.com/) . See more podcasts at PsychPearls by Psychiatric Times (https://www.psychiatrictimes.com/psychpearls-podcast) .

PSYCHPEARLS Many factors have come into play during the coronavirus 2019 (COVID-19) pandemic, not the least of which has been meeting the flood of challenges in the realm of mental health. Rather than paint a bleak picture, Christine Moutier, MD, presents the unique opportunities for clinicians in identifying risk and preventing suicide. In this podcast, Moutier discusses her recent paper published in JAMA Psychiatry, "Suicide Prevention in the COVID-19 Era: Transforming Threat Into Opportunity (https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2772135) ." Moutier is chief medical officer of the American Foundation for Suicide Prevention (https://afsp.org/bio/christine-moutier-m-d) .

How can clinicians help patients struggling with addiction, especially during this time when uncovering past traumas might feel impractical? Psychiatric Times interviews child and adolescent and addiction psychiatrist, John Calvin Chatlos, MD. Dr Chatlos is affiliated with Rutgers-Robert Wood Johnson Medical School, in New Brunswick, NJ, and medical director of the Wei Ji Point Ambulatory Withdrawal Management program and the Specialized Addiction Treatment Services outpatient program.

There are many reasons why symptoms worsen in younger patients who are prescribed antidepressants. Five possible scenarios are discussed in this podcast with Chris Aiken, MD. The full report can be accessed here: When Children Get Worse on Antidepressants: Activation or Bipolar? (https://www.psychiatrictimes.com/view/when-children-get-worse-antidepressants-activation-or-bipolar)

Chris Aiken, MD, and Kellie Newsome, PMH-NP, discuss how to dose quetiapine for the treatment of bipolar disorder. Dr Aiken is the Mood Disorders Section Editor for Psychiatric Times, the Editor in Chief of The Carlat Psychiatry Report, (https://thecarlatreport.com/) and the Director of the Mood Treatment Center. (http://www.moodtreatmentcenter.com/) His written several books on mood disorders, most recently The Depression and Bipolar Workbook (https://www.amazon.com/Depression-Bipolar-Workbook-Strengthen-Brain/dp/1683732359) . He can be heard in the weekly Carlat Psychiatry Podcast (https://podcasts.apple.com/us/podcast/the-carlat-psychiatry-podcast/id1463414537) with his co-host Kellie Newsome, PMH-NP. Dr Aiken does not accept honoraria from pharmaceutical companies but receives royalties from PESI for The Depression and Bipolar Workbook (https://www.amazon.com/Depression-Bipolar-Workbook-Strengthen-Brain/dp/1683732359) and from W.W. Norton & Co. for Bipolar, Not So Much (https://www.amazon.com/Bipolar-Not-Much-Understanding-Depression/dp/0393711749/ref=sr_1_1?ie=UTF8&qid=1483750639&sr=8-1&keywords=bipolar+not+so+much) . Kellie L. Newsome, PMH-NP, is the cohost of the Carlat Psychiatry Podcast and is also a practicing Psychiatric Mental Health Nurse Practitioner in Winston Salem, NC, at the Mood Treatment Center. Raised in Tasmania, Australia, Kellie moved to the United States in 1998. For more on this topic, see Top Mood Stabilizers for Bipolar Disorder (https://www.psychiatrictimes.com/view/new-answers-treatment-resistant-depression) .

In a recent podcast (https://www.psychiatrictimes.com/view/mood-stabilizers-for-bipolar-disorder) , the presenters listed 4 mood stabilizers that stand out in bipolar disorder treatment. In this podcast, Chris Aiken, MD, and Kellie Newsome, PMH-NP, will discuss how to dose one of them: lithium.

If you were stranded on a desert island, which mood stabilizers would you want on the formulary? That question and more will be discussed in this podcast with Chris Aiken, MD, and Kellie Newsome, PMH-NP. For more on this topic, see Top Mood Stabilizers for Bipolar Disorder (https://www.psychiatrictimes.com/view/top-mood-stabilizers-bipolar-disorder) .

Child and adolescent psychiatrist Abhijit Ramanujam, MD, discusses clinically relevant issues in childhood schizophrenia. Dr Ramanujam is Regional Director of Community Psychiatry, Sacramento, CA (https://www.communitypsychiatry.com/locations/sacramento/) . 

Allie Shapiro, MD, and Minoo Mahmoudi, MD, psychiatrists with California-based Community Psychiatry (https://www.communitypsychiatry.com/) talk about what children are currently experiencing during the pandemic, along with their families. They offer their real-world experience of what they have seen in practice, together with tips and suggestions for clinicians who may be seeing similar symptoms in their patients. For more on this topic, see the original post (https://www.psychiatrictimes.com/view/clinical-insights-treating-depression-and-anxiety-youth) at Psychiatric Times.

In this podcast, we speak with Dr Leela R. Magavi, Regional Medical Director for Community Psychiatry (https://www.communitypsychiatry.com/providers/leela-magavi-m-d/) , in Newport Beach, CA. For the full transcript and details, please go to our website at: https://www.psychiatrictimes.com/view/treating-adhd-children-concerns-controversies-safety-measures

Unprecedented numbers of Americans are losing their jobs. When patients describe psychiatric symptoms (eg, anxiety, insomnia, irritability), psychiatrists should ask about workplace issues.

In this podcast, Dr Andrew Brown, a member of the Group for the Advancement of Psychiatry and lead psychiatrist for the Boston Police Department, provides his views on how psychiatrists can help support patients who have anxiety associated with the categorization as “essential.”

Dr Daven Morrison of the Group for Advancement of Psychiatry, Work and Organizations committee provides his views on how, and why, psychiatrists should take a thorough work history, especially now, during the COVID-19 pandemic.

Psychiatrists from the Group for Advancement of Psychiatry, Work and Organizations committee, walk us through assessing how a patient's work ties to their sense of identity. They describe ways to validate a patient's feelings, provide reassurance, and help manage their emotions.