NYU Langone Insights on Psychiatry

Bipin Subedi, MD, explores how health systems can better care for patients with severe mental illness who cycle between hospitals, homelessness, addiction, and the justice system. He argues that acute inpatient treatment, while essential, is rarely sufficient on its own. Preventing the revolving door of repeated hospitalizations requires psychiatry to extend beyond hospital walls and build integrated systems that follow patients into the community.Drawing on his leadership at NYU Bellevue and his background in forensic psychiatry, Dr. Subedi describes a model of care built on sustained relationships, flexibility, and continuity. He reflects on how programs like transitional housing and mobile post-discharge support can provide the “scaffolding” patients need when insight and executive function are impaired by psychosis. The conversation closes with practical guidance on strengthening medication adherence—particularly through thoughtful use of long-acting injectables—and on meeting patients where they are to advance more humane, effective care.Bipin Subedi, MD, is Associate Professor of Psychiatry at NYU Grossman School of Medicine and Chief of Psychiatry at NYU Bellevue Hospital. He is a forensic psychiatrist with prior leadership experience in New York City’s jail system.▶️ Watch Insights on Psychiatry on YouTube01:36 Bellevue’s Mission and Rising Clinical Complexity04:43 Extending Care Beyond the Hospital Walls05:15 Bridge to Home and Transitional Stabilization10:44 Forensic Psychiatry and the Justice System14:17 Psychosis and Impaired Insight15:53 Post-Discharge Scaffolding and Critical Time Intervention18:47 Preventing Relapse with Long-Acting Injectables22:36 Meeting Patients Where They AreThis episode is intended for psychiatrists, mental health clinicians, and health system leaders interested in serious mental illness and innovative models of integrated community care.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

Katlyn Nemani, MD, explores how autoimmune and inflammatory brain disorders can present as first-episode psychosis—and why some patients diagnosed with schizophrenia may actually have a treatable immune-mediated illness. She explains the clinical features that should prompt suspicion for autoimmune psychosis, including subacute onset, subtle neurologic signs, and poor response to antipsychotics, even when standard imaging and antibody tests are unrevealing.Dr. Nemani also discusses the limits of current biomarkers, how to think clinically when diagnostic certainty is incomplete, and why early immunotherapy can dramatically alter outcomes. The conversation closes with a forward-looking discussion of emerging research suggesting that a meaningful subset of schizophrenia-like illness may ultimately be reclassified as autoimmune in origin.Katlyn Nemani, MD, is a Research Assistant Professor in the Departments of Psychiatry and Neurology at NYU Grossman School of Medicine and a graduate of NYU’s combined Neurology-Psychiatry residency program.▶️ Watch Insights on Psychiatry on YouTube00:00 When Psychosis May Be an Autoimmune Disease01:18 Early Psychiatric Symptoms of Autoimmune Encephalitis02:47 Why Subtle Neurologic Clues Matter04:00 A Case of Rapidly Reversible Psychosis06:37 The Limits of Antibody Testing07:51 Why Early Treatment Changes Outcomes08:18 Rethinking the Heterogeneity of Schizophrenia09:31 How Common Is Autoimmune Contribution to Psychosis?10:48 Network-Level Brain Effects and Open Research QuestionsThis episode is intended for psychiatrists, neurologists, and other clinicians interested in psychosis, neuroinflammation, and complex diagnostic presentations at the psychiatry–neurology interface.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

Lindsey Gurin, MD, discusses how clinicians can approach patients whose symptoms fall at the intersection of psychiatry and neurology. Drawing on her work with traumatic brain injury, PTSD, and persistent post-concussive symptoms, she explains why attempts to separate psychological trauma from neurological injury often obscure what patients actually need.The conversation explores identity disruption after brain injury, the unintended effects of rigid recovery timelines, and the importance of continuity in understanding symptoms over time. Dr. Gurin also discusses how neurodevelopmental traits such as ADHD shape vulnerability and treatment response, when stimulant medications can be appropriate after concussion, and why breaking complex presentations into treatable components often matters more than assigning a single diagnosis.Lindsey Gurin, MD, is Assistant Professor in the Departments of Neurology, Psychiatry, and Rehabilitation Medicine at NYU Langone Health, and Director of the Neurology/Psychiatry Residency Program.▶️ Watch Insights on Psychiatry on YouTube00:00 Brain Injury and Identity01:27 What Is the Psychiatry–Neurology Double Board?02:41 Why PTSD and TBI Overlap03:28 What “Shell Shock” Really Means06:00 When Concussion Symptoms Don’t Go Away07:25 Life Before vs After Brain Injury08:46 ADHD as a Hidden Risk Factor10:28 Using Stimulants After Brain Injury12:40 Rethinking “Post-Concussion Syndrome”13:27 The Future of Neuropsychiatric CareThis episode is intended for psychiatrists and other clinicians caring for patients with complex neuropsychiatric presentations at the intersection of psychiatry and neurology.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

Michael Bogenschutz, MD, explains how psychedelic-assisted treatments may offer new options for patients with severe, treatment-refractory psychiatric conditions. He discusses why standard approaches often fall short for complex cases, how psychedelics like psilocybin and MDMA differ from conventional medications, and what careful screening and clinical structure make these treatments safe and effective.Drawing on randomized clinical trials and years of clinical experience, Dr. Bogenschutz describes how psychedelic treatments can produce durable symptom improvement in disorders such as alcohol use disorder and trauma-related conditions. He also explores unresolved scientific questions, including whether the psychedelic experience itself is necessary for therapeutic benefit.Michael Bogenschutz, MD, is Professor of Psychiatry and Director of the Center for Psychedelic Medicine at NYU Langone Health.▶️ Watch Insights on Psychiatry on YouTube00:00 A Remarkable Case: Sustained Sobriety After Psilocybin Treatment00:39 Introducing Dr. Michael Bogenschutz01:04 Why Psychiatry Is Re-Examining Psychedelics02:50 Safety, Screening, and Managing the Psychedelic Experience03:45 Landmark Trial: Psilocybin for Alcohol Use Disorder06:16 How Psychedelics Work: Neuroplasticity vs. Subjective Experience08:53 Can Non-Psychedelic Analogs Deliver the Same Benefits?11:47 MDMA, Fear Reduction, and Emotional Processing13:44 Who Benefits Most? A Composite of Treatment-Refractory Patients15:45 The Future of Psychedelic Psychiatry at NYUThis episode is intended for psychiatrists, mental health clinicians, and others interested in complex and treatment-resistant psychiatric conditions.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

Lenard Adler, MD, explains how clinicians can safely and effectively treat ADHD when bipolar disorder and addiction are also in the picture. He addresses how to distinguish chronic ADHD symptoms from episodic mood disorders, why bipolar disorder is often missed in adults referred for depression or attention problems, and how substance use complicates both diagnosis and medication selection.Dr. Adler also shares guidance on identifying red flags for diversion or misuse, setting appropriate expectations for medication trials, and navigating the limits of current treatment guidelines. The episode closes with a look toward emerging directions in ADHD treatment, including research on emotional dysregulation, executive function deficits, and next-generation neurofeedback approaches.Lenard Adler, MD, is Pottash Professor of Psychiatry and Director of the Adult ADHD Program at NYU Langone Health▶️ Watch Insights on Psychiatry on YouTube00:00 Why ADHD, Bipolar Disorder, and Addiction Must Be Treated Together01:02 What Makes These ADHD Cases So Difficult02:05 ADHD vs. Bipolar Disorder: Key Diagnostic Distinctions04:43 The Link Between ADHD and Addiction05:53 Using Stimulants Safely When Substance Use Is a Concern07:57 Choosing Stimulants vs. Non-Stimulants10:07 How Severity and Comorbidity Shape Treatment Decisions12:06 The Limits of Guidelines and Biomarkers in ADHD Care15:34 Executive Function and Emotional Dysregulation16:13 Where ADHD Treatment Is Headed NextThis episode is intended for psychiatrists, mental health clinicians, and others interested in complex adult ADHD presentations.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

Ayana Jordan, MD, PhD, discusses how precision psychiatry must expand beyond biology to address the social, cultural, and structural realities shaping addiction and mental health care for historically underrepresented patients. The conversation explores how trauma, poverty, housing instability, health literacy, and stigma interact with substance use and serious mental illness—and why traditional clinic-based models often fail to meet patients where they are.Dr. Jordan describes the work of the Jordan Wellness Collaborative, including partnerships that integrate addiction treatment into primary care, community settings, and faith-based institutions. She explains how peer facilitators, housing support, and trusted community spaces can dramatically improve engagement, retention, and outcomes. Looking ahead, she reflects on how emerging tools—from AI-supported care models to novel treatments for addiction—may further transform access and equity in psychiatric care.Ayana Jordan, MD, PhD, is the Barbara Wilson Professor of Psychiatry at NYU Grossman School of Medicine and Principal Investigator of the Jordan Wellness Collaborative.▶️ Watch Insights on Psychiatry on YouTubeTOPICSExpanding precision psychiatry beyond biological modelsStructural barriers to care: housing, literacy, and stigmaAddiction treatment for historically underrepresented communitiesIntegrating care into primary care, community, and faith-based settingsThe role of peer facilitators and lived experience in treatmentTrust, safety, and engagement for patients with complex needsFuture directions: AI, novel addiction treatments, and workforce trainingThis discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

Dan Iosifescu, MD, discusses why bipolar depression and mixed episodes remain among the most difficult—and highest-risk—conditions in psychiatry. Even when mood symptoms improve, many patients continue to experience significant cognitive and functional impairment. Dr. Iosifescu argues that standard approaches often fall short because symptom suppression is mistaken for recovery, short-term improvement is confused with durable treatment, and mixed episodes expose the limits of one-size-fits-all care.The conversation explores the clinical dangers of mixed episodes, the challenge of recognizing them, and the importance of moving deliberately from acute stabilization to sustainable long-term treatment. Dan Iosifescu, MD, is Director of Clinical Research at the Nathan Kline Institute and Director of the Mood Disorders Clinical and Research Program at NYU Langone Health.▶️ Watch Insights on Psychiatry on YouTube00:33 Introduction01:22 Challenges of Treating Bipolar Depression02:58 Case Study: The Impact of Bipolar Depression05:01 Novel Treatments and Approaches07:23 Understanding and Managing Mixed Episodes13:44 Future Directions in Bipolar Disorder Treatment16:09 Innovative Research at NYU Psychiatry22:33 Conclusion and Final ThoughtsThis episode is intended for psychiatrists, mental health clinicians, and others interested in treatment-resistant forms of depression and bipolar disorder.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

Joshua Berman, MD, PhD, discusses how careful evaluation, patient priorities, and risk-benefit tradeoffs guide the use of interventional treatments when conventional approaches fall short. Dr. Berman also explains how tools such as ketamine, TMS, ECT, and neurofeedback can be used strategically—sometimes in sequence or combination—to address different vulnerabilities within mood-related brain circuits.Dr. Berman is Associate Professor of Psychiatry and Director of Interventional Psychiatry at NYU Langone Health.▶️ Watch Insights on Psychiatry on YouTube00:47 What Is Interventional Psychiatry?02:33 Evaluating Treatment-Resistant Presentations06:31 Precision, Patient Priorities, and Clinical Judgment09:35 Sequencing and Combining Interventions10:40 Limits of Treatment Guidelines12:18 The Future of Interventional Psychiatry13:23 Emerging Technologies: Neurofeedback and Focused Ultrasound17:15 Building a Comprehensive Interventional Program18:13 Tools vs. Understanding Brain CircuitsThis episode is intended for psychiatrists, mental health clinicians, and others interested in interventional approaches to complex psychiatric disorders.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

To kick off Season 4, Charles Marmar, MD, explains how precision psychiatry is reshaping the way clinicians and researchers think about diagnosis, treatment selection, and the underlying biology of psychiatric disorders. This conversation is a overview of where the field stands today—including emerging molecular markers, biologically informed subtypes, and new translational approaches inspired by oncology and other precision-based specialties.Dr. Marmar is Chair of Psychiatry at NYU Grossman School of Medicine, and Director of the Center for the Study of Alcohol Use Disorder and Traumatic Stress.▶️ Watch Insights on Psychiatry on YouTubeIn this episode, Dr. Marmar outlines current work on:Molecular and genomic signatures that may distinguish patient subtypesClinical trials examining targeted treatments for alcohol use disorderThe development of proxy “brain biopsy” methods such as exosomal analyses and iPSC-derived organoidsHow converging biological data could eventually support more individualized treatment planningThis discussion reflects ongoing efforts at NYU Langone Health to move psychiatry toward a more mechanism-based, biologically grounded model of care, while acknowledging the complexity and early stage of the work.This episode is intended for psychiatrists, mental health clinicians, and others interested in the treatment of complex psychiatric disorders.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle

What if mental health care worked more like cancer treatment—tailored to the individual, informed by biology, and driven by data? Charles Marmar, MD, Chair of Psychiatry at NYU Grossman School of Medicine, takes us through the latest advances in precision psychiatry. From brain imaging to digital phenotyping, Dr. Marmar outlines the tools shaping a future where treatment is fully customized. He also shares stories from the front lines: a patient whose depression was treated with the help of a brain biopsy, why PTSD and depression aren’t one-size-fits-all, and how quantum computing could radically accelerate psychiatric research.🔍 Topics Covered00:00 Introduction02:24 Personalized Treatment Approaches05:13 Challenges in Precision Psychiatry11:12 The Role of Genomics and Brain Imaging23:35 Digital Psychiatry and AI25:57 Quantum Computing in Psychiatry33:04 Future of Precision Psychiatry37:22 Conclusion📚 Related ResourcesCharles Marmar, MD – NYU Faculty ProfileNYU Langone Psychiatry Adriana Heguy, PhD – NYU Faculty Profile Javad Shabani, PhD – NYU Faculty Profile🙌 Support & SubscribeIf this episode challenged your thinking, like, share, and subscribe to help bring smart, science-forward conversations to a wider audience.This discussion is for educational purposes and does not substitute for individual clinical judgment or patient care.Senior Producer: Jon Earle