PsychEd Shorts 10: Harm Reduction Principles

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This is our second book club episode centered around the novel Healing: Our Path from Mental Illness to Mental Health by Thomas Insel, MD.This book is a part memoir / part manifesto written by one of our generation’s most important leaders in neuroscience and psychiatry, Dr. Thomas Insel. Dr. Insel served as the director of the NIMH for 13 years from 2002-2015. Healing is replete with his reflections on personal and clinical experiences as well as epidemiological data, research, and policies related to mental health. Dr. Insel argues that medicine’s failure to significantly reduce the mortality and morbidity of psychiatric illnesses is less due to a lack of scientific progress, and more a result of poor implementation of existing interventions that are already well supported by the evidence.Guest: Dr. Thomas InselHosts: Dr. Gaurav Sharma - Staff psychiatrist working in Nunavut, CanadaDr. Kate Braithwaite - Family doctor from South AfricaAhmad Khan - MS4 at Western UniversityDr. Sophie Gregoire-Mitha - PGY1 Psychiatry resident in ManitobaAudio editing: Dr. Gaurav SharmaEpisode Evaluation: Dr. Angad SinghOur discussion is divided into 3 main sections:(2:48): Main themes from the book(15:58): Clinical application of strategies discussed in the book(41:30): Reflections on the book in the current Psychiatric landscapeFor more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers harm reduction principles.Hosts: Dr. Andrew Nguyen, Dr. Zakia Hussain, and Shelly PalchikAudio editing: Dr. Kate BraithwaiteEpisode Evaluation: Dr. Angad SinghResources:Chapter 4: Substance Use and Addictive Disorders. In Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral SciencesServing Clients Who Use Substances: A guide for community workersA Harm Reduction Approach (Alberta Health Services)References:Alberta Health Services. A Harm Reduction Approach: Key Principles.BC Centre for Disease Control (2023). Harm Reduction Services & Supply Guidelines.Canadian Mental Health Association Ontario. Harm Reduction.Ontario Ministry of Health (2018). Substance Use Prevention and Harm Reduction Guideline.NL Centre for Applied Health Research (2020). Harm Reduction 101.Public Health Agency of Canada. Reducing Stigma Toward People Who Use Drugs.For more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers psychiatry and ethics in the Ontario context with Dr. Suze Berkhout, a clinician investigator and practicing psychiatrist working in acute inpatient psychiatry at University Health Network. She is an Associate Professor at the University of Toronto in the department of psychiatry and affiliate faculty with the Institute for the History & Philosophy of Science and Technology. Her research draws on critical creative methods in ethnography, art-science collaborations, and feminist science and technology studies, to consider the politics of diagnosis and social lives of interventions and emerging technologies in biomedicine. She works with artists, service users, clinicians and scientists to understand how serious illness experiences impact our sense of identity and our social roles, and she studies the impacts of novel and emerging technologies on experiences in healthcare settings. Suze loves coffee and finding new ways to think with stories.The learning objectives are as follows: 1. Gain familiarity with key ethical concepts in psychiatry, including how ethics differs from law and the major ethical frameworks used in clinical reasoning.2.  Identify and analyze common ethical challenges in psychiatric practice, such as autonomy, confidentiality, boundaries, and justice.3. Apply practical strategies for ethical decision-making in clinical encounters. Guest: Dr. Suze BerkhoutHosts: Dr. Matthew Cho (PGY1), Dr. Annie Yu (PGY4) and Sena Gok (MD)Audio Editing: Angad Singh (PGY2)Resources from our guest:Bioethics for the People Podcast: https://www.bioethicsforthepeople.com/Mimi Khúc Open in Emergency: https://www.mimikhuc.com/projects/open-in-emergencyFor more PsychEd, follow us on Instagram (@psyched.podcast), Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website atpsychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of sleep hygiene.Hosts: Jo Kikukawa (MS2) and Grant Yao (MS4)Audio editing: Grant YaoTimestamps:(0:33) - Background(2:07) - Core principles and strategies(5:37) - Counselling on sleep(6:18) - When to get help with sleep(7:29) - SummaryReferences:Centre for Addiction and Mental Health. Sleep disorders. CAMH.Harvard Health Publishing. Sleep hygiene: Simple practices for better rest. Harvard Health.Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–133.Sleep Foundation. Sleep hygiene. SleepFoundation.org.Spielman AJ, Caruso LS, Glovinsky PB. Behavioral treatment of insomnia: A clinical case series. Sleep. 1987;10(1):87–92.For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers Types of SubstancesHosts: Sara Abrahamson, Shaoyuan Wang and Kate Braithwaite.Audio Editing: Kate BraithwaiteReferences:American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5, text revision (DSM-5-TR). 5th ed. Washington, D.C.: American Psychiatric Association Publishing; 2022.CAMH. (2013). Inhalants. Inhalants | CAMHCAMH. (2010). Cocaine and Crack. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/cocaineCAMH. (2012). Amphetamines. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/amphetamines#:~:text=Chronic%20use%20of%20amphetamines%20can,can%20also%20cause%20amphetamine%20psychosis.Chae J, Marsden J and Sutherland A. (2024, August 21). Benzodiazepine Withdrawal. Emergency Care BC. Benzodiazepine Withdrawal : Emergency Care BCChildHealthBC. (2023, September 21). Common Street names for Substances. https://childhealthbc.ca/mhsu/common_streetnames_substances/printfileJauch EC. (2023, January 18) Inhalants Clinical Presentation. Medscape. Inhalants Clinical Presentation: History, Physical, CausesKaye, AD, Staser, AN, Mccollins, TS, Zheng, J, Berry, FA, Burroughs, CR, Heisler, M, Mouhaffel, A, Ahmadzadeh, S, Kaye, AM, Shekoohi, S, & Varrassi, G. (2024). Delirium Tremens: A Review of Clinical Studies. Cureus, 16(4), e57601. https://doi.org/10.7759/cureus.57601Long N. (2020, November 3). GHB toxicity. Life in the Fast Lane. GHB toxicity • LITFL • Toxicology Library ToxicantMedx. (2025, November 26). Understanding What is the MOA of Alcohol: A Pharmacological Perspective. What is the MOA of Alcohol? Explained: Receptors and EffectsMendelson, J. H., & Mello, N. K. (1996). Management of cocaine abuse and dependence. The New England journal of medicine, 334(15), 965–972. https://doi.org/10.1056/NEJM199604113341507Nichols DE. Hallucinogens. Pharmacol Ther. 2004 Feb;101(2):131-81. doi: 10.1016/j.pharmthera.2003.11.002.Nickson C. (2024, December 18). Sedative toxidrome. Life in the Fast Lane. Sedative Toxidrome • LITFL • CCC ToxicologyPorter RS, Kaplan JL, Homeier BP, editors. The Merck manual of diagnosis and therapy. 20th ed. Kenilworth (NJ): Merck Sharp & Dohme; 2018.PsychDB. (2021, March). Opioid Intoxication. Opioid Intoxication - PsychDBPsychDB. (2023, October). Opioid Withdrawal. Opioid Withdrawal - PsychDBPsychDB. (2023 February). Cannabis Withdrawal. Cannabis Withdrawal - PsychDBRoth BL, Gumpper RH. Psychedelics as Transformative Therapeutics. Am J Psychiatry. 2023 May 1;180(5):317-20.Vollenweider FX, Kometer M. The neurobiology of psychedelic drugs: implications for the treatment of mood disorders. Nat Rev Neurosci. 2010 Sep;11(9):642-51. doi: 10.1038/nrn2884.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers the psychiatric case presentation with Dr. Justin Delwo, a staff psychiatrist at Toronto Western Hospital where he works in the emergency department and urgent care settings.The learning objectives for this episode are as follows:What is the goal of a psychiatric case presentation?What are some ground rules for a case presentation?What are the key sections of a case presentation and what should you include under each? How can you tailor your case presentation to the settingGuest: Dr. Justin DelwoHosts: Dr. Matt Cho (PGY1), Dr. Daamoon Ghahari (PGY2), and Dr. Angad Singh (PGY2)Audio editing: Dr. Angad Singh (PGY2)Episode evaluation: Shelly Palchik (MS4)Time Stamps:(1:50) - Goals of a case presentation(4:49) - Ground rules for presenting(7:56) - General overview(19:44) - Identifying Data(23:16) - Chief complaint and reason for referral(25:42) - History of presenting illness(38:38) - Review of systems(42:16) - Safety(49:42) - Past psychiatric history(53:54) - Medications(55:55) - Past medical history(59:14) - Allergies(1:00:13) - Family psychiatric history(1:02:07) - Personal history(1:06:23) -  Mental status exam(1:09:45) - Impression(1:14:20) - Plan(1:18:43) - Tailoring to different settingsFor more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website atpsychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers how to take a substance use historyHosts: Dr. Andrew Nguyen, Dr. Zakia Hussain, Jo Kikukawa, and Dr. Kate Braithwaite.Audio editing: Dr. Kate BraithwaiteResources:Chapter 4: Substance Use and Addictive Disorders. In Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral SciencesMeta:Phi Resource LibraryTen Domains of De-escalation to Prevent Behavioural Emergencies (from Alberta Health Services)References:American Psychiatric Association Publishing. (2022). Substance-Related and Addictive Disorders. In Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition, Text Revision: DSM-5-TR (5th ed., pp. 481-590). American Psychiatric Association Publishing. Boland, R.J., Verduin, M.L., & Ruiz, P. (2022). Chapter 4: Substance Use and Addictive Disorders. In Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences, Clinical Psychiatry (12th ed., pp. 269 - 336). Wolters Kluwer. Porter, L.D. Getting to the Good Part: How to Take an Engaging SUD History. [Presentation Transcript]. University of California, Los Angeles Integrated Substance Use and Addictions Programs. https://www.uclaisap.org/clinicalproviderquicktips/docs/La-Donna-Porter/Porter_LD_Transcript_Clean.pdf Welsh, C.J. “Trapped”: A Mnemonic for Taking a Substance Use History. Acad Psychiatry 27, 289 (2003). https://doi.org/10.1176/appi.ap.27.4.289For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers Functional Neurological Disorder with Dr. Patricia Rosebush. Dr. Rosebush is a Professor in the Department of Psychiatry & Behavioural Neurosciences at McMaster University. She is the distinguished author of numerous articles on clinical neuroscience, including considerable work on mitochondrial disorders in mental illness and over 30 papers on catatonia, and practices consultation-liaison psychiatry at St. Joseph’s Healthcare Hamilton.The learning objectives for this episode are as follows:Provide a definition and conceptual approach to FNDIdentify clinical signs and patient histories relevant to a diagnosis of FNDDescribe an approach to the treatment of FNDUnderstand the special challenges of communication and collaboration in this illnessGuest: Dr. Patricia RosebushHosts: Dr. Alastair Morrison, Dr. Kate BraithwaiteAudio editing: Dr. Alastair MorrisonShow notes: Dr. Kate BraithwaiteInterview content:(02:39) Learning objectives(03:09) Conceptualization of FND(08:30) Underlying psychological processes(09:35) Difference between FND and factitious disorder/malingering(14:54) Alexithymia(16:51) Common symptomatic presentations(18:00) Types of underlying stressors(19:17) Other risk factors for FND(22:12) Communicating with patients to address stigma(24:32) Psychotherapy in FND(29:36) Referral pathways for patients with FND(31:15) Prognosis of FND(33:09) Social media and FNDResources:Functional Neurological Disorder Society. Functional Neurological Disorder Society (FNDS). Includes a podcast and courses for physiciansFunctional Neurological Disorder (FND) – A Patient's Guide to FNDReferences:Hull, M., & Parnes, M. (2021). Tics and TikTok: Functional Tics Spread Through Social Media. Movement disorders clinical practice, 8(8), 1248–1252. https://doi.org/10.1002/mdc3.13267National Institute for Neurological Disorders and Stroke. (2024, July.) Functional Neurological Disorder.  U.S. Department of Health and Human Services, National Institutes of Health. Functional Neurologic Disorder | National Institute of Neurological Disorders and StrokePsychDB. (2024, April). Conversion Disorder (Functional Neurological Disorder. Conversion Disorder (Functional Neurological Disorder) - PsychDBRosebush, P. I., & Mazurek, M. F. (2011). Treatment of conversion disorder in the 21st century: have we moved beyond the couch?. Current treatment options in neurology, 13(3), 255–266. https://doi.org/10.1007/s11940-011-0124-yScamvougeras, A., & Castle, D. (2024). Functional Neurological Disorders: Challenging the Mainstream Agnostic Causative Position. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 69(7), 487–492. https://doi.org/10.1177/07067437241245957For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at [email protected] and visit our website at psychedpodcast.org.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers metabolic monitoring for patients on antipsychotic medications.Hosts: Grant Yao (MS4) and Dr. Angad Singh (PGY2)Audio editing: Dr. Angad Singh (PGY2)Timestamps:(0:21) - Background(2:22) - Monitoring for metabolic side effects(6:16) - Managing metabolic side effects(9:50) - SummaryReferences:Agarwal, S. M., Stogios, N., Faulkner, G. E., & Hahn, M. (2023). Pharmacological interventions for the prevention of antipsychotic-induced weight gain in people with schizophrenia: A Cochrane systematic review and meta-analysis. Schizophrenia Bulletin, 49(4), 833-835.Carolan, A., Hynes-Ryan, C., Agarwal, S. M., Bourke, R., Cullen, W., Gaughran, F., ... & O’Donoghue, B. (2024). Metformin for the prevention of antipsychotic-induced weight gain: guideline development and consensus validation. Schizophrenia bulletin, sbae205.Cooper, S. J., Reynolds, G. P., With expert co-authors (in alphabetical order):, Barnes, T. R. E., England, E., Haddad, P. M., ... & Smith, J. (2016). BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. Journal of Psychopharmacology, 30(8), 717-748.DeJongh, B. M. (2021). Clinical pearls for the monitoring and treatment of antipsychotic induced metabolic syndrome. Mental Health Clinician, 11(6), 311-319.Stogios, N., Humber, B., Agarwal, S. M., & Hahn, M. (2023). Antipsychotic-induced weight gain in severe mental illness: risk factors and special considerations. Current Psychiatry Reports, 25(11), 707-721.For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode is part of the PsychEd Book Club, a forum where we discuss books of interest to psychiatry learners from a variety of disciplines. We invite you to read along with us and contribute to our discussion.This short introductory episode gives you a heads-up about our upcoming book club on Healing: Our Path from Mental Illness to Mental Health by Thomas Insel. Stay tuned for a longer episode in a few months where we’ll share our thoughts on the book.If you’d like to share your thoughts or questions about the book, email us at [email protected] or reach out on social media.Hosts: Dr. Kate Braithwaite, Dr. Sophie Gregoire-Mitha, Dr. Gaurav SharmaAudio editing by: Dr. Gaurav SharmaFor more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠[email protected]⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.