American Journal Of Psychiatry Audio

Dr. Margaret Sibley (University of Washington, Seattle, WA) joins the podcast this month to discuss an article from the February issue of the Journal looking at patterns of remission in attention deficit hyperactivity disorder in children.  Dr. Ned Kalin, Editor-in-Chief of AJP will join us afterwards to discuss the rest of the February issue of the Journal. Sibley interview [00:51] What does “full remission” from ADHD mean? [01:54] Variable patterns of remission in children with ADHD [02:33] The DSM definition of ADHD and the impact of ADHD symptoms [04:10] Advantages and disadvantages of using longitudinal data [06:50] What does the pattern of intermittent remission mean for treatment of ADHD? [09:39] What does this suggest for further research into ADHD diagnosis and treatment? [11:08] How does this affect treatment going forward? [12:48] Kalin interview [15:25] Flavin et al. [16:04] Sibley et al. [16:45] Markowitz et al. [18:20] Tadmon and Olfson [19:07] Manfredi et al. [20:30] Morgan et al. [22:39]

In this month’s AJP Audio, Dr Margert Haney (Director of the Cannabis Research Laboratory at Columbia Psychiatry) discusses her new review from the January issue of the American Journal of Psychiatry, “Cannabis Use and the Endocannabinoid System: A Clinical Perspective,” and the questions around the legal status of cannabis research.  Afterward, Dr. Ned Kalin, Editor-in-Chief of the Journal discusses the January 2022 issue of AJP. Haney interview: How does cannabis interact with our brains? [00:30] CBD and how it’s different [01:26] Impact of state legalization of cannabis on research [02:08] Federal attitudes towards cannabis legalization [03:43] A single source of cannabis for research [04:57] Limitations on research and an expanding, unexamined market [06:11] Marketing of other cannabinoids [06:38] Consequences of cannabis legalization [08:06] Cannabis use disorder [08:36] What happens with daily cannabis use – and abrupt cessation? [09:27] What happens to your endocannabinoid system with daily use? [10:3

In this month’s AJP Audio, Dr. Samuel Wilkinson (Yale University, Associate Director of the Yale Depression Research Program) discusses a study looking at the association of electro-convulsive therapy or ECT on all-cause mortality and suicide in Medicare patients with mood and bipolar disorders.  Following that, Dr. Ned Kalin, Editor-in-Chief of the Journal discusses the December issue of AJP.   Wilkinson interview: Effects of ECT on older patients with mood disorders [00:50] A brief history of ECT [01:20] A troubled history [02:00] A backlash against ECT [02:24] Improved techniques and practices [03:32] Limitations of past research into ECT [04:20] Strength of the study [05:33] How patients were matched [05:59] Limitations of the present study [07:17] Treatment of patients going forward [08:18] Difficulties in administering and accessing ECT [09:49] Next steps in research into ECT and patients with elevated suicide risk [11:14] All-cause mortality and ECT [11:57] Kalin interview: The December issue of AJP [

Dr. Jennifer Stevens (Assistant Professor of Psychiatry and Behavioral Sciences, Emory University) discusses a technique to classify trauma victims into discrete biotypes in the immediate aftermath of trauma, with the hope of providing insight into the groups that could guide treatment, and American Journal of Psychiatry Editor-in-Chief Dr. Ned Kalin puts the November, 2021 issue of AJP into context.   Stevens interview [00:44] Using brain imaging data to understand how people respond to trauma [01:07] Patient enrollment [01:21] AURORA Study [01:42] Can patterns of brain activity help map different responses to trauma? [02:12] Biotypes [02:48] Structure of the study [03:40] Neuroimaging and fMRI tasks [04:11] Limitations [05:44] Biotypes definitions [07:30] Highest risk group [09:10] Most resilient group [09:51] What does this mean for treating trauma patients going forward? [10:17] Next steps [11:31] Kalin interview: looking at trauma and suicide [12:37] Stevens et al. look at neuroimaging and trauma [13:16

Executive Editor Michael Roy speaks with Lara N. Coughlin, Ph.D., and Lewei Allison Lin, M.D., M.S., about their article on the provision of guideline-concordant depression treatment to patients with and without substance use disorders. Dr. Lara Coughlin is an assistant professor in the Department of Psychiatry and an adjunct assistant professor of psychology at the University of Michigan. She is also a licensed clinical psychologist. Her research aims to find new ways to use behavioral economic frameworks to improve outcomes among individuals with substance use disorders. In particular, she is interested in decision making around health behaviors, such as choosing between sooner and smaller rewards, like substance use, and delayed and larger rewards, like overall health or career development. Her current work looks at the delivery and evaluation of care for underserved and rural populations. Dr. Allison Lin is an addiction psychiatrist, an assistant professor in the Department of Psychiatry at the University

Executive Editor Michael Roy speaks with Karen L. Bierman, Ph.D., about her article on reducing adolescent psychopathology in socioeconomically disadvantaged children with a preschool intervention. Dr. Karen Bierman is the Evan Pugh University Professor, Professor of Psychology, Professor of Human Development and Family Studies, and Director of the Child Study Center at Penn State University. Her research looks at the design and evaluation of programs for social and emotional learning within schools and communities. She has also developed and evaluated group interventions for peer-rejected children. How the author became interested in this area of research [1:58] What we know about how exposure to chronic or unpredictable negative circumstances disturbs a developing brain [3:21] Why the intersection of growing up in adverse conditions and the beginning of formal schooling is significant in the life of a child [6:41] Objective of the study [7:54] Outline of the Head Start REDI program [9:26] Description of st

Executive Editor Michael Roy speaks with Ayana Jordan, M.D., Ph.D., and Christina Mangurian, M.D., M.A.S., about their article on psychiatry diversity leadership in academic medicine. Dr. Ayana Jordan is an associate program director of the adult psychiatry training program and an assistant professor of psychiatry at the Yale University School of Medicine. She is a member of the APA Board of Trustees, and she serves on the Early-Career Psychiatrist Advisory Committee for the journal Psychiatric Services. Her research is concentrated on increasing access to care for minoritized populations with substance use problems. Dr. Christina Mangurian is a professor of psychiatry, epidemiology, and biostatistics in the School of Medicine at the University of California, San Francisco (UCSF). She is also vice chair for diversity and health equity at the UCSF Department of Psychiatry and Behavioral Sciences and a former chair of the APA Council on Minority Mental Health and Health Disparities. Her primary research program

Executive Editor Michael Roy speaks with Glenn Verner, M.P.H., and Sonja Entringer, Ph.D., about their article on the relationship between maternal psychological resilience during pregnancy and newborn telomere length. Ms. Glenn Verner is a doctoral candidate in medical psychology at Charité University Medicine in Berlin. She is interested in studying the biological mechanisms that underpin maternal and fetal health. Dr. Sonja Entringer is a professor of medical psychology at Charité University Medicine in Berlin. She is also an associate professor in the Health and Disease Research Program at the University of California, Irvine. Her research interests broadly include how developmental programming affects health and disease risk. In particular, she is interested in how stress during pregnancy affects offspring development. How the authors became interested in this area of research [2:10] Overview of the telomere system [4:35] Aims of the study, which examined how positive maternal psychological conditions d

Executive Editor Michael Roy speaks with Luke J. Norman, Ph.D., and Kate D. Fitzgerald, M.D., about their article examining whether brain activity is associated with treatment response to cognitive-behavioral therapy (CBT) in adolescents and adults with obsessive-compulsive disorder (OCD), and whether any associations are treatment specific relative to an active control psychotherapy (stress management therapy; SMT). Dr. Luke Norman was recently a neuroscience postdoctoral fellow at the University of Michigan. He is now affiliated with the National Institutes of Health. His research has looked at treatment for obsessive-compulsive disorder and attention deficit hyperactivity disorder. Dr. Kate Fitzgerald is the Phil F. Jenkins Research Professor of Depression and associate professor in the Department of Psychiatry at the University of Michigan. She is the academic director for child and adolescent psychiatry and co-director of the Pediatric Anxiety Disorders Clinic. She is also an adjunct associate professor

Executive Editor Michael Roy speaks with American Journal of Psychiatry Editor-in-Chief Ned H. Kalin, M.D., and Deputy Editor Carolyn Rodriguez, M.D., Ph.D., about the Journal’s response to COVID-19; strategies to combat racism, social injustice, and health care inequities; research highlights from the past year; and what lies ahead in 2021. Dr. Kalin is the Hedberg Professor and Chair of the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health, where he also serves as the Director of the Health Emotions Research Institute, and Director of the Lane Neuroimaging Laboratory. He is a member of the National Academy of Medicine, is a Distinguished Fellow of the American Psychiatric Association, and serves on the APA Council on Research. His work has aimed to understand the brain mechanisms underlying mental disorders. Dr. Rodriguez is an Associate Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University, where she is Director of the Translatio

Executive Editor Michael Roy speaks with Sara K. Blaine, Ph.D., and Rajita Sinha, Ph.D., about their article on the use of brain imaging in the evaluation of drinking outcomes during early outpatient treatment for alcohol use disorder. Dr. Sara Blaine is an assistant professor in the Department of Psychological Sciences at Auburn University. She recently completed postdoctoral work at Yale University. Her work has looked at how genes and aspects of the brain affect the development of alcoholism under conditions of stress. Dr. Rajita Sinha is the Foundations Fund Professor of Psychiatry at the Yale University School of Medicine, where she also is a professor of neurobiology. She is chief of the psychology section in psychiatry and co-director of education at the Yale Center for Clinical Investigation. In addition, she is a professor in the Child Study Center and founding director of the Yale Stress Center. Her research has looked at the mechanisms of chronic stress, adversity, and coping. She is also intereste

Executive Editor Michael Roy speaks with Constance Guille, M.D., and Richard F. Summers, M.D., about their article on the prevalence of burnout and depressive symptoms among North American psychiatrists, demographic and practice characteristics associated with risk for these symptoms, and the correlation between burnout and depression. A related commentary on burnout by Dr. Summers also is discussed. Dr. Guille is a professor in the Departments of Psychiatry and Behavioral Sciences and of Obstetrics and Gynecology at the Medical University of South Carolina. She is a member of the American Psychiatric Association (APA) Board of Trustees Workgroup on Psychiatrist Well-Being and Burnout, and she is co-investigator on the Intern Health Study, a large prospective study examining stress and depression among medical trainees. She directs the Women’s Reproductive Behavioral Health Division at the Medical University of South Carolina and has published widely on topics including women’s health, stress, and depression.

Executive Editor Michael Roy speaks with Emily Robertson, M.A., and Paul Frick, Ph.D., about their article on the role that callous-unemotional traits have in the risk for gun carrying and gun use during a crime. Ms. Emily Robertson is a clinical psychology doctoral student in the Developmental Psychopathology Lab at Louisiana State University. This fall, she begins a predoctoral internship at the Mailman Center for Child Development in the Miller School of Medicine at the University of Miami. Dr. Paul Frick leads the Developmental Psychopathology Lab at LSU, where he is the Roy Crumpler Memorial Chair in the Department of Psychology. He holds a joint appointment in the Institute for Learning Sciences and Teacher Education at Australian Catholic University in Brisbane. Why gun violence in the United States has become a significant concern among young people [2:46] What are callous-unemotional traits, and how common are these traits in the general population? [4:10] Why the authors decided to examine the rela

Executive Editor Michael Roy speaks with Jennifer Dwyer, M.D., Ph.D., and Awais Aftab, M.D., about the physiology of three major endocrine systems and about the evidence for hormone-based interventions in the treatment of major depressive disorder. Dr. Dwyer is an assistant professor at Yale University, where she is affiliated with the Child Study Center and the Department of Radiology and Biomedical Imaging. Dr. Aftab is a clinical assistant professor in the Department of Psychiatry at Case Western Reserve University. He is also an attending psychiatrist at Northcoast Behavioral HealthCare Hospital. Why are effective treatments for major depressive disorder lacking? [2:22] Why have hormones been implicated in the pathophysiology of major depression? [4:28] Three particular parts of the hormonal system that have been linked to alterations in mood [7:05] The role of the HPA axis in major depression [8:44] The role of the HPT axis in major depression [11:39] The role of the HPG axis in major depression, and di

Executive Editor Michael Roy speaks with Stéphane Potvin, Ph.D., and Alexandre Dumais, M.D., Ph.D., about their meta-analysis investigating the association between cannabis use and violence, and, more specifically, the perpetration of any type of physical violence by adolescents and young adults. How prevalent is the use of cannabis among young people? [2:23] What are some of the adverse outcomes that are linked to the use of cannabis, and are these outcomes linked to other difficulties over time? [4:06] Why has the literature been mixed as to whether there is a link between the use of cannabis and violent behavior and aggression? [6:11] How the authors chose their research objective [8:15] Steps of the meta-analysis [9:51] Methods used to analyze the data [11:33] Main findings [14:12] Potential mechanisms that may have a role in the perpetration of violence [16:17] Implications for young people who use cannabis [18:07] Limitations affecting the results [19:19] Does the medical use of marijuana have any bear

Executive Editor Michael Roy speaks with Katherine MacDuffie, Ph.D., and Annette Estes, Ph.D., about their longitudinal neuroimaging study examining associations between sleep difficulties and developmental trajectories among infants who go on to develop autism spectrum disorder. Why is sleep so important during early life? [2:16] How can sleep affect a child's behavioral and mental development, as well as overall functioning? [3:34] Why the authors conducted this research [4:47] Areas of the brain that were of particular interest [6:35] Methods used in the research [8:34] Main findings of the research [10:54] How results aligned with previous research [12:22] Potential neurobiological mechanisms underlying the results [13:57] Limitations of the work [15:26] Conclusions that researchers, clinicians, and other mental health professionals can take away from the work [17:12] Recommendations for further research in this area [18:21] Be sure to let your colleagues know about the podcast, and please rate and revi

Executive Editor Michael Roy speaks with Collin Reiff, M.D., and William McDonald, M.D., about their evidenced-based summary of the literature on the clinical application of psychedelic drugs in psychiatric disorders. How hallucinogens were first used, and some of the key individuals involved in the development of these drugs for medical use [2:23] What led to the worry about use of these compounds in the 1960s, and what actions did U.S. policymakers take at the time? [5:35] How have opinions changed from the 1960s to the present? [7:01] How the authors conducted their research [8:23] How the authors determined which drugs to examine [9:38] What findings stood out to the authors? [10:28] Relationships between the psychological effects and the neurobiology of psychedelic compounds [12:59] How ketamine came to be used in clinical care, and what studies have shown about its safety and effectiveness [14:18] An outline of psycholytic therapy and psychedelic therapy [17:16] What is the potential for these kinds of

Executive Editor Michael Roy speaks with Sarah A. Sullivan, Ph.D., and Stanley Zammit, Ph.D., about their research on the incidence, course, and outcome of psychotic experiences from childhood through early adulthood in the general population, and the prediction of psychotic disorder. How common are psychotic experiences in the general population, and what burdens do they place on public health systems? [2:19] What kinds of services are available to identify and treat individuals who have psychotic experiences? [3:48] Study methods [5:33] What kind of psychotic experiences were reported? [7:41] Age as a significant factor [8:57] Prediction of psychotic disorder by age 24 [10:33] Implications for practicing clinicians and other mental health professionals [11:58] Limitations of the study [12:41] What other studies should explore regarding first-episode psychosis [13:52] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Play, Stitcher, Spotify, or w

Executive Editor Michael Roy speaks with Damiaan Denys, M.D., Ph.D., and Ilse Graat, M.D., about their research on the tolerability and effectiveness of deep brain stimulation (DBS) for patients with refractory obsessive-compulsive disorder (OCD). What characterizes OCD, and how widespread is it? [2:35] What treatment with DBS involves [4:07] Outline of study methods [6:25] Why the part of the brain studied is relevant for DBS, and description of the scales used to measure how well the treatment worked [7:54] Main findings with regard to response of OCD symptoms in patients who received DBS [10:51] Discussion of adverse events [12:40] Implications of the work for researchers, clinicians, and other mental health professionals [14:54] What further studies should explore with regard to treatment with DBS [15:43] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Play, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. List

Executive Editor Michael Roy speaks with Arthur Robin Williams, M.D., M.B.E., and Mark Olfson, M.D., M.P.H., about their research on adverse health outcomes following discontinuation of buprenorphine among Medicaid beneficiaries who were retained for variable periods beyond 6 months. How buprenorphine helps patients, and factors affecting the use of this medication [2:50] Are there any quality measures for buprenorphine or for the treatment of opioid use disorder more generally? [7:48] What the authors aimed to achieve in the study [10:59] How the authors determined what methods to use in the study [13:51] Main findings with regard to adverse health outcomes after patients discontinued buprenorphine [16:22] Implications of the results [19:01] What further studies should explore with regard to treatment for opioid use disorder [21:50] Takeaways for researchers, clinicians, and other mental health professionals [23:06] Be sure to let your colleagues know about the podcast, and please rate and review it on App