Show cover of PsyDactic

PsyDactic

A resource for psychiatrists  interested in exploring the neuroscientific basis of psychiatric disorders, psychopharmacology, neuromodulation, and other psychiatric interventions, as well as discussions of pseudoscience, Bayesian reasoning, ethics, the history of psychiatry, and human psychology in general.This podcast is not medical advice.  It strives to be science communication.  Dr. O'Leary is a skeptical thinker who often questions what we think we know.  He hopes to open more conversations about what we don't know we don't know.Find transcripts with show-notes and references on each episodes dedicated page at psydactic.buzzsprout.com.You can leave feedback at https://www.psydactic.com.The visual companions, when available, can be found at https://youtube.com/@PsyDactic.

Tracks

In a Word - Aphasia
Send us a Text Message.In this episode, Dr. O'Leary discusses a word that he has struggled to understand since medical school.  The word is aphasia.  The root “phasia” comes from the Greek phanai which means “to speak.”  When aphasia is used medically, it refers to an inability to speak, although not always.  More generally it is often used to mean a failure to understand or produce language, but it gets complicated.  Dr. O'Leary reviews the brain regions responsible for various kinds of aphasia and how to identity them.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
37:22 6/9/24
WTF Cerebellum - Little Brain, Big Deal
Send us a Text Message.I did not until recently even consider the cerebellum when thinking about psychiatric conditions, but the more I read, the more I wonder why the cerebellum is not considered a potential important player in nearly every psychiatric disorder.  Although it can be said that all brain regions primarily function to make predictions, the cerebellum is especially active at refining impromptu predictions through short periods of time as sensory data changes to help us better navigate the world, not only in physical space, but our entire internal space.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
32:58 5/4/24
WTF - Thalamus
Send us a Text Message.The thalami are bilaterally symmetrical structures in the subcortical part of the brain that are cradled by the basal ganglia.  They are major hubs of pretty much everything your brain does and all of the sensory information coming into the brain with the exception of smell.More primitive models of the brain visualized it as a bunch of relatively isolated modules, each specialized to perform a single task when queried and able to send that information to wherever it should go.  More modern ideas propose a more integrated picture, with various regions of the brain contributing to a more diffuse process through parallel connections with other network communities and hubs.  It appears that nearly every integrated process in the brain is influenced at some level by thalamic modulation.  You could characterize the Thalamus as a brain wide gateway to the cortex, modulator and mediator of inputs, coordinator of feedback, relay between higher cognitive areas, manager of brainstem nuclei, and facilitator of attention.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
22:32 4/24/24
Seroquel (Quetiapine) - Drugs, Sex, Money and Psychopharm
Send us a Text Message.In this episode, I discuss a medication that patients who saw a psychiatrist or their primary care provider between about 1997 and 2015 were very likely to find themselves prescribed.  More recently, it has been taken down a notch or two on prescribers lists of preferred meds.  This medication is quetiapine, marketed as Seroquel by AstraZeneca in the US.  Whether you were diagnosed with schizophrenia, bipolar disorder, depression, anxiety, an eating disorder, insomnia, PTSD, borderline personality disorder, obsessive compulsive disorder, and many others it appeared in the mid 2000s that Quetiapine was just the thing for you.  Was it ever?Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
24:53 4/12/24
In a Word - Confabulation
Send us a Text Message.This episode continues an intermittent series called “In a Word.”  Past episodes have explored words like Akathisia, Dissociation, Perseveration, and even the difference between Impulsive and Compulsive.  This episode explores Confabulation, including some of the brain circuits involved, and what might differentiate confabulation from other kinds of false or implanted memories or delusions.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
14:22 3/20/24
How guilty are adolescents for their crimes?
Send us a Text Message.In 2012 the Supreme Court heard two related cases involving adolescents convicted of murder and sentenced to life in prison without parole because of mandatory minimum sentencing guidelines in their states.  One of the boys, Evan Miller along with an accomplice, had beat a man unconscious with a baseball bat after a fight that ensued when the man awoke to find Miller robbing him.  Miller and his friend then decided to set fire to the home to cover up the evidence.  This resulted in the man’s death.  The second petitioner, Kuntrell Jackson, had accompanied two other boys to a convenience store in order to rob it.  During the robbery, one of the boys, not Jackson, shot and killed the clerk.  Both boys were convicted and were sentenced according to minimum sentencing guidelines to life in prison without parole.  The decision that the court was asked to make was not whether the boys should have been convicted, but instead, whether the sentencing guidelines that resulted in them being given life without parole constituted cruel and unusual punishment.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
29:31 3/3/24
Serious Mental Illness in America with Dr. Zac Brooks
Send us a Text Message.I am lucky today to be able to bring you an interview with Dr. Zac Brooks who is passionate about serious mental illness (SMI).  “What is serious mental illness?” you might ask.  That is one of the things we are going to discuss, and you may be surprised when Dr. Brooks explains how it was first formally defined.  We also discuss the numerous ways the US has tried to reform how SMI is treated with variable results.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
45:59 2/16/24
HIV, PrEP, and Mental Health with Dr. Jon Lindefjeld
Send us a Text Message.PsyDactic welcomes Dr. Jon Lindefjeld for a discussion of the history of HIV and AIDS.  In particular, we discuss the development of effective antiretroviral therapies, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), highlighting the CDC guidelines for use and monitoring, need to treat psychiatric com-morbidities, and the importance of monitoring adherence and drug interactions.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
46:48 2/9/24
Perspectives on the Borderline: The Most Disordered Personality
Send us a Text Message.Dr. O'Leary discusses some of the history of the borderline personality, how different perspectives have attempted to explain its origin, how to treat it and how not to treat it.  He starts in 1947 with some colorful descriptions of patients living with borderline personality disorder that would never get published today, and highlights some of the ways in which we have made progress (or not made progress) in our understanding of this disorder over the next 75 years.  As usual, Dr. O'Leary also waxes philosophical about science or the lack thereof in certain perspectives or treatments.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
40:07 2/2/24
The Ghost of Personality Disorders Future
Send us a Text Message.Our current diagnostic criteria for personality disorders have failed to demonstrate validity or reliability.  The DSM 5 encouraged psychiatrists to start considering a broad range of personality features adapted from the Five Factor Model. These are combined with global functioning measures to build a personality inventory for any patient who is having dysfunction related to their personality.  Proposed criteria include a Personality Disorder - Trait Specified diagnostic category that permits diagnosticians to accommodate the new formulation.  Criterion A considers the salient aspects of personality functioning while Criterion B catalogs which of the Big 5 Factors are notably deranged.  Dr. O'Leary reviews the basics of these criteria and explores why our current formulations are in such dire need of reform.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
23:27 1/26/24
Tattoos, Stigma, Racists, and Psychiatry
Send us a Text Message.Humans have a history of tattooing that stretches millennia into prehistory.  The western ban on tattoos by the early church resulted in a systematic effort to paint tattooed individuals as pagan, primitive, vulgar, criminal, and mentally ill.  Psychiatrists have historically contributed to this characterization but are in a position to help reframe how citizens and policymakers view tattooed individuals. Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
26:11 1/22/24
Attractor Networks and the Bayesian Brain
Send us a Text Message.The brain understands the world by building models that predict the future.  One of the ways that it does this is by utilizing attractor networks.  These small world networks are constantly trying to determine what is a true signal from the constant noise in the neural net.  Dr. O'Leary explores how attractor networks have been hypothesized to explain psychosis, depression, and obsessive compulsive disorder, and how our various treatments might work to stabilize these networks.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
58:06 1/16/24
Serotonin - Jack of All Trades, Master of None
Send us a Text Message.When I started to make this episode, I thought I would try to do a comprehensive review of all of the various functions of serotonin across its 15 or more receptor types, but I soon found myself overwhelmed.  More importantly, I found that some stories are more interesting to tell than others, so here I discuss serotonin and focus on how a few 5-HT receptors can not only help us survive, but also motivate ourselves to reach our goals, and, sometimes, convince us that we are fusing bodies with a tree.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
32:44 12/31/23
Antipsychotics and their discontents
Send us a Text Message.Frequently I have complained that the terms "typical and atypical" or "first generation and second generation" antipsychotics were not very helpful.  When I give chalk talks to junior residents and interns about antipsychotics, this is one of the first things that I note.  It is the medicines relative affinities for different receptors that appear to make the difference, not whether they were discovered prior to 1980 or not.  A few weeks ago, I was lucky enough to encounter a paper that was published in April of 2023 by McCutcheon et al in Biological Psychiatry titled "Data-Driven Taxonomy for Antipsychotic Medication: A New Classification System."  In this episode, I use their results to guide a discussion of variability in target effects and side effects of different groups of antipsychotics.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
21:31 12/15/23
Extrapyramidal Side Effects and Tardive Dyskinesia for Super Nerds
Send us a Text Message.This episode explores side effects of antipsychotics at the molecular level.  It starts by exploring receptors and their ligands and takes a turn into the dorsal striatum where dopamine, acetylcholine, serotonin, and glutamate work together to help us dance the mamba.  Dr. O'Leary explores what happens when the complex pathways of the cortico-striatal-thalamo-cortical tract are disrupted by antipsychotics both in the short term and after many months or years of use.  As the title suggests, there is a ridiculous amount of detail, so let's get our nerd on!Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
37:22 12/14/23
The STAR*D Trial: Scientifically Flawed or Scientific Fraud?
Send us a Text Message.The authors of the famous sequenced treatment alternatives to relieve depression trial or STAR*D reported that about two-thirds or 67% of patients had achieved remission after 4 trials of antidepressant medication.   This remission rate has been questioned over the years and in October of 2023, the journal BMJ Open published an article that reports to have reanalyzed the date from STAR*D using the original study design.  This re-analysis found much much lower rates of remission.  It reported the cumulative remission rate as only 35 percent.  How do two different sets of researchers using the same data set get a result that is just half of what the other researchers reported?  That is the mystery that I report on today.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
22:02 12/11/23
Dopamine Networks and Psychosis
Send us a Text Message.This episode is about dopamine.  In episode 32, I discussed the pseudoscientific trend of the “dopamine detox”  or "dopamine fasting."  Instead of talking about pseudoscience in this episode, I discuss the actual science surrounding dopamine and its relationship with the neuroleptics or antipsychotics as they are more commonly known.   The effects and side effects of antipsychotics are related to the function of the major dopamine networks of the brain: the mesolimbic, mesocortical, nigrostriatal, and tuberoinfundibular pathways.  Dopamine levels in each of these pathways can be regulated also by serotonin receptors, and so this episode contains a discussion of how first generation, second generation, and novel antipsychotics affect dopamine by affecting serotonin receptors.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
32:17 12/3/23
In a Word - Impulsive vs Compulsive
Send us a Text Message.In this Episode, I  continue an intermittent series called “In A Word.”  The difference between prior episodes and this one is that today I have two words.  I chose these words because I don’t really know the difference between them, and even after reading and trying to understand the difference, I am not sure that there is a clear difference.  The two words are Impulsive and Compulsive.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
29:00 11/11/23
Traumatic Brain Injury - How Severe Was It?
Send us a Text Message.I discuss something  that is likely to present itself to a physician long after the fact: a single mild brain injury.  This episode focuses on how to classify the severity of a single brain injury.  While working in a brain injury unit, I noticed that some providers used the term severe brain injury when referring patients to neurology or neuropsychiatry, and this communicates something very specific that they may not realize they are communicating. Those of us seeing a patient after a brain injury may not know the specific terminology to use, so this episode is meant to help the listener understand how brain injury experts classify these injuries.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
24:34 10/18/23
The Medial Prefrontal Cortex
Send us a Text Message.This episode continues a series on the prefrontal cortex, a complex region of the brain that gives us the ability to have the kinds of thoughts no other species on earth is known to have.   The medial (or mesial) prefrontal cortex is especially important for emotional and autonomic regulation, attention and goal-directed behaviors (including addiction), and building our sense of self (that is our identity as a thing separate from the world around us), and considering salient aspects of the social context we are in and what others might be thinking (among many other things).Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
15:28 8/7/23
The Orbitofrontal Cortex - Our built-in Economist
Send us a Text Message.In this episode, I am sliding down and under the front part of the brain and consider the orbital frontal cortex, that part of the brain right above and a little behind your eyes.  It is much smaller than the lateral gyri on the prefrontal cortex, but appears to be an important probability generator in our brain when we need to consider different options that can result in different rewards or in order to avoid aversive stimuli.  The most basic kinds of rewards that neuroscientists can study are for food, because lab animals will respond to those, and while the OFC is definitely intimately related to food, in humans, its powers of prognostication are much more generalized.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
25:30 7/18/23
The Dorsolateral Prefrontal Cortex - Our Executor and Speech Writer
Send us a Text Message.We seem to understand the specializations of the the dorsolateral prefrontal cortex on the left better than the right side of our brain.  That is because most of us do a lot more language processing on the left or dominant side.  The more inferior and caudal parts of the dorsolateral PFC on the left side are more specialized for speech.  The more superior parts are more involved in working memory, attention control, and task switching.  The entire DLPFC is extensively connected to other cortical regions that pass information to it for consideration, and the DLPFC is extensively connected to the supplementary and motor regions that help to plan actions, and the striatum, which helps coordinate those actions.   It is also intimately involved with motivation and helps us to control our emotions.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
36:15 7/17/23
The Prefrontal Cortex - An Introduction to What Makes Us Human
Send us a Text Message.Besides being relatively hairless apes, there are some things about humans that make us special among animals.  In the past we have noted things like, “We have big brains and we use tools,” or “We contemplate the future and our own mortality,” or “We use a truly complex language both verbal and written to communicate complex ideas.”  These are things we have and do, but what is it about our brains that makes that possible.  More and more we are identifying crucial hubs or nodes within our brain that specialize in various tasks, but none of these work alone. I am going to start by discussing that big blob of gooey mush on the front of our brains called the prefrontal cortex, and in subsequent episodes, I will discuss how these regions function in tandem with deeper structures within the brain to create what we think of when we say “human.”Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
20:09 7/14/23
Psychological versus Neuropsychological Testing
Send us a Text Message.This episode is about how to decide whether to send a patient to get neuropsychological or just psychological testing, and this decision is determined by at least two things.  The first is the question that you are trying to answer.   The second  is, what can the service that I am referring to provide for the patient?  In this episode, I will focus primarily on the first consideration:  the question that you are asking.  As a referring provider, then, it is helpful to know what kinds of tests a psychologist or neuropsychologist can administer, because these are designed to answer very specific questions. Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
40:23 7/12/23
In a Word - Validity
Send us a Text Message.Today I discuss the term “validity.”  Let’s say we wanted to develop a test that identifies pathological character traits or quantifies depression symptom burden on a patient.  A good test is going to do more than simply list the diagnostic criteria for various diagnoses and then ask the patient if they think that sounds like them.  A test needs to have a few things.  First it needs to have a defined purpose.  Is it to be used for diagnosis in a clinic or for research?  Is it going to measure symptoms in already diagnosed patients and track their response to therapy?  Is it meant to predict if a person would be a good candidate for something like being an astronaut or a member of the military?  Once the purpose is determined, then you need to define something called a construct, and then you have to determine the validity of that construct.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
25:50 7/11/23
Guns - Starting the Conversation
Send us a Text Message.Today I talk about guns.  More specifically, I talk about talking about guns.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
29:41 6/8/23
In a Word - Akathisia
Send us a Text Message.Today I am continuing an intermittent series called, “In a Word,” and the word that I chose for today is akathisia.  Akathisia is broadly defined as an inability to remain still.  If you ask someone with Akathisia to stop moving, they will likely become very uncomfortable, but while they are moving, they experience at least some relief.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
23:17 5/17/23
Dopamine Detox and Pseudoscience
Send us a Text Message.There is a narrative wave in popular psychology and neuroscience that has taken a small amount of very basic science and twisted it into a fantastic narrative of feast and famine.  Its central character is dopamine.  The Dopamine Detox also known as dopamine fasting is a pseudoscientific treatment that at best illustrates how magnificently strange and evidence-less some claims about dopamine can be.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
29:00 5/4/23
Artificial Intelligence and Psychiatry
Send us a Text Message.I have recently added some artificial intelligence produced answers to psychiatry questions in my past episodes in an effort to try to understand what it is that AI text generators can do and what value they might add to my future as a psychiatrist versus what problems it might introduce into my practice. I realized that since I have opened this pandora's box, I need to provide some more context. Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
26:45 4/13/23
What is a placebo?
Send us a Text Message.What is a placebo?  You may already be thinking something like: A placebo is an imitation, fake, sham, decoy, or trick treatment that we give to people in studies to see if the treatment under investigation is any better or worse.  Placebos are supposed to be both benign and inert, meaning they should neither harm nor help a patient beyond the patient feeling or reporting that they are better or worse after they received some kind of treatment.  It seems strange that there is something that can take innumerable forms and still seems to work at least a little bit on so many different things. Placebos are like an all-powerful potion or magic spell.  For some treatments, even active treatments, placebo effects account for the vast majority of the effect size and it is not just an illusion.Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else. We reserve the right to be wrong. Nothing in this podcast should be treated as individual medical advice.
24:31 3/13/23

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