What a psychiatric diagnosis means – and what it doesn’t mean Helpful to go back to basics from time to time… here’s a no-nonsense introduction psyche.co/ideas/what-a-p…

Why I routinely under-diagnose: 1)Initial impressions often wrong 2)We see patients on worst day- doesnt extrapolate to future 3)Easy to later up diagnose 4)Hard to erase wrong label 5)Harms of overdiagnosis far worse- stigma/meds 6)I wish all diagnosis could be written in pencil

Psychiatry Boot Camp is back for Season 3! Join Allen Frances for some wisdom on making “magic moments.” I will always treasure this interview and it is packed with clinical pearls! open.spotify.com/episode/7g77JO… #psychiatry #FOAMed

"Magic Moments" Therapy doesn’t work in gradual steps- I treated some for yrs with no impact/others changed lives after 1 meeting. No session ever routine/Always be ready for chance to make real difference. Useful interview on how to promote "corrective emotional experiences":

I deprescribe psych meds and follow the Ashton method for tapering benzos as part of my regular daily psychiatric practice I don’t charge my patients $50-60k a year to do that

🙌 I was honored to join Mark Mullen again on his Psychiatry Bootcamp Podcast--this time, on #catatonia! 🎙️ Here's part 1 of 2: podcasts.apple.com/us/podcast/3-5… #FOAMed #psychtwitter #MedTwitter

Made an entire Season 3 of Psychiatry Boot Camp just so I could interview Mark Oldham on Catatonia 😂 Here we cover diagnosis, including a fascinating discussion contrasting the DSM with the Bush-Francis Catatonia Rating Scale. Part 2 drops Monday! open.spotify.com/episode/7osJwc…

🚨 Part 2 on #catatonia management is up Managing catatonia generally involves treating... 📍 The syndrome w/ lorazepam, first as a challenge then followed by scheduled doses 📍 Any underlying/associated condition(s) 📍 Medical/functional sequelae podcasts.apple.com/us/podcast/3-6…

Management of catatonia is such a challenging area in psychiatry. Join Mark Oldham and I for an entertaining review of the evidence, and a discussion on the nooks and crannies of catatonia management! #FOAMed #psychtwitter #catatonia open.spotify.com/episode/3vAbcx…

So once physicians learn the root cause of “disease,” and we talk about diet and exercise (which already happens but for the sake of argument) and “disease” still exists, then what do we do? Do we still prescribe medicine? At what point in the process do we become pharma shills?

Join ⁦Tyler Black, MD⁩ for a ridiculously enlightening episode on Suicide Risk Assessment. This is the latest in our journey through CL psychiatry. I learned more here than in any other 90 min through all of medical training‼️ #FOAMed #psychtwitter podcasts.apple.com/us/podcast/psy…

Here's a free access link until August 7. authors.elsevier.com/a/1lHuj9UUH05C…

NEW BLOOD TEST FOR #ALZHEIMERS A DISASTER 1)Will cause massive overdiagnosis 2)Fear mongering turns normal aging into disease 3)No effective treatment 4)Available treatments> awful complications/huge expense 5)Drug company hype/False hope Great reporting: garyschwitzer.substack.com/p/the-coverage…

🧵 the most common mistake I see by non-psychiarists At the core of any psychiatric diagnosis is an important task: FORMULATION This is synthesis by the clinician of the knowledge gained about heir biology, psychology, and factors that have played/will play in their life. /1

This is ESSENTIAL. And the lack of understanding/practice of formulation DOES cause harm. Diagnosing a patient with any mental disorder after a 5 minute evaluation is unacceptable. #FOAMed

A big reason why I'm ambivalent about the microdosing model is that many seem to assume microdosers can go about all of their usual daily activities in that altered mode. I'm unconvinced that they're right to assume it's safe/good/fine to do that... 🤷‍♂️

Over a hundred years ago, Karl Jaspers proposed that what makes a belief delusional is not its content, but its form--how it is held, its imperviousness to reason, etc. I think this emphasis on form over content is true for a wide range of psychiatric symptoms, including those

Helped a patient off benzodiazepines and didn’t charge them $50,000 to do it

Having Moncreiff, McFillin, and the guy who makes stupid money off of tapering people on an FDA "expert panel" had it's predictable results. While they spew their one-sided diatribes (highly conflicted ideologically&financially), real pregnant women will be made to suffer more.

Equally misguided myths: Mental disorders are brain diseases Vs Mental disorders are not brain diseases My chaos theory view: Most mental disorders emerge from complex bio/psycho/social/spiritual interactions- no simple explanations. Best summary brain's role in psychiatry: