In this episode, I discuss Catalepsy, Postering, Grimacing and Waxy Flexibility. I grouped the diagnostic signs that I am going to cover today because they are all similar. Your patient acts like a wax statue. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. 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 o...
May 14, 2022•12 min•Ep. 14
Stupor, Mutism, and Negativism on the surface appear to have some overlapping features. Of all the features of catatonia that non-experts might be able to describe, stupor and mutism are like the ones. They are also the most common signs. A patient is not entirely unconscious, but they don’t move, they stare forward, they don’t talk, and they don’t follow commands. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. References and readings (when ava...
Apr 07, 2022•10 min•Ep. 13
In the last episode, I promised [or threatened] to get into more of the nitty-gritty of the symptoms of catatonia. Well, like it or not, that is what I am going to do in this episode. Today I will focus on Mannerisms and Stereotypy, two of the potential signs of catatonia. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com ...
Mar 26, 2022•10 min•Ep. 12
In this episode, I introduce a diagnosis that is not a diagnosis. By that, I mean that it is a condition that we may find our patients in, but it is not considered to be a diagnosis by itself, like major depressive disorder or schizophrenia are considered to be diagnoses. I am talking about catatonia, a condition characterized by either a lack of interaction with the world or as purposeless interaction with the world. Please leave feedback at https://www.psydactic.com or send any comments to fee...
Mar 06, 2022•23 min•Ep. 11
This episode is a quick take in a new intermittent series I am calling “In a Word,” and in this series I hope to dig down into some neuropsychiatric terms that we use every day, but maybe don’t really understand very well. The first word I am taking on is PERSEVERATION. The reason I chose PERSEVERATION is because I see it written in psych notes by med studs and residents frequently, but for you Princess Bride fans out there, “You keep using this word. I don’t not think it means what you think it...
Feb 26, 2022•10 min•Ep. 10
My last three episodes focussed on classical cases of Obsessive Compulsive Disorder, but the DSM 5 has included a few other related diagnoses in the same chapter including body dysmorphic disorder (BDD), hoarding disorder, trichotillomania, and excoriation disorder. Each of these have distinct obsessional components and compulsions, age of onset, degree of insight, and chronic course. Hence, they get their own diagnostic category. Please leave feedback at https://www.psydactic.com or send any co...
Feb 19, 2022•19 min•Ep. 9
I briefly explore how to treat patients with OCD. Choosing first-line treatment is relatively straight-forward, but there is less clarity on how to proceed if my patient does not respond. It is imperative, then, to make sure that I understand my patient’s symptoms and their goals very well. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. References and readings (when available) are posted at the end of each episode transcript, located at psydact...
Feb 12, 2022•14 min•Ep. 8
This episode explores the brain space of obsessive compulsive disorder (OCD) with a creative journey through neuroanatomy and brain circuitry. I try to make it much less boring than it sounds. After listening to this episode, it is my goal that the listener will understand the complex interactions of the cortico-striatal-thalamo-cortical (CSTC) circuit and have a fuller appreciating of how the brain decides what to do and how to do it. Please leave feedback at https://www.psydactic.com or send a...
Jan 29, 2022•20 min•Ep. 7
In previous episodes, I’ve hacked a path through Electroconvulsive Therapy and Transcranial Magnetic Stimulation, trying to reveal some of the secrets in those jungles. Now I am turning my machete to a different landscape: Obsessive Compulsive Disorder or OCD for short. The name is confusing, because the writers of the DSM decided to name a personality disorder Obsessive Compulsive Personality Disorder or OCPD, but this podcast is not about a personality disorder. It is about a neuropsychiatric ...
Jan 22, 2022•19 min•Ep. 6
This episode is dedicated to all the med studs and residents who cringe every time they have to go to journal club. I report the results of an initial trial of a special kind of Transcranial Magnetic Stimulation of the brain that might be the future of depression treatment, at least for the treatment resistant or severe varieties. I also use this as an opportunity to explain a little more about how repetitive TMS is usually performed (that is, its current FDA approved form), killing two dinosaur...
Jan 15, 2022•18 min•Ep. 6
I wanted to do this episode, because when I did my episodes on electroconvulsive therapy (or ECT), I feel like I sounded a tiddly-bit dismissive of it, and I wanted to clarify what I meant when I said, “TMS, short for Transcranial Magnetic Stimulation of the Brain, as of yet is not nearly as efficacious as ECT.” If you haven’t listened to the ECT episodes, you should still be able to follow this discussion, so don’t feel left out. I give a history of TMS development, discuss some of its approved...
Jan 08, 2022•17 min•Ep. 5
In the last episode, I gave a brief discussion about how electroconvulsive therapy (ECT) works by causing convulsive seizures and discussed some of the proposed mechanisms by which seizures might result in benefit. In this episode, I discuss who you should consider sending for ECT, some of the considerations for different patient populations, and how you might approach explaining to a patient that you want to electrify their skull and make them seize. Please leave feedback at https://www.psydact...
Jan 02, 2022•23 min•Ep. 4
The mechanism of action of electroconvulsive therapy remains elusive, so I am going to describe how ECT induces seizures, discuss the evidence that ECT is not just an elaborate placebo (or in other words, inducing the seizure is what results in the therapeutic benefit), and then briefly discuss some of the many proposed mechanisms by which it might work. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. References and readings (when available) are...
Dec 29, 2021•14 min•Ep. 3
A brief and exciting history of electroconvulsive therapy. You will learn how a method for anesthetizing pigs before slaughter was first used on a homeless and psychotic man and how it soon became the gold standard treatment for severe mood disorders. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com . All opinions express...
Dec 29, 2021•12 min•Ep. 2
Dr. O'Leary explains what inspired him to start this podcast, where the first episodes will take you, and why you should be skeptical of everything he says. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. 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...
Dec 29, 2021•2 min•Ep. 1
