Dr. Paula Zimbrean, Professor of Psychiatry and Yale School of Medicine and Director of Transplant Psychiatry Services at Yale New Haven Hospital, introduces us to the field of transplant psychiatry.

We discuss the role of psychiatrists in solid organ transplantation, including pre-transplant evaluations. We then discuss the various phases through which transplant patients require support, starting with a diagnosis of advanced organ disease. We cover the pre-transplant phase, peri-operative recovery, early post-transplant stressors, and finally psychiatric considerations that last months to years after transplant. Dr. Zimbrean discusses ethical challenges faced by psychiatrists working in a transplant setting, and shares considerations for the future of transplant psychiatry.

Selected references:

1. Transplant Psychiatry: A Case-Based Approach to Clinical Challenges
2. Transplant Psychiatry: An Introduction

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A season on consultation-liaison psychiatry would not be complete without an episode on suicide risk assessment!

Dr. Black: "I say without exaggeration that this podcast, in which Dr. Mullen and I discuss suicide risk assessment, is one of the professional things in life that I am most proud of."

WOW! That's quite the claim from one of the world's foremost psychiatrists about a podcast episode. Take a listen and see what you think!

Dr. Tyler Black, a suicidologist and child psychiatrist at British Columbia Children's Hospital, walks through common suicide myths, structuring the suicide risk assessment interview, common motivations for suicide, clinical decision making, best practices for documentation, and what works in preventing suicide.

Selected references:

1. ⁠Changeability, confidence, common sense and corroboration: comprehensive suicide risk assessment (O'Connor 2004)⁠

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Dr. George Grossberg, Henry and Amelia Nasrallah Endowed Professor of Psychiatry & Behavioral Neuroscience at Saint Louis University School of Medicine, past president of the American Association for Geriatric Psychiatry, and past president of the International Psychogeriatric Association, orients us to behavioral disturbances in patients with neurocognitive disorders.

We walk through common behavioral disturbances in patients with dementia, including apathy, depression, psychosis, and agitation. We discuss management strategies including nonpharmacological and pharmacological interventions. Dr. Grossberg shares his expertise on difficult clinical management decisions when working with this population, and centers us around the importance of knowing the patient as well as the disease.

Selected References:

1. ⁠Progress in Pharmacologic Management of Neuropsychiatric Syndromes in Neurodegenerative Disorders: A Review (Cummings 2024)
2. Neuropsychiatric Symptoms of Dementia and their nonpharmacological and pharmacological management (Tampi 2022)⁠
3. Management of BPSD Algorithm (Chen with Osser 2021)⁠
4. Atypical Antipsychotics for Aggression and Psychosis in Alzheimer's disease (Ballard 2006)
5. Efficacy and Adverse Effects of Atypical Antipsychotics for Dementia (Schneider 2006)
6. Sequential Drug Treatment Algorithm for Agitation and Aggression in Alzheimer's and Mixed Dementia (Davies 2018)

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