Psychiatry Boot Camp – Details, episodes & analysis

Welcome to Season 4! Join Dr. Mark Mullen and expert guests as we explore AI in psychotherapy, emerging treatments, and the ethical, clinical questions reshaping psychiatric care, and MUCH more. To share topic ideas, ask questions, and get more of the pod, visit psychiatrybootcamp.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, I speak with Dr. Nicholas Kontos, Program Director of the Consultation–Liaison Psychiatry Fellowship at Massachusetts General Hospital, about one of the field’s most challenging topics: malingering and factitious disorder. We discuss how to move beyond the impulse to “catch deception” and instead adopt a framework of clinical curiosity, empathy, and ethical clarity. Dr. Kontos introduces the concept of “thinking dirty”, the disciplined consideration of complex motives such as safety, shelter, or secondary gain, while preserving therapeutic respect. The conversation covers practical strategies for differential diagnosis, documentation, and the therapeutic discharge, reframing it as a compassionate boundary rather than a punishment.  Takeaways: Clinicians must be willing to consider non-altruistic motives (sex, money, drugs, safety, attention) without moral judgment. This mindset sharpens diagnostic reasoning while maintaining therapeutic respect.The classical distinction between factitious disorder and malingering is often clinically unstable. Both exist on a behavioral spectrum shaped by unmet needs, structural deprivation, and adaptive strategiesProperly framed, discharge is not punitive but restorative, a boundary that ends maladaptive cycles while affirming the patient’s moral agencyThe note itself is a clinical act. A comprehensive chart review, clear description of inconsistencies, and transparent reasoning both protect the patient and clarify physician thought Effective care balances compassion with stewardship of finite resources. Clinicians serve both patient and system by refusing to reinforce maladaptive behavior while still honoring human dignity Teaching Psychiatric Trainees to “Think Dirty”: Addressing Hidden Motivations in the Consultation Setting (Beach, 2017) The Therapeutic Discharge I: An Approach to the Management of Deceptive Suicidality (Kontos, 2017) The Therapeutic Discharge II: An Approach to Documentation in the Setting of Feigned Suicidal Ideation (Kontos, 2018) SUPPORT OUR PARTNERS: ⁠⁠⁠⁠SimplePractice.com/bootcamp⁠⁠⁠⁠ (Now with AI documentation! Exclusive 7 day free trial and 50% off four months) ⁠⁠⁠⁠Beat the Boards⁠⁠⁠⁠ Boot camp listeners now get FREE access to over 4400 exam-style questions) Learn more and get transcripts for EVERY episode at https://www.psychiatrybootcamp.com/ For Sales Inquiries & Ad Rates, Please Contact:⁠⁠⁠Sales@Human-Content.Com⁠⁠⁠ Connect with HumanContent on Socials: @humancontentpods Produced by: ⁠⁠⁠Human Content⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

When a patient stops moving, stops speaking, or stares through you like you’re not there, it’s easy to miss what’s really happening. In this episode, I’m joined again by Dr. Mark Oldham, one of the leading voices on catatonia, to break down what this strange, often misunderstood syndrome actually looks like in the real world. We walk through the diagnostic features step-by-step, how to assess, what to ask, and what’s too often overlooked. From the history of the disorder to modern DSM confusion, from the meaning of “waxy flexibility” to the haunting truth about patients who are fully aware but trapped inside their bodies, this conversation will completely change the way you think about motor symptoms and psychiatric emergencies. Takeaways: Catatonia is common, but underrecognized. It’s not just “psychiatric immobility.” It spans a spectrum from stupor to hyperactivity. Diagnosis starts with curiosity. Learn to test for features like mutism, posturing, and negativism systematically. Many patients are aware. Always treat them with dignity and assume comprehension, even when they can’t respond. It’s treatable and rapidly reversible. A single dose of lorazepam can sometimes unlock a frozen mind and body. Malignant catatonia kills. When autonomic instability appears, it’s a medical emergency that demands immediate escalation and often ECT. Selected references: British Association for Psychopharmacology Guidelines ⁠Rochester Catatonia Assessment Resources⁠ NEJM Review on Catatonia Nature Review on Catatonia Schizophrenia Research Volume on Catatonia Describing the Features of Catatonia (Oldham) SUPPORT OUR PARTNERS: ⁠⁠SimplePractice.com/bootcamp⁠⁠ (Now with AI documentation! Exclusive 7 day free trial and 50% off four months) ⁠⁠Beat the Boards⁠⁠ Boot camp listeners now get FREE access to over 4400 exam-style questions) Learn more and get transcripts for EVERY episode at https://www.psychiatrybootcamp.com/ For Sales Inquiries & Ad Rates, Please Contact:⁠Sales@Human-Content.Com⁠ Connect with HumanContent on Socials: @humancontentpods Produced by: ⁠Human Content⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Mark Oldham, Associate Professor of Psychiatry at University of Rochester Medical Center, President-Elect of the American Delirium Society, and Deputy Editor of the Journal of the Academy of Consultation-Liaison Psychiatry, further explores delirium. This episode covers the pathophysiology of delirium including predisposing and precipitating factors, neurocircuitry, and neurotransmitters. We then discuss conceptual frameworks for management of delirium, the importance of identifying and addressing the underlying cause, and strategies for managing specific neuropsychiatric disturbances in delirium. References can be found on the ⁠episode website.⁠ SUPPORT OUR PARTNERS: ⁠⁠⁠⁠SimplePractice.com/bootcamp⁠⁠⁠⁠ (Now with AI documentation! Exclusive 7 day free trial and 50% off four months) ⁠⁠⁠⁠Beat the Boards⁠⁠⁠⁠ Boot camp listeners now get FREE access to over 4400 exam-style questions) Learn more and get transcripts for EVERY episode at https://www.psychiatrybootcamp.com/ For Sales Inquiries & Ad Rates, Please Contact:⁠⁠⁠Sales@Human-Content.Com⁠⁠⁠ Connect with HumanContent on Socials: @humancontentpods Produced by: ⁠⁠⁠Human Content⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Mark Oldham, Associate Professor of Psychiatry at University of Rochester Medical Center, President-Elect of the American Delirium Society, and Deputy Editor of the Journal of the Academy of Consultation-Liaison Psychiatry, introduces us to delirium. This episode covers the epidemiology, clinical features, and diagnosis of delirium. References can be found on the ⁠episode website.⁠ SUPPORT OUR PARTNERS: ⁠⁠⁠⁠SimplePractice.com/bootcamp⁠⁠⁠⁠ (Now with AI documentation! Exclusive 7 day free trial and 50% off four months) ⁠⁠⁠⁠Beat the Boards⁠⁠⁠⁠ Boot camp listeners now get FREE access to over 4400 exam-style questions) Learn more and get transcripts for EVERY episode at https://www.psychiatrybootcamp.com/ For Sales Inquiries & Ad Rates, Please Contact:⁠⁠⁠Sales@Human-Content.Com⁠⁠⁠ Connect with HumanContent on Socials: @humancontentpods Produced by: ⁠⁠⁠Human Content⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

When you think about core topics in consultation-liaison psychiatry, “supportive psychotherapy” probably isn’t the first thing that comes to mind. But maybe it should be. In this episode, I sit down with Dr. John C. Markowitz, Columbia psychiatrist, researcher, and co-author of Supportive Psychotherapy: A Guide, to talk about the therapy that “gets no respect.” Dr. Markowitz explains how this deceptively simple approach, built on empathy, affect, and alliance, rivals more “sophisticated” treatments for depression. We explore why the most powerful interventions often come down to being present, listening well, and helping patients feel understood. And we talk about the threat facing psychotherapy itself and what we stand to lose if psychiatrists give it up. Takeaways: Supportive psychotherapy works and evidence shows it can be just as effective as CBT or IPT for depression. Common factors like alliance, empathy, affect focus, and ritual account for much of what makes any therapy succeed. Following affect matters emotions are uncomfortable, but they’re not dangerous, and they guide the healing process. Less is often more letting patients lead, listening actively, and resisting the urge to “fix” can create deeper insight. Psychotherapy is under siege and preserving its human core may be psychiatry’s most important act of resistance. Selected references: What is Supportive Psychotherapy? (Markowitz 2014) Brief Supportive Psychotherapy (2022) Psychiatrist Effects in the Psychopharmacological Treatment of Depression (McKay 2006) SUPPORT OUR PARTNERS: ⁠⁠SimplePractice.com/bootcamp⁠⁠ (Now with AI documentation! Exclusive 7 day free trial and 50% off four months) ⁠⁠Beat the Boards⁠⁠ Boot camp listeners now get FREE access to over 4400 exam-style questions) Learn more and get transcripts for EVERY episode at https://www.psychiatrybootcamp.com/ For Sales Inquiries & Ad Rates, Please Contact:⁠Sales@Human-Content.Com⁠ Connect with HumanContent on Socials: @humancontentpods Produced by: ⁠Human Content⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome to Season 3 of Psychiatry Bootcamp. This time, I’m stepping into the world of consultation-liaison psychiatry. The bridge between medicine and meaning. To kick things off, I’m joined by the legendary Dr. Allen Frances, former chair of the DSM-IV Task Force and Duke Psychiatry, who reminds us that the briefest interactions can be the most transformative. We talk about what really happens when you walk into a hospital room: the loneliness, the fear, the need to be seen. Dr. Frances shares why “magic moments” aren’t superstition, but the heart of good medicine, and how to create hope in patients who’ve all but lost it. Takeaways: Every patient encounter is a chance for transformation, even a 15-minute consult can change a life. Consult psychiatry lives between medicine and therapy and requires both logic and empathy. Corrective emotional experiences can happen in moments, not months, when vulnerability meets presence. Demoralization is the real danger, hope and understanding are often the most powerful treatments. The “magic moment” is simply humanity made visible and it’s what patients remember long after the diagnosis. SUPPORT OUR PARTNERS: ⁠SimplePractice.com/bootcamp⁠ (Now with AI documentation! Exclusive 7 day free trial and 50% off four months) ⁠Beat the Boards⁠ Boot camp listeners now get FREE access to over 4400 exam-style questions) Learn more and get transcripts for EVERY episode at https://www.psychiatrybootcamp.com/ For Sales Inquiries & Ad Rates, Please Contact:Sales@Human-Content.Com Connect with HumanContent on Socials: @humancontentpods Produced by: Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

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Dr. Sameer Jauhar, Senior Clinical Lecturer in Affective Disorders and Psychosis at the Institute of Psychiatry, Psychology and Neuroscience, King's College, London, and as a Consultant Psychiatrist at Maudsley NHS Foundation Trust, introduces us to schizophrenia. Explore core clinical features of schizophrenia and what is known about the neuroscience of schizophrenia. We'll also discuss psychopharmacological and psychosocial treatment approaches, rooted in Dr. Jauhar's humanistic approach. This episode is intended to supplement Dr. Jauhar's Lancet Seminar on Schizophrenia (2022). Connect with Dr. Jauhar: @SameerJauhar Support our partners: SUPPORT OUR PARTNERS: ⁠SimplePractice.com/bootcamp⁠ (Now with AI documentation! Exclusive 7 day free trial and 70% off four months) ⁠Oasis Psychiatry Conferences ⁠(enter code BOOTCAMP at checkout for additional 10% savings) ⁠Beat the Boards⁠ (enter code BOOTCAMP at checkout for addition 10% savings) ⁠CME to Go⁠ (enter code BOOTCAMP at checkout for addition 10% savings) ⁠⁠⁠Beat The Boards⁠⁠⁠ (enter referral code BOOTCAMP at checkout) Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Laura Watkins, Clinical Psychologist and Assistant Professor of Psychiatry at Emory University School of Medicine, introduces us to post-traumatic stress disorder (PTSD). We walk though the diagnostic criteria and discuss how these symptoms can impact a person's day-to-day life. We then learn to conceptualize PTSD in terms of both classical and operant conditioning. Finally, we explain evidence based psychotherapies for PTSD and conclude with a primer on psychopharmacology for PTSD. Essential references: 1) Osser Psychopharmacology Algorithm for PTSD 2) Clinical Guidelines for PTSD (United States Department of Veteran's Affairs and Department of Defense) 3) This American Life: Ten Sessions SUPPORT OUR PARTNERS: ⁠SimplePractice.com/bootcamp⁠ (Now with AI documentation! Exclusive 7 day free trial and 70% off four months) ⁠Oasis Psychiatry Conferences ⁠(enter code BOOTCAMP at checkout for additional 10% savings) ⁠Beat the Boards⁠ (enter code BOOTCAMP at checkout for addition 10% savings) ⁠CME to Go⁠ (enter code BOOTCAMP at checkout for addition 10% savings) Learn more about your ad choices. Visit megaphone.fm/adchoices