PsyDactic

Dr. O'Leary discusses his critical perspective on Oppositional Defiant Disorder (ODD) and argues that ODD is not a primary diagnosis but rather a risk syndrome, a set of symptoms (defiance, irritability, and vindictiveness) resulting from various underlying conditions like ADHD, anxiety, or trauma. He explains that conceptualizing ODD as a stand-alone disorder often leads to the risky treatment pathway of off-label antipsychotic medication, whereas recognizing it as a syndrome necessitat...

Functional Neurological Disorder was previously called Conversion Disorder or psychogenic neurological symptoms and is a condition in which a patient develops any number of neurological symptoms (such as loss of ability to move or seizure like episodes or inability to feel parts of their body or phantom pain) that cannot be explained by a clear lesion in the nervous system. It was called conversion disorder because it was previously thought that repressed emotions or desires had been co...

-- Dr. O'Leary explores how an artificial intelligence tool summarizes recent data on the use of nicotinic receptor modulators for the treatment of anxiety and PTSD. Please send any comments to feedback@psydactic.com. Please leave feedback at https://www.psydactic.com or send any comments to feedback@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 podcas...

In the last episode, Dr. O'Leary interviewed the creator and host of the Psychiatry Bootcamp Podcast, Dr. Mark Mullen, who is currently a psychiatry clerkship director at St. Louis University School of Medicine. He created this podcast after discovering a dearth of resources available for medical students and junior psychiatry residents to prepare them for their transition to practice. He graciously allowed PsyDactic to include a couple of his episodes in this feed as a way to spr...

--In today's episode, Dr. O'Leary explores agonists, inverse agonists, partial agonists, and antagonists. These terms describe how molecules bind to receptors and either increase, decrease, or prevent changes in receptor signaling. Agonists increase receptor activity, with full agonists like dopamine and serotonin raising activity to its maximum. Partial agonists can increase activity in the absence of full agonists but decrease it in their presence. Inverse agonists reduce the baseline activ...

-- More recently I have faced the diagnostic conundrum of catatonia in autism, and that is what I want to explore in more excruciating detail today. There is surprisingly little literature on the subject, and that is concerning because being able to identify and treat catatonia can be life-saving, not to mention life-altering for patients and their caretakers. Misidentifying catatonia as mere aggression or highly limited interests in autism can result in exactly the wrong m...

- - In the world of psychotropic medication, the question is not just whether it works or not, but whether it works better than a placebo and whether the effect size is clinically significant and the benefits outweigh the risks. In the case of MDMA (aka molly or ecstasy), the effect size for improving post-traumatic stress disorder symptoms reported by researchers has been very large. Often it is found to be two to three times higher than is often found for serotonin reuptake inhi...

Dr. O'Leary discusses a variety of concerns that all clinicians should have in mind when using psychometrics. In the end, he hopes you come away with some level of agreement with the statement: “Our primary concern should not be with the quantity of data, but with the quality of the data.” Statistics are conceptual machines that will produce results no matter what you feed them. These results can be truly helpful and informative. But statistics are also poop in p...