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    Yeah, No Journal Club

    A podcast for all psychiatrists about the psychiatry literature and evidence-based practice. Hey, psychiatrists! Do you think “yeah, no” anytime you hear the words journal club? Have you felt like you don’t get much out of reading a journal article? Do you feel like you don’t have the time for that life-long learning thing? We’re here to help! Listen in as a group of board-certified, practicing psychiatrists—some with expertise in research and some without—tackle a paper. We’ll start with something in the paper the non-researchers don’t understand and finish with everyone on the panel agreeing that they get it now. We will cover a wide range of topics in psychiatry, including some of the journal articles that are included in the ABPN MOC Pilot Program for psychiatry. This is the perfect podcast for psychiatrists and psychiatry residents. Our goal is to help you stop worrying and love the literature! (Adriane dela Cruz, M.D., Ph.D., is an Assistant Professor of Psychiatry at UT Southwestern Medical Center and with the Peter O’Donnell Jr. Brain Institute who focuses on treating patients with drug and alcohol addictions. The opinions expressed are her own and do not reflect those of UT Southwestern, the O’Donnell Brain Institute, the UT System, or the state.)
    enThe University of Texas Southwestern Medical Center - Adriane dela Cruz11 Episodes

    Episodes (11)

    Neuroscience+Clinical Trial=Effective Treatment of OCD

    Neuroscience+Clinical Trial=Effective Treatment of OCD

    The paper we discuss is H Tyagi et al. (2019) A Randomized Trial Directly Comparing Ventral Capsule and Anteromedial Subthalamic Nucleus Stimulation in Obsessive-Compulsive Disorder: Clinical and Imaging Evidence for Dissociable Effects. Biological Psychiatry 85:726-734.

    You can find a copy of the Yale Brown Obsessive Compulsive Scale (Y-BOCS), complete with detailed instructions for administering the scale, here.

    A bit more information on the set-shifting/cognitive flexibility task used in the study can be found here.

    AA Efficacy and Self-Selection Bias

    AA Efficacy and Self-Selection Bias

    The paper we discuss is  K Humphreys, JC Blodgett, and TH Wagner. Estimating the Efficacy of Alcoholics Anonymous Without Self-Selection Bias: An Instrumental Variables Re-Analysis of Randomized Clinical Trials. Alcoholism: Clinical and Experimental Research. 2014; 38(11): 2688-2694.

    The primary outcomes from Project MATCH, which looked at the efficacy of different psychotherapeutic interventions for alcohol use disorder, can be found here.

    Helpful reference on instrumental variables analysis: ML Maciejewski and MA Brookhart. Using Instrumental Variables to Address Bias from Unobserved Confounders. JAMA 2019; 321(21): 2124-2125.

    Another example of using instrumental variable analysis to address an important question in psychiatry (this time, related to ECT and hospital re-admission): AT LoSasso. Use of Instrumental Variables Methods in Examining Psychiatric Readmissions. JAMA Psychiatry 2017; 74(8): 805-806.

    Is Prazosin Effective for PTSD? Depends on the Inclusion Criteria

    Is Prazosin Effective for PTSD? Depends on the Inclusion Criteria

    The article we discuss is MA Raskind et al. Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans. New England Journal of Medicine 2018; 378(6):507-517

    For an  example of an earlier study that DID find benefit of prazosin for PTSD, check out Raskind, MA et al. A Trial of Prazosin for Combat Trauma PTSD with Nightmares in Active-Duty Soldiers Returned from Iraq and Afghanistan. Am J Psychiatry 2013; 170: 1003-1010.

    Recent meta-analyses of the efficacy of prazosin for PTSD can be found here and here

    A brief review on the ethical principles of equipoise in research.

    What's a GWAS? What can it teach me about bipolar disorder?

    Efficacy of Antipsychotics for Delirium and Odds Ratios

    Efficacy of Antipsychotics for Delirium and Odds Ratios

    The paper we discuss is TD Girard et al. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness. N Engl J Med 2018; 379(26):2506-2516. This paper is part of the ABPN MOC program. The podcast authors are not associated with the MOC program and have no knowledge of the questions about the article included in the MOC program.

    The JAMA Guide to Statistics and Methods has an easy-to-read, 1.5 page overview of the odds ratio.

     

     

    Is All Psychosis The Same?

    Is All Psychosis The Same?

    The paper we discuss is BA Clementz et al. Identification of Psychosis Biotypes Using Brain-Based Biomarkers. Am J Psychiatry  2016; 173(4): 373-384.

    Here's the paper Dr Toups mentions about depression, biotypes, and treatment response:  AT Drysdale et al. Resting-state connectivity biomarkers define neurophysiological subtypes of depression. Nature Medicine 2017; 23: 28-28.

    The  discussion about psychiatric nosology has led to some heated discussions and received a bit of attention in the popular press.  The New Yorker's take is here.

    We are not the only the psychiatry podcast that has discussed these questions. There's also an excellent discussion on the first episode of the podcast Ten to the Fifteenth, which is produced by the National Neuroscience Curriculum Initiative.

    Intranasal Esketamine and the Placebo Response

    What Part of DBT Actually Works and A Single-Sided P Value

    OUD Treatment and Intent To Treat Analysis

    OUD Treatment and Intent To Treat Analysis

    X:BOT primary outcomes

    We discuss the X:BOT primary outcomes paper in this episode of the podcast. Use the link above or the citation below to find it. Take a look at the figures!

    JD Lee et al.  Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicenter, open-label, randomized controlled trial. Lancet 2018. 391:309-318.

     

    X:BOT rationale and design paper

    In this fascinating and thoughtful paper, the X:BOT authors discuss the study design choices they considered and how they selected various aspects of the trial design. A great read for those with interest in OUD treatment or clinical trials design.

    X:BOT cost effectiveness analysis

    This planned analysis of the X:BOT data provides an additional lens for determining which medication is the best option.

    A great buprenorphine review

    Thorough  but brief review on the  use of buprenorphine.