Ep.56 – Role of Imaging in Psychiatry

EEG, MRI, CT Brain

Necessary to allow to further investigate the brain.

Who should do it:

  • If in age above 50 and suddenly develop symptoms to see mental health specialist.  Do a CT brain first
  • If young, symptom of psychosis or mood.  Best to do to find possibility of reversing symptoms.
  • diagnosed and treated with symptom, but not much improvement in recovery or a change in symptom.

Listen Now!

Friends in Psychiatry

I had the pleasure to share space during the recently concluded Masters Conjoint Exam with these two young psychiatrists, both my juniors and leading the way in advocacy.

(Dr Fadzli Mohd Isa – addiction psychiatrist, Dr Ahmad Rostam – budding liaison psychiatrist and I)

It was an interesting session we had. We were discussing the way forward for the use of social media for mental health advocacy, apart from the pitfalls which can or has happened as we work in this area using social media. This included responding to questions posed, handling emails and private if not direct messages and also the inadvertent viral tweet/statement/opinion.

Of recent concern is the over eager trainee who advocates with, at times, little knowledge and to much enthusiasm which, can, be a problem. Now we are not saying don’t do it, but be careful. If you’re a trainee you’re bound by the university code of conduct and as a medical doctor, you’re also bound by the medical code. If you’re a Ministry of Health practitioner, you need the relevant clearance too. Also, unless you’re really really good in your studies, you’re also playing with the risk of the halo effect which might be a problem for some.

Nevertheless, we are excited by the interest among our younger colleagues and we believe it augurs well for psychiatry in Malaysia.

To all exam goers – good luck. Results out on Friday 😊

(Dr Ahmad Rostam and I are also members of the #MedtweetMY family)

Meeting Prof John Kane

Prof John Kane and I.

For all #medstudents and in particular trainees in psychiatry, this is one of the “legends” in psychiatry. Even as a medical student, (I), we were taught the Kane Criteria for diagnosing Treatment Resistant Schizophrenia (TRS). TRS are people with schizophrenia who have not responded to available treatments. According to Prof Kane, one needs to have failed 2 types of treatment – with adequate dose and adequate duration – before a diagnosis of TRS is made. The criteria to diagnose TRS is important as it is a reason to start or to justify the use of clozapine, a highly effective treatment for schizophrenia but requires some caution.

We had an extremely fruitful discussion as a group and a more intimate session for some of us in discussing the management of schizophrenia, particularly in the use of long acting injectables (LAIs). If you have been listening to my podcasts. I’ve been using these for my own patients and am convinced that this is way to go to protect brain function, reduce relapse and increase Quality of Life and day to day functionality. I hope to add more podcasts on this to share with all of you my learnings.

Today’s session was also extremely helpful as concerns that Malaysian psychiatrists have in the treatment of this population was no different from the international psychiatrists which was reassuring.

I only wish all medical students and trainees in psychiatry could have met and be inspired by him and his work. He is truly an inspiration as a clinician, scientist and advocate for mental health.