Raj Persaud in conversation - the podcasts
The Psychiatry of 'Breaking Bad' - Crystalline methamphetamine use and abuse

Professor Michael Farrell FRCP FRCPsych is the Director of NDARC (National Drug and Alcohol Research Centre). He moved to Sydney from London in March 2011 following his appointment to NDARC. Prior to joining NDARC he was Professor of Addiction Psychiatry at the Institute of Psychiatry at Kings College London. His extensive research interests include treatment evaluation, including the development of the National Treatment Outcomes Profile, a brief outcomes measurement instrument for drug and alcohol dependence. He has a long standing interest in drug dependence in prisons and within the wider criminal justice system. He has been a member of the WHO Expert Committee on Drug and Alcohol Dependence since 1995 and chaired the WHO External Evaluation of the Swiss Heroin Trial.

 

From the paper presented at the Annual Congress of the Royal College of Psychiatrists:

FROM AN ORIGINAL PAPER ENTITLED:

Crystalline methamphetamine use and methamphetamine-related harms in Australia

 

EXCERPT:

 

Concerns about crystal methamphetamine use and harm have increased in multiple countries. The harms of regular methamphetamine use include mental disorders such as anxiety, depression, dependence and psychosis, physical health problems, violent and aggressive behaviour, involvement in criminal activity, injecting and sexual risk, and in some cases, overdose deaths.

The types of methamphetamine used range from amphetamine-type-stimulant pills and amphetamine powder to high purity crystalline methamphetamine. ‘Ice’ is the street name given to the relatively pure preparation of methamphetamine hydrochloride salt because its translucent crystalline appearance resembles ice (also referred to by the street names ‘shard’, ‘crystal’ and ‘skates’). This pure preparation of methamphetamine originated in Taiwan and South Korea, and subsequently spread to the USA where it was dubbed the ‘drug of the 1990s’.

The increased use of crystal methamphetamine raises concerns because the high purity of the drug allows a new route of administration, inhalation. Crystal methamphetamine vaporises when heated, and can be inhaled, affording high bioavailability and an almost immediate drug effect because the drug is rapidly absorbed into the blood stream via the lungs, bypassing the metabolic processes that reduce the proportion of the drug that reaches the brain.

 

BY

Louisa Degenhardt1, Grant Sara2, Rebecca McKetin3, Amanda Roxburgh1, Timothy Dobbins1, Michael Farrell1, Lucinda Burns1 and Wayne D. Hall4,5

  1. National Drug and Alcohol Research Centre

UNSW Australia

Sydney NSW Australia 2052

  1. Sydney Medical School

Northern Clinical School

University of Sydney

Sydney NSW Australia

  1. National Drug Research Institute

Curtin University

Perth WA Australia 6008

  1. Centre for Youth Substance Abuse Research

University of Queensland

St Lucia QLD Australia

  1. National Addiction Centre

Institute of Psychiatry, Psychology and Neuroscience

Kings College London

London England

 

Corresponding author: Louisa Degenhardt

l.degenhardt@unsw.edu.au

 

 

Direct download: DR-100_0079.mp3
Category:(2) General Podcasts -- posted at: 10:37pm UTC

The Euthansia Program in Nazi-Psychiatry - Dr Michael Von Cranach talks to Dr Raj Persaud about German Psychiatry in the Nazi era.

The “Euthanasia “ Program in Nazi-Psychiatry

Dr Michael Von Cranach, an eminent German Psychiatrist, discusses with Dr Raj Persaud his research into the Nazi era, at the Royal College of Psychiatrists Annual Congress, London, 27th of June 2016.


More than 200000 psychiatric patients and handicapped persons where murdered in Germany between 1939 and 1945 by doctors and nurses. Alexander Mitscherlich, rapporteur of the Nuremberg Medical Trials wrote 1947, but published decades later,:
” Their atrocities were so unrestrained and at the same time organised with such technical bureaucratic coldness, malice and bloodthirstiness, that no one can read about it without feeling shame”.

Direct download: DR-100_0078.mp3
Category:general -- posted at: 6:49am UTC

Prof Frank Schneider discusses mass murder of psychiatric patients during World War 2

Professor Frank Schneider, M.D., Ph.D. Chair, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen and Adjunct Professor of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia, also Past President of the German Society for Psychiatry and Psychotherapy, talks to Dr Raj Persaud about the role of the German Society for Psychiatry and Psychotherapy in the mass murder of psychiatric patients which occurred in Germany during the Second World War at the hands of Nazis and Nazi ideology. How was it that elite doctors and psychiatrists, caring and highly accomplished clinicians, could so rapidly be transformed into killing machines? Some 200,000 psychiatric patients eventually lost their lives, often at the hands of their own doctors – could the same thing happen again? The interview occurs at the Royal College of Psychiatrist Annual Congress 2016 just before Professor Schneider takes part in a panel discussion on how German psychiatric patients suffered during the Nazi era partly as a result of the rise in eugenics or genetic theories concerning the spread of mental illness. Is it possible that the modern rise of biological psychiatry could presage the same atrocities occurring again?

Direct download: DR-100_0077.mp3
Category:general -- posted at: 11:20pm UTC

A victim of stalking describes her harrowing story

What is it like to be stalked? In this astonishing interview a victim of stalking describes in vivid detail what it feels like to be stalked. Do her experiences explain why stalkiing has been described as a kind of psychological rape or terrorism?

Direct download: raj_talks_to_eleanor_about_her_terrifying_stalking_experience.mp4
Category:general -- posted at: 10:18pm UTC

Does Eating More Fish Cure or Prevent Depression?

Walk into any health food shop and you would think that  omega-3 highly unsaturated fatty acids (HUFAs) were a panacea for all ills - the hype for these dietary supplements arises from recent research which appeared to find various benefits but now a study published by Brian Hallahan and colleagues attempts to pool all the data accumulated on the subject and cut through to the truth.

From the original recently published paper by Brian Hallahan and colleagues

Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression* Brian Hallahan, Timothy Ryan, Joseph R. Hibbeln, Ivan T. Murray, Shauna Glynn, Christopher E. Ramsden, John Paul SanGiovanni and John M. Davis

The British Journal of Psychiatry 1–10. doi: 10.1192/bjp.bp.114.160242

Many randomised controlled trials (RCTs) have reported beneficial effects for omega-3 highly unsaturated fatty acids (HUFAs) in bipolar and major depressive disorder, but others have reported essentially no effect.... possible explanatory factors: (a) that only eicosapentaenoic acid (EPA)-predominant formulations of omega-3 HUFA have an antidepressant effect;37,38 and (b) that the putative antidepressant effects of omega-3 HUFAs only occur in episodes of diagnosed clinical depression...

The study found that:  

Among participants with diagnosed depression, eicosapentaenoic acid (EPA)-predominant formulations (450% EPA) demonstrated clinical benefits compared with placebo... whereas docosahexaenoic acid (DHA)-predominant formulations (450% DHA) did not. EPA failed to prevent depressive symptoms among populations not diagnosed for depression.

 


Being A Syrian Refugee - is this the toughest test of anyone's mental health?

Interview with Ruth Wells - lead author on new paper on mental health of Syrian Refugees published in the British Journal of Psychiatry - From the introduction in the paper:

The United Nations (UN) has labelled the current Syrian conflict as the worst humanitarian crisis that has occurred within the first part of the 21st century. It is estimated that there are in excess of 4 million displaced Syrian refugees in the Middle East and over 629 000 who have been displaced to Jordan, the focus of this review. Although many displaced Syrians live in refugee camps, the largest being Za’atari camp which is home to over 120 000 people, the vast majority live in the host community. In Jordan, people from Syria have limited access to work permits and are often required to work in the informal sector to secure livelihood. Those registered with the UN are eligible to access some cash assistance, food vouchers and education and health systems, although the health system has struggled to keep up with demand. Stressors inherent in forced displacement,5 combined with exposure to potentially traumatic events (PTEs) during conflict, are likely to contribute to the development of heightened mental health difficulties in such settings.

 

From the introduction to this new paper

Psychosocial concerns reported by Syrian refugees living in Jordan: systematic review of unpublished needs assessments Ruth Wells, Zachary Steel, Mohammad Abo-Hilal, Abdul Halim Hassan and Catalina Lawsin

The British Journal of Psychiatry 1–8. doi: 10.1192/bjp.bp.115.165084

Ruth Wells, BSc, University of Sydney, Australia; Zachary Steel, PhD, MClinPsych, School of Psychiatry, University New South Wales, The Black Dog Institute, Hospital Road, Prince of Wales Hospital, New South Wales, Australia; Mohammad Abo Hilal, MD, Syria Bright Future; Abdulhalim Hasan, MD, American Medical Center, Erbil, Iraq; Catalina Lawsin, PhD, Department of Behavioral Sciences, RUSH Medical Center, Chicago, USA


1