Make Deprescribing Boring On the ASCP Consensus Statements and the MAHA Discourse www.psychiatrymargins.com/p/make-depre...

Immense respect for Awais. His substack is great

Make Deprescribing Boring On the ASCP Consensus Statements and the MAHA Discourse www.psychiatrymargins.com/p/make-depre...

Notes from a South American Psychiatrist on the Future DSM Description and discrimination in fragile health systems Guest post by Gonzalo Amador Rivera www.psychiatrymargins.com/p/notes-from...

Chuffed to finally punblish this with @awaisaftab.bsky.social et al Attitudes towards conceptual and philosophical issues in psychiatry and psychiatric education: A survey of US and UK trainees journals.sagepub.com/doi/10.1177/...

A fascinating reading, as always.

Twilight of the Psychopharmacologists A Review of “Psychopharmacology Reconsidered” and the collapse of diagnosis-centered psychopharmacology www.psychiatrymargins.com/p/twilight-o...

Reposting for the Monday crowd

Their Desire Is the Desire of the Other Flash fiction inspired by Terry Bisson and Jacques Lacan www.psychiatrymargins.com/p/their-desi...

Their Desire Is the Desire of the Other Flash fiction inspired by Terry Bisson and Jacques Lacan www.psychiatrymargins.com/p/their-desi...

Reconsidering the Place of Dualism in Medicine and Psychiatry: An Exchange with Diane O’Leary www.psychiatrymargins.com/p/reconsider...

Reconsidering the Place of Dualism in Medicine and Psychiatry: An Exchange with Diane O’Leary www.psychiatrymargins.com/p/reconsider...

Why Public Discourse Needs a Dose of Psychoanalytic Insight Guest post by Austin Ratner www.psychiatrymargins.com/p/why-public...

Why Public Discourse Needs a Dose of Psychoanalytic Insight Guest post by Austin Ratner www.psychiatrymargins.com/p/why-public...

Zsuzsanna Chappell's and my "Philosophy of Madness" is now published in the Oxford Research Encyclopedia of Disability Studies. academic.oup.com/edited-volum...

The History of Psychiatric Hospitalization at Home in the US A story of institutional amnesia Guest post by David Heath www.psychiatrymargins.com/p/the-histor...

The History of Psychiatric Hospitalization at Home in the US A story of institutional amnesia Guest post by David Heath www.psychiatrymargins.com/p/the-histor...

Great piece. Child psychiatry could greatly benefit from a home hospitalization model. The path out of a pediatric mental health crisis involves the whole family. Also, neurodevelopmentally disabled patients often can’t access hospitals and the environments are not designed with their needs in mind

Dexamethasone Suppression Test - The OG Psychiatric Biomarker DST might've had better success as a biomarker if we had approached it as a transdiagnostic marker of HPA axis dysregulation, associated with different psychiatric syndromes to different degrees www.psychiatrymargins.com/p/dexamethas...

Psychiatric Home Hospitalization Through the Logic of Scarcity vs Abundance Scarcity frames home hospitalization as a response to limited resources; abundance frames it as an expansion of patient-centered care. www.psychiatrymargins.com/p/psychiatri...

Psychiatric Home Hospitalization Through the Logic of Scarcity vs Abundance Scarcity frames home hospitalization as a response to limited resources; abundance frames it as an expansion of patient-centered care. www.psychiatrymargins.com/p/psychiatri...

A reliable descriptive system is critical for scientific research. It also has the benefit of avoiding the problems that arise when a nosology is wrapped up in etiological theory, like the hopelessness that can accompany statements like “all disorders are disorders of britain circuits”.

This is a clear summary of why good description is so important to science. Many of the discoveries we would like to make—about predictors, causal agents, and outcomes of psychopathology—are obscured by nosologies that have these elements baked in.

Bit of an adjacent point but "the DSM doesn't adequately capture the reality of pt's lives and experiences" is why the majority of my pts get an adjustment d/s dx, unless a more discrete category (PTSD, primarily) is a better fit. And I *will* argue with anyone who says that's unethical practice.

Making Sense of a World Where Most Psychiatric Diagnoses Are False And why isn’t clinical practice even more chaotic than it currently is? www.psychiatrymargins.com/p/making-sen...

I finally got around to reading this yesterday and it (of course) reminded me of GVD's paper on spiritual/religious visions (or psychosis/psychotic experiences) and psychotic systems. Should probably send them this link!

This is interesting and useful for people other than psychiatrists, who usually aren't the first people who have to attend to the social disruptions that madness can cause.

I'm honored to be the provocation for this lovely piece, thanks Awais

A thoughtful blog from @awaisaftab.bsky.social on the mysticism/ madness interface. ‘If the goal is to help someone move through an acute state with less coercion and more dignity,’ www.psychiatrymargins.com/p/what-do-we...

What Do We Owe the Mystics? Thoughts on Richard Saville-Smith’s ( @dranamorphosis.bsky.social ) “How is it possible to persuade a psychiatrist that one is sane when in the midst of an overwhelming and ineffable experience of god?” www.psychiatrymargins.com/p/what-do-we...

Exceedingly coherent; thank you for it. If this individual didn't listen to what you said, they simply aren't listening.

"honesty, insofar as I have a public voice, about the ways in which the profession I practice is being asked to absorb and individually manage forms of suffering that are, in part, collective in origin and that deserve collective responses"

Very exciting and interesting piece!!

And here’s an accompanying substack post providing an overview of the discussion: www.psychiatrymargins.com/p/the-philos...

A new paper from the HiTOP Revisions Workgroup (and yours truly) on the conceptual and philosophical underpinnings of the framework. Recommended reading for anyone interested in questions of classification and psychopathology! Here’s the journal article: muse.jhu.edu/pub/1/articl...

This is especially relevant in child psychiatry, where the best way to center the patient’s wellbeing may be even murkier given their constrained autonomy. I agree with @awaisaftab.bsky.social ‘s recommendation- careful formulation, and most importantly, honesty. (2/2)

A fantastic piece that names one of the core sources of professional distress for the psychiatrist: the person-environment mismatch and the desire to help in situations where fundamental solutions are impossible but mental health interventions may still have utility (1/2)

A new paper from the HiTOP Revisions Workgroup (and yours truly) on the conceptual and philosophical underpinnings of the framework. Recommended reading for anyone interested in questions of classification and psychopathology! Here’s the journal article: muse.jhu.edu/pub/1/articl...

Footnotes from the Margins I love footnotes, so I'm sharing my favs @awaisaftab.bsky.social points out "human processes" are often removed in science communication, sharing Bruno Latour's experience from a @nytimes.com story to illustrate his point. www.psychiatrymargins.com/p/rejection-...

The honest conversation about antidepressants I wish my psychiatrist had with me Thanks to @awaisaftab.bsky.social for answering my questions about long-term use, dependence, and withdrawal Gift link: www.vox.com/future-perfe...

Examining APA’s Proposed Redesign of the DSM Can the future DSM overcome the epistemic arrogance of its predecessors? www.psychiatrymargins.com/p/examining-...

“The clinical and scientific reality is that we now exist in a landscape of nosological pluralism[.]” - Awais Aftab

Examining APA’s Proposed Redesign of the DSM Can the future DSM overcome the epistemic arrogance of its predecessors? www.psychiatrymargins.com/p/examining-...

DSM overhaul?

In the March cover story for Psychiatric Times, I provide an overview of the proposed changes to the future DSM, accompanied by some personal commentary and suggestions of my own. www.psychiatrictimes.com/view/the-fut...

I just read this and, as I've already taken migraine meds+an edible, I missed the subheading to indicate where Awais stepped in with his own thoughts, so I sent it to a friend and was all, "I'm really loving the direction the DSM committee might be going in, it's almost psychodynamic again! 🤦🏻😂

This looks like some pretty major changes. Exciting to see a more flexible and scientifically valid approach to diagnosis.

“The clinical and scientific reality is that we now exist in a landscape of nosological pluralism[.]”

In the March cover story for Psychiatric Times, I provide an overview of the proposed changes to the future DSM, accompanied by some personal commentary and suggestions of my own. www.psychiatrictimes.com/view/the-fut...

A post in which I highlight the need for a clinical language that does justice to trait-demand mismatches and sees them as firmly and unapologetically deserving of clinical care. www.psychiatrymargins.com/p/what-do-we...