Mic Drop: The Algorithm Will See You Now - AI and Psychiatry

Podcast: Click Here
Host: Dena Temple-Raston
Guest: Dr. Stephen Xenakis
Release Date: February 7, 2025

Introduction to Dr. Stephen Xenakis

In this episode of Click Here, host Dena Temple-Raston delves into a compelling conversation with Dr. Stephen Xenakis, a retired Brigadier General and seasoned psychiatrist with 28 years of service in the Army. Dr. Xenakis has dedicated his career to working with military families, veterans, and detainees at Guantanamo Bay, addressing complex mental health issues such as PTSD and traumatic brain injuries.

Notable Quote:
“When you think of a psychiatrist, you probably have a picture in your head, calm demeanor, notebook, pen maybe, sitting across from a patient... But I’m not exactly that kind of psychiatrist.” – Dr. Stephen Xenakis [00:37]

Challenging Traditional Psychiatry

Dr. Xenakis challenges the conventional image of psychiatry by highlighting his unique experiences and approaches. Unlike the stereotypical psychiatrist, his work spans high-stress environments and involves innovative treatments, including advocating for psychedelic therapy for PTSD— a method once considered fringe in the field.

Notable Quote:
“I’m a big proponent of psychedelic therapy for PTSD, something that for a long time was considered kind of out there.” – Dr. Stephen Xenakis [00:37]

Integrating AI into Psychiatric Practice

A significant portion of the discussion revolves around Dr. Xenakis's vision of incorporating Artificial Intelligence (AI) into psychiatric practice to enhance diagnostic accuracy and personalize treatment plans. He envisions AI as a tool to parse through complex patient data, enabling psychiatrists to identify the most effective treatments for individual patients.

Notable Quote:
“I’ve been for years thinking that we needed to use these AI tools in identifying patients who would best respond to particular treatments.” – Dr. Stephen Xenakis [01:51]

Key Points:

• Beyond Questionnaires: Dr. Xenakis criticizes traditional questionnaires for their lack of depth and advocates for open-ended interviews that AI can analyze for nuanced insights.

  “We’re getting away from questionnaires. That’s what I’m trying not to do... It’s quantum leaps beyond a questionnaire.” – Dr. Stephen Xenakis [05:37]

• AI as a Force Multiplier: Especially in rural areas with limited psychiatric resources, AI can act as a force multiplier, enhancing the capabilities of existing psychiatrists by providing access to extensive patient data and comparative analysis.

  “AI could be a force multiplier for doctors.” – Dr. Stephen Xenakis [09:58]

Practical Applications of AI in Psychiatry

Dr. Xenakis outlines a hypothetical scenario where AI assists in diagnosing and treating veterans suffering from multiple overlapping conditions such as PTSD, traumatic brain injury, chronic pain, and sleep disorders. By analyzing patient interviews against a vast database of similar cases, AI can identify patterns and correlations that may inform more effective treatment strategies.

Notable Quote:
“It would just be a raw interview that could be uploaded and compared to what we think is our reference interview... It’s quantum leaps beyond a questionnaire.” – Dr. Stephen Xenakis [06:03]

Examples Discussed:

• Personalized Medication: AI can help determine which medications are likely to be effective for specific patients, reducing the trial-and-error approach often associated with psychiatric treatment.

  “We can get a better idea of who would be a responder. And that’s really important.” – Dr. Stephen Xenakis [11:22]

• Wearable Technology Integration: Incorporating data from wearables like Apple Watches or Fitbits can provide objective measurements of patients' sleep patterns, activity levels, and physiological responses, which the AI can analyze alongside interview data to inform treatment.

  “With wearables, we have data that can change the game.” – Dena Temple-Raston [13:09]

Notable Quote:
“The more we have that and we can look at it together, the better decisions we can make.” – Dr. Stephen Xenakis [13:30]

Ethical and Humanistic Considerations

While the integration of AI presents exciting possibilities, the conversation also touches on the inherent challenges of blending technology with the deeply human art of psychiatry. Dr. Xenakis acknowledges the potential for AI to enhance efficiency and accuracy but remains mindful of maintaining the essential human connection in therapeutic settings.

Key Points:

• Balancing Technology and Humanity: Psychiatry is not just a science; it’s an art that requires empathy and human insight, areas where AI currently lacks proficiency.

  “Psychiatry isn’t just science. It’s an art. And AI isn’t an artist. At least not yet.” – Dena Temple-Raston [14:51]

• Data Accuracy and Patient Honesty: Dr. Xenakis recognizes the limitations of patient self-reporting and how objective data from AI and wearables can mitigate inaccuracies in patient-provided information.

  “It’s really hard to get good information from your patients about how well they slept.” – Dr. Stephen Xenakis [12:47]

Future Implications and Conclusions

Dr. Xenakis envisions a future where AI significantly augments psychiatric care, particularly in underserved areas. By leveraging large language models and extensive data sets, AI can provide psychiatrists with deeper insights, leading to more personalized and effective treatment plans. This technological advancement promises to bridge gaps in mental health care accessibility and quality, transforming how psychiatric services are delivered.

Notable Quote:
“This is a real turning point, a way to customize treatment better and get past the guesswork.” – Dr. Stephen Xenakis [13:51]

Final Thoughts: The episode underscores the transformative potential of AI in psychiatry while emphasizing the need to preserve the human elements that are crucial to mental health care. Dr. Xenakis’s innovative approach highlights a future where technology and human expertise collaborate to enhance patient outcomes.

Credits:
Mic Drop: The Algorithm Will See You Now - AI and Psychiatry was written and produced by Erica Gajda, Megan Dietri, Sean Powers, and Dena Temple-Raston, with editing by Karen Duffett.

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