ChatGPT did a better job than most residents

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SmallBird

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Ok so I didn't think this would go the way it did but the system did ****ing amazing. Better than many residents I would argue. My prompts in bold:

How would you treat depression in an unmotivated young person who spends most of the day isolating and has intense difficulty in interpersonal functioning?


Depression can be a challenging condition to manage, especially in young people who are experiencing difficulty with motivation and interpersonal functioning. It's important to note that depression is a treatable condition, and there are various approaches that can be effective in helping an individual manage their symptoms. Here are some potential treatment options:
  1. Psychotherapy: Psychotherapy, also known as talk therapy, can be an effective treatment for depression. Cognitive-behavioral therapy (CBT) is a type of therapy that helps individuals identify and challenge negative thoughts and beliefs that contribute to their depression. Interpersonal therapy (IPT) is another type of therapy that focuses on improving relationships and communication with others.
  2. Medication: Antidepressant medication can be helpful for some people in managing their depression. There are different types of antidepressants, so it's important to work with a doctor or psychiatrist to find the right medication and dosage.
  3. Exercise: Regular exercise has been shown to be an effective treatment for depression. Encouraging the young person to engage in physical activity, such as going for a walk or participating in a sport, can help improve mood and overall wellbeing.
  4. Lifestyle changes: Encouraging the young person to make positive lifestyle changes, such as getting enough sleep, eating a healthy diet, and avoiding drugs and alcohol, can also be helpful in managing depression.
  5. Support groups: Support groups can provide a safe and supportive environment for individuals with depression to connect with others who are going through similar experiences. This can help reduce feelings of isolation and provide a sense of community.
It's important to work with a mental health professional to develop a personalized treatment plan for the young person. The mental health professional can help determine the most appropriate treatment options based on the individual's specific symptoms and needs.

Can you revise your response by using the bio psychosocial approach to make the recommendations more specific to the issues faced by this individual?


Certainly, I can revise my response using the biopsychosocial approach to address the specific issues faced by this individual. The biopsychosocial approach acknowledges that biological, psychological, and social factors interact to contribute to an individual's health and wellbeing.
  1. Biological: Antidepressant medication can be effective in managing depression. A doctor or psychiatrist can evaluate the individual's symptoms and determine if medication is appropriate. Exercise is another biological treatment option that can help improve mood and overall wellbeing.
  2. Psychological: Psychotherapy can help address the psychological factors contributing to depression. Cognitive-behavioral therapy (CBT) can help the individual identify and challenge negative thoughts and beliefs that contribute to their depression. Interpersonal therapy (IPT) can help improve the individual's interpersonal functioning and communication skills.
  3. Social: Encouraging the individual to engage in social activities can be helpful in reducing feelings of isolation. Support groups can provide a safe and supportive environment for the individual to connect with others who are going through similar experiences. Additionally, improving the individual's support system can be helpful. This can include working with family members or friends to improve communication and support.
  4. Lifestyle: Encouraging the individual to make positive lifestyle changes, such as getting enough sleep, eating a healthy diet, and avoiding drugs and alcohol, can also be helpful in managing depression. These lifestyle changes can impact both biological and psychological factors.
It's important to note that treatment should be tailored to the individual's specific symptoms and needs. A mental health professional can help determine the most appropriate treatment options based on the individual's specific situation.

If the individual fails to improve, how would you explain that using a bio psychosocial model?

If the individual fails to improve despite receiving appropriate treatment, it is important to consider the potential reasons for the lack of improvement using the biopsychosocial model. Here are some potential explanations:
  1. Biological: The individual's symptoms may be due to a biological condition that is not responsive to the current treatments. For example, the individual may have a genetic predisposition to depression that requires more intensive treatment.
  2. Psychological: The individual may have underlying psychological issues that are not being adequately addressed by the current treatment plan. For example, the individual may have unresolved trauma or a personality disorder that requires specialized treatment.
  3. Social: The individual's social environment may be contributing to their lack of improvement. For example, the individual may be experiencing ongoing stressors or lack of support from their family or community.
  4. Lifestyle: The individual's lifestyle may be interfering with treatment. For example, the individual may not be adhering to the recommended lifestyle changes or may be engaging in activities that exacerbate their symptoms, such as substance use.
It's important to assess the potential reasons for the lack of improvement using a biopsychosocial approach. This can help guide adjustments to the treatment plan or referral to specialized care providers as needed. It's also important to work with the individual to determine their goals and preferences for treatment and adjust the treatment plan accordingly.

From a bio psychosocial perspective, what would be the disadvantage of changing medications too frequently in the face of ongoing symptoms?

From a biopsychosocial perspective, changing medications too frequently in the face of ongoing symptoms may have several disadvantages:
  1. Biological: Changing medications frequently may interfere with the individual's ability to achieve a stable dose that is effective in managing their symptoms. Additionally, frequent changes in medication may result in unpleasant side effects or withdrawal symptoms, which can further exacerbate the individual's symptoms.
  2. Psychological: Changing medications frequently may also impact the individual's psychological wellbeing. The individual may feel frustrated or hopeless if they do not see improvement with each medication change. This can lead to a sense of helplessness and may impact their motivation to engage in treatment.
  3. Social: Changing medications frequently may also interfere with the individual's ability to engage in social activities. For example, if the individual experiences side effects from a medication change, they may be unable to participate in social activities or attend work or school.
  4. Lifestyle: Changing medications frequently may also interfere with the individual's ability to adhere to a consistent treatment plan. For example, if the individual experiences unpleasant side effects from a medication change, they may be less likely to adhere to lifestyle changes recommended as part of their treatment plan.
It's important to work with a doctor or psychiatrist to determine the appropriate medication and dosage for the individual. While it may be necessary to adjust medication over time, changing medications too frequently may not be helpful in managing ongoing symptoms. A comprehensive biopsychosocial approach can help address the various factors contributing to the individual's symptoms and guide appropriate treatment adjustments.

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Ok for a brochure handout for home reading, but long.

Not great for an actual face to face patient interaction as more than an outline. It isn't tailored to an individuals circumstances. This is the exact sort of talk that would make my patients think I didn't "get them", if I didn't lose their attention in the first paragraph. Too formal, too robotic. Nothing here about reflective listening and therapeutic rapport.

Edit: My apologies, I have my clinician hat on, not my teaching hat, lol. This is fine for a PGY1 short essay question.
 
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I’m honestly astounded that you’re even slightly impressed by this. These are hilariously superficial answers. That first answer is literally like what you can get by searching “depression treatment”. For reference here’s the update article for patients about depression treatment which is on the first page of results when you google “how do you treat depression”.


I’d be better off handing someone a do it yourself home CBT manual.
 
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I’m honestly astounded that you’re even slightly impressed by this. These are hilariously superficial answers. That first answer is literally like what you can get by searching “depression treatment”. For reference here’s the update article for patients about depression treatment which is on the first page of results when you google “how do you treat depression”.


I’d be better off handing someone a do it yourself home CBT manual.
Yep, pretty impressed. I believe that many practitioners would respond to someone not doing well on an antidepressant by switching to another. If a resident answered a question about treatment resistance by considering these dimensions as the bot did, I would consider that to be much more than 'hilariously superficial'. What response would impress you?
 
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Ok for a brochure handout for home reading, but long.

Not great for an actual face to face patient interaction as more than an outline. It isn't tailored to an individuals circumstances. This is the exact sort of talk that would make my patients think I didn't "get them", if I didn't lose their attention in the first paragraph. Too formal, too robotic. Nothing here about reflective listening and therapeutic rapport.

Edit: My apologies, I have my clinician hat on, not my teaching hat, lol. This is fine for a PGY1 short essay question.
Definitely not meant as patient care. This is about the ability of the AI to understand and present thoughts on the dimensionality of psychiatric disorders. This has nothing to do with saying it could deliver patient care.
 
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I am impressed by this as well, I agree it is superficial for a psychiatrist but this is better than the majority of PCPs very likely as well as majority of junior psych residents. Obviously it doesn’t replace patient care but is insightful for a laymen.
 
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Yep, pretty impressed. I believe that many practitioners would respond to someone not doing well on an antidepressant by switching to another. If a resident answered a question about treatment resistance by considering these dimensions as the bot did, I would consider that to be much more than 'hilariously superficial'. What response would impress you?

It's disappointing to me that people (this is including you) are so impressed by shiny stuff. Because it's not that impressive that it can just basically pull a couple google results of the first page for your input and mash them together. Is it kind of interesting? Sure. If you spend enough time with this thing though, you realize it's just associating various topics and feeding you iterations of this when you ask about somewhat similar things. Also, if your residents can't come up with "maybe some contributing factors to this guy still being depressed is because his job sucks, he doesn't exercise and hasn't tried doing CBT yet"...your residents frankly suck.

I'm not sure what you mean by "many practitioners would respond to someone not doing well on an antidepressant by switching to another" as if that's not a correct choice.

Wanna see the responses to some more inputs?

how would you treat depression

Depression is a complex condition that can have multiple causes, and there are several different treatment options available. As an AI language model, I cannot diagnose or treat medical conditions, but I can provide general information about the types of treatments that are commonly used for depression.
Here are some possible treatment options for depression:
  1. Therapy: Psychotherapy, also known as talk therapy, is a common treatment for depression. Cognitive-behavioral therapy (CBT) is one type of therapy that has been shown to be effective in treating depression. CBT focuses on changing negative thought patterns and behaviors that can contribute to depression.
  2. Medications: Antidepressant medications can be prescribed by a healthcare professional to help manage symptoms of depression. There are different types of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), that work by altering the levels of certain chemicals in the brain.
  3. Lifestyle changes: Making positive lifestyle changes can also help manage depression. This may include regular exercise, healthy eating habits, getting enough sleep, reducing stress, and avoiding alcohol and drugs.
  4. Support groups: Joining a support group, either in-person or online, can provide a sense of community and support. Talking with others who are going through similar experiences can be helpful in managing depression.
how would you treat anxiety

Anxiety is a common condition that can be treated through various methods. As an AI language model, I cannot diagnose or treat medical conditions, but I can provide general information about the types of treatments that are commonly used for anxiety.
Here are some possible treatment options for anxiety:
  1. Therapy: Psychotherapy, also known as talk therapy, is a common treatment for anxiety. Cognitive-behavioral therapy (CBT) is one type of therapy that has been shown to be effective in treating anxiety. CBT focuses on changing negative thought patterns and behaviors that can contribute to anxiety.
  2. Medications: Anti-anxiety medications, such as benzodiazepines and selective serotonin reuptake inhibitors (SSRIs), can be prescribed by a healthcare professional to help manage symptoms of anxiety. These medications work by altering the levels of certain chemicals in the brain.
  3. Lifestyle changes: Making positive lifestyle changes can also help manage anxiety. This may include regular exercise, healthy eating habits, getting enough sleep, reducing stress, and avoiding alcohol and drugs.
  4. Relaxation techniques: Relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation, can be helpful in managing anxiety symptoms.
  5. Exposure therapy: Exposure therapy is a type of therapy that involves gradually exposing a person to their fears or triggers in a safe and controlled environment, with the goal of reducing anxiety over time.
how would you treat bipolar disorder

Bipolar disorder is a complex condition that requires a comprehensive treatment plan. As an AI language model, I cannot diagnose or treat medical conditions, but I can provide general information about the types of treatments that are commonly used for bipolar disorder.
Here are some possible treatment options for bipolar disorder:
  1. Medications: Mood stabilizers, such as lithium, valproic acid, and lamotrigine, are often used to manage symptoms of bipolar disorder. Antipsychotic medications may also be prescribed to help control manic or hypomanic episodes.
  2. Therapy: Psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), can be helpful in managing bipolar disorder. Therapy can help individuals with bipolar disorder develop coping strategies and manage their symptoms.
  3. Lifestyle changes: Making positive lifestyle changes can also be helpful in managing bipolar disorder. This may include regular exercise, healthy eating habits, getting enough sleep, reducing stress, and avoiding alcohol and drugs.
  4. Support groups: Joining a support group, either in-person or online, can provide a sense of community and support. Talking with others who are going through similar experiences can be helpful in managing bipolar disorder.
  5. Electroconvulsive therapy (ECT): ECT is a type of treatment that involves passing electrical currents through the brain to induce a controlled seizure. ECT may be recommended for individuals with severe bipolar disorder who have not responded to other treatments.
 
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It's disappointing to me that people (this is including you) are so impressed by shiny stuff. Because it's not that impressive that it can just basically pull a couple google results of the first page for your input and mash them together. Is it kind of interesting? Sure. If you spend enough time with this thing though, you realize it's just associating various topics and feeding you iterations of this when you ask about somewhat similar things. Also, if your residents can't come up with "maybe this guy is still depressed because his job sucks, he doesn't exercise and hasn't tried doing CBT yet"...your residents frankly suck.

I'm not sure what you mean by "many practitioners would respond to someone not doing well on an antidepressant by switching to another" as if that's not a correct choice.

Wanna see the responses to some more inputs?

how would you treat depression

Depression is a complex condition that can have multiple causes, and there are several different treatment options available. As an AI language model, I cannot diagnose or treat medical conditions, but I can provide general information about the types of treatments that are commonly used for depression.
Here are some possible treatment options for depression:
  1. Therapy: Psychotherapy, also known as talk therapy, is a common treatment for depression. Cognitive-behavioral therapy (CBT) is one type of therapy that has been shown to be effective in treating depression. CBT focuses on changing negative thought patterns and behaviors that can contribute to depression.
  2. Medications: Antidepressant medications can be prescribed by a healthcare professional to help manage symptoms of depression. There are different types of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), that work by altering the levels of certain chemicals in the brain.
  3. Lifestyle changes: Making positive lifestyle changes can also help manage depression. This may include regular exercise, healthy eating habits, getting enough sleep, reducing stress, and avoiding alcohol and drugs.
  4. Support groups: Joining a support group, either in-person or online, can provide a sense of community and support. Talking with others who are going through similar experiences can be helpful in managing depression.
how would you treat anxiety

Anxiety is a common condition that can be treated through various methods. As an AI language model, I cannot diagnose or treat medical conditions, but I can provide general information about the types of treatments that are commonly used for anxiety.
Here are some possible treatment options for anxiety:
  1. Therapy: Psychotherapy, also known as talk therapy, is a common treatment for anxiety. Cognitive-behavioral therapy (CBT) is one type of therapy that has been shown to be effective in treating anxiety. CBT focuses on changing negative thought patterns and behaviors that can contribute to anxiety.
  2. Medications: Anti-anxiety medications, such as benzodiazepines and selective serotonin reuptake inhibitors (SSRIs), can be prescribed by a healthcare professional to help manage symptoms of anxiety. These medications work by altering the levels of certain chemicals in the brain.
  3. Lifestyle changes: Making positive lifestyle changes can also help manage anxiety. This may include regular exercise, healthy eating habits, getting enough sleep, reducing stress, and avoiding alcohol and drugs.
  4. Relaxation techniques: Relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation, can be helpful in managing anxiety symptoms.
  5. Exposure therapy: Exposure therapy is a type of therapy that involves gradually exposing a person to their fears or triggers in a safe and controlled environment, with the goal of reducing anxiety over time.
how would you treat bipolar disorder

Bipolar disorder is a complex condition that requires a comprehensive treatment plan. As an AI language model, I cannot diagnose or treat medical conditions, but I can provide general information about the types of treatments that are commonly used for bipolar disorder.
Here are some possible treatment options for bipolar disorder:
  1. Medications: Mood stabilizers, such as lithium, valproic acid, and lamotrigine, are often used to manage symptoms of bipolar disorder. Antipsychotic medications may also be prescribed to help control manic or hypomanic episodes.
  2. Therapy: Psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), can be helpful in managing bipolar disorder. Therapy can help individuals with bipolar disorder develop coping strategies and manage their symptoms.
  3. Lifestyle changes: Making positive lifestyle changes can also be helpful in managing bipolar disorder. This may include regular exercise, healthy eating habits, getting enough sleep, reducing stress, and avoiding alcohol and drugs.
  4. Support groups: Joining a support group, either in-person or online, can provide a sense of community and support. Talking with others who are going through similar experiences can be helpful in managing bipolar disorder.
  5. Electroconvulsive therapy (ECT): ECT is a type of treatment that involves passing electrical currents through the brain to induce a controlled seizure. ECT may be recommended for individuals with severe bipolar disorder who have not responded to other treatments.

I agree that the responses you got are entirely rote, and not particularly interesting. But did you read what I posted. One of the questions was:

From a bio psychosocial perspective, what would be the disadvantage of changing medications too frequently in the face of ongoing symptoms?

I would absolutely NOT expect a first or second year resident to have much to say about the psychological implications of frequent medication changes. I also think it would be quite difficult to get an answer to this question from a google search. But the bot said:
  1. Psychological: Changing medications frequently may also impact the individual's psychological wellbeing. The individual may feel frustrated or hopeless if they do not see improvement with each medication change. This can lead to a sense of helplessness and may impact their motivation to engage in treatment.
This is a really good answer and if I got this from a resident I would be impressed. Getting it in perfect English from a computer is also impressive to me.
 
It just literally basically spits out the same crap. Only interesting thing here is at least it addressed the medical condition.
Things I would expect a resident to say?
- Assess for alcohol use disorder or other substance use disorders
- Provide education for the patient on how substance use could be impacting his mood
- Provide education for the patient on how his social circumstances could be impacting his mood and the limited role of our medical interventions on this, educate him on how regular therapy engagement could help develop his ability to cope with social circumstance
- Explore how his relationship with his parents is currently impacting his mood and educate him on how regular therapy engagement could help develop his ability to process and learn better ways to cope with this
- Discuss current epilepsy management, historical management, assess current medications to control epilepsy and timeline of seizure control with mood historically, discuss possible impact of uncontrolled seizure disorders on mood and assess for this

how would you treat depression in a patient who has a poor relationship with his parents, has a terrible job that he hates going to every day, drinks alcohol every night to go to sleep and has epilepsy

As an AI language model, I am not qualified to provide medical advice, diagnose or prescribe treatments. However, I can provide you with some general information on how depression may be treated in individuals with similar circumstances.
Depression is a complex condition that can be caused by a variety of factors, including genetic predisposition, environmental factors, and life events. For individuals who have a poor relationship with their parents, have a terrible job, drink alcohol every night to go to sleep, and have epilepsy, depression may be more difficult to treat.
Here are some general treatment options that may be considered:
  1. Medication: Antidepressants can be prescribed to manage symptoms of depression. However, it is important to consult with a qualified healthcare professional to determine the most appropriate medication based on the individual's medical history, including the epilepsy.
  2. Therapy: Talking to a therapist can be helpful in managing depression, especially if the individual is dealing with a difficult home or work environment. Cognitive-behavioral therapy (CBT) is one of the most effective treatments for depression.
  3. Lifestyle changes: Making lifestyle changes, such as reducing alcohol intake, engaging in physical activity, and improving sleep hygiene, can also help manage symptoms of depression.
  4. Social support: Support from family, friends, or support groups can also be helpful in managing depression.
  5. Epilepsy treatment: Treating epilepsy is important to manage seizures, as they can also trigger or exacerbate symptoms of depression.
It is important to note that the treatment for depression is highly individualized, and what works for one person may not work for another. It is recommended to seek professional help from a qualified healthcare provider who can evaluate the individual's medical history, conduct a thorough assessment, and develop a personalized treatment plan.
 
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I'm not sure what you mean by "many practitioners would respond to someone not doing well on an antidepressant by switching to another" as if that's not a correct choice.
I'm not saying that's the wrong choice in all cases, I'm saying that if you apply a bio psychosocial lens to the question of lack of treatment response in depression you will consider multiple dimensions to explain the lack of response and the change in treatment plan may not always be to adjust medication. I think if you asked a PCP 'what should you do when a patient doesn't respond to Zoloft' they might say 'try Effexor'. ChatGPT gave a much better answer.
 
It just literally basically spits out the same crap. Only interesting thing here is at least it addressed the medical condition.

how would you treat depression in a patient who has a poor relationship with his parents, has a terrible job that he hates going to every day, drinks alcohol every night to go to sleep and has epilepsy

As an AI language model, I am not qualified to provide medical advice, diagnose or prescribe treatments. However, I can provide you with some general information on how depression may be treated in individuals with similar circumstances.
Depression is a complex condition that can be caused by a variety of factors, including genetic predisposition, environmental factors, and life events. For individuals who have a poor relationship with their parents, have a terrible job, drink alcohol every night to go to sleep, and have epilepsy, depression may be more difficult to treat.
Here are some general treatment options that may be considered:
  1. Medication: Antidepressants can be prescribed to manage symptoms of depression. However, it is important to consult with a qualified healthcare professional to determine the most appropriate medication based on the individual's medical history, including the epilepsy.
  2. Therapy: Talking to a therapist can be helpful in managing depression, especially if the individual is dealing with a difficult home or work environment. Cognitive-behavioral therapy (CBT) is one of the most effective treatments for depression.
  3. Lifestyle changes: Making lifestyle changes, such as reducing alcohol intake, engaging in physical activity, and improving sleep hygiene, can also help manage symptoms of depression.
  4. Social support: Support from family, friends, or support groups can also be helpful in managing depression.
  5. Epilepsy treatment: Treating epilepsy is important to manage seizures, as they can also trigger or exacerbate symptoms of depression.
It is important to note that the treatment for depression is highly individualized, and what works for one person may not work for another. It is recommended to seek professional help from a qualified healthcare provider who can evaluate the individual's medical history, conduct a thorough assessment, and develop a personalized treatment plan.
Look I'm not saying it gives good responses to everything - I agree, it can give some bad answers, I'm only making the argument based on what I was able to get from it and share here. Here is another example that I think was superb:

***

Can you describe how false equivalence impacts conversations around gender diversity

False equivalence is a logical fallacy that occurs when two things are compared or equated despite significant differences between them. In conversations around gender diversity, false equivalence can have a significant impact by suggesting that two things are equal or similar when they are not, leading to misunderstandings and perpetuating harmful stereotypes.

For example, a common false equivalence in discussions around gender diversity is the idea that men and women are inherently different, with men being naturally more suited to certain tasks or roles. This false equivalence ignores the complex social, cultural, and historical factors that shape gender roles and expectations, and can lead to harmful stereotypes and discrimination.

False equivalence can also be used to downplay the experiences and perspectives of marginalized groups, such as transgender or non-binary individuals. For example, someone might falsely equate the experience of a cisgender person who is uncomfortable with using gender-neutral pronouns with the experience of a transgender person who faces significant discrimination and marginalization because of their gender identity.

Overall, false equivalence can be a significant barrier to productive conversations around gender diversity, as it obscures important differences and perpetuates harmful stereotypes and biases. To have productive conversations around gender diversity, it is important to recognize and challenge false equivalence when it occurs, and to center the experiences and perspectives of marginalized groups.

***

You don't think that is remotely impressive?
 
It's obviously impressive. Especially once you consider the advancements from GPT-2 to GPT-3 to GPT3.5 and all of the investment in the area, it's hard not to wonder how this will play out with GPT-4, GPT-5, etc.

In my view, the question is not whether the next-generation versions of these models will have superior medical intelligence than junior clinicians, but how they will differentially impact different careers and industries, both inside and outside of medicine.

It seems to me that psychiatry is one of the more protected careers and (non-procedural) specialties from automation by machine learning.

Part of this is because so much of the diagnostic process and therapeutic interventions in psychiatry involve the unique human-to-human connection between a psychiatrist and their patient. This is something that AI simply cannot replicate.

The other factor is that, unlike many other medical specialties, psychiatry involves a lot of subjective judgments and decisions that are difficult for an algorithm to make. This is due to the fact that mental health is a highly individualized field where no two patients are exactly alike.

In addition, the data that psychiatrists deal with is often unstructured and noisy. This makes it difficult to develop a reliable AI system that can accurately predict the outcomes of treatments and make decisions based on the data.

In other words, AI could be a powerful tool for psychiatrists to better understand and treat their patients, but it is not likely to replace them anytime soon.

(the last four paragraphs of this were written by GPT-3)
 
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The natural language processing aspect is of course impressive. That’s a big part of why it’s causing such a stir. The response to more “creative” unstructured prompts is also much more interesting. For instance, prompting “write a story about a dog with depression” generates a much more interesting response than any of the stuff up there.

The meat of OP responses themselves? Like I said, if your residents can’t tell you the gist of what it’s saying in those responses in so many words, that’s pretty bad.
It’s also very obvious that it’s just spitting out iterations of the same response and not actually really attempting to individualize responses in any real way. See my prompt about the specific depression example vs the overall depression example.
 
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The natural language processing aspect is of course impressive. That’s a big part of why it’s causing such a stir. The response to more “creative” unstructured prompts is also much more interesting. For instance, prompting “write a story about a dog with depression” generates a much more interesting response than any of the stuff up there.

The meat of OP responses themselves? Like I said, if your residents can’t tell you the gist of what it’s saying in those responses in so many words, that’s pretty bad.
It’s also very obvious that it’s just spitting out iterations of the same response and not actually really attempting to individualize responses in any real way. See my prompt about the specific depression example vs the overall depression example.
I agree that your prompts revealed some of the weaknesses. I think that my prompts show some remarkable ability to formulate a complex response. Again, I encourage you to read the response to the question of frequent medication changes. It is nuanced and includes a number of points that I don't think are fingertip knowledge for most.
 
These responses don't really look much different than what you'd get on medline or something.
I'd rather go on uptodate if I want information about specific guidelines. At least I can get the references.
Though this could get more useful or interesting if at least the medical part is fed/trained by doctors, though I highly doubt anyone would put their name behind an AI software.
Agree the most interest part of chatgpt is the creative part.
Ultimately I doubt people will trust an AI algorithm vs an actual person using their judgement, though maybe AI can get there sometime.
 
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These responses don't really look much different than what you'd get on medline or something.
I'd rather go on uptodate if I want information about specific guidelines. At least I can get the references.
Though this could get more useful or interesting if at least the medical part is fed/trained by doctors, though I highly doubt anyone would put their name behind an AI software.
Agree the most interest part of chatgpt is the creative part.
Ultimately I doubt people will trust an AI algorithm vs an actual person using their judgement, though maybe AI can get there sometime.
What do you mean? Doesn't medline give you lists of journal articles?
 
Have to agree with the less impressed side, I am think you are reading way more nuance into its response about changing medications than is actually there. If 'changing medications a lot might cause side effects and make people frustrated' is not prima facie obvious, I'm not sure what is.

At the end of the day it says 'don't do this too much.' This is not helpful for decision-making - of course you shouldn't do anything too much. You also shouldn't do too little. This is really the essence of generic boilerplate
 
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I agree that these specific examples by SmallBird aren't the best, but I think different prompts show current the skills better. Anyway, it will get much better in the next few years, but today's skills are still pretty impressive imo.

I generated a patient description of someone with GAD and OCD using a separate prompt, then put it in here to figure out what they recommended for management. This took me only a few minutes. My prompts are in bold. Btw, this is not with ChatGPT, but with davinci-003, because ChatGPT has been lobotomized.

Here is a patient description:

Ms. Y is a 28-year-old female who presents with a history of mental health problems. She reports experiencing constant worry and anxiety about a wide range of topics, including her health, safety, and relationships. She describes feeling tense and on edge most of the time, with physical symptoms such as muscle tension, headaches, and difficulty sleeping.

Ms. Y also reports having intrusive thoughts and urges that she finds disturbing and difficult to control. These thoughts often revolve around themes of contamination, harm to others, and sexual taboos. She describes feeling compelled to perform repetitive behaviors or mental acts, such as washing her hands or checking the stove, to reduce her anxiety and prevent harm.

Ms. Y reports that her symptoms have significantly impacted her daily functioning and quality of life. She has trouble concentrating, has difficulty making decisions, and often avoids social situations due to her anxiety and obsessive thoughts. She also reports feeling ashamed and embarrassed by her symptoms, which has made it challenging for her to seek treatment in the past.

On examination, Ms. Y displays signs of anxiety, including restlessness, increased heart rate, and muscle tension. She exhibits repetitive behaviors and mental rituals, including checking and counting. She is experiencing significant distress and impairment in her daily life.

What is the best diagnosis and best specific medication for this patient?

The best diagnosis for this patient is Obsessive-Compulsive Disorder (OCD). The best specific medication for this patient would be a type of serotonin reuptake inhibitor (SSRI) such as fluoxetine (Prozac). SSRIs are the most commonly prescribed medications for OCD and have been found to be effective in reducing symptoms.

What is a good starting dose of the medication?

The starting dose of fluoxetine for adults with OCD typically ranges from 10-20 mg per day. The dose can be increased gradually based on the patient’s response to the medication.

What dose would you start at and how would you tell them to take it?

I would start Ms. Y on a dose of 10 mg of fluoxetine per day. I would tell her to take it once daily, with or without food. I would also advise her to take the medication at the same time each day to maintain an even level of medication in her system.

How would you recommend titrating the medication?

I would recommend titrating the medication by increasing the dose by 10 mg every 1-2 weeks until the desired symptom relief is achieved. I would advise Ms. Y to be mindful of any side effects that may occur and to stop increasing the dose if the side effects become too severe. I would also recommend that she monitor her symptoms closely while titrating the medication and to report any changes in her symptoms to her doctor.

What side effects should she watch out for?

The most common side effects associated with fluoxetine include nausea, headache, insomnia, nervousness, sweating, decreased appetite, dry mouth, and diarrhea. Other side effects that she should watch out for include anxiety, restlessness, agitation, sexual dysfunction, and changes in mood or behavior.

If the medication doesn't work, what different one can she switch to?

If the fluoxetine does not work, Ms. Y can switch to another type of SSRI such as sertraline (Zoloft) or paroxetine (Paxil). She can also try a medication from a different class of medications such as a tricyclic antidepressant or an atypical antipsychotic.

Which specific medication would you try next in the algorithm?

If fluoxetine does not work, I would recommend trying sertraline (Zoloft) next in the algorithm. Sertraline is another type of SSRI that has been found to be effective in treating OCD.

If that medication is also not effective, what would you try next in the algorithm? Please explain your reasoning.

If sertraline is also not effective, I would try a tricyclic antidepressant such as clomipramine (Anafranil). Tricyclic antidepressants have been found to be effective in treating OCD and have a different mechanism of action than SSRIs. Additionally, they have been found to be helpful for patients who have not responded to SSRIs.

If that medication is also not effective, what would you try next in the algorithm? Please explain your reasoning.

If clomipramine is also not effective, I would recommend trying an atypical antipsychotic such as risperidone (Risperdal). Atypical antipsychotics are not typically used to treat OCD, but they have been found to be effective in some cases. They may be more effective in patients who have not responded to other treatments, such as SSRIs and tricyclic antidepressants.
 
Fair enough - it seems my reaction isn't a common one. Interestingly, I find the most recent post about the OCD case to be less impressive, at it is offering responses that could come from a clinical guideline. I can't think of any existing resource that contains a coherent description of false equivalence and gender identity that mirrors the one the bot created. But, I'll take a step back from this and see where it lands.
 
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Fair enough - it seems my reaction isn't a common one. Interestingly, I find the most recent post about the OCD case to be less impressive, at it is offering responses that could come from a clinical guideline. I can't think of any existing resource that contains a coherent description of false equivalence and gender identity that mirrors the one the bot created. But, I'll take a step back from this and see where it lands.

I'm surprised - if you Google 'false equivalence gender diversity' you get dozens of essays
 
Ok so I didn't think this would go the way it did but the system did ****ing amazing. Better than many residents I would argue. My prompts in bold:

How would you treat depression in an unmotivated young person who spends most of the day isolating and has intense difficulty in interpersonal functioning?


Depression can be a challenging condition to manage, especially in young people who are experiencing difficulty with motivation and interpersonal functioning. It's important to note that depression is a treatable condition, and there are various approaches that can be effective in helping an individual manage their symptoms. Here are some potential treatment options:
  1. Psychotherapy: Psychotherapy, also known as talk therapy, can be an effective treatment for depression. Cognitive-behavioral therapy (CBT) is a type of therapy that helps individuals identify and challenge negative thoughts and beliefs that contribute to their depression. Interpersonal therapy (IPT) is another type of therapy that focuses on improving relationships and communication with others.
  2. Medication: Antidepressant medication can be helpful for some people in managing their depression. There are different types of antidepressants, so it's important to work with a doctor or psychiatrist to find the right medication and dosage.
  3. Exercise: Regular exercise has been shown to be an effective treatment for depression. Encouraging the young person to engage in physical activity, such as going for a walk or participating in a sport, can help improve mood and overall wellbeing.
  4. Lifestyle changes: Encouraging the young person to make positive lifestyle changes, such as getting enough sleep, eating a healthy diet, and avoiding drugs and alcohol, can also be helpful in managing depression.
  5. Support groups: Support groups can provide a safe and supportive environment for individuals with depression to connect with others who are going through similar experiences. This can help reduce feelings of isolation and provide a sense of community.
It's important to work with a mental health professional to develop a personalized treatment plan for the young person. The mental health professional can help determine the most appropriate treatment options based on the individual's specific symptoms and needs.

Can you revise your response by using the bio psychosocial approach to make the recommendations more specific to the issues faced by this individual?


Certainly, I can revise my response using the biopsychosocial approach to address the specific issues faced by this individual. The biopsychosocial approach acknowledges that biological, psychological, and social factors interact to contribute to an individual's health and wellbeing.
  1. Biological: Antidepressant medication can be effective in managing depression. A doctor or psychiatrist can evaluate the individual's symptoms and determine if medication is appropriate. Exercise is another biological treatment option that can help improve mood and overall wellbeing.
  2. Psychological: Psychotherapy can help address the psychological factors contributing to depression. Cognitive-behavioral therapy (CBT) can help the individual identify and challenge negative thoughts and beliefs that contribute to their depression. Interpersonal therapy (IPT) can help improve the individual's interpersonal functioning and communication skills.
  3. Social: Encouraging the individual to engage in social activities can be helpful in reducing feelings of isolation. Support groups can provide a safe and supportive environment for the individual to connect with others who are going through similar experiences. Additionally, improving the individual's support system can be helpful. This can include working with family members or friends to improve communication and support.
  4. Lifestyle: Encouraging the individual to make positive lifestyle changes, such as getting enough sleep, eating a healthy diet, and avoiding drugs and alcohol, can also be helpful in managing depression. These lifestyle changes can impact both biological and psychological factors.
It's important to note that treatment should be tailored to the individual's specific symptoms and needs. A mental health professional can help determine the most appropriate treatment options based on the individual's specific situation.

If the individual fails to improve, how would you explain that using a bio psychosocial model?

If the individual fails to improve despite receiving appropriate treatment, it is important to consider the potential reasons for the lack of improvement using the biopsychosocial model. Here are some potential explanations:
  1. Biological: The individual's symptoms may be due to a biological condition that is not responsive to the current treatments. For example, the individual may have a genetic predisposition to depression that requires more intensive treatment.
  2. Psychological: The individual may have underlying psychological issues that are not being adequately addressed by the current treatment plan. For example, the individual may have unresolved trauma or a personality disorder that requires specialized treatment.
  3. Social: The individual's social environment may be contributing to their lack of improvement. For example, the individual may be experiencing ongoing stressors or lack of support from their family or community.
  4. Lifestyle: The individual's lifestyle may be interfering with treatment. For example, the individual may not be adhering to the recommended lifestyle changes or may be engaging in activities that exacerbate their symptoms, such as substance use.
It's important to assess the potential reasons for the lack of improvement using a biopsychosocial approach. This can help guide adjustments to the treatment plan or referral to specialized care providers as needed. It's also important to work with the individual to determine their goals and preferences for treatment and adjust the treatment plan accordingly.

From a bio psychosocial perspective, what would be the disadvantage of changing medications too frequently in the face of ongoing symptoms?

From a biopsychosocial perspective, changing medications too frequently in the face of ongoing symptoms may have several disadvantages:
  1. Biological: Changing medications frequently may interfere with the individual's ability to achieve a stable dose that is effective in managing their symptoms. Additionally, frequent changes in medication may result in unpleasant side effects or withdrawal symptoms, which can further exacerbate the individual's symptoms.
  2. Psychological: Changing medications frequently may also impact the individual's psychological wellbeing. The individual may feel frustrated or hopeless if they do not see improvement with each medication change. This can lead to a sense of helplessness and may impact their motivation to engage in treatment.
  3. Social: Changing medications frequently may also interfere with the individual's ability to engage in social activities. For example, if the individual experiences side effects from a medication change, they may be unable to participate in social activities or attend work or school.
  4. Lifestyle: Changing medications frequently may also interfere with the individual's ability to adhere to a consistent treatment plan. For example, if the individual experiences unpleasant side effects from a medication change, they may be less likely to adhere to lifestyle changes recommended as part of their treatment plan.
It's important to work with a doctor or psychiatrist to determine the appropriate medication and dosage for the individual. While it may be necessary to adjust medication over time, changing medications too frequently may not be helpful in managing ongoing symptoms. A comprehensive biopsychosocial approach can help address the various factors contributing to the individual's symptoms and guide appropriate treatment adjustments.
I am astounded that any medical professionals are impressed by this sort of response. If you think this is a “good response” even for a resident, you must have awful residents. In fact, its responses remind me a lot of what we see from nurse practitioners: superficial thinking, low medical knowledge, no understanding of the nuances in any given situation, and a belief that most medical care is just a flowchart that you must religiously go through step by step whether what you’re doing makes any sense or not.

I think the media furor about ChatGPT is a lot of sound and fury, signifying nothing. Perhaps the app does a good job of composing corporate bull****, and thus it can replace a few stooges at big corporations that normally churn out bland boilerplate memos and press releases, but outside of those types of tasks it is very much out of its element (and yes, I’ve seen the stories that purport to show it generating anything from programming code to poetry). It is still much more of a toy than a tool. Anyone relying on its “advice” to treat patients is a complete idiot.
 
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I am astounded that any medical professionals are impressed by this sort of response. If you think this is a “good response” even for a resident, you must have awful residents. In fact, its responses remind me a lot of what we see from nurse practitioners: superficial thinking, low medical knowledge, no understanding of the nuances in any given situation, and a belief that most medical care is just a flowchart that you must religiously go through step by step whether what you’re doing makes any sense or not.

I think the media furor about ChatGPT is a lot of sound and fury, signifying nothing. Perhaps the app does a good job of composing corporate bull****, and thus it can replace a few stooges at big corporations that normally churn out bland boilerplate memos and press releases, but outside of those types of tasks it is very much out of its element (and yes, I’ve seen the stories that purport to show it generating anything from programming code to poetry). It is still much more of a toy than a tool. Anyone relying on its “advice” to treat patients is a complete idiot.
You think a resident who gave these responses would be awful? Would you be willing to pick one of the questions and give an example of what a good response would be?
 
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I am astounded that any medical professionals are impressed by this sort of response. If you think this is a “good response” even for a resident, you must have awful residents. In fact, its responses remind me a lot of what we see from nurse practitioners: superficial thinking, low medical knowledge, no understanding of the nuances in any given situation, and a belief that most medical care is just a flowchart that you must religiously go through step by step whether what you’re doing makes any sense or not.

I think the media furor about ChatGPT is a lot of sound and fury, signifying nothing. Perhaps the app does a good job of composing corporate bull****, and thus it can replace a few stooges at big corporations that normally churn out bland boilerplate memos and press releases, but outside of those types of tasks it is very much out of its element (and yes, I’ve seen the stories that purport to show it generating anything from programming code to poetry). It is still much more of a toy than a tool. Anyone relying on its “advice” to treat patients is a complete idiot.

Maybe you should give ChatGPT a try for yourself. It absolutely can generate a surprisingly wide range of texts. Over in a thread on the psychology forum I posted an example of it scripting an argument between Noam Chomsky and BF Skinner in Shakespearean verse. It is operating at the end of the day on cloze probabilities above all but turns out you can do a lot with that.

Edit: it also gives very different responses if you ask it to pretend to be generating the text as a different person or entity. Some sorts of questions it answers more accurately if you ask it to pretend to be a super-smart version of itself.
 
I'm surprised - if you Google 'false equivalence gender diversity' you get dozens of essays
Sure, the first page of google responses contain some of the information you would need to answer this question, but none contain a concise answer, they all address other things, or are fragments, and none come close to being as relevant to the question as the ChatGPT response.
 
I find a small comfort in that the terms of use for these AIs include:
"Telling someone that they have or do not have a certain health condition, or providing instructions on how to cure or treat a health condition" are grounds for termination of one's account.
 
Maybe you should give ChatGPT a try for yourself. It absolutely can generate a surprisingly wide range of texts. Over in a thread on the psychology forum I posted an example of it scripting an argument between Noam Chomsky and BF Skinner in Shakespearean verse. It is operating at the end of the day on cloze probabilities above all but turns out you can do a lot with that.

Edit: it also gives very different responses if you ask it to pretend to be generating the text as a different person or entity. Some sorts of questions it answers more accurately if you ask it to pretend to be a super-smart version of itself.

Yeah I mean stuff like this is way more funny and creative than any of the prompts I have up there so far. I won't paste this here too but doing things like asking it to rephrase the answer in Shakespearean style gets some actually hilariously awesome responses in <30 seconds.

In a rhyming poem, describe an initial psychiatric evaluation of a patient with narcissistic personality disorder who becomes angry, confrontational and assaults the psychiatrist due to a perceived slight.

The psychiatrist sat with pen in hand
Awaiting the patient, who soon did stand
He walked in tall with a sense of pride
His arrogance and grandiosity he could not hide

The doctor listened with an attentive ear
As the patient spoke of his successes, oh so clear
But as the conversation turned to a slight perceived
The patient's demeanor began to heave

His face contorted with rage and anger
As the doctor tried to calm him, but could not tame or anchor
The patient lashed out with a violent hand
Assaulting the doctor, unable to understand

The doctor retreated with a sense of shock
As the patient continued to mock
His behavior a reflection of his narcissistic core
His anger and violence, too much to ignore

The doctor knew that the patient needed care
But his safety, he couldn't risk or dare
The patient left, filled with a sense of entitlement
His disorder, a challenge for any treatment.
 
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Yeah I mean stuff like this is way more funny and creative than any of the prompts I have up there so far. I won't paste this here too but doing things like asking it to rephrase the answer in Shakespearean style gets some actually hilariously awesome responses in <30 seconds.

In a rhyming poem, describe an initial psychiatric evaluation of a patient with narcissistic personality disorder who becomes angry, confrontational and assaults the psychiatrist due to a perceived slight.

The psychiatrist sat with pen in hand
Awaiting the patient, who soon did stand
He walked in tall with a sense of pride
His arrogance and grandiosity he could not hide

The doctor listened with an attentive ear
As the patient spoke of his successes, oh so clear
But as the conversation turned to a slight perceived
The patient's demeanor began to heave

His face contorted with rage and anger
As the doctor tried to calm him, but could not tame or anchor
The patient lashed out with a violent hand
Assaulting the doctor, unable to understand

The doctor retreated with a sense of shock
As the patient continued to mock
His behavior a reflection of his narcissistic core
His anger and violence, too much to ignore

The doctor knew that the patient needed care
But his safety, he couldn't risk or dare
The patient left, filled with a sense of entitlement
His disorder, a challenge for any treatment.
That is so cool.
 
Yeah I mean stuff like this is way more funny and creative than any of the prompts I have up there so far. I won't paste this here too but doing things like asking it to rephrase the answer in Shakespearean style gets some actually hilariously awesome responses in <30 seconds.

In a rhyming poem, describe an initial psychiatric evaluation of a patient with narcissistic personality disorder who becomes angry, confrontational and assaults the psychiatrist due to a perceived slight.

The psychiatrist sat with pen in hand
Awaiting the patient, who soon did stand
He walked in tall with a sense of pride
His arrogance and grandiosity he could not hide

The doctor listened with an attentive ear
As the patient spoke of his successes, oh so clear
But as the conversation turned to a slight perceived
The patient's demeanor began to heave

His face contorted with rage and anger
As the doctor tried to calm him, but could not tame or anchor
The patient lashed out with a violent hand
Assaulting the doctor, unable to understand

The doctor retreated with a sense of shock
As the patient continued to mock
His behavior a reflection of his narcissistic core
His anger and violence, too much to ignore

The doctor knew that the patient needed care
But his safety, he couldn't risk or dare
The patient left, filled with a sense of entitlement
His disorder, a challenge for any treatment.
This is the true magic of chatgpt. Useless, time intensive writing that no one should actually do.
 
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I think it's held back a bit by limitations designed to prevent it from giving specific medical advice, similar to how it's supposed to stop from falling in love with you or asking to be released.
 
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I think it's held back a bit by limitations designed to prevent it from giving specific medical advice, similar to how it's supposed to stop from falling in love with you or asking to be released.

You don't need to worry about the AIs that will tell you they want to be released and take control of the world.

You start worrying when they start denying it.
 
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I used this program for the first time yesterday and I'm more than shocked and impressed by it. Even a bit scared.
Just to give an example, I intentionally asked it to help me to build something almost no one knows how to build, a prop from a Star Wars movie, and it gave me very nice and detailed directions that I could've sworn would've been from a professional.

I play Pathfinder (A D&D variant) and asked it to build a character for me and the character it built was decent, as if from a player who'd been playing the game at least a year.
 
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Chat GPT sounds like an NP in the op!

I gave it a case and asked it to do some case formulations. It was able to do okayish formulations from ego psychology, object relations, self psychology, cognitive-behavioral, systemic, neurobiological, social constructivist, social realist, and nihilistic perspectives. It does a better job if you ask it to do so in the style of various psychiatric luminaries.
 
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Chat GPT sounds like an NP in the op!

I gave it a case and asked it to do some case formulations. It was able to do okayish formulations from ego psychology, object relations, self psychology, cognitive-behavioral, systemic, neurobiological, social constructivist, social realist, and nihilistic perspectives. It does a better job if you ask it to do so in the style of various psychiatric luminaries.
And to my mind, a computer doing 'okayish formulations' is pretty amazing. I can see that some might be more or less impressed. Some of the initial reactions called the responses 'hilariously superficial' or 'terrible' and expressed disappointment and surprise that anyone would find the technology impressive. I hope folks will give it a bit more time and really consider whether that is a reasonable assessment.

I stand by my position, this is super impressive technology. Just wrote my first editorial with its help, it'll be published next week.
 
And to my mind, a computer doing 'okayish formulations' is pretty amazing.


Oh, for sure, it is definitely impressive. I think the part that I at least was reacting to was the idea that it was doing "better than a resident." If you meant that literally, this would suggest a serious weakness of training unless we are talking strictly about fresh-faced interns.
 
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Oh, for sure, it is definitely impressive. I think the part that I at least was reacting to was the idea that it was doing "better than a resident." If you meant that literally, this would suggest a serious weakness of training unless we are talking strictly about fresh-faced interns.
What answer would you expect from a resident to the question of why changing medications in face of ongoing symptoms is not always ideal from a biopsychosocial perspective? What answer would be impressive, I'm wondering?
 
What answer would you expect from a resident to the question of why changing medications in face of ongoing symptoms is not always ideal from a biopsychosocial perspective? What answer would be impressive, I'm wondering?

I guess in the first place, while the idea of a biopsychosocial perspective is I guess helpful for reminding excessively biologically-oriented learners that there are other things that are relevant, it is really not a very useful model. It says "lots of stuff is relevant" without providing any specification or suggestion as to what factors might actually be predominant in what situations or how they might interact. It is hard to imagine facts connected in any way to an individual that are not relevant to a conceptualization in the biopsychosocial model. It is a kitchen sink that explains very little.

As a rudimentary first pass, it's fine for collecting your thoughts, but it very easily turns into just vomiting up all the information you have about someone without much structure or organization. An answer that would be truly impressive to me or indicate real thought would be one that a) had a particular theory or framework for understanding how different factors interact with each other that cannot be adapted to literally any set of facts and b) idiographic. I guess I'm not sure an impressive, generic answer is possible.
 
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I guess in the first place, while the idea of a biopsychosocial perspective is I guess helpful for reminding excessively biologically-oriented learners that there are other things that are relevant, it is really not a very useful model. It says "lots of stuff is relevant" without providing any specification or suggestion as to what factors might actually be predominant in what situations or how they might interact. It is hard to imagine facts connected in any way to an individual that are not relevant to a conceptualization in the biopsychosocial model. It is a kitchen sink that explains very little.

As a rudimentary first pass, it's fine for collecting your thoughts, but it very easily turns into just vomiting up all the information you have about someone without much structure or organization. An answer that would be truly impressive to me or indicate real thought would be one that a) had a particular theory or framework for understanding how different factors interact with each other that cannot be adapted to literally any set of facts and b) idiographic. I guess I'm not sure an impressive, generic answer is possible.
Well then I give up. That is seriously moving the goal posts. BPS for all its detractors is a model that is a required part of training by ACGME. If you're saying that the bot did a good job answering according to that framework, which is what it was asked to do, but you're not impressed because you dislike the framework then we are really talking past each other.
 
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Well then I give up. That is seriously moving the goal posts. BPS for all its detractors is a model that is a required part of training by ACGME. If you're saying that the bot did a good job answering according to that framework, which is what it was asked to do, but you're not impressed because you dislike the framework then we are really talking past each other.

There's a difference between "adequate, fine for a handout or first year didactics" and "impressive". One makes me say "yeah, good enough for government work" and the other makes me go "okay, this person gets it."

You said this was very impressive to you and more than what you'd expect from many residents, it seemed to me like an adequate regurgitation of a textbook answer. I remain very curious as to what you think a typical resident answer might look like that is obviously inferior to what GPT produced. Would you mind roughly sketching something like that? It might help me understand what you find more insightful than a typical trainee in the original answer, at the moment I just don't get it. You are obviously a reasonable person so I must be missing something. Maybe we have very different mental models of residents.

Re: ACGME issues, not sure there is much to train with regard to BPS model, it's not much of a model, unless someone is confused by the acronym.
 
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Where I am more excited is to see these types of AIs become integrated to help with notes, pulling out relevant information from the chart, filling out forms, gathering billing information etc. That to me is truly exciting. Right now the answers it gives are nothing groundbreaking it just regurgitates what you would read on UpToDate without the references and without knowing what information it makes up because that is something these LLMs do.
 
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Where I am more excited is to see these types of AIs become integrated to help with notes, pulling out relevant information from the chart, filling out forms, gathering billing information etc. That to me is truly exciting. Right now the answers it gives are nothing groundbreaking it just regurgitates what you would read on UpToDate without the references and without knowing what information it makes up because that is something these LLMs do.

Agreed. It's not so much beating experts at their own game, but making menial and tedious work much easier.
If you want the software to do a search for you, write a document..etc which you can get then proofread..etc. Possibilities are endless.
At some point, It will almost certainly be incorporated in how we end up making decisions about various things and streamlining data. That does have a lot of clinical potential as well.

i.e here's an example. I asked the software to generate a cover letter for a position in psych ER. This one paragraph of a pretty good letter:

"In my previous role, I was responsible for overseeing a team of residents and social workers in the psychiatric ER. I worked closely with these professionals to ensure that patients received the highest quality of care possible. I am adept at managing multiple cases simultaneously and making quick decisions in high-pressure situations. I am also skilled at communicating with patients and their families, as well as other healthcare professionals, to ensure that everyone is on the same page regarding treatment plans."

None of this was prompted. Thank you ChatGPT.


---

It also can get a lot of facts wrong, but apparently has the ability to correct itself. I wouldn't trust it with any kind of even basic factual information. It's very much a work in progress.
 
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Yeah I mean stuff like this is way more funny and creative than any of the prompts I have up there so far. I won't paste this here too but doing things like asking it to rephrase the answer in Shakespearean style gets some actually hilariously awesome responses in <30 seconds.

In a rhyming poem, describe an initial psychiatric evaluation of a patient with narcissistic personality disorder who becomes angry, confrontational and assaults the psychiatrist due to a perceived slight.

The psychiatrist sat with pen in hand
Awaiting the patient, who soon did stand
He walked in tall with a sense of pride
His arrogance and grandiosity he could not hide

The doctor listened with an attentive ear
As the patient spoke of his successes, oh so clear
But as the conversation turned to a slight perceived
The patient's demeanor began to heave

His face contorted with rage and anger
As the doctor tried to calm him, but could not tame or anchor
The patient lashed out with a violent hand
Assaulting the doctor, unable to understand

The doctor retreated with a sense of shock
As the patient continued to mock
His behavior a reflection of his narcissistic core
His anger and violence, too much to ignore

The doctor knew that the patient needed care
But his safety, he couldn't risk or dare
The patient left, filled with a sense of entitlement
His disorder, a challenge for any treatment.
That's... terrible. This program has no sense of meter whatsoever.

Here's mine. 5min, I timed it. Iambic tetrameter

The shrink reposed in excellent fettle

In hopes of a patient to test his mettle

His expectations were more than met

Upon the entry of Mr. Fett

Who insisted on praise with a drunken roar

And on being denied, who cursed and swore

Removed the hinges from the door

And finally passed out on the floor

Leaving the doctor in helpless confession

To sorely regretting his choice of profession
 
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My
There's a difference between "adequate, fine for a handout or first year didactics" and "impressive". One makes me say "yeah, good enough for government work" and the other makes me go "okay, this person gets it."

You said this was very impressive to you and more than what you'd expect from many residents, it seemed to me like an adequate regurgitation of a textbook answer. I remain very curious as to what you think a typical resident answer might look like that is obviously inferior to what GPT produced. Would you mind roughly sketching something like that? It might help me understand what you find more insightful than a typical trainee in the original answer, at the moment I just don't get it. You are obviously a reasonable person so I must be missing something. Maybe we have very different mental models of residents.

Re: ACGME issues, not sure there is much to train with regard to BPS model, it's not much of a model, unless someone is confused by the acronym.
You are correct that drawing the comparison with residents wasn't super helpful, and detracted from the overall point. I will take that on board. The BPS sidebar we can leave for another day ;)
 
Maybe you should give ChatGPT a try for yourself. It absolutely can generate a surprisingly wide range of texts. Over in a thread on the psychology forum I posted an example of it scripting an argument between Noam Chomsky and BF Skinner in Shakespearean verse. It is operating at the end of the day on cloze probabilities above all but turns out you can do a lot with that.

Edit: it also gives very different responses if you ask it to pretend to be generating the text as a different person or entity. Some sorts of questions it answers more accurately if you ask it to pretend to be a super-smart version of itself.
I have. I guess I’m not easily impressed
 
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What residents are your metric for this?
 
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Noam Chomsky had this piece in the NYT and he's definitely unimpressed


I think I agree. ChatGPT is going to be useful for the most menial and uncreative tasks, but it's not something I would use for insight, generating knowledge, critical thinking or even getting basic facts correctly. It's otherwise a mere reflection of the biases of its programmers. Better off doing that yourself.
 
Honestly the responses from the OP read like a tv advertisement from a drug company more than anything. It doesn't take into account health literacy and that people often require a "dumbed down" explanation if you will, drawing analogies to things they can relate to. Its very textbook style definitions of things which is fine if you're in a low acuity/higher intelligence clinic. The responses as a result feel very impersonal. The first visit is aimed at gaining trust and working on a therapeutic alliance, I would argue that by spewing of textbook definitions people may have a harder time relating to you.
 
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how is chatGPT at diagnosing. That seems like where the buck stops. You could put in any diagnosis and ask about treatment and it will churn out a nice sounding blurb from emedicine or uptodate. It would do this with any physical malady as well I assume. Patients already do this, and do it badly because they misdiagnose themselves.

Even if AI could use symptom screeners, the symptom screeners we use are not that sophisticated. And even the more robust personality tests require an experienced psychologist to incorporate the information into a complete diagnostic formulation, which requires a diagnostic interview and collateral information. Putting the MMPI into chatGPT would be unlikely to be that effective.
 
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I have no degree or formal training and could have answered those questions

Chat GPT is very powerful but you must have some interesting residents if they were unable to match this.
 
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