Medical Specialties Commons^™

Education Mitigates The Relationship Of Stress And Mental Disorders Among Rural Indian Women, Nisha Fahey, Apurv Soni, Jeroan J. Allison, Jagdish Vankar, Anusha Prabhakaran, Tiffany A. Moore Simas, Nancy Byatt, Ajay Phatak, Eileen O'Keefe, Somashekhar Nimbalkar

Apurv Soni

BACKGROUND: Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.

OBJECTIVES: To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.

METHODS: Cross-sectional survey of 700 women from rural Gujarat, India. …

Use Of Memantine In Autism Spectrum Disorder: A Case Report, Adam Schindzielorz Md, Kristina Bryant-Melvin Md, Suzanne Holroyd Md, Kelly Melvin Md

Kristina Bryant-Melvin

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder of varying severity and phenotypic expression that is characterized by persistent deficits in social relatedness, communication skills, and interfering repetitive behaviors. Associated behavioral pathology can include inattention, aggression, irritability, hyperactivity, anxiety, and self-injury. Currently, FDAapproved treatments exist to treat secondary symptoms but not core symptomatology. The etiology of autism and other ASD is thought to be multifactorial but is not well understood. Some studies suggest that glutamate excitotoxicity may play a role in the pathogenesis of ASD. Memantine, an NMDAreceptor antagonist, could potentially address core symptoms in ASD by targeting disease-specific pathophysiology. …

Telepsychiatry: Access In Rural Areas, David P. Paul Iii, Brianna Washington, Annie Robinson, Mike Tonnie, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Rural areas have experienced higher than average healthcare workforce problems, especially concerning limited access to mental health services. Telepsychiatry may provide at least a partial solution, as it has improved access and quality of care available in rural environments despite implementation problems. As technology continues to advance access, telepsychiatry will also need to strengthen making access more readily available. Additional research is required to identify modalities and diverse methods that can be used to increase access to mental health services further and improve outcomes in rural and underserved areas.

A Scoping Review Of The Associations Between Mental Health And Factors Related To Hiv Acquisition And Disease Progression In Conflict-Affected Populations, Erica Koegler, Erica Koegler, Caitlin E. Kennedy

Erica Koegler

Musical Hallucinations Treated With Atypical Antipsychotics In A Geriatric Population – A Case Series, Adam Schindzielorz Md, D. Scott Murphy Md, Suzanne Holroyd Md

Suzanne Holroyd

Musical hallucinations have been likened to the auditory equivalent of Charles Bonnet Syndrome, which involves complex visual hallucinations, most often in the context of visual impairment. Musical hallucination frequently take the form of hymns, carols, and show-tunes and are strongly associated with hearing loss, with some studies suggesting a prevalence of 2.5–3.6% in the hearing impaired. Musical hallucinations are typically treated with anticonvulsant and anticholinesterase medications, with some studies having evaluated the efficacy of sedative hypnotics, antipsychotics and antidepressants in various psychiatric and medical subpopulations suggesting a heterogeneous spectrum of causes for this disorder.

We present two cases of musical …

Guidance For Switching From Off-Label Antipsychotics To Pimavanserin For Parkinson’S Disease Psychosis: An Expert Consensus, Kevin J. Black, Henry Nasrallah, Stuart Isaacson, Mark Stacy, Rajesh Pahwa, Charles H. Adler, Gustavo Alva, Jeffrey W. Cooney, Daniel Kremens, Matthew A. Menza, Jonathan M. Meyer, Ashwin A. Patkar, Tanya Simuni, Debbi A. Morrissette, Stephen Stahl

Kevin J. Black, MD

Computer Administered Safety Planning For Individuals At Risk For Suicide: Development And Usability Testing, Edwin D. Boudreaux, Gregory K. Brown, Barbara Stanley, Rajani S. Sadasivam, Carlos A. Camargo Jr, Ivan W. Miller

Rajani S. Sadasivam

BACKGROUND: Safety planning is a brief intervention that has become an accepted practice in many clinical settings to help prevent suicide. Even though it is quick compared to other approaches, it frequently requires 20 min or more to complete, which can impede adoption. A self-administered, Web-based safety planning application could potentially reduce clinician time, help promote standardization and quality, and provide enhanced ability to share the created plan. OBJECTIVE: The aim of this study was to design, build, and test the usability of a Web-based, self-administered safety planning application. METHODS: We employed a user-centered software design strategy led by a …

Multi-Scale Motility Amplitude Associated With Suicidal Thoughts In Major Depression, Premananda Indic, Greg Murray, Carlo Maggini, Mario Amore, Tiziana Meschi, Loris Borghi, Ross J. Baldessarini, Paola Salvatore

Premananda Indic

Major depression occurs at high prevalence in the general population, often starts in juvenile years, recurs over a lifetime, and is strongly associated with disability and suicide. Searches for biological markers in depression may have been hindered by assuming that depression is a unitary and relatively homogeneous disorder, mainly of mood, rather than addressing particular, clinically crucial features or diagnostic subtypes. Many studies have implicated quantitative alterations of motility rhythms in depressed human subjects. Since a candidate feature of great public-health significance is the unusually high risk of suicidal behavior in depressive disorders, we studied correlations between a measure (vulnerability …

Neurobiology Of The Premonitory Urge In Tourette’S Syndrome: Pathophysiology And Treatment Implications, Andrea E. Cavanna, Kevin J. Black, Mark Hallett, Valerie Voon

Kevin J. Black, MD

A New Treatment For Psychosis In Parkinson’S Disease, Kevin J. Black

Kevin J. Black, MD

Growing Organizational Capacity To Facilitate The Streamlining Of Patients With Psychiatric Disorders In A Community Academic Health Network; An Eight Year Review, Edward R. Norris Md, Fapa, Fapm, Michael W. Kaufmann Md, David B. Burmeister Do, Muhamad Aly Rifai Md, Laurence P. Karper Md, Ralph A. Primelo Md

David Burmeister, DO, FACEP, CPE

No abstract provided.

Brain Structure In Pediatric Tourette Syndrome, Alton C. Williams, Kevin J. Black

Kevin J. Black, MD

Topical Administration Of Psychotropic Medications In Pluronic Lecithin Organogel To Treat Patients With Dementia: A Retrospective Observational Study, Cornelius W. Thomas, Md, Suzanne Holroyd, Md. Chair, Department Of Psychiatry

Suzanne Holroyd

OBJECTIVE: Treatment of mood and behavioral symptoms in geriatric patients with advanced dementia may be impeded by poor compliance with oral medications. Pluronic lecithin organogel (PLO) is a compounding substrate that can be used for the topical administration of psychotropic medications. METHODS: Charts of patients treated with psychotropic medications compounded with PLO cream were reviewed for treatment outcomes. All patients were treated by a nursing home outreach service. RESULTS: Records from twenty-four patients, mean age 86.8 + 5.9, were reviewed. Common psychiatric symptoms included agitation, aggressive behavior, and depression. Medications most commonly administered as a PLO cream included quetiapine and …

The Promise Of Healthcare Reform In Transforming Services For Jail Detainees, Maureen Mcdonnell, Laura Brookes, Arthur J. Lurigio

Arthur J. Lurigio

Chronic behavioral health conditions, such as psychiatric and substance use disorders, affect at least half of all arrestees, with two-thirds suffering from at least one chronic medical disorder. These conditions contribute to their criminal behaviors and propensities to recycle through the criminal justice system (Binswanger et al. Journal of Urban Health 89:183-190, 2012). Despite their limited resources, jails have nonetheless become de facto settings for the delivery of healthcare services. With the passage of the Affordable Care Act (ACA) of 2010, jail releasees will become eligible for government-subsidized healthcare coverage in 2014. The widespread availability of integrated healthcare services for …

Use And Perceived Effectiveness Of Coping Skills Among Police Officer Spouses, Andrea L. Dinsmore

Andrea L. Dinsmore

Discusses her research on the types of psychological stressors faced by the spouses of police officers and their methods of coping.

Assessment Of Competence Restoration: Determining The Threshold, Andrea L. Dinsmore

Andrea L. Dinsmore

Discusses the legal precedent and research basis of evaluating a defendant's mental competency to stand trial, the variables that contribute to non-restorable incompetence to stand trial, and the differences between patients who are restorable to competency versus those who are not restorable to competency.

Ptsd/Sud In Individuals With Physical Disabilities: Identifying Problems And Promising Interventions, Melissa L. Anderson, Douglas M. Ziedonis, Lisa M. Najavits

Melissa L. Anderson

Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is common, affects multiple domains of functioning, and presents complex challenges to recovery. Initial research indicates that individuals with physical disabilities experience higher rates of lifetime trauma and PTSD, and exhibit more severe SUD compared to non-disabled individuals. To expand upon these initial findings, we conducted a series of two studies on PTSD and SUD among individuals with physical disabilities.

Morphological Knowledge And Decoding Skills Of Deaf Readers, M. Diane Clark, Gizelle L. Gilbert, Melissa L. Anderson

Melissa L. Anderson

Many studies have reported the necessity of phonological awareness to become a skilled reader, citing barriers to phonological information as the cause for reading difficulties experienced by deaf individuals. In contrast, other research suggests that phonological awareness is not necessary for reading acquisition, citing the importance of higher levels of syntactic and semantic knowledge. To determine if deaf students with higher language skills have better word decoding strategies, students responded to a morphological test, where monomorphemic words and multimorphemic words were matched to their definitions. Two studies are reported, one focusing on English placement levels and a second with formal …

Supporting Recovery In The Deaf Community: Creating Continuum Of Behavioral Health Care In Central Massachusetts, Melissa L. Anderson, Neil S. Glickman, Lisa Mistler, Susan Jones, Monika E. Kolodziej, Douglas M. Ziedonis

Melissa L. Anderson

Across the U.S., there is a paucity of mental health and substance abuse services for Deaf individuals. Without the availability of communication accommodations and specialized clinical expertise, Deaf individuals seeking behavioral health services contend with access limitations, misdiagnoses, and superficial treatments. Moreover, while the assessment and treatment of co-occurring disorders and the infusion of trauma-informed care are key components of effective treatment in the mainstream literature, the investigation and application of these initiatives to the Deaf population has not yet occurred. The proposed poster will outline the current state of specialized behavioral health services for Deaf individuals in Central Massachusetts, …

Parkinson’S Disease Psychosis: A Roundtable Discussion, Jennifer G. Goldman, Rajesh Pahwa, Stuart H. Isaacson, Kevin J. Black

Kevin J. Black, MD

Development Of A Self-Report Measure Of Dual Diagnosis Capability For Addiction And Mental Health Programs, Kenneth E. Fletcher, Anna Kline, Tara Zandi, Gregory Seward, Sun Kim, Douglas M. Ziedonis

Douglas M. Ziedonis

The purpose of this study is to develop and test the psychometrics of a self-report version of a measure of the capacity of addiction and mental health programs to deliver dual-diagnosis treatment, that is, to provide treatment for both addiction problems and mental health problems. Traditionally these services are provided by very different service providers that did not until recently interact very well, if at all. The increasing recognition that patients who suffer from both kinds of problems – who are dually diagnosed – would benefit from integrated delivery of addiction and mental health services has led to efforts to …

Implementing The Massachusetts Child Trauma Project (Mctp) To Improve Services For Children With Complex Trauma In Child Welfare: Phase I Needs And Readiness Assessment, Charmaine B. Lo, Melodie Wenz-Gross, Jessica L. Griffin

Melodie Wenz-Gross

MCTP seeks to improve placement stability and outcomes for children with complex trauma in the care of the Massachusetts Department of Children and Families (DCF) by creating a sustainable capacity for providing evidence-based trauma interventions within provider agencies, and trauma-informed practices within DCF.

Outpatient Commitment: A Competency Based Justification, Albert J. Grudzinskas, Jeffrey L. Geller, Jonathan C. Clayfield, William H. Fisher

Jeffrey L. Geller

A recent survey of state statutes for outpatient commitment (Torrey and Kaplan, 1995) indicates that while thirty-five states and the District of Columbia have laws permitting outpatient commitment, Massachusetts is not one of them. Rather, Massachusetts uses a competency-based, substituted-decision-making model for the involuntary administration of medication in the community. To appreciate the Massachusetts model, it is important to understand how this court-ordered involuntary outpatient treatment fits into the overall scheme of outpatient commitment and how it is structured. A review of involuntary outpatient treatment (IOT) literature indicates that it is prudent to distinguish between outpatient commitment, conditional release, and …

The Family Options Project: Implementing An Innovative Intervention For Parents With Mental Illnesses And Their Families, Joanne Nicholson, Kathleen Biebel, Valerie F. Williams, Elizabeth A. Aaker, Karen Albert, Bernice Gershenson, Brenda Warren, Katherine Woolsey

Kathleen Biebel

The Family Options Project reflects a productive partnership between researchers and providers at the UMMS Center for Mental Health Services Research and Employment Options, Inc., Marlborough, MA The Family Options Intervention is an evidence-informed psychiatric rehabilitation intervention, developed and tested within the context of a community-based agency setting.

A Pilot Study Of Basal Ganglia And Thalamus Structure By High Dimensional Mapping In Children With Tourette Syndrome, Alton C. Williams, Marie E. Mcneely, Deanna J. Greene, Jessica A. Church, Stacie L. Warren, Johanna M. Hartlein, Bradley L. Schlaggar, Kevin J. Black, Lei Wang

Kevin J. Black, MD

No abstract provided.

Keynote Speaker Presentations: 5th Annual Umass Center For Clinical And Translational Research Retreat (Video), Robert H. Brown Jr., Thomas Grisso

Thomas Grisso

This video features the full keynote presentations from the 5th Annual UMass Center for Clinical and Translational Science Research Retreat at the University of Massachusetts Medical School (UMMS) in Worcester, MA, on May 20, 2014.

Beginning at 12:40

1st Keynote Speaker: Robert H. Brown, Jr., MD, D.Phil, Chair, Department of Neurology, UMMS. “Lou Gehrig Disease: From Mapping to Medicines”

Beginning at 1:22:19

2nd Keynote Speaker: Thomas Grisso, PhD, Director, Law and Psychiatry Program and Professor, Department of Psychiatry, UMMS. Recipient, Chancellor’s Medal for Distinguished Scholarship. “Translational Research in Law and Psychiatry”

Also included is a brief introductory presentation with updates …

A Pilot Study Of Qigong For Reducing Cocaine Craving Early In Recovery, David A. Smelson, Kevin W. Chen, Douglas M. Ziedonis, Ken Andes, Amanda Lennox, Lanora Callahan, Stephanie Rodrigues, David Eisenberg

Douglas M. Ziedonis

OBJECTIVES: This pilot study examined the feasibility, preliminary efficacy, and determined the effect sizes of external qigong therapy (EQT) in reducing cue-elicited cocaine craving and associated symptoms among recently abstinent cocaine-dependent (CD) individuals. METHODS: This study randomized 101 CD subjects to either a real EQT (n=51) or sham EQT control (n=50) group. Subjects underwent a baseline assessment and a weekly cue-exposure session for 2 weeks. Total EQT or sham treatments ranged from 4 to 6 sessions in 2 weeks. RESULTS: EQT-treated subjects displayed a greater reduction in cue-elicited craving (p=0.06) and symptoms of depression (p<0.05) with medium effect sizes. …

Personality Heterogeneity In Ptsd: Distinct Temperamental And Interpersonal Typologies, Katherine M. Thomas, Christopher J. Hopwood, M. Brent Donnellan, Aidan G. C. Wright, Charles A. Sanislow, Meghan E. Mcdevitt-Murphy, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, M. Tracie Shea, John C. Markowitz, Andrew E. Skodol, Mary C. Zanarini, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create …

Socioeconomic-Status And Mental Health In A Personality Disorder Sample: The Importance Of Neighborhood Factors, Zach Walsh, M. Tracie Shea, Shirley Yen, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Donna S. Bender, Andrew E. Skodol, Charles A. Sanislow, Leslie C. Morey, John G. Gunderson

Charles A. Sanislow, Ph.D.

This cross-sectional study examined the associations between neighborhood-level socioeconomic-status (NSES), and psychosocial functioning and personality pathology among 335 adults drawn from the Collaborative Longitudinal Personality Disorders Study. Participants belonged to four personality disorder (PD) diagnostic groups: Avoidant, Borderline, Schizotypal, and Obsessive Compulsive. Global functioning, social adjustment, and PD symptoms were assessed following a minimum two-year period of residential stability. Residence in higher-risk neighborhoods was associated with more PD symptoms and lower levels of functioning and social adjustment. These relationships were consistent after controlling for individual-level socioeconomic-status and ethnicity; however, the positive association between neighborhood-level socio-economic risk and PD symptoms was …

Core Competencies For Clinical Supervisors, David Kalman, Stephanie Rodrigues

Stephanie Rodrigues

This chapter provides useful strategies that will help guide clinical supervisors who oversee and support the work of MISSION-VET Case Managers and Peer Support Specialists. It includes an overview of the MISSION-VET supervisor’s role and a description of each team member’s primary area of responsibility within the MISSION-VET program. The remainder of the chapter describes key strategies that MISSION-VET supervisors will need in order to establish productive working relationships with MISSION Case Managers and Peer Support Specialists. These strategies, which are designed to foster a strong supervisory alliance and assure that services are being delivered with fidelity to the MISSION-VET …