Psychiatry Commons^™

Ethical Considerations Of Deep Brain Stimulation For Treatment Refractory Schizophrenia: Surveying Stakeholders., Judith M Gault, Nicola Cascella, Nidal Moukaddam, Stephanie Lehto, Patrick Hosokawa, Paul S Appelbaum, Akira Sawa, Jocelyn Lippman-Bell, William S Anderson, Wayne Goodman, Sameer A Sheth, Daniel Kramer, John A Thompson, Elyn R Saks, Rachel A Davis

PCOM Scholarly Works

INTRODUCTION: Ethical concerns have been raised by both current and historically controversial neurosurgical interventions for treatment-refractory schizophrenia and schizoaffective disorder (TR-SZ). Considering advances in next-generation deep brain stimulation (DBS), initial success in treating a few cases of TR-SZ, and how challenging trial enrollment is, transparency and disseminating knowledge about DBS is important, as is input from involved groups. Here information was presented about DBS as an experimental treatment option for TR-SZ to stakeholders to gauge enthusiasm after consideration of potential risks and benefits.

METHODS: Stakeholders were presented with information about DBS (total

RESULTS: Most (83%) research participants and presentation audience …

Wearable-Derived Heart Rate Variability Reveals Autonomic Dysfunction In Schizophrenia (Preprint), Alec J. Pupo, Stephanie H. Felgoise

Internal Medicine Resident Research

Autonomic dysfunction has long been implicated in schizophrenia, yet objective physiological markers remain underutilized in psychiatric research. Heart rate variability (HRV), a noninvasive measure of autonomic regulation, is conventionally derived from short electrocardiographic recordings. In this study, we tested whether continuous, wearable-derived HRV can identify physiologic alterations in schizophrenia-spectrum disorders. Using the NIH All of Us database, we analyzed second-level Fitbit heart rate data from 26 individuals with schizophrenia-spectrum diagnoses and 26 matched controls. Frequency-domain analyses focused on ultra-low frequency (ULF), very low frequency (VLF), and truncated low frequency (tLF) bands, given sampling constraints. Schizophrenia participants showed significantly reduced power …

Social Determinants Of Health In People Living With Psychiatric Disorders: The Role Of Pharmacists., Carla D Cobb, Shari N. Allen, Joseph M Cusimano, Michelle Ding, Amanda S Eloma, Carol A Ott, Kimberly B Tallian

PCOM Scholarly Works

INTRODUCTION: Social determinants of health (SDOH) affect outcomes of people living with psychiatric disorders, including substance use disorders. As experts in medication optimization, pharmacists play a vital role in identifying and addressing medication-related problems associated with SDOH. However, there is a paucity of literature on how pharmacists can be part of the solution.

OBJECTIVE: The purpose of this article is to provide a narrative review and commentary on the intersection between SDOH, medication-related outcomes in people living with psychiatric disorders, and the role of pharmacists in addressing them.

METHOD: The American Association of Psychiatric Pharmacists appointed an expert panel to …

A Rare Case Report Of A Corpus Callosal Splenial Lesion In The Context Of Atypical Neuroleptic Malignant Syndrome., Ryan Serdenes, Samuel Orr, Pamela Trio, Seetha Chandrasekhara, Meghan Musselman

Transitional Year Resident Research

In this report, we describe a case of atypical neuroleptic malignant syndrome (NMS) presenting with an isolated lesion in the splenium of the corpus callosum (ILSCC). There is a paucity of information regarding this topic within the literature and only 7 previous case reports have been published at the time of writing. To our knowledge, this case report is also the first to describe an atypical NMS variant in the context of an ILSCC. In this report, we describe the important considerations in formulating differential diagnosis for ILSCC and are the first report to propose a possible pathophysiological mechanism relating …

Is Mdma-Assisted Psychotherapy An Effective Treatment For Posttraumatic Stress Disorder (Ptsd)?, Joey Rudd

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not MDMA-assisted psychotherapy is an effective treatment for posttraumatic stress disorder (PTSD).

Study Design: Systematic review of three published, randomized controlled trials (double-blind, placebo-controlled) between 2008-2013.

Data Sources: All articles used were published in English, in peer-reviewed journals, and found using PubMed/MEDLINE and Cochrane Review databases.

Outcomes Measured: The primary outcome measure in all three studies was the severity of PTSD symptoms. The primary outcome measure was assessed using the Clinician-Administered PTSD Scale (CAPS) and the Severity of Symptoms Scale for PTSD (SSSPTSD). …

Trends In Hospital Admissions Due To Antidepressant-Related Adverse Drug Events From 2001 To 2011 In The U.S., Harish S. Parihar, Hongjun Yin, Jennifer L Gooch, Shari N. Allen, Samuel N. John, Jianwei Xuan

PCOM Scholarly Works

BACKGROUND: Depression is a prevalent mental health disorder and the fourth leading cause of disability in the world as per the World Health Organization. Use of antidepressants can lead to adverse drug events (ADEs), defined as any injury resulting from medication use. This study aimed to examine changes in hospital admissions due to antidepressant-related ADEs (ArADEs) among different socio-demographic groups and changes in lengths of stay (LOS) and hospital charges in ArADE admissions from 2001 to 2011.

METHODS: The Healthcare Cost and Utilization Project database was used. ArADE admissions in different socio-demographic groups were examined including characteristics such as age, …

Can Coloring Pre-Structured Designs That Have Complexity Aid In Reducing Anxiety In Those Greater Than 17 Years Of Age?, Kaitlyn P. Probasco

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine (EBM) review is to determine whether or not coloring mandalas or designs that have complexity and structure can aid in reducing anxiety in those greater than 17 years of age.

Study Design: Review of three English language randomized controlled trials (RCTs), published in 2007, 2012, and 2015.

Data Sources: Three randomized controlled trials published in peer-reviewed journals obtained using PubMed and EBSCOhost.

Outcomes Measured: The Curry and Kasser study and the van dV and Serice7study both used the State Anxiety Inventory (SAI) to record anxiety. The Henderson …

Is Aristada (Aripiprazole Lauroxil) A Safe And Effective Treatment For Schizophrenia In Adult Patients?, Kyle J. Knowles

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Aristada (aripiprazole lauroxil) a safe and effective treatment for schizophrenia in adult patients?”

STUDY DESIGN: Review of three randomized controlled studies. All three trials were conducted between 2014 and 2015.

DATA SOURCES: One randomized, controlled trial and two randomized, controlled, doubleblind trials found via Cochrane Library and PubMed.

OUTCOMES MEASURED: The outcomes that were measured include adverse events (pain at injection site, insomnia, headache, toothache, abdominal discomfort, constipation, diarrhea, akathisia, back pain, dyskinesia, dystonia, nasopharyngitis) measured by vital signs, physical examination, …

Is Lisdexamfetamine Dimesylate Safe And Effective In Reducing Adhd Symptoms?, Jordan A. Drelich

PCOM Physician Assistant Studies Student Scholarship

Objective: The purpose of this careful EBM review is to determine whether lisdexamfetamine dimesylate (LDX) is safe and effective in reducing attention-deficit/hyperactivity disorder (ADHD) symptoms.

Study Design: A systematic review of two randomized controlled studies and one double-blind, 2-arm, parallel-group placebo-controlled RWP published between 2011-2014, all in the English language.

Data Sources: Two randomized controlled trials and one double-blind, 2-arm, parallel-group placebo-controlled RWP published between 2011 and 2014 which were found using PubMed and Cochrane databases.

Outcomes Measured: ADHD global symptomatic improvement was measured using Clinical Global Impressions – Severity of Illness (CGI-S), Clinical Global Impression-Improvement …

Is Mindfulness-Based Therapy Effective In Increasing Total Sleep Time In Adults?, Johanna F. Detwiler

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine review is to determine whether or not mindfulness-based therapy is effective in increasing total sleep time in adults.

Study design: Review of three randomized controlled trials published in 2011, 2014 and 2015, all English language.

Data source-The three randomized controlled trials that were used in this review were found using PubMed.

Outcomes measured: Total sleep time, sleep onset latency, wake after sleep onset, number of awakenings, time in bed, subjective sleep quality, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medications, and daytime dysfunction were …

Is Botox A Safe And Effective Treatment To Reduce Symptoms Of Depression?, Bradin T. Carter

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Botox is a safe and effective treatment to reduce symptoms of depression?

Study Design: The review is based on three Randomized Control Trials that were double-blind and placebo controlled clinical trials.

Data Source: All articles were researched and found using PubMed and Medline. The articles were selected based on the relevance to my clinical question and if the articles included patient oriented outcomes (POEMS).

Outcomes Measured: The outcomes were measured by the improvement of depressive symptoms (sleep disturbances, suicide ideations, change in …

Is L-Theanine An Effective Treatment For Reducing Anxiety In Patients Ages 18-25?, Nicole Bubes

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not L-theanine, an amino acid analogue found in green tea leaves, is an effective treatment for reducing anxiety in patients ages 18-25.

Study design: Review of two double-blind, randomized controlled studies and one single-blind, randomized controlled study published in 2007, 2012 and 2013 respectively.

Data sources: PubMed

Outcome(s) measured: Each study measured L-theanine’s ability to reduce acute anxiety with a series of self-report measures assessing acute anxiety and stress, including the Profile of Mood States (POMS), the visual analogue scales (VAS), State-Trait Anxiety …

Is Oral Vitamin D Supplementation Safe And Effective For Adults As Therapy To Improve Symptoms Associated With Seasonal Affective Disorder (Sad) During Wintertime?, James Berking

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not oral vitamin D supplementation is safe and effective for adults as therapy to improve symptoms associated with seasonal affective disorder (SAD) during wintertime.

Study Design: This review is based on three randomized controlled trials (RCTs) which were published in 2006, 2012, 2014. Two of the studies were double blind and placebo controlled. The studies evaluated the efficacy of oral vitamin D supplementation for improvement of seasonal affective disorder (SAD) symptoms. One of the studies also evaluated safety.

Data Sources: All articles used were …

Is Ginkgo Biloba Effective In Managing The Symptoms Of Adhd And Does It Exhibit Lower Adverse Side Effects As Compared To The Current Standard Of Treatment?, Joshua Meir Alge

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine review is to determine whether or not ginkgo biloba is effective in managing the symptoms of ADHD and if it exhibits lower adverse side effects as compared to the current standard of treatment.

Study Design: Systematic review of three English language studies, two of which were randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study, published between 2009-2015.

Data Source: Two randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study. In one …

Is Cariprazine Effective And Safe In Treating Acute Mania In Bipolar I Disorder?, Evan A. Reaume

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is cariprazine effective and safe in treating acute mania in bipolar I disorder?”

Study Design: This review is based on three double-blind, randomized controlled trials (RCTs) published in English, in 2015. These studies compared both the efficacy, safety, and tolerability of cariprazine in the treatment of acute mania in bipolar I disorder.

Data sources: Three double-blind, placebo-controlled, RCTs published in English, in peer-reviewed journals, and found using Medline, Pubmed, and Cochrane Review databases.

Outcomes Measured: The primary efficacy scale used in all …

Does Increasing Speech Production And Language Acquisition Through Therapies Aimed At Emphasizing Speech Therapy Improve The Verbal Communication Capabilities In Autistic Children?, Jessica Olejnik

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this EBM review was to determine if increasing speech production & language acquisition through therapies which emphasized speech therapy, would improve verbal communication skills in autistic individuals.

Study Design: Three RCTs selected due to relevance to the proposed question and fulfillment of the requirement of measuring POEMs.

Data Sources: All articles were published in peer-reviewed journals via PubMed.

Outcome Measures: The Preschool Language Scale 4 and Comprehensive Assessment of Spoken Language was measured pre-intervention and 12 months later. The verbal production evaluation scale which measured phonology, pragmatics, prosody, and sematic features. The …

The Effects Of A Trauma-Informed Care Training Program On Mental Health Professionals Knowledge, Skills, And Attitudes With The Smi, Angelina Pelletier

PCOM Psychology Dissertations

Trauma has been found to be highly prevalent among individuals diagnosed with SMIs. Mental health professionals have been reported to misdiagnose or avoid addressing trauma in this population. There is a need to provide information about trauma and to foster awareness among mental health professionals who are treating individuals diagnosed with SMIs. With a TIC approach, operating from a recovery-oriented philosophy, there have been interventions created to address trauma and SMIs with the aim of developing awareness about trauma and the impact it may have on someone’s life. With these factors in mind, mental health professionals should be competent in …