Psychiatry Commons^™

A Case Of Diabulimia In A 23-Year-Old Woman With Extensive Comorbidities, Stephen Poos, Kaitlin Mcgowan, Ashaki Martin

Rowan-Virtua Research Day

Diabulimia is defined as intentionally withholding insulin injections for the purpose of weight loss in the setting of type 1 diabetes mellitus (T1D).

It is characterized as an eating disorder (ED), although it does not yet have DSM diagnosis status.

Recognition of the condition among medical professionals is limited but growing.

Family-Centered Training And Therapy As Substance Abuse Intervention In Adolescents, Ryan St. John, Cam'ron Klotz, Muskaan Bibi, Archana Salek, Health Careers Opportunity Program - Rowansom, Rowan University

Rowan-Virtua Research Day

We hypothesized that providing mental health resources for adolescents and educating their parents and families would decrease the prevalence of substance abuse in the Camden, NJ community given that overdose death had risen 138% from 2014-2018. Educating parents and families on the importance of adolescents dealing with mental disorders may help evaluate the mental stability of their child and prevent them from turning to illicit substance to cope. Increasing the communication and the availability of resources for adolescents to turn to before resorting to illicit substances can have beneficial effects.

Obsessions In Ocd Mimicking Capgras: A Case Report, Ricky Chu, Alexander Swartz, Helen Yi

Rowan-Virtua Research Day

Obsessive Compulsive Disorder (OCD) is a mentally debilitating condition that can present in a multitude of ways and its manifestations can vary within the diagnosed patient population. OCD can be diagnosed with the presence of either obsessions or compulsions and does not require both. Sometimes, OCD can affect a patient in a way that mimics delusional misidentification syndromes. In these cases, a patient's ego-dystonia can be a key distinguishing feature in diagnosis. In one specific delusional misidentification syndrome, Capgras, a patient possesses fixed beliefs that a known person (or sometimes object) is an imposter. And even though the textbook OCD …

A Holistic Approach To Physical And Mental Health: Associations Between Chronic Disease And Psychiatric Conditions, Pooja Patel, Alison Mancuso

Rowan-Virtua Research Day

OBJECTIVE:

• To investigate the link between chronic medical conditions and psychiatric disorders

BACKGROUND

• Limited research has been done studying the relationship between chronic medical conditions and psychiatric disorders in patients comorbid with both types of conditions.

• Prior research studies have demonstrated that patients with chronic medical conditions are more likely to develop psychiatric disorders compared to healthy individuals without any medical conditions.

• As individuals develop chronic medical conditions, they may encounter additional obstacles in their lives,

Alzheimer's Patients’ Mental Health During The Covid 19 Pandemic, Maryanna Schweininger, Yvonne Maduka, Ajh'shana Collins

Rowan-Virtua Research Day

Alzheimer’s disease (AD) is a degenerative brain disease caused by β Amyloid plaques and neurofibrillary tangles, which results in memory loss and cognitive decline. It is the sixth leading cause of death in the United States. Approximately 50% of those with AD experience some degree of depression during the course of the disease, which has been shown to accelerate functional decline, institutionalization, and even mortality.

Many who cannot care for themselves live in an assisted living facility or retirement home. Since the beginning of the COVID 19 pandemic, people have been urged to social distance in order to decrease the …

The Prevalence Of Postpartum Depression In Black And Hispanic Women In New Jersey, Courtney Chineme, Rachel Shmuts, Chris Canlas

Rowan-Virtua Research Day

Postpartum depression (PPD) is defined as symptoms of major depressive disorder (MDD) within one month of giving birth with the prevalence in the United States being 10-15%. There are well documented instances of racial differences and their effects on maternal outcomes including infant, maternal mortality and postpartum mood disorders. In New Jersey, there are monitoring systems that explore the relationships between maternal characteristics such as race, age, education level, insurance status, and racial bias and how they may correlate with higher incidences of Postpartum Depression (PPD) in these communities of women. The purpose of this comparative study is to analyze …

Mental Health Outcomes At A Student-Run Free Clinic, Jessica-Sophie Horoschak, Riya Tandra, Sahil Parikh, Shayna Peterzell, Roma Padalkar, Tara Pellegrino

Rowan-Virtua Research Day

In this project we aim to:

1. Assess the outcomes of screening, management, and diagnosis for patients at the Rowan Community Health Center (RCHC).

2. Compare the outcomes of screening, management, and diagnosis between different groups (gender, race, income, insurance status) using validated surveys.

3. There is a need for accessible and affordable primary care in the South Jersey area, which the RCHC is hoping to meet.

Hypothesis:

The quality of mental health care available to patients at the RCHC is comparable to that at other insured practices.

Case Of New Onset Alice In Wonderland Syndrome In Adolescent After Prolonged Hospitalization, Michaela Margolis, Timothy Wong, Richard Hadi

Rowan-Virtua Research Day

Alice in wonderland syndrome (AIWS) has been described as body image illusions involving distortions of the size, mass, or shape of the patient’s own body or its position in space, often occurring with depersonalization and derealization. Most cases typically affect young children.

Common distortions are micropsia, macropsia, metamorphopsia, and pelopsia.

The term was adopted from the book by Lewis Carroll, wherein the main character perceived her size and shape to change in different scenarios.

These distortions are often expressed as sensory perceptions rather than illusions or hallucinations, and are often distressing to the patient.

AIWS onset has been found to …

A Terrible Prank Gone Horribly Wrong The Development Of Delusional Infestation As An Adjustment Reaction To A Traumatic Hoax, Timothy Wong, Nardin El-Shammaa, Munaza Khan, Stephen Scheinthal

Rowan-Virtua Research Day

Delusional infestation (DI) is a somatic type delusional disorder, characterized by a fixed belief that one is infested by living or nonliving pathogens (1,3) . DI is a relatively rare disorder (4,5), with an estimated 20-80 cases per million people annually (6). Effective management of patients suffering from DI is crucial, as patients may cause significant harm to themselves in their attempts to remove the pathogens (7,8). Regarding treatment options, antipsychotic medications such as pimozide and risperidone have been promising (8,10). However, there remain many barriers to care (11), and patients are hardly ever seen in psychiatry as they preferably …

The Psychiatry Milestones 2.0: How Did We Get From 1.0 To 2.0 And What Can Users Expect?, Matthew Macaluso, Mark Kinzie, Deborah Cowley, Lillian J Houston, Sandra Dejong, Furhut Janssen, Adrienne Bentman, Laura Edgar, Brittany Campbell, Lynneice Bowen, Jeffery Aronowitz, Elie Aoun, Patcho Santiago, George Keepers

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Graduate medical education (GME) in psychiatry, like other medical specialties, has been transitioning to competency-based training and assessment. Competency-based medical education was born from a desire to certify physicians based on training outcomes, rather than training inputs such as the amount of time one spends in training [1]. The transition to a focus on training outcomes has been at least 25 years in the making

The "M" Word: Accusations Of Malingering Are Harmful To Patient Care, Joshua S. Ellis

Cooper Rowan Medical Journal

It starts as a small seed of doubt. It can be planted by anyone: the physician, the nurse, a family member, or even the patient. But once the seed gets planted in the minds of those involved in caring for the patient, every word and action from the patient function as water and sunshine, encouraging the seed to grow. The seed of doubt grows into a small tree of criticism which blooms into a collection of judgment and prejudice that prevent the patient from receiving the care that he or she deserves. All of this can happen after a patient …

Omt For The Treatment Of Depression And Anxiety, Zachary Winchell

Rowan-Virtua Research Day

Osteopathic manipulative therapy (OMT) fundamentally aims to remedy somatic dysfunction through the manipulation of the patient. In this regard, OMT is a particularly viable non-pharmacological adjunct for patients with depressive and generalized anxiety disorder (GAD).

In both of these disorders, the hypothalamic-pituitary-adrenal axis has an interdependent relationship with physiological stress that feed one another to both increase symptomology and leave patients vulnerable to negative life events. Additionally, pro-inflammatory cytokines acting on the brain over long periods of time can lead to exacerbation of disease and the development of depression in susceptible individuals. Altered cytokine balance has also been found in …

Affective Disturbance In Mild Cognitive Impairment, Jason Greenhagen, Emily Matusz, Sheina Emrani, David Libon, Sherry Pomerantz

Rowan-Virtua Research Day

Mild cognitive impairment (MCI) is an identifiable, prodromal stage of cognitive impairment and has been further defined into subtypes: amnestic, language, executive functioning, and multi domain/mixed MCI (Jak et al. 2009 ). The purpose of this study is to (1) examine the differences in depression, anxiety, and apathy between MCI subtypes; and (2) assess the relationship between the neurocognitive domains (executive functioning, language, and memory and affective symptoms. We hypothesize that apathy will be greater in dysexecutive/mixed MCI (dys/mixed MCI) and be more highly correlated to neurocognitive deficits compared to depression or anxiety. This is a retrospective study of 113 …

Survey Of Primary Care Physicians’ And Pediatricians’ Competency In Identifying Prodromal Symptoms In Schizophrenia And Psychotic Disorders, Mark Shephard, Joanna Petrides Psy.D.

Rowan-Virtua Research Day

• To address whether primary care physicians and pediatricians are equipped to recognize the prodromal symptoms of psychotic disorders

• Patients of primary care physicians exhibited increased help seeking behaviors prior to schizophrenia diagnosis [1]

• Primary care physicians in numerous countries have shown a lack of sufficient knowledge related to diagnosing and treating schizophrenia [2,3,4,5,6]

• Unclear if primary care physicians in the United States are adequately trained and prepared to recognize prodromal signs of schizophrenia, and diagnose and treat a variety of psychotic disorders

Prefrontal Corticotropin-Releasing Factor (Crf) Neurons Act Locally To Modulate Frontostriatal Cognition And Circuit Function., Sofiya Hupalo, Andrea J Martin, Rebecca K Green, David M Devilbiss, Craig W Berridge

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The PFC and extended frontostriatal circuitry support higher cognitive processes that guide goal-directed behavior. PFC-dependent cognitive dysfunction is a core feature of multiple psychiatric disorders. Unfortunately, a major limiting factor in the development of treatments for PFC cognitive dysfunction is our limited understanding of the neural mechanisms underlying PFC-dependent cognition. We recently demonstrated that activation of corticotropin-releasing factor (CRF) receptors in the caudal dorsomedial PFC (dmPFC) impairs higher cognitive function, as measured in a working memory task. Currently, there remains much unknown about CRF-dependent regulation of cognition, including the source of CRF for cognition-modulating receptors and the output pathways modulated …

Antibodies In The Diagnosis, Prognosis, And Prediction Of Psychotic Disorders., Thomas A Pollak, Jonathan P Rogers, Robert G Nagele, Mark Peakman, James M Stone, Anthony S David, Philip Mcguire

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Blood-based biomarker discovery for psychotic disorders has yet to impact upon routine clinical practice. In physical disorders antibodies have established roles as diagnostic, prognostic and predictive (theranostic) biomarkers, particularly in disorders thought to have a substantial autoimmune or infective aetiology. Two approaches to antibody biomarker identification are distinguished: a "top-down" approach, in which antibodies to specific antigens are sought based on the known function of the antigen and its putative role in the disorder, and emerging "bottom-up" or "omics" approaches that are agnostic as to the significance of any one antigen, using high-throughput arrays to identify distinctive components of the …

Supervision In Community Mental Health: Understanding Intensity Of Ebt Focus., Leah Lucid, Rosemary Meza, Michael D Pullmann, Nathaniel Jungbluth, Esther Deblinger, Shannon Dorsey

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the …

Multinational Comparative Cross-Sectional Survey Of Views Of Medical Students About Acceptable Terminology And Subgroups In Schizophrenia, Shanaya Rathod, Muhammad Irfan, Rachna Bhargava, Narsimha Pinninti, Joseph Scott, Haifa Mohammad Algahtani, Zhihua Guo, Rishab Gupta, Pallavi Nadkarni, Farooq Naeem, Fleur Howells, Katherine Sorsdahi, Kerensa Thorne, Victoria Osman-Hicks, Sasee Pallikadavath, Peter Phiri, Hannah Carr, Lizi Graves, David Kingdon

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries.

OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

SETTING: The study …

Agreement Between Clinician-Rated Versus Patient-Reported Outcomes In Huntington Disease, Noelle E Carlozzi, Nicholas R Boileau, Joel S Perlmutter, Kelvin L Chou, Julie C Stout, Jane S Paulsen, Michael K Mccormack, David Cella, Martha A Nance, Jin-Shei Lai, Praveen Dayalu

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Clinician-rated measures of functioning are often used as primary endpoints in clinical trials and other behavioral research in Huntington disease. As study costs for clinician-rated assessments are not always feasible, there is a question of whether patient self-report of commonly used clinician-rated measures may serve as acceptable alternatives in low risk behavioral trials.

AIM: The purpose of this paper was to determine the level of agreement between self-report and clinician-ratings of commonly used functional assessment measures in Huntington disease.

DESIGN: 486 participants with premanifest or manifest Huntington disease were examined. Total Functional Capacity, Functional Assessment, and Independence Scale assessments …

Supervising Ebt: What Content Do Workplace-Based Supervisors Cover And What Techniques Do They Use?, Shannon Dorsey, Michael D Pullmann, Suzanne E.U. Kerns, Esther Deblinger, Leah Lucid, Julie P Harrison, Kelly Thompson, Lucy Berliner

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Workplace-based clinical supervision in public mental health is an underutilized resource for supporting evidence- based treatments (EBTs) [1], despite the fact that supervisors may offer a cost-effective way to support clinician fidelity to EBT. Very little, however, is known about the content and techniques used by workplace-based supervisors [2]; particularly in the context of EBT implementation [3].

Trauma-Focused Cognitive Behavioural Therapy For Young Children: Clinical Considerations, Elisabeth Pollio, Esther Deblinger

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Trauma-focused Cognitive Behavioural Therapy (TF-CBT) has been utilized with children of a wide age range and with diverse trauma experiences. This article will focus on the application of TF-CBT to young children. After presenting an overview of the model, challenges and developmentally-sensitive and creative strategies for engaging young children and their caregivers in TF-CBT PRACTICE components will be highlighted. A brief review of the strong empirical support for TF-CBT will then be provided.

Objective Coding Of Content And Techniques In Workplace-Based Supervision Of An Ebt In Public Mental Health, Shannon Dorsey, Suzanne E U Kerns, Leah Lucid, Michael D Pullmann, Julie P Harrison, Lucy Berliner, Kelly Thompson, Esther Deblinger

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Workplace-based clinical supervision as an implementation strategy to support evidence-based treatment (EBT) in public mental health has received limited research attention. A commonly provided infrastructure support, it may offer a relatively cost-neutral implementation strategy for organizations. However, research has not objectively examined workplace-based supervision of EBT and specifically how it might differ from EBT supervision provided in efficacy and effectiveness trials.

METHODS: Data come from a descriptive study of supervision in the context of a state-funded EBT implementation effort. Verbal interactions from audio recordings of 438 supervision sessions between 28 supervisors and 70 clinicians from 17 public mental health …

Suicidal Ideation Assessment In Individuals With Premanifest And Manifest Huntington Disease., Melissa Wesson, Nicholas R Boileau, Joel S Perlmutter, Jane S Paulsen, Stacey K Barton, Michael K Mccormack, Noelle E Carlozzi

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Huntington disease (HD) is associated with increased risk of suicide.

OBJECTIVE: This study compares suicide ideation in HD to the general population, assesses factors associated with increased prevalence of suicidal thoughts, and compares clinician-rated to self-reported assessments of suicidal ideation.

METHODS: We examined 496 participants with premanifest or manifest HD. Clinician-rated suicidal ideation was measured using the Problem Behaviors Assessment - short form. Self-reported ideation was measured using two items from the HDQLIFE Concern with Death and Dying item bank. Independent sample t-tests were conducted to compare the prevalence of suicidal thoughts between our HD sample and the U.S. …

Onset Of Multiple Chronic Conditions And Depressive Symptoms: A Life Events Perspective., Maureen Wilson-Genderson, Allison R Heid, Rachel Pruchno

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Background: While the association between depressive symptoms and chronic illness has been the subject of many studies, little is known about whether depressive symptoms differ as a function of the illnesses people have as they transition to living with multiple chronic conditions.

Methods: Self-reports of five diagnosed chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) and depressive symptoms were provided by 3,396 people participating in three waves of the ORANJ BOWL

Results: Between 2006 and 2014, controlling for age, gender, income, race, and a lifetime diagnosis of depression, people who transitioned to having a diagnosis of multiple chronic …

The Cognition-Enhancing Effects Of Psychostimulants Involve Direct Action In The Prefrontal Cortex, Robert C. Spencer, David M. Devilbiss, Craig Berridge

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Psychostimulants are highly effective in the treatment of attention-deficit/hyperactivity disorder. The clinical efficacy of these drugs is strongly linked to their ability to improve cognition dependent on the prefrontal cortex (PFC) and extended frontostriatal circuit. The procognitive actions of psychostimulants are only associated with low doses. Surprisingly, despite nearly 80 years of clinical use, the neurobiology of the procognitive actions of psychostimulants has only recently been systematically investigated. Findings from this research unambiguously demonstrate that the cognition-enhancing effects of psychostimulants involve the preferential elevation of catecholamines in the PFC and the subsequent activation of norepinephrine α2 and dopamine D1 receptors. …

Psychostimulants As Cognitive Enhancers: The Prefrontal Cortex, Catecholamines And Attention Deficit Hyperactivity Disorder, Craig Berridge, David M. Devilbiss

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Psychostimulants exert behavioral-calming and cognition-enhancing actions in the treatment of attention deficit hyperactivity disorder (ADHD). Contrary to early views, extensive research demonstrates that these actions are not unique to ADHD. Specifically, when administered at low and clinically-relevant doses, psychostimulants improve a variety of behavioral and cognitive processes dependent on the prefrontal cortex (PFC) in subjects with and without ADHD. Despite the longstanding clinical use of these drugs, the neural mechanisms underlying their cognition-enhancing/therapeutic actions have only recently begun to be examined. At behaviorally-activating doses, psychostimulants produce large and widespread increases in extracellular levels of brain catecholamines. In contrast, cognition-enhancing doses …