Psychiatry Commons^™

Depression With Pain Co Morbidity Effect On Quality Of Life Among Hiv Positive Patients In Uganda: A Cross Sectional Study, Shirley Moore, Martha Sajatovic

Faculty Scholarship

Background: Depression with pain comorbidity (DPC) has not been clearly defined among HIV positive patients in sub-Saharan Africa. It still remains a challenge despite many studies in Africa documenting a high prevalence of pain and depression among people living with HIV/AIDS. Both are associated with a grave impact on the health related outcomes in this pandemic. This study aimed at determining the prevalence, factors associated and effect on quality of life of DPC among HIV positive patients. Methods: In a cross-sectional survey, 345 HIV positive patients were enrolled into the study. Using a pre-tested standardised questionnaire the presence of DPC …

Knowledge, Attitudes And Perceptions Of Stroke: A Cross-Sectional Survey In Rural And Urban Uganda, Svetlana Pundik, Anthony J. Furlan, Martha Sajatovic

Faculty Scholarship

Background: Information regarding the increasing burden of non-communicable diseases such as stroke is largely unknown among the vulnerable communities. This analysis, which is part of a larger U.S. National Institute of Heath-funded Medical Education Partnership Initiative neurological disorder survey, assessed community knowledge and attitudes on stroke and stroke risk factors. Methods: A population cross-sectional survey was conducted in urban and rural Mukono, district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants who were interviewed about selected aspects of stroke knowledge, attitudes and perception using a pretested structured questionnaire. Results: A total of 377 participants …

Asenapine For Bipolar Disorder, Thomas Scheidemantel, Irina Korobkova, Martha Sajatovic

Faculty Scholarship

Asenapine (Saphris®) is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD). Data from randomized, double-blind trials comparing asenapine to placebo or olanzapine in the …

Describing The Prevalence And Awareness Of Sport-Related Concussion In University Intramural And Club Sport Participants, Makenzie L. Brown

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Concussion injuries are growing in number among athletes across the nation. The majority of concussion research to date focuses on collegiate and high school athletes. University athletes make up a small percentage of the student body population compared to the large number of students that participate in club and intramural sports. These students participate in the same sports, assume the same risks, and may experience the same adverse effects of concussion, often without appropriate medical oversight.

Purpose: The purpose of this study was to determine if concussion is a problem among intramural and club sport participants, if these participants …

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

Marshall Journal of Medicine

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 …

Knowledge And Attitudes Of Parkinson's Disease In Rural And Urban Mukono District, Uganda: A Cross-Sectional, Community-Based Study, Martha Sajatovic

Faculty Scholarship

Background. Parkinson's disease (PD) negatively affects the quality of life. There is limited information on PD published from Africa. Lack of adequate knowledge poses a barrier in the provision of appropriate treatment and care for individuals with PD. Methods. A cross-sectional survey was conducted in urban and rural Mukono district, central Uganda. Through the systematic sampling method, data were gathered from 377 adult participants, interviewed on selected aspects of PD knowledge and attitudes. Results. Of the 377 participants, 47% were from urban settings and 68% (260/377) were women with a median age (IQR) of 34 (26-48) years. Half of the …

Standards Of Evidence For Efficacy, Effectiveness, And Scale-Up Research In Prevention Science: Next Generation., Denise C. Gottfredson, Thomas D. Cook, Frances E.M. Gardner, Deborah Gorman-Smith, George W. Howe, Irwin N. Sandler, Kathryn M. Zafft

Psychiatry and Behavioral Sciences Faculty Publications

A decade ago, the Society of Prevention Research (SPR) endorsed a set of standards for evidence related to research on prevention interventions. These standards (Flay et al., Prevention Science 6:151-175, 2005) were intended in part to increase consistency in reviews of prevention research that often generated disparate lists of effective interventions due to the application of different standards for what was considered to be necessary to demonstrate effectiveness. In 2013, SPR's Board of Directors decided that the field has progressed sufficiently to warrant a review and, if necessary, publication of "the next generation" of standards of evidence. The Board convened …

Early Mortality And Functional Outcome After Acute Stroke In Uganda: Prospective Study With 30 Day Follow-Up, Martha Sajatovic

Faculty Scholarship

Identification of early outcomes post stroke and their predictors is important in stroke management strategies. We prospectively analysed 30-day outcomes (mortality and functional ability) after stroke and their predictors among patients admitted within 7 days post event to a national referral hospital in Uganda. This was a prospective study of acute stroke patients consecutively enrolled between February and July 2014. Social demographics, clinical, laboratory, imaging characteristics, outcomes (all through 30 days), time of death were assessed using standardised questionnaires. Multiple regression was used to analyse the independent influence of factors on outcomes. Of 127 patients, 88 (69.3 %) had ischemic …

A Technology-Enabled Adherence Enhancement System For People With Bipolar Disorder: Results From A Feasibility And Patient Acceptance Analysis, Martha Sajatovic, Kristina A. Cassidy, Johnny Sams, Edna Fuentes-Casiano

Faculty Scholarship

Objective: As poor medication adherence is common in bipolar disorder (BD), technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system. Methods: This prospective study tested the system in five BD patients over a 15-day period. System components included: 1) an automated pill cap with remote monitoring sensor; 2) a multimedia adherence enhancement program; and 3) a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale), knowledge …

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 Departmental Research

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. …

Clinical Management Of Insomnia, Karl Doghramji, Paul P. Doghramji

Department of Psychiatry and Human Behavior Faculty Papers

Throughout the book, we are guided by our main goal of providing practitioners with clinically relevant, evidence-based, and state-of-the-art information in the evaluation and management of insomnia. We have made a concerted attempt to ensure that our reviews are consistent with professional guidelines to the extent that current knowledge permits.

Genetic Polymorphisms And Antidepressant Adverse Effects, Rajnish Mago, S. Gupta, Kelly Huhn, R. Shah

Department of Psychiatry and Human Behavior Faculty Papers

Abstract

Background

Aim: to assess whether pharmacogenetic polymorphisms are associated with increased adverse effects or non-response with certain antidepressants whose metabolism is highly dependent on specific CYP450 isoenzymes. This is interim analysis of an ongoing study

Methods

We used a Case Control design comparing patients with major depressive disorder or generalized anxiety disorder who had had increased adverse effects from specified antidepressants (Cases) to patients who were poor responders to an antidepressant but without significant adverse effects (Controls) Genecept Assay™ (battery of pharmacogenetic tests relevant to psychiatry) was obtained using saliva or cheek swab

Results

Importantly, 57.1% of Cases were …

Distinguishing Originality From Creativity In Adhd: An Assessment Of Creative Personality, Self-Perception, And Cognitive Style Among Attention-Deficit/Hyperactivity Disorder Adults, Jean-Pierre J. Issa

Creative Studies Graduate Student Master's Theses

Debates over whether Attention-Deficit/Hyperactivity Disorder (ADHD) relates to high levels of creativity have been hampered by a lack of rigor when defining creativity. The purpose of the present study was to go beyond the rhetoric by empirically investigating creative personality, creative self-perception, and cognitive style among 49 ADHD adults. Comparative analysis to studies of non-ADHD samples revealed distinctive tendencies: A mean group score of 115.71 (SD=18.02) on the Kirton Adaption-Innovation Inventory (KAI) indicated preferences for originality, nonconformity, paradigm-breaking, and low efficiency that was over one standard deviation higher than average non-ADHD population scores. Combined inattentive/hyperactiveimpulsive subtypes (n …

Negative Symptoms And Impaired Social Functioning Predict Later Psychosis In Latino Youth At Clinical High Risk In The North American Prodromal Longitudinal Studies Consortium, Tracy Alderman, Jean Addington, Carrie Bearden, Tyrone D. Cannon, B. A. Cornblatt, Thomas H. Mcglashan, Diana O. Perkins, Elaine F. Walker, Scott W. Woods, Kristin S. Cadenhead, +2 Additional Authors

Journal Articles

No abstract provided.

Alcohol Confounds Relationship Between Cannabis Misuse And Psychosis Conversion In A High-Risk Sample, A. M. Auther, K. S. Cadenhead, R. E. Carrion, J. Addington, C. E. Bearden, T. D. Cannon, T. H. Mcglashan, E. F. Walker, S. W. Woods, B. A. Cornblatt, +3 Additional Authors

Journal Articles

ObjectiveCannabis use has been examined as a predictor of psychosis in clinical high-risk (CHR) samples, but little is known about the impact of other substances on this relationship. MethodSubstance use was assessed in a large sample of CHR participants (N=370, mean age=18.3) enrolled in the multisite North American Prodrome Longitudinal Study Phase 1 project. Three hundred and forty-one participants with cannabis use data were divided into groups: No Use (NU, N=211); Cannabis Use without impairment (CU, N=63); Cannabis Abuse/Dependence (CA/CD, N=67). Participants (N=283) were followed for 2years to determine psychosis conversion. ResultsAlcohol (45.3%) and cannabis (38.1%) were the most common …

Interpersonal Functioning In Obsessive-Compulsive Personality Disorder, N. M. Cain, E. B. Ansell, H. B. Simpson, A. Pinto

Journal Articles

The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. This study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others, whereas OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported …

Ld Score Regression Distinguishes Confounding From Polygenicity In Genome-Wide Association Studies, B. K. Bulik-Sullivan, P. R. Loh, H. K. Finucane, S. Ripke, J. Yang, N. Patterson, M. J. Daly, A. L. Price, B. M. Neale, A. Malhotra

Journal Articles

Both polygenicity (many small genetic effects) and confounding biases, such as cryptic relatedness and population stratification, can yield an inflated distribution of test statistics in genome-wide association studies (GWAS). However, current methods cannot distinguish between inflation from a true polygenic signal and bias. We have developed an approach, LD Score regression, that quantifies the contribution of each by examining the relationship between test statistics and linkage disequilibrium (LD). The LD Score regression intercept can be used to estimate a more powerful and accurate correction factor than genomic control. We find strong evidence that polygenicity accounts for the majority of the …

A Common Polymorphism In Scn2a Predicts General Cognitive Ability Through Effects On Pfc Physiology, M. A. Scult, J. W. Trampush, F. Zheng, E. D. Conley, T. Lencz, A. K. Malhotra, D. Dickinson, D. R. Weinberger, A. R. Hariri

Journal Articles

Here we provide novel convergent evidence across three independent cohorts of healthy adults (n = 531), demonstrating that a common polymorphism in the gene encoding the alpha2 subunit of neuronal voltage-gated type II sodium channels (SCN2A) predicts human general cognitive ability or "g." Using meta-analysis, we demonstrate that the minor T allele of a common polymorphism (rs10174400) in SCN2A is associated with significantly higher "g" independent of gender and age. We further demonstrate using resting-state fMRI data from our discovery cohort (n = 236) that this genetic advantage may be mediated by increased capacity for information processing between the dorsolateral …

Demographic Correlates Of Attenuated Positive Psychotic Symptoms, R. N. Waford, A. Macdonald, K. S. Cadenhead, T. D. Cannon, B. A. Cornblatt, R. Heinssen, D. O. Perkins, L. J. Seidman, S. W. Woods, T. H. Mcglashan, +8 Additional Authors

Journal Articles

It is now well established that the utilization of standardized clinical criteria can enhance prediction of psychosis. These criteria are primarily concerned with the presence and severity of attenuated positive symptoms. Because these symptom criteria are used to derive algorithms for designating clinical high risk (CHR) status and for maximizing prediction of psychosis risk, it is important to know whether the symptom ratings vary as a function of demographic factors that have previously been linked with symptoms in diagnosed psychotic patients. Using a sample of 356 CHR individuals from the NAPLS-II multi-site study, we examined the relation of three sex, …

Association Of A Schizophrenia Risk Variant At The Drd2 Locus With Antipsychotic Treatment Response In First-Episode Psychosis, J. P. Zhang, D. G. Robinson, Juan Gallego, M. John, J. Yu, J. Addington, M. Tohen, John Kane, Anil Malhotra, T. Lencz

Journal Articles

Findings from the Psychiatric Genomics Consortium genome-wide association study (GWAS) showed that variation at the DRD2 locus is associated with schizophrenia risk. However, the functional significance of rs2514218, the top DRD2 single nucleotide polymorphism in the GWAS, is unknown. Dopamine D2 receptor binding is a common mechanism of action for all antipsychotic drugs, and DRD2 variants were related to antipsychotic response in previous studies. The present study examined whether rs2514218 genotype could predict antipsychotic response, including efficacy and adverse events, in a cohort of patients with first episode of psychosis treated with either risperidone or aripiprazole for 12 weeks. Subjects …

Clinical And Functional Outcomes After 2 Years In The Early Detection And Intervention For The Prevention Of Psychosis Multisite Effectiveness Trial, W. R. Mcfarlane, B. Levin, L. Travis, F. L. Lucas, S. Lynch, M. Verdi, Barbara Cornblatt, S. F. Taylor, A. M. Auther, E. Spring, +11 Additional Authors

Journal Articles

OBJECTIVE: To test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth. METHODS: In a risk-based allocation study design, 337 youth (age 12-25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted …

Insistence On Sameness Relates To Increased Covariance Of Gray Matter Structure In Autism Spectrum Disorder., Ian W Eisenberg, Gregory L Wallace, Lauren Kenworthy, Stephen J Gotts, Alex Martin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Autism spectrum disorder (ASD) is characterized by atypical development of cortical and subcortical gray matter volume. Subcortical structural changes have been associated with restricted and repetitive behavior (RRB), a core component of ASD. Behavioral studies have identified insistence on sameness (IS) as a separable RRB dimension prominent in high-functioning ASD, though no simple brain-behavior relationship has emerged. Structural covariance, a measure of morphological coupling among brain regions using magnetic resonance imaging (MRI), has proven an informative measure of anatomical relationships in typical development and neurodevelopmental disorders. In this study, we use this measure to characterize the relationship between brain …

Cannabinoid Cb2 Receptors In A Mouse Model Of A Beta Amyloidosis: Immunohistochemical Analysis And Suitability As A Pet Biomarker Of Neuroinflammation, A. V. Savonenko, T. Melnikova, Y. C. Wang, H. Ravert, Y. J. Gao, J. Koppel, D. Lee, P. Davies, M. G. Pomper, A. G. Horti, +6 Additional Authors

Journal Articles

In Alzheimer's disease (AD), one of the early responses to A beta amyloidosis is recruitment of microglia to areas of new plaque. Microglial receptors such as cannabinoid receptor 2 (CB2) might be a suitable target for development of PET radiotracers that could serve as imaging biomarkers of A beta-induced neuroinflammation. Mouse models of amyloidosis (J20APPswe/ind and APPswe/PS1 Delta E9) were used to investigate the cellular distribution of CB2 receptors. Specificity of CB2 antibody (H60) was confirmed using J20APPswe/ind mice lacking CB2 receptors. APPswe/PS1 Delta E9 mice were used in small animal PET with a CB2-targeting radiotracer, [C-11]A836339. These studies revealed …

Lifetime Prevalence, Age Of Risk, And Genetic Relationships Of Comorbid Psychiatric Disorders In Tourette Syndrome, M. E. Hirschtritt, P. C. Lee, D. L. Pauls, Y. Dion, M. A. Grados, R. A. King, P. Sandor, W. M. Mcmahon, G. J. Lyon, C. A. Mathews, +4 Additional Authors

Journal Articles

IMPORTANCE: Tourette syndrome (TS) is characterized by high rates of psychiatric comorbidity; however, few studies have fully characterized these comorbidities. Furthermore, most studies have included relatively few participants (

Abnormal Resting State Fmri Activity Predicts Processing Speed Deficits In First-Episode Psychosis, M. Argyelan, J. A. Gallego, D. G. Robinson, T. Ikuta, D. Sarpal, M. John, P. B. Kingsley, J. M. Kane, A. K. Malhotra, P. R. Szeszko

Journal Articles

Little is known regarding the neuropsychological significance of resting state functional magnetic resonance imaging (rs-fMRI) activity early in the course of psychosis. Moreover, no studies have used different approaches for analysis of rs-fMRI activity and examined gray matter thickness in the same cohort. In this study, 41 patients experiencing a first-episode of psychosis (including N = 17 who were antipsychotic drug-naive at the time of scanning) and 41 individually age-and sex-matched healthy volunteers completed rs-fMRI and structural MRI exams and neuropsychological assessments. We computed correlation matrices for 266 regions-of-interest across the brain to assess global connectivity. In addition, independent component …

Expanded Genetic Screening Panel For The Ashkenazi Jewish Population, B. Baskovich, I. Peter, J. H. Cho, G. Atzmon, L. Clark, J. Yu, T. Lencz, I. Pe'er, H. Ostrer, C. Oddoux, +7 Additional Authors

Journal Articles

PURPOSE: Carrier screening programs that identify the presence of known mutations have been effective for reducing the incidence of autosomal recessive conditions in the Ashkenazi Jewish (AJ) population and other populations. Yet, these programs have not realized their full potential. Furthermore, many known autosomal recessive and dominant conditions are not screened for and the molecular basis of other conditions for which screening might be offered is unknown. METHODS: Through literature review and annotation of full sequenced genomes from healthy individuals, we expanded the list of mutations. Mutations were identified in a sample of 128 fully sequenced AJ genomes that were …

Prenatal Exposure To Maternal Smoking And Symptom Severity Among Offspring With First-Episode Nonaffective Psychosis, F. Bernardini, C. R. Wan, A. Crisafio, S. H. Massey, M. T. Compton

Journal Articles

No abstract provided.

Role Of Social Media And The Internet In Pathways To Care For Adolescents And Young Adults With Psychotic Disorders And Non-Psychotic Mood Disorders, M. L. Birnbaum, A. F. Rizvi, Christoph Correll, J. M. Kane

Journal Articles

AIMS: Although psychosis often occurs during adolescence, there has been little research on how the ubiquitously used Internet and social media could impact pathways to care. We examined how youth with psychotic spectrum disorders (PSD) versus non-psychotic mood disorders (NPMD) use online resources in the early illness stages. METHODS: Social media use and pathways to care data were collected using a semi-structured interview from 80 youth (PSD = 40 and NPMD = 40) aged 12-21 years within 2 years of symptom onset. RESULTS: A total of 97.5% of participants (mean age = 18.3 years) regularly used social media, spending approximately …

Evaluating The Impact Of Cannabis Use On Thalamic Connectivity In Youth At Clinical High Risk Of Psychosis, L. Buchy, T. D. Cannon, A. Anticevic, K. Lyngberg, K. S. Cadenhead, B. A. Cornblatt, D. O. Perkins, L. J. Seidman, M. T. Tsuang, J. Addington, +5 Additional Authors

Journal Articles

No abstract provided.

Evaluating The Relationship Between Cannabis Use And Iq In Youth And Young Adults At Clinical High Risk Of Psychosis, L. Buchy, L. J. Seidman, K. S. Cadenhead, T. D. Cannon, B. A. Cornblatt, E. F. Walker, S. W. Woods, C. E. Bearden, D. H. Mathalon, J. Addington, +4 Additional Authors

Journal Articles

Among people with psychosis, those with a history of cannabis use show better cognitive performance than those who are cannabis naive. It is unknown whether this pattern is present in youth at clinical high risk (CHR) of psychosis. We evaluated relationships between IQ and cannabis use while controlling for use of other substances known to impact cognition in 678 CHR and 263 healthy control (HC) participants. IQ was estimated using the Vocabulary and Block Design subtests of the Wechsler Abbreviated Scale of Intelligence. Drug and alcohol use severity and frequency were assessed with the Alcohol and Drug Use Scale, and …