Psychiatry Commons^™

Mindfulness Based Stress Interventions In Physician Assistant Programs, Lucas Vance

Physician Assistant Capstones, 2020-current

Mindfulness based interventions (MBI) have been used successfully in a variety of venues from the treatment of chronic pain to reducing stress in the workplace. The benefits of MBI programs that have been studied range from self-reported anxiety, depression, and empathy levels to levels of cortisol¹ to amygdala changes seen on magnetic resonance imaging.² MBI programs have been studied in pre-medical, medical, and graduate schools, as well as, nursing programs, and generalized healthcare cohorts.

Accuracy Of Psychiatrists' Assessment Of Medication Adherence In An Outpatient Setting., Katherine B. Martin Md

Department of Psychiatry

BACKGROUND: Many patients have uncontrolled psychiatric symptoms because they are not taking their medication as prescribed. Psychiatrists may have difficulty accurately assessing medication adherence, which is important because it helps guide them in how they prescribe. If nonadherence is the cause of uncontrolled symptoms, then strategies to improve adherence are advised. However, if nonadherence is not the cause, then the usual course of action would be to intensify or modify the medication regimen. Knowing whether nonadherence is a factor at the time of an appointment could help guide clinical decision making in real-time.

METHODS: A cohort of established patients in …

Clinically Relevant Interactions Between Atypical Antipsychotics And Anti-Infective Agents, Edoardo Spina, Maria Antonietta Barbieri, Giuseppe Cicala, Jose De Leon

Psychiatry Faculty Publications

This is a comprehensive review of the literature on drug interactions (DIs) between atypical antipsychotics and anti-infective agents that focuses on those DIs with the potential to be clinically relevant and classifies them as pharmacokinetic (PK) or pharmacodynamic (PD) DIs. PubMed searches were conducted for each of the atypical antipsychotics and most commonly used anti-infective agents (13 atypical antipsychotics by 61 anti-infective agents/classes leading to 793 individual searches). Additional relevant articles were obtained from citations and from prior review articles written by the authors. Based on prior DI articles and our current understanding of PK and PD mechanism, we developed …

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 Departmental Research

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

Retraction Note: Identification Of De Novo Mutations In Prenatal Neurodevelopment-Associated Genes In Schizophrenia In Two Han Chinese Patient-Sibling Family-Based Cohorts (Translational Psychiatry, (2020), 10, 1, (307), 10.1038/S41398-020-00987-Z), Shan Jiang, Daizhan Zhou, Yin Ying Wang, Peilin Jia, Chunling Wan, Xingwang Li, Guang He, Dongmei Cao, Xiaoqian Jiang, Kenneth S. Kendler, Ming Tsuang, Travis Mize, Jain Shing Wu, Yimei Lu, Lin He, Jingchun Chen, Zhongming Zhao, Xiangning Chen

School of Medicine Faculty Research

© 2020, The Author(s). This article1 has been retracted at the request of Authors Xingwang Li and Lin He. After publication, it was realized that approval to use data from the NSFC-NIH Sino-US cooperation project (Project No. 81361120389) was not obtained from the data owners. Authors Dongmei Cao, Xiangning Chen, Lin He, Kenneth Kendler, Xingwang Li, Travis Mize, Chunling Wan and Jain-Shing Wu agree to this retraction. Authors Shan Jiang, Jingchun Chen and Zongming Zhao do not agree to this retraction. Authors Guang He, Peilin Jia, Xiaoqian Jiang, Yimei Lu, Ming Tsuang, Yin-Ying Wang and Daizhan Zhou did not respond …

Low Cognitive Function Is Associated With Reduced Functional Fitness Among Community-Dwelling Older Adults, Michelle Gray, Joshua Gills, Jordan Glenn, Erica Madero, Aidan Hall, Nami Fuseya, Jennifer Vincenzo, Nick Bott

Health, Human Performance and Recreation Faculty Publications and Presentations

Among older adults over 70, 22-30% report difficulty performing at least one activity of daily living (ADL). While the precipitants of ADL decline are multifactorial, over 50% of cognitively impaired adults require assistance with ADLs. The exact relationship between cognitive and functional decline remains unknown, but it is important to understand their relationship. Eighty-three older adults (80.9 + 5.4 years) enrolled in this study and completed functional fitness and cognitive assessments. Functional fitness assessments included: Short Physical Performance Battery (SPPB), 10-meter walk, dual-task, and power chair stand (average and peak). Cognition was assessed using the Montreal Cognitive Assessment (MoCA) and …

Neuropsychiatric Presentation Of Covid-19: A Case Report Of Disinhibition In An Acute Sars-Cov-2 Infection, I. Jack Abramson, Kristy A. Fisher, Clara V. Alvarez, Jacqueline Horan Fisher

HCA Healthcare Journal of Medicine

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral infection is notable for a high degree of symptom diversity. Emerging evidence suggests viral invasion of the central nervous system; therefore, serious neurological and psychiatric manifestations are anticipated. We present the case of a 67-year-old male physician with a history of stable Bipolar Disorder for decades, hospitalized for persistent COVID-19 symptoms with documented positive serology, who presented with new and acute onset neuropsychiatric symptoms of disinhibition proximate the viral infection. We postulate neuroinvasion as the putative origin of the patient’s psychiatric instability. Further investigation is needed to expand upon our understanding of the …

Corticotropin-Releasing Factor Infusion In The Bed Nucleus Of The Stria Terminalis Of Lactating Mice Alters Maternal Care And Induces Behavioural Phenotypes In Offspring, Kerstin Camile Creutzberg, Érika Kestering-Ferreira, Thiago Wendt Viola, Luis Eduardo Wearick-Silva, Rodrigo Orso, Bernardo Aguzzoli Heberle, Lucas Albrechet-Souza, Rosa Maria Martins De Almeida, Rodrigo Grassi-Oliveira

School of Medicine Faculty Publications

The peripartum period is accompanied by numerous physiological and behavioural adaptations organised by the maternal brain. These changes are essential for adequate expression of maternal behaviour, thereby ensuring proper development of the offspring. The corticotropin-releasing factor (CRF) plays a key role in a variety of behaviours accompanying stress, anxiety, and depression. There is also evidence that CRF contributes to maladaptations during the peripartum period. We investigated the effects of CRF in the bed nucleus of the stria terminalis (BNST) of lactating mice during maternal care and analysed locomotor activity and anxiety-like behaviour in the offspring. The BNST has been implicated …

Reflecting On The First Year Of A New Psychiatric Econsult Service, Katherine B. Martin Md, Edward R. Norris Md, Fapa, Fapm, Rory L. Marraccini Md, Shanthi P. Lewis Md, Cecilia E. Zemanek Bs

Department of Psychiatry

No abstract provided.

Reliability And Validity Of The Rs14 In Orphaned And Separated Adolescents And Youths In Western Kenya, Sarah C. Sutherland, Harry S. Shannon, David Ayuku, David L. Streiner, Olli Saarela, Lukoye Atwoli, Paula Braitstein

Internal Medicine, East Africa

Purpose: The 14-item Resilience Scale (RS14) is a tool designed to measure psychological resilience. It has been used effectively in diverse populations. However, its applicability is largely unknown for Sub-Saharan adolescent populations and completely unknown for orphaned and separated adolescents and youths (OSAY), a highly vulnerable population for whom resilience may be critical. This study assesses the RS14's psychometric properties for OSAY in Uasin Gishu County, Kenya.

Methods: Survey responses from a representative sample of 1016 OSAY (51.3% female) aged 10-25 (mean = 16; SD = 3.5) living in institutional and home-based environments in Uasin Gishu County were analyzed. The …

Perampanel-Induced Cataplexy In A Young Male With Generalized Epilepsy, Kelsey Kenaan, Mohsin Zafar, Ronnie Bond, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Perampanel (Fycompa) is a newer anti-epileptic drug believed to exert its effects in the central nervous system by inhibiting post-synaptic glutamate receptors. However, the precise therapeutic mechanism is unknown. The most common neuropsychiatric side effect is affective dysregulation; there are also reports of psychosis. We describe a 32 year old African American male with recurring generalized tonic-clonic (GTC) seizures, who presented to our hospital with onset of mood lability for several months, after Perampanel was added to his antiepileptic medications. Perampanel administration was temporarily withheld, and subsequently on restarting, noted to be coincident with neuropsychiatric symptomatology, including motor weakness in …

Antipsychotic Treatment Experiences Of People With Schizophrenia: Patient Perspectives From An Online Survey, Martha Sajatovic

Faculty Scholarship

Background: This survey examined the experiences of people living with schizophrenia who have used oral antipsychotics (APs). Methods: Adults with self-reported physician-diagnosed schizophrenia (N=200), who were members of an online research participation panel and reported taking one or more oral APs within the last year, completed a cross-sectional online survey that focused on direct report of their experiences regarding APs (eg, symptoms, side effects, adherence). Descriptive analyses were conducted for the total survey sample and for subgroups defined a priori by experience with specific, prevalent side effects. Results: The mean age of the sample was 41.9 (SD=11.0) years, 50% of …

Association Of Depression And Resilience With Fertility Quality Of Life Among Patients Presenting To The Infertility Centre For Treatment In Karachi, Pakistan, Shireen Shehzad Bhamani, Nida Zahid, Wajeeha Zahid, Salima Farooq, Saima Sachwani, Marilyn Chapman, Nargis Asad

School of Nursing & Midwifery

Background: In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors.
Methods: An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version …

Clinical Approach To A Request For Phentermine-Topiramate In A Young Woman With A History Of High-Risk Eating Behavior, Erin Spencer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Safer DL, Adler S, Dalai SS, et al. A randomized, placebo-controlled crossover trial of phentermine-topiramate ER in patients with binge-eating disorder and bulimia nervosa. Int J Eat Disord. 2019;(September):1-12. https://doi.org/10.1002/eat.23192 to inform the clinical decision of whether or not to prescribe phentermine-topiramate to an overweight 27-year-old woman who endorses risky eating behaviors.

Go On With The Good Work – The Still-Hildreth Osteopathic Sanatorium, Part 2, Robyn Oro

Notes from the Archives

No abstract provided.

The Reliability, Validity And Factorial Structure Of The Swahili Version Of The 7-Item Generalized Anxiety Disorder Scale (Gad-7) Among Adults Living With Hiv From Kilifi, Kenya, Moses K. Nyongesa, Paul Mwangi, Hans M. Koot, Pim Cuijpers, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Generalized Anxiety Disorder (GAD) is under-investigated in people living with HIV/AIDS from sub-Saharan Africa. In part, this is due to paucity of culturally appropriate measures for GAD which are psychometrically robust. This study aimed to evaluate the reliability, factorial structure, and validity of Swahili version of the 7-item GAD questionnaire (GAD-7) among adults living with HIV.

Study design: Descriptive cross-sectional study.

Methods: 450 adults receiving comprehensive care from an HIV specialized clinic in Kilifi County, coastal Kenya, were consecutively recruited. Swahili versions of GAD-7, Patient Health Questionnaire (PHQ-9) and a 12-item HIV stigma scale were administered alongside measures of …

Carbamazepine-Induced Dress Syndrome: A Case Report, Andrada Luciana Lazar, Olga Hilda Orășan, Corina Baican, Nicolae Voicu Rednic, Adela Sitar-Tăut, Bogdan Man, Vasile Negrean, Nicolae Rednic, Angela Cozma

Journal of Mind and Medical Sciences

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, idiosyncratic, acute adverse drug reaction. Fever, morbilliform cutaneous eruption, and eosinophilia are essential features for the diagnosis of this syndrome, along with significant multisystem involvement, hepatitis being the most common, followed by nephritis. The pathogenesis of DRESS syndrome is not yet fully understood. Several hypotheses have been proposed which support the involvement of an intricate interplay of multiple factors. We report a clinical case of DRESS syndrome with renal injury, induced by carbamazepine, in a patient with alcohol abstinence syndrome. In order to define the case, the …

When Myocardial Infarction Is Choosing Young Victims, Cristina Nedelcu, Mihaela Ionescu, Paris Ionescu, Vitalie Morosanu, Gabriel Smarandache, Dumitru Cristinel Badiu, Florentina Gherghiceanu, Vlad Denis Constantin, Emanuele Maria Merlo, Daniel Niţă

Journal of Mind and Medical Sciences

We present the case of a 31-year-old patient, without cardiovascular risk factors, without significant pathological or family history of cardiovascular disease, who was diagnosed with severe coronary artery disease, left main bifurcation localization, which required surgical coronary revascularization. The angiographic and intraoperative aspect excluded the most common causes of non-atherosclerotic causes of coronary lesions. Vasculitis was another possible etiology but was also excluded based on the normal clinical examination, negative inflammation markers, lack of diffuse vascular impairment, TPHA and negative VDRL. Prolonged mental stress can lead to accelerated progression of atherosclerosis by inducing endothelial dysfunction, our patient describing a “burnout …

Covid-19 Outbreak Impact On Plastic Surgery Residents From Romania, Cristina N. Marina, Daniela E. Gheoca-Mutu, Laura Răducu, Adelaida Avino, Lăcrămioara A. Brîndușe, Corina M. Stefan, Razvan V. Scaunasu, Cristian R. Jecan

Journal of Mind and Medical Sciences

The COVID-19 outbreak triggered a global crisis with long-term effects on people’s daily lives. It has altered surgical practice and education and imposed major changes in healthcare systems and resources. In order to analyze the impact the COVID-19 pandemic has had on Romanian Plastic Surgery residents, we carried out an anonymous questionnaire through Google forms. Survey items addressed aspects such as how the pandemic has affected their surgical practice, their exposure to the virus, and the protective measures that have been implemented to minimize risk. Among other results, our study found that nearly 1 in 5 respondents had contact with …

The Quality Of Sexual Life After Vaginal Surgical Interventions, Maria Pană, Romina-Marina Sima, Oana-Denisa Bălălău, Anca-Daniela Stănescu, Liana Pleş, Mircea-Octavian Poenaru

Journal of Mind and Medical Sciences

Introduction. The malfunction of the supporting pelvic system generates signs and symptoms that require various procedures. The aim of our study was to evaluate whether vaginal surgical interventions for genital prolapse or urinary incontinence have an impact on patients’ sexual quality of life. Materials and methods. We studied 40 eligible women who underwent vaginal surgical procedures in Saint John Hospital, Bucharest. Patients completed a questionnaire 6 months after the intervention. Results. Patients who underwent vaginal surgery for prolapse were 50-64 years of age. The most frequent vaginal surgical intervention was vaginal hysterectomy (32.5%), followed by anterior and …

Work Place Impact On Mental Wellbeing Of Frontline Doctors, Vishnupriya Veeraraghavan, Krishnan Srinivasan

Journal of Mind and Medical Sciences

Background. Coronavirus Disease 2019 (COVID-19, also known as 2019-nCoV), a cluster of acute respiratory illness with unknown causes, has occurred in India since January 2020. Over the past several months, the entire world is struggling to cope with and contain the virus spread. Several studies showed that mental health problems could occur in both healthcare workers and SARS survivors during the SARS epidemic. Considering the geographical variation, dense population, multi-strata health care structure, and rising COVID cases in South India, we have a reason to speculate that the burden on the frontline doctors is high and their psychological condition …

Indicators Of Psychological Distress And Body Image Disorders In Female Patients With Breast Cancer, Helena Van Oers, Lourens Schlebusch

Journal of Mind and Medical Sciences

Breast cancer patients are vulnerable to elevated stress related to receiving the diagnosis, unfamiliar and invasive treatment, and coping with the side-effects of treatment, which may find various forms of expression. Another common feature of this patient population is body image dysphoria. Both the disease and treatment lead to impairments in physical appearance and general bodily functioning. This study aimed to explore the differential manifestations of stress and the nature of body image dysphoria within a sample of female breast cancer patients (n=80), compared to female patients with other sites of disease (n=80) in order to examine differences in the …

Assessing Test Anxiety And Resilience Among Greek Adolescents During Covid-19 Pandemic, Sofia Sakka, Vasiliki Aliki Nikopoulou, Eleni Bonti, Paraskevi Tatsiopoulou, Panayiota Karamouzi, Aikaterini Giazkoulidou, Virginia Tsipropoulou, Eleni Parlapani, Vasiliki Holeva, Ioannis Diakogiannis

Journal of Mind and Medical Sciences

The aim of the present study was to explore the impact of school year’s extension due to the coronavirus pandemic (COVID-19) by addressing test anxiety and by studying the coping strategies adolescents used to overcome it. For the majority of the adolescents the final exams can be a powerful source of stress, since the entrance examinations are required for admission into higher education and further reflect the transition to adulthood. The sample consisted of 67 High School students and the data collection was conducted online due to the imposed measures by the Greek government. Results showed normal or average levels …

Implementing Nudges For Suicide Prevention In Real-World Environments: Project Inspire Study Protocol, Molly Davis, Courtney Benjamin Wolk, Shari Jager-Hyman, Rinad S Beidas, Jami F Young, Jennifer A Mautone, Alison M Buttenheim, David S Mandell, Kevin G Volpp, Katherine Wislocki, Anne Futterer, Darby Marx, E L Dieckmeyer, Emily M Becker-Haimes

College of Life Sciences Faculty Papers

Background: Suicide is a global health issue. There are a number of evidence-based practices for suicide screening, assessment, and intervention that are not routinely deployed in usual care settings. The goal of this study is to develop and test implementation strategies to facilitate evidence-based suicide screening, assessment, and intervention in two settings where individuals at risk for suicide are especially likely to present: primary care and specialty mental health care. We will leverage methods from behavioral economics, which involves understanding the many factors that influence human decision making, to inform strategy development.

Methods: We will identify key mechanisms that limit …

Time For Some Drugs Or Drugs For Some Time, Linda Zhang, Lauren Wilson, Benjamin Pierce

Psychiatry

No abstract provided.

12 Tips To Guarantee A Fragmented (Absolutely Terrible) Curriculum In A Time Of Crisis, Constance Tucker, Abigail Kay

Department of Psychiatry and Human Behavior Faculty Papers

Medical education scholarship is filled with articles focused on rigorous curriculum design and innovation. In the midst of a public health crisis, the authors aim to provide a reflective guide to curriculum development focused on curriculum gone wrong. The authors propose twelve recommendations that will bring all educators closer to curricular failure.

Linguistic Analysis Of Empathy In Medical School Admission Essays, Mary Yaden, David Yaden, Anneke Buffone, Johannes Eichstaedt, Patrick Crutchley, Laura Smith, Jonathan Cass, Clara Callahan, Susan Rosenthal, Lyle Ungar, Andrew Schwartz, Mohammadreza Hojat

Department of Psychiatry and Human Behavior Faculty Papers

Objectives: This study aimed to determine whether words used in medical school admissions essays can predict physician empathy.

Methods: A computational form of linguistic analysis was used for the content analysis of medical school admissions essays. Words in medical school admissions essays were computationally grouped into 20 'topics' which were then correlated with scores on the Jefferson Scale of Empathy. The study sample included 1,805 matriculants (between 2008-2015) at a single medical college in the North East of the United States who wrote an admissions essay and completed the Jefferson Scale of Empathy at matriculation.

Results: After correcting for multiple …

Gautama Buddha: Illustration Of A Patient’S Vision, Haryashpal Bhullar

HCA Healthcare Journal of Medicine

As a psychiatrist in training, I often have the privilege to connect with the unique thoughts and visions patients may be experiencing. The descriptions shared by one patient during my early psychiatry inpatient rotations stuck with me and eventually inspired me to pursue a residency in the field. While interviewing, she expressed a deep spirituality and often finding solace in the mindfulness teachings of Gautama Buddha whenever she was distressed. She would strengthen this coping mechanism by contemplating him sitting and meditating deeply, within a naturalistic setting, however struggled in describing exactly what she was imagining. I further gathered this …

Substance Use Service Availability In Hiv Treatment Programs: Data From The Global Iedea Consortium, 2014-2015 And 2017, Angela M. Parcesepe, Kathryn Lancaster, E. Jennifer Edelman, Raquel Deboni, The Foundation For Aids Research, Bangkok, Thailand, Lukoye Atwoli

Internal Medicine, East Africa

Background: Substance use is common among people living with HIV and has been associated with suboptimal HIV treatment outcomes. Integrating substance use services into HIV care is a promising strategy to improve patient outcomes.

Methods: We report on substance use education, screening, and referral practices from two surveys of HIV care and treatment sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. HIV care and treatment sites participating in IeDEA are primarily public-sector health facilities and include both academic and community-based hospitals and health facilities. A total of 286 sites in 45 countries participated in the 2014–2015 …

A Literature Review: An Analysis Of The Widespread Effects Of Solitary Confinement/Social Isolation On Mental Illness And Mortality, Taneasha Muonio

Theses and Graduate Projects

Solitary confinement or isolation is widespread globally and has been used as a form of punishment, reform, reflection, and cleansing throughout time. The devastating impacts of not having social interactions for extended periods of time have been documented and noted.1 These impacts include severe mental health disorders such as schizophrenia, bipolar disorder, anxiety, depression, post-traumatic stress disorder (PTSD), suicide, motor disturbances, biological changes, and increased mortality.1-3 The analysis of how the United States became the country with the largest prison system and mentally ill population is addressed in this thesis including understanding how the prison-industrial complex was built. Understanding how …