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Articles 1 - 30 of 97
Full-Text Articles in Psychiatry
Involuntary Medication Administration Review: A Historical Look At New Jersey Psychiatric Law And Its Significance, Casey Burke, Joon Min Chun D.O., Ramya Kommidi D.O., Salvatore Montana Messina D.O.
Involuntary Medication Administration Review: A Historical Look At New Jersey Psychiatric Law And Its Significance, Casey Burke, Joon Min Chun D.O., Ramya Kommidi D.O., Salvatore Montana Messina D.O.
Rowan-Virtua Research Day
The legal and ethical evolution of involuntary psychiatric medication in New Jersey has been shaped through the landmark legal cases Rennie v. Klein and Brandt v. Monte. To this effect, this poster explores how each case shaped state hospital policy and the balance between patient autonomy and clinical judgment. Rennie v. Klein (1978) established a constitutional right for involuntarily committed patients to refuse psychotropic medication, except in emergencies or with due process safeguards. Decades later, Brandt v. Monte (2006) exposed flaws in New Jersey’s administrative procedures—particularly Administrative Bulletin 78-3—which permitted coercive practices under the guise of emergency treatment and lacked …
Neuroinflammation And Its Role In Depression– A Review Of Emerging Biomarkers And Therapeutic Targets, Sophia M. Valerino
Neuroinflammation And Its Role In Depression– A Review Of Emerging Biomarkers And Therapeutic Targets, Sophia M. Valerino
Advances in Clinical Medical Research and Healthcare Delivery
Major depressive disorder (MDD) is a prevalent and debilitating mental illness that affects millions globally. Traditionally, the pathophysiology of MDD was thought to be due primarily neurotransmitter imbalances. However, emerging research highlights the role of neuroinflammation in MDD pathogenesis. Elevated levels of pro-inflammatory cytokines, microglial activation, and blood-brain barrier dysfunction have been implicated in the etiology of MDD. Additionally, biomarkers such as C-reactive protein and neuroimaging findings further support the neuroinflammatory hypothesis. This growing body of evidence has led to increased interest in novel treatment approaches, including anti-inflammatory medications and lifestyle interventions, as potential therapeutic strategies. While selective serotonin reuptake …
Suicidality, Self-Neglect, And Medical Refusal In Advanced Illness: An Ethical Case Report, Austin Supak, Sarah Greene, Madeline Adelman, Whitney Snyders
Suicidality, Self-Neglect, And Medical Refusal In Advanced Illness: An Ethical Case Report, Austin Supak, Sarah Greene, Madeline Adelman, Whitney Snyders
Continental and Mountain Divisions GME Resarch Day 2026
No abstract provided.
Educational Attainment And Symptom Improvement In Treatment-Resistant Depression: A Longitudinal Cohort Analysis Across Treatment Modalities, Marjorie Harrison, Giselli Scaini Msc, Phd, Aspen Viamontes
Educational Attainment And Symptom Improvement In Treatment-Resistant Depression: A Longitudinal Cohort Analysis Across Treatment Modalities, Marjorie Harrison, Giselli Scaini Msc, Phd, Aspen Viamontes
Summer Research Program Abstracts
No abstract provided.
The Role Of Ect In Ocd: A 10-Year Review (2014-2024), Mariana Sales, Tainiz Polanco, Amy Nguyen
The Role Of Ect In Ocd: A 10-Year Review (2014-2024), Mariana Sales, Tainiz Polanco, Amy Nguyen
Rowan-Virtua Research Day
Background: Obsessive-compulsive disorder (OCD) affects up to 2.5% of the population with significant impacts on everyday functioning and relationships. First-line treatment includes selective serotonin reuptake inhibitors (SSRI) and cognitive behavioral therapy; however, studies have found that up to 40-60% of patients do not respond to SSRIs. ECT is an alternative approach that has demonstrated limited efficacy in OCD.
Objective: The current review aims to summarize the results of published work between 2014-2024 to assess the efficacy of ECT in the treatment of OCD.
Methods: A literature review was conducted using eight studies from 2014-2024 to assess the effectiveness of ECT …
Beyond The Label: Understanding And Addressing Occupational Stigma In Psychiatry, Mahesh Vasudevan, Madeeha Sheriff
Beyond The Label: Understanding And Addressing Occupational Stigma In Psychiatry, Mahesh Vasudevan, Madeeha Sheriff
Rowan-Virtua Research Day
Introduction:Stigma is a social classification that devalues individuals or groups, and occupational stigma targets entire professions. Psychiatry is particularly affected, often viewed by the public and medical community as lacking scientific rigor and prestige. This negative perception has far-reaching consequences.
Methods:A narrative literature review was conducted to explore the scope, sources, and impact of occupational stigma toward psychiatrists. Peer-reviewed articles and professional resources published between 2002 and 2023 were selected based on relevance to psychiatric stigma, education, and public perception. Databases searched included PubMed, Google Scholar, and professional association websites using keywords such as “psychiatry stigma” and “psychiatrist …
The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri
The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri
Indiana Journal of Law and Social Equality
This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …
Second Generation Antipsychotics And Cardiovascular Adverse Effects: Developing Evidence-Based Recommendations For Primary Care Medicine, Sana Borda, Ahn-Dao Lee, Paul F. Bell
Second Generation Antipsychotics And Cardiovascular Adverse Effects: Developing Evidence-Based Recommendations For Primary Care Medicine, Sana Borda, Ahn-Dao Lee, Paul F. Bell
HCA Healthcare Journal of Medicine
Background
Second-generation antipsychotic medications (SGAs) are often used by primary care physicians (PCPs) to treat multiple psychiatric diagnoses. SGAs have been connected to a number of adverse effects, including cardiovascular disease. Currently, there are no published evidence-based recommendations addressing SGAs and cardiotoxicity that are directed toward PCPs. This project aims to fill this gap.
Methods
Relevant search terms related to SGAs and cardiovascular disease were identified and then used to search databases (PubMed, PubMed Central, and AccessMedicine). Research studies obtained from the searches were narrowed to include systematic reviews and meta-analyses. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool was …
Perceived Disruption Of Covid-19 On Medical Education In Incoming Psychiatric Residents, Steven Sprenger, Ashley Mahajan, Jeffrey Anderson, Napatkamon Ayutyanont, Jessica C. Wells, Gregory Guldner
Perceived Disruption Of Covid-19 On Medical Education In Incoming Psychiatric Residents, Steven Sprenger, Ashley Mahajan, Jeffrey Anderson, Napatkamon Ayutyanont, Jessica C. Wells, Gregory Guldner
HCA Healthcare Journal of Medicine
Background
In 2020, the global COVID-19 pandemic caused educational disruptions to many medical students nationally. Societal and hospital guidelines, including social distancing protocols, resulted in the cancellation or postponement of many elective procedures. A shortage in personal protective equipment also contributed to restrictions in clinical experiences for trainees. The purpose of this study was to determine resident-perceived preparedness in core clinical competencies and evaluate the disruptions to core clerkships.
Methods
A survey was developed to assess self-perceptions of clinical competencies and disruptions to core clerkship experiences. It was distributed to 63 incoming psychiatric residents who were matched to training programs …
Fregoli Case Report, Don D. Shamilov, David F. Lo, Gaurav Kumar
Fregoli Case Report, Don D. Shamilov, David F. Lo, Gaurav Kumar
Rowan-Virtua Research Day
Fregoli Syndrome is a rare delusional disorder in the psychotic spectrum named after Italian actor Leopoldo Fregoli. Existing reports focus on clinical aspects and standard treatments, leaving gaps in understanding complexity and tailored interventions. This case report contributes comprehensive analysis of a young adult male with Fregoli syndrome and emphasizes interplay of psychopathology, neurocognition, and psychosocial factors. This report highlights a holistic approach, including differential diagnosis and psychosocial dynamics and aims to improve diagnostic considerations and personalized treatment strategies for better patient outcomes.
Review Of Psychogenic Nonepileptic Seizures And Patient-Centered Approaches To Care, Rabeel Ahmad, Rebekah Dietrich, Munaza Khan
Review Of Psychogenic Nonepileptic Seizures And Patient-Centered Approaches To Care, Rabeel Ahmad, Rebekah Dietrich, Munaza Khan
Rowan-Virtua Research Day
Psychogenic nonepileptic seizures (PNES) are defined as involuntary experiential and behavioral responses to internal or external stimuli. They are behaviors, not associated with pathological alterations in the physiology of the brain. Although some of them mimic syncope, they have historically been regarded to clinically resemble epileptic episodes.
There is a multiplicity of different names for this condition. PNES is the most widely used term, though the term "functional seizures" is increasingly used. Alternatives such as "psychogenic seizures," "dissociative seizures," "psychogenic nonepileptic attacks" (PNEA), and "nonepileptic seizures" are also used.
Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov
Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov
Rowan-Virtua Research Day
Ms. R, a 32-year-old Hispanic female, suffers from severe anxiety exacerbated by a car accident and past struggles with depression and substance use. Evaluation reveals hypothyroidism, mild anemia, and GAD as the primary diagnosis. Factors contributing to her condition include genetic predispositions, medical issues, and social stressors. Treatment involves pharmacotherapy, psychotherapy, and monitoring her physiological health. Research on wearable data for GAD severity offers potential insights for her treatment. A holistic approach, considering biological, psychological, and social factors, guides her tailored treatment plan for overall well-being.
Trichotillomania Case Report, Kimberly Kluglein, David F. Lo, Don D. Shamilov
Trichotillomania Case Report, Kimberly Kluglein, David F. Lo, Don D. Shamilov
Rowan-Virtua Research Day
Trichotillomania is a psycho-dermatologic disorder involving self-inflicted hair loss through pulling. Often complicated by anxiety and depression. Multifactorial etiology and limited evidence-based treatment options makes management difficult. Treatment approaches include a combination of pharmacotherapy, CBT, HRT, and ACT. Case presentation involves a 24-year-old female, diagnosed with treatment-resistant trichotillomania who achieved remission and hair regrowth through mindset reframing, physical barriers, and community support. Novel approaches focusing on mindset and community support can yield positive outcomes.
Demographic And Psychographic Trends Among Patients Discharged On Multiple Antipsychotics, Nicola Eric, Tringali Joseph, Finazzo John, Jeffrey Ferraro, Eileen Venable, Mark Strickland, Erica Paulos
Demographic And Psychographic Trends Among Patients Discharged On Multiple Antipsychotics, Nicola Eric, Tringali Joseph, Finazzo John, Jeffrey Ferraro, Eileen Venable, Mark Strickland, Erica Paulos
North Florida Division GME Research Day 2024
No abstract provided.
Identifying Demographic Disparities In Urine Drug Screen Ordering In Psychiatric Inpatients, Michael Tompkins, Jacob Henderson, Eileen Venable, Jeffrey Ferraro
Identifying Demographic Disparities In Urine Drug Screen Ordering In Psychiatric Inpatients, Michael Tompkins, Jacob Henderson, Eileen Venable, Jeffrey Ferraro
North Florida Division GME Research Day 2024
No abstract provided.
How Does Ect Treatment Affect The Chances Of Future Psychiatric Hospitalizations? A Retrospective Study, Aneesh Rahangdale, Joshua Wasdin, Jeffrey Ferraro
How Does Ect Treatment Affect The Chances Of Future Psychiatric Hospitalizations? A Retrospective Study, Aneesh Rahangdale, Joshua Wasdin, Jeffrey Ferraro
North Florida Division GME Research Day 2024
No abstract provided.
Improving Mental Status Exam Based On Body Mass Index In A Residency Program, Shaina Aifuwa, Murali Sampreeth, Valerie Cordero, Nadia Jacobs, Almari Ginory
Improving Mental Status Exam Based On Body Mass Index In A Residency Program, Shaina Aifuwa, Murali Sampreeth, Valerie Cordero, Nadia Jacobs, Almari Ginory
North Florida Division GME Research Day 2024
No abstract provided.
Reflections On The Use Of Patient Records: Privacy, Ethics, And Reparations In The History Of Psychiatry, Jonathan Sadowsky
Reflections On The Use Of Patient Records: Privacy, Ethics, And Reparations In The History Of Psychiatry, Jonathan Sadowsky
Faculty Scholarship
One of the most common questions we get asked as historians of psychiatry is “do you have access to patient records?” Why are people so fascinated with the psychiatric patient record? Do people assume they are or should be available? Does access to the patient record actually tell us anything new about the history of psychiatry? And if we did have them, what can, or should we do with them? In the push to both decolonize and personalize the history of psychiatry, as well as make some kind of account or reparation for past mistakes, how can we proceed in …
Long-Term Bidirectional Association Between Asthma And Attention Deficit Hyperactivity Disorder: A Big Data Cohort Study, Hye Jin Park, Young Hyeon Kim, Da Ye Na, Seong Won Jeong, Min Gyu Lee, Jong-Hwan Lee, Yun Na Yang, Min Gu Kang, Sang Woo Yeom, Jong Seung Kim
Long-Term Bidirectional Association Between Asthma And Attention Deficit Hyperactivity Disorder: A Big Data Cohort Study, Hye Jin Park, Young Hyeon Kim, Da Ye Na, Seong Won Jeong, Min Gyu Lee, Jong-Hwan Lee, Yun Na Yang, Min Gu Kang, Sang Woo Yeom, Jong Seung Kim
Faculty, Staff and Student Publications
BACKGROUND: Previous studies have argued that attention deficit hyperactivity disorder (ADHD) is associated with asthma. However, reliable evidence to verify this association has not yet been reported.
OBJECTIVES: To investigate the bidirectional association between asthma and ADHD through a 12-year big data cohort study.
METHODS: The independent variable group was extracted from 3.5 million individuals randomly sampled by the National Health Insurance Service (NHIS). In Study 1, the incidence of ADHD according to asthma was evaluated, while in Study 2, the incidence of asthma according to ADHD was analyzed. Propensity score (PS) matching with several variables was used to obtain …
Implementing An Arts And Humanities Curriculum In A Psychiatry Residency: A One-Year Investigation, Christopher Rogers, Briana Tillman, Matthew Adamson, Christine Wahlmeier
Implementing An Arts And Humanities Curriculum In A Psychiatry Residency: A One-Year Investigation, Christopher Rogers, Briana Tillman, Matthew Adamson, Christine Wahlmeier
Continental, MidAmerica, & Mountain Divisions GME Research Day 2023
No abstract provided.
Age-Related Differences In Accelerometer-Assessed Physical Activity And Sleep Parameters Among Children And Adolescents With And Without Autism Spectrum Disorder: A Meta-Analysis, Xiao Liang, Justin A. Haegele, Sean Healy, Andy Choi-Yeung Tse, Hui Qiu, Shi Zhao, Chunxiao Li
Age-Related Differences In Accelerometer-Assessed Physical Activity And Sleep Parameters Among Children And Adolescents With And Without Autism Spectrum Disorder: A Meta-Analysis, Xiao Liang, Justin A. Haegele, Sean Healy, Andy Choi-Yeung Tse, Hui Qiu, Shi Zhao, Chunxiao Li
Human Movement Studies & Special Education Faculty Publications
Importance: Physical inactivity and sleep disorders are health-related concerns of youth with autism spectrum disorder (ASD) that can persist from childhood and exacerbate core symptoms. However, evidence on group differences in accelerometer-assessed physical activity and sleep parameters among youth with and without ASD is inconclusive and age-specific effects remain unclear.
Objective: To synthesize evidence on group differences in accelerometer-assessed physical activity and sleep parameters and examine the moderating effects of age between children and adolescents with and without ASD.
Data Sources: American Psychological Association PsychInfo, CINAHL Ultimate, ERIC, MEDLINE, SPORTDiscus with Full Text, and Web of Science from inception to …
Mind Matters : Vol 1, Issue 1 - 2023, Department Of Psychiatry
Mind Matters : Vol 1, Issue 1 - 2023, Department Of Psychiatry
Department of Psychiatry Archives
• Message from the Chair
• Meet our Faculty Members
• Non-full-time Faculty Members
• Professor Emeritus
• Visiting Faculty
• Psychiatry Services
• Allied Services
• Occupational Therapists
• Outreach Services
• Education Activities / CME
• Conferences & Workshops
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• PGME Activities/Achievements
• Meet Our Residents & Fellows
• UGME Activities
• Research Activities
• Key Achievements
• Upcoming Event
• Newsletter Editors
Depression Secondary To Isotretinoin – A Case Report, Rohan Karkra, Megha Sadashiv, Kishor M
Depression Secondary To Isotretinoin – A Case Report, Rohan Karkra, Megha Sadashiv, Kishor M
Digital Journal of Clinical Medicine
Depression is one of the leading causes of morbidity in the world and significantly affects the lives of people suffering from it. The exact cause of depression has not been established and it is believed to be a complex play between various social, biological, environmental, personal factors. A relatively rare but distinct cause includes pharmacological agents.
In this case report, we describe the case of a 17-year-old girl who developed depression with psychotic symptoms on two occasions, both preceded by a history of Isotretinoin use. She was admitted and treated with anti-psychotics and psychotherapy with significant improvement in her mental …
Patterns Of Suicide And Self-Harm In Pakistan: A Retrospective Descriptive Study Protocol, Nargis Asad, Shahina Pirani, Summaiya Tariq, Asra Qureshi, Mohammad Zaman, Mustafa Aslam, Farhat Mirza, Murad M. Khan
Patterns Of Suicide And Self-Harm In Pakistan: A Retrospective Descriptive Study Protocol, Nargis Asad, Shahina Pirani, Summaiya Tariq, Asra Qureshi, Mohammad Zaman, Mustafa Aslam, Farhat Mirza, Murad M. Khan
Department of Psychiatry
Introduction: Suicide is a major global public health problem. Low-income and middle-income countries contribute 78% of all suicidal deaths. Pakistan, a South Asian country, lacks official statistics on suicides at national level. Statistics on suicide are neither collected nationally nor published in the annual national morbidity and mortality surveys. Medicolegal reports on suicides and self-harm are extremely rich and important source of information but greatly underused in Pakistan. We aim to examine the patterns of suicides and self-harm retrospectively in patients who were registered with medicolegal centres (MLCs) in Karachi, during the period January 2017 to December 2021.
Methods and …
Prazosin Dosed 3 Times A Day To Treat Flashbacks Related To Ptsd: A Case Report, Christie Richardson, Alexander Swartz, Martin Forsberg
Prazosin Dosed 3 Times A Day To Treat Flashbacks Related To Ptsd: A Case Report, Christie Richardson, Alexander Swartz, Martin Forsberg
Rowan-Virtua School of Osteopathic Medicine Departmental Research
Prazosin is an alpha-1 adrenergic receptor antagonist widely known by mental health providers for its off-label use for nightmares in patients with PTSD. Prazosin is lipophilic and crosses the blood-brain barrier to antagonize alpha-1 receptors in the central nervous system, potentially reducing autonomic arousal caused by PTSD. There have been numerous case reports describing the reduction of nightmares and daytime flashbacks due to PTSD with prazosin dosed at night and during the day, respectively. This case report illustrates the resolution of flashbacks related to chronic PTSD with prazosin dosed 3 times a day. As the half-life of prazosin is only …
Seizure To Drug Induced Schizophrenia: A Rare Case Of Keppra-Induced Psychosis, Shadi Shams, Riddhima Issar, Nardin El-Shammaa, Munaza Khan
Seizure To Drug Induced Schizophrenia: A Rare Case Of Keppra-Induced Psychosis, Shadi Shams, Riddhima Issar, Nardin El-Shammaa, Munaza Khan
Rowan-Virtua Research Day
Levetiracetam is a broad-spectrum antiseizure medication and is approved as adjunctive therapy to treat focal-onset seizures in children and adults with epilepsy. Levetiracetam has a wide margin of safety and patient-friendly pharmacokinetics that distinguish it from other currently available antiepileptic drugs.
Most common side effects are fatigue, somnolence, dizziness, and upper respiratory infection. Neuropsychiatric symptoms are reported. Psychotic symptoms, paranoid ideation, hallucinations, and behavioral problems may occur in adult and pediatric patients. Among all adverse effects, the rate of psychosis is very low and ranges from less than 1% to 1.4%. A retrospective study showed that this rate is higher …
Bipolar I And Bipolar Ii Subtypes In Older Age: Results From The Global Aging And Geriatric Experiments In Bipolar Disorder (Gage-Bd) Project, Farren Briggs, Martha Sajatovic, Kaylee Sarna, Joy Yala
Bipolar I And Bipolar Ii Subtypes In Older Age: Results From The Global Aging And Geriatric Experiments In Bipolar Disorder (Gage-Bd) Project, Farren Briggs, Martha Sajatovic, Kaylee Sarna, Joy Yala
Faculty Scholarship
Objectives: The distinction between bipolar I disorder (BD-I) and bipolar II disorder (BD-II) has been a topic of long-lasting debate. This study examined differences between BD-I and BD-II in a large, global sample of OABD, focusing on general functioning, cognition and somatic burden as these domains are often affected in OABD. Methods: Cross-sectional analyses were conducted with data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database. The sample included 963 participants aged ≥50 years (714 BD-I, 249 BD-II). Sociodemographic and clinical factors were compared between BD subtypes including adjustment for study cohort. Multivariable analyses were conducted …
Provider Experiences Of Virtual Reality In Clinical Treatment, Christine Vincent, Margaret Eberts, Tejal U. Naik, Victoria Gulick, C. Virginia O'Hayer
Provider Experiences Of Virtual Reality In Clinical Treatment, Christine Vincent, Margaret Eberts, Tejal U. Naik, Victoria Gulick, C. Virginia O'Hayer
Department of Medicine Faculty Papers
Background: Virtual reality (VR) has proven effective in the treatment of specific phobias and trauma particularly when in-vivo exposure therapy might be costly (e.g. fear of flying, combat scenes). Similarly, VR has been associated with improvement of chronic pain and of acute pain during medical procedures. Despite its effectiveness as a healthcare tool, VR technology is not well-integrated into common practice. This qualitative study aims to explore the provider perception of the value of VR and identify barriers to VR implementation among healthcare providers.
Methods: A 66-item self-report survey was created to examine application of VR to clinical practice, perceived …
Acute Psychosis With Recurrent Neurocysticercosis: A Case Presentation, Nasir F. Siddique, Kristy A. Fisher, Joshua Chang, Clara L. Alvarez Villalba
Acute Psychosis With Recurrent Neurocysticercosis: A Case Presentation, Nasir F. Siddique, Kristy A. Fisher, Joshua Chang, Clara L. Alvarez Villalba
HCA Healthcare Journal of Medicine
Neurocysticercosis, a parasitic infection of the central nervous system (CNS) caused by the Taenia solium cestode, presents clinically with a large and diverse spectrum of symptomatology, dependent upon lesion number, locale and ensuing inflammatory response. To this date, there are only two documented cases of psychosis presenting in patients with neurocysticercosis, both of which were published in India. This case presentation depicts the first documented case of Psychotic Disorder Due to Another Medical Condition: Neurocysticercosis in the United States. The authors postulate that the atypical presentation of the neuropsychiatric instability with the aberrant recurrence of neurocysticercosis is predominantly attributable to …
A Holistic Approach To Physical And Mental Health: Associations Between Chronic Disease And Psychiatric Conditions, Pooja Patel, Alison Mancuso
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,