Psychiatry Commons^™

Dementia In A Resource-Constrained Sub-Saharan African Setting: A Comprehensive Retrospective Analysis Of Prevalence, Risk Factors, And Management At The Only Neuropsychiatric Facility In Northeastern Nigeria, Ibrahim Abdu Wakawa, Umar Baba Musami, Suleiman Hamidu Kwairanga, Placidus Nwankuba Ogualili, Mohammed Yusuf Mahmood, Muhammad Abba Fugu, Mohammed Mala Gimba, Muktar Mohammed Allamin, Zaharadeen Umar Abbas, Chinedu Momoh

Brain and Mind Institute

INTRODUCTION: Dementia prevalence is increasing in sub-Saharan Africa, poten-tially due to population growth and aging. Resource-constrained settings such asNortheastern Nigeria face challenges in dementia management.

METHODS: We assessed dementia burden and management at the Federal Neuropsy-chiatric Hospital Maiduguri, the only neuropsychiatric facility in Northeastern Nigeria.This retrospective analysis included patient records from 1999 to 2023 for individuals60 year of age and older with a dementia diagnosis.

RESULTS: Of the 1216 cases reported, Alzheimer’s disease (60.5%) was the mostcommon subtype, followed by vascular dementia (24.5%). Hypertension (41.6%) wasthe most frequent comorbidity. Memory loss was present in all cases, whereasbehavioral …

The “Wearing Off” Phenomenon For Rasagiline, Entacapone, Carbidopa, And Levodopa In The Setting Of Parkinson’S Disease, Ryan Cromwell, Tevin Um

HCA Healthcare Journal of Medicine

Background

Parkinson’s disease is a primary neurological dysfunction syndrome in which the body’s natural production of dopamine is reduced. Therapeutic intervention for this disease primarily includes medications that increase the body’s natural production of dopamine. These medications can have side effects, requiring constant titration based on the patient’s symptoms.

Case Presentation

We report a case study of a 75-year-old man diagnosed with Parkinson’s disease who had a profound acute exacerbation of psychological symptoms following modifications to his dopaminergic treatment regimen. Initially, the patient was prescribed carbidopa/levodopa, rasagiline, and carbidopa/levodopa/entacapone. However, the treatment plan was adjusted due to the worsening of …

Intersect Between Brain Mechanisms Of Conditioned Threat, Active Avoidance, And Reward, Muhammad Badarnee, Zhenfu Wen, Mira Z Hammoud, Paul Glimcher, Christopher K Cain, Mohammed R Milad

Faculty, Staff and Student Publications

Active avoidance is a core behavior for human coping, and its excess is common across psychiatric diseases. The decision to actively avoid a threat is influenced by cost and reward. Yet, threat, avoidance, and reward have been studied in silos. We discuss behavioral and brain circuits of active avoidance and the interactions with fear and threat. In addition, we present a neural toggle switch model enabling fear-to-anxiety transition and approaching reward vs. avoiding harm decision. To fully comprehend how threat, active avoidance, and reward intersect, it is paramount to develop one shared experimental approach across phenomena and behaviors, which will …

Empowering Resident Autonomy, Competence, And Relatedness Through Opt-Out Visits, Emily Lisco, Md, Alexandra Hughes, Lcsw, Meghan O’Meara, Phd, Lpc

Department of Psychiatry and Human Behavior Posters

Background

• House staff officers are more likely to experience burnout than their age-matched peers in the general population.³
• ACGME Common Program requirements emphasize the importance of well-being in residency programs, including the opportunity to attend healthcare appointments during working hours.¹
• Opt-out programs have been used to increase help-seeking behavior and provide low-barrier access to mental health care and other supports.^{2, 4-5}
• Self-determination theory proposes that individuals’ well-being can be enhanced if the core psychological needs of autonomy, competence, and relatedness are met.⁶
• The lack of perceived autonomy, competence, and connection felt by residents can lead to …

Intraocular Pressure Changes Associated With Psychological Stress Or Anxiety In Both Healthy And Glaucoma-Diagnosed Patients, Triston Crook, Porter Biggs, James Fini, Zane Kingsbury

Annual Research Symposium

No abstract provided.

Long-Acting Injectables: A Strategy To Mitigate Nonadherence In Bipolar Disorder, Justin Faden, Elina Maymind

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Role Of Dexmedetomidine In Psychiatry - A Literature Review, Mehar Durah, Dayana Balsalobre Do, Sahar Nadeem Do, Megan De Armond Mslis, Mfa, Sherli Koshy-Chenthittayi Ph.D

Annual Research Symposium

Purpose This literature review aims to evaluate the clinical use of dexmedetomidine in psychiatry, specifically in the management of neurobehavioral manifestations associated with psychiatric diagnoses defined by the DSM-5 or ICD-10. Dexmedetomidine, an alpha-2 receptor agonist, effectively reduces a heightened sympathetic response and provides sedative, analgesic, and anti-inflammatory effects. The neurobehavioral manifestations include psychomotor agitation, delirium, catatonia, impaired focus, hyperactivity, mania, and hallucinations as seen in psychiatric conditions such as bipolar disorder, schizophrenia, alcohol withdrawal syndrome, ADHD, and autism. The purpose of this review is to identify use of dexmedetomidine in clinical psychiatry in controlling neurobehavioral manifestations and identifying its …

Role Of Psychiatric Factors Hindering Physical Rehabilitation After Acl Reconstructive Surgery, Malak Rafik, Davian Caraballo, James Fini Jr., Nathan Barnhurst

Annual Research Symposium

No abstract provided.

A Compelling Case Of The Use Of Electroconvulsive Therapy In Severe Treatment Resistant Depression With Suicidality, Neha Narayanan, Ryan Tam, James Mead

Advances in Clinical Medical Research and Healthcare Delivery

Treatment-resistant depression is a condition that occurs when an individual, experiencing major depressive disorder episodes, has failed the first line of treatment with medication therapy of adequate dose and duration. This is important to be addressed as there is a high likelihood of progression to having thoughts and an intended plan for suicide. Electroconvulsive therapy is a recommended option for those who have failed medication therapy, but it has been controversial in its use due to its stigma and side effects of memory impairment. Here, we present a case of a patient who had undergone several sessions of ECT with …

Acceptance And Commitment Therapy With Huntington's Disease: A Narrative Review And Case Report Of A Caregiver-Assisted Intervention, Simone H. Schriger, Chelsi N. Nurse, C. Virginia O'Hayer

Department of Psychiatry and Human Behavior Faculty Papers

Acceptance and commitment therapy (ACT) is an experiential, action-oriented talk therapy that emphasizes acceptance of painful inner experience through increased psychological flexibility. In this narrative review and case report, we first review the extant literature on applications of ACT to patients with a variety of mental and physical health challenges, including neurodegenerative disorders, and their caregivers. We then discuss applications of ACT to Huntington's disease (HD). We provide a case report of a 52-year-old man living with HD who, accompanied by his caregiver, received a virtually-delivered 6-session ACT intervention. We measured the patient's self-reported symptoms of depression (PHQ-9) and anxiety …

Nitrous Oxide Induced Psychosis: A Case Report, Brianne Kimmet, Barbara Gracious

South Atlantic Division GME Research Day 2025

No abstract provided.

Case Series Of Psychiatric Patients With Hypothermia: A Clinical Review, Amy Mackenzie, Brianne Kimmet, James Free, Ubaid Khokhar, Barbara Gracious

South Atlantic Division GME Research Day 2025

No abstract provided.

Neurosyphilis Mortality Trends In The United States (1999–2023): A Cdc Wonder Database Analysis, Amy Mackenzie, Barbara Gracious

South Atlantic Division GME Research Day 2025

No abstract provided.

The Hatchet Man Of Baghdad: A Serial Killer Under The Ba’Ath Regime, Amy Mackenzie, Muniza Shah

South Atlantic Division GME Research Day 2025

No abstract provided.

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Comparing Efficacy Of Psychotropic Classes To Control Aggression Among Pediatric Patients Hospitalized With Oppositional Defiant Disorder, Orestes Hadjistamoulou, Sindhura Kompella, Melissa Ricardo, Samuel Neuhut

East Florida Division GME Research Day 2025

No abstract provided.

Video Games In The Management Of Adhd: A Novel Approach To Adjunct Traditional Treatment, Lekhya Kintada, France Leandre

North Florida Division GME Research Day 2025

No abstract provided.

Emerging Role Of Liafensine In The Treatment Of Treatment Resistant Depression: Insights From The Enlighten Trial, Karla Narvaez, Saad Masud, Richard Callahan

East Florida Division GME Research Day 2025

Background: Treatment-resistant depression (TRD) remains a significant unmet need, affecting about one third of patients with major depressive disorder who fail to respond to two or more antidepressant trials. There is a need for new pharmacological approaches. Liafensine (also known as DB104) is a first-in-class triple reuptake inhibitor targeting serotonin, norepinephrine, and dopamine transporters, whose development has recently incorporated a precision medicine approach. Mechanism of Action: Liafensine inhibits reuptake of all three major monoamines (serotonin, norepinephrine, and dopamine) distinguishing it from existing SSRIs, SNRIs, or other agents which typically target one or two systems. A genetic biomarker, ANK3 (also called …

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, …

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

Internal Medicine Resident Research

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

“University Stress” Exploring The Potential Impact Of An Immersive Art Experience On A College Campus, Lyn Godley, C. Virginia O'Hayer, Raegan Davis, Emily Wakschal, Chelsi N. Nurse, Wendy J. Ross, Abigail Spraker, Nate Godshall, Rosemary Frasso

Department of Psychiatry and Human Behavior Faculty Papers

There is growing interest in the effects of immersive art on wellbeing, which engages multiple senses and facilitates deeper engagement. University settings, particularly during high-stress periods like exams, are increasingly emphasizing mental health interventions to combat rising rates of anxiety, depression, stress, and suicidal ideation. This study investigates the potential of a fully immersive art experience to positively impact mood and reduce stress in a university setting. Pre- and post-visit questionnaires, including the Positive and Negative Affect Schedule (PANAS) survey, were administered to assess emotional changes. Additional open-ended questions provided qualitative feedback. Results showed statistically significant decreases in 12 negative …

Pregnancy-Related Delusional Beliefs In Midlife And Late-Life Women: A Case Series, Dyuksha Arora, Ashita Adarsh, Kishor M. Manohar Rao, Anand R, Soumya Rajshekar Patil, Akshatha Cj

Digital Journal of Clinical Medicine

Pseudocyesis and delusional pregnancy represent rare but clinically significant presentations across psychiatric practice. While pseudocyesis involves a false belief of pregnancy accompanied by physical manifestations, delusion of pregnancy refers to a fixed belief of being pregnant despite clear contrary evidence. Both conditions pose considerable challenges as they involve close consultation and liaison between Obstetrics & Gynaecology and Psychiatry. There are a few studies from tertiary care general hospitals in India. Here we report two case series.

Case 1: A 43-year-old married woman from a rural background with an 8-year history of recurrent depressive disorder and dysthymia, presented with 3 months …

Ketamine Infusion Treatment For Depression, Isabella Schwing

Capstone Showcase

Depression remains a significant public health challenge in the U.S., affecting millions of adults and contributing to both psychological and financial burdens. Major depressive disorder impacts approximately 14.5 million U.S. adults, with about 30% of cases classified as treatment-resistant depression. Traditional antidepressant therapies, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, often have delayed onset and limited efficacy, leaving a substantial portion of patients without adequate relief. Given these limitations, there is an urgent need for alternative treatment options.

Recent research has highlighted ketamine as a promising intervention for Major Depressive Disorder and Treatment Resistant Depression. Initially identified as …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Exploring The Correlation Between Medical Book Authors And Their Dedication, Simlum N A, Kishor M

Digital Journal of Clinical Medicine

Training in medical sciences is considered one of the most challenging disciplines in higher education. India has one of the largest number of medical institutions in the world. Many initiatives are being taken to engage budding doctors. There has been phenomenal growth in medical literature to enrich students understanding and application of the knowledge in health care services. The authors of books on medical literature, are probably passionate experts keen to present the information in the best possible way for the readers. However, there is hardly any literature on what are the factors which inspires these works or who were …

Rare Variant Analysis Of Electronic Health Record-Defined Major Depressive Disorder In The All Of Us Research Program, Stephen Emil Vieno

Theses and Dissertations

The underlying pathogenesis of MDD remains poorly understood, with multiple competing hypotheses regarding its exact etiology. As a heterogeneous disorder with relatively low heritability, large-scale genome-wide association studies of MDD have relied on increasingly large sample sizes to identify common genetic variants associated with the disorder. However, the rare variant genetic architecture of MDD is still largely unknown. The aim of the present analysis was to use the AoU—a United States-based biobank that integrates healthcare records from over 50 healthcare systems and possesses whole genome sequencing data for participants—to perform a gene set–based analysis of MDD. This analysis presented several …

Evaluating The Emotional Accuracy Of Ai-Generated Facial Expressions In Neurotypical Individuals, Antonio Pagán, Katherine A Loveland, Ronald Acierno

Faculty, Staff and Student Publications

This study examines the ability of generative artificial intelligence to produce facial expressions representing basic emotions in a neutral context using black-and-white cartoon imagery. Mentalization, the capacity to recognize and interpret one’s own and others’ mental states, is critical for social interaction and emotional regulation. We explored the emotional validation of artificial intelligence (AI)-generated images by assessing the agreement between human interpretations of emotions and those generated by an AI model. Thirty-four participants evaluated images depicting six basic emotions: sadness, anger, happiness, surprise, fear, and disgust. Our findings revealed significant variability in human agreement, with higher concordance for sadness, anger, …

Primary Polydipsia In A Case Of Genetic Behavioral Variant Frontotemporal Dementia, Yesenia Cantu, Taryn White, Gabriela Austgen, Christine Rizk, Olaoluwa O Okusaga, Melissa B Jones

Faculty, Staff and Students Publications

No abstract provided.

Poststroke Impulsivity: A Narrative Review, Melissa B Jones, Dakota E Broadway, Malena Gimenez-Zapiola, Ricardo E Jorge

Faculty, Staff and Students Publications

In this narrative review, the authors examine the multidimensional nature and presentations of impulsivity after stroke. Impulsivity manifests as immediate or premature responses, impaired delayed gratification, perseverance despite punishment, and other displays of impaired emotional and behavioral regulation. The literature on the assessments, outcomes, and treatment of patients with these various manifestations after a cerebrovascular injury is reviewed. Findings from case reports indicate that poststroke impulsivity may manifest across neurobehavioral syndromes that are not well defined in the psychiatric nomenclature, such as alien hand syndrome and atypical impulse control disorders. Overall, impulse control disorders appear to be rare poststroke. Therapeutic …

Suicide Phenotyping From Clinical Notes In Safety-Net Psychiatric Hospital Using Multi-Label Classification With Pre-Trained Language Models, Zehan Li, Yan Hu, Scott Lane, Salih Selek, Lokesh Shahani, Rodrigo Machado-Vieira, Jair Soares, Hua Xu, Hongfang Liu, Ming Huang

Faculty, Staff and Student Publications

Accurate identification and categorization of suicidal events can yield better suicide precautions, reducing operational burden, and improving care quality in high-acuity psychiatric settings. Pre-trained language models offer promise for identifying suicidality from unstructured clinical narratives. We evaluated the performance of four BERT-based models using two fine-tuning strategies (multiple single-label and single multi-label) for detecting coexisting suicidal events from 500 annotated psychiatric evaluation notes. The notes were labeled for suicidal ideation (SI), suicide attempts (SA), exposure to suicide (ES), and non-suicidal self-injury (NSSI). RoBERTa outperformed other models using binary relevance (acc=0.86, F1=0.78). MentalBERT (F1=0.74) also exceeded BioClinicalBERT (F1=0.72). RoBERTa fine-tuned with …