Psychiatry Commons^™

Is Aristada (Aripiprazole Lauroxil) A Safe And Effective Treatment For Schizophrenia In Adult Patients?, Kyle J. Knowles

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Aristada (aripiprazole lauroxil) a safe and effective treatment for schizophrenia in adult patients?”

STUDY DESIGN: Review of three randomized controlled studies. All three trials were conducted between 2014 and 2015.

DATA SOURCES: One randomized, controlled trial and two randomized, controlled, doubleblind trials found via Cochrane Library and PubMed.

OUTCOMES MEASURED: The outcomes that were measured include adverse events (pain at injection site, insomnia, headache, toothache, abdominal discomfort, constipation, diarrhea, akathisia, back pain, dyskinesia, dystonia, nasopharyngitis) measured by vital signs, physical examination, …

Is Lisdexamfetamine Dimesylate Safe And Effective In Reducing Adhd Symptoms?, Jordan A. Drelich

PCOM Physician Assistant Studies Student Scholarship

Objective: The purpose of this careful EBM review is to determine whether lisdexamfetamine dimesylate (LDX) is safe and effective in reducing attention-deficit/hyperactivity disorder (ADHD) symptoms.

Study Design: A systematic review of two randomized controlled studies and one double-blind, 2-arm, parallel-group placebo-controlled RWP published between 2011-2014, all in the English language.

Data Sources: Two randomized controlled trials and one double-blind, 2-arm, parallel-group placebo-controlled RWP published between 2011 and 2014 which were found using PubMed and Cochrane databases.

Outcomes Measured: ADHD global symptomatic improvement was measured using Clinical Global Impressions – Severity of Illness (CGI-S), Clinical Global Impression-Improvement …

Is Mindfulness-Based Therapy Effective In Increasing Total Sleep Time In Adults?, Johanna F. Detwiler

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine review is to determine whether or not mindfulness-based therapy is effective in increasing total sleep time in adults.

Study design: Review of three randomized controlled trials published in 2011, 2014 and 2015, all English language.

Data source-The three randomized controlled trials that were used in this review were found using PubMed.

Outcomes measured: Total sleep time, sleep onset latency, wake after sleep onset, number of awakenings, time in bed, subjective sleep quality, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medications, and daytime dysfunction were …

Is Botox A Safe And Effective Treatment To Reduce Symptoms Of Depression?, Bradin T. Carter

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Botox is a safe and effective treatment to reduce symptoms of depression?

Study Design: The review is based on three Randomized Control Trials that were double-blind and placebo controlled clinical trials.

Data Source: All articles were researched and found using PubMed and Medline. The articles were selected based on the relevance to my clinical question and if the articles included patient oriented outcomes (POEMS).

Outcomes Measured: The outcomes were measured by the improvement of depressive symptoms (sleep disturbances, suicide ideations, change in …

Is L-Theanine An Effective Treatment For Reducing Anxiety In Patients Ages 18-25?, Nicole Bubes

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not L-theanine, an amino acid analogue found in green tea leaves, is an effective treatment for reducing anxiety in patients ages 18-25.

Study design: Review of two double-blind, randomized controlled studies and one single-blind, randomized controlled study published in 2007, 2012 and 2013 respectively.

Data sources: PubMed

Outcome(s) measured: Each study measured L-theanine’s ability to reduce acute anxiety with a series of self-report measures assessing acute anxiety and stress, including the Profile of Mood States (POMS), the visual analogue scales (VAS), State-Trait Anxiety …

Is Oral Vitamin D Supplementation Safe And Effective For Adults As Therapy To Improve Symptoms Associated With Seasonal Affective Disorder (Sad) During Wintertime?, James Berking

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not oral vitamin D supplementation is safe and effective for adults as therapy to improve symptoms associated with seasonal affective disorder (SAD) during wintertime.

Study Design: This review is based on three randomized controlled trials (RCTs) which were published in 2006, 2012, 2014. Two of the studies were double blind and placebo controlled. The studies evaluated the efficacy of oral vitamin D supplementation for improvement of seasonal affective disorder (SAD) symptoms. One of the studies also evaluated safety.

Data Sources: All articles used were …

Is Ginkgo Biloba Effective In Managing The Symptoms Of Adhd And Does It Exhibit Lower Adverse Side Effects As Compared To The Current Standard Of Treatment?, Joshua Meir Alge

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine review is to determine whether or not ginkgo biloba is effective in managing the symptoms of ADHD and if it exhibits lower adverse side effects as compared to the current standard of treatment.

Study Design: Systematic review of three English language studies, two of which were randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study, published between 2009-2015.

Data Source: Two randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study. In one …

Is Cariprazine Effective And Safe In Treating Acute Mania In Bipolar I Disorder?, Evan A. Reaume

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is cariprazine effective and safe in treating acute mania in bipolar I disorder?”

Study Design: This review is based on three double-blind, randomized controlled trials (RCTs) published in English, in 2015. These studies compared both the efficacy, safety, and tolerability of cariprazine in the treatment of acute mania in bipolar I disorder.

Data sources: Three double-blind, placebo-controlled, RCTs published in English, in peer-reviewed journals, and found using Medline, Pubmed, and Cochrane Review databases.

Outcomes Measured: The primary efficacy scale used in all …

Does Increasing Speech Production And Language Acquisition Through Therapies Aimed At Emphasizing Speech Therapy Improve The Verbal Communication Capabilities In Autistic Children?, Jessica Olejnik

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this EBM review was to determine if increasing speech production & language acquisition through therapies which emphasized speech therapy, would improve verbal communication skills in autistic individuals.

Study Design: Three RCTs selected due to relevance to the proposed question and fulfillment of the requirement of measuring POEMs.

Data Sources: All articles were published in peer-reviewed journals via PubMed.

Outcome Measures: The Preschool Language Scale 4 and Comprehensive Assessment of Spoken Language was measured pre-intervention and 12 months later. The verbal production evaluation scale which measured phonology, pragmatics, prosody, and sematic features. The …

Investigation On Genetic Modifiers Of Age At Onset Of Major Depressive Disorder, Huseyin Gedik

Theses and Dissertations

Major Depressive Disorder (MDD) is a complex multifactorial disorder, which would lead to disability. Environmental and genetic factors are involved in MDD etiology. The aim of this project was to identify loci modifying age at onset (AAO) of MDD using survival models after adjusting for Childhood Sexual Abuse (CSA). To achieve this aim, a dataset was made available by the China Oxford and VCU Experimental Research on Genetic Epidemiology (CONVERGE) consortium. The study population had 5,220 controls and 5,282 cases with MDD. We performed two univariate association analyses using Cox Proportional Hazard (Cox PH) models. These two are Full Sample …

Epigenetic Editing To Validate Findings From Methylome-Wide Association Studies Of Neuropsychiatric Disorders, Robin F. Chan

Theses and Dissertations

DNA methylation is necessary for learning, memory consolidation and has been implicated in a number of neuropsychiatric disorders. Obtaining high quality and comprehensive data for the three common forms of methylation in brain is challenging for methylome-wide association studies (MWAS). To address this we optimized a panel of enrichment methods for screening the brain methylome. Results show that these enrichment techniques approach the coverage and fidelity of the current gold standard bisulfite based techniques. Our MBD-based method can also be used with low amounts of genomic material from limited human biomaterials. Psychiatric disorders have high prevalence and are often chronic …

How Useful Is Electroencephalography In The Diagnosis Of Autism Spectrum Disorders And The Delineation Of Subtypes: A Systematic Review, Oana Gurau, William Bosl, Charles R. Newton

Nursing and Health Professions Faculty Research and Publications

Autism spectrum disorders (ASD) are thought to be associated with abnormal neural connectivity. Presently, neural connectivity is a theoretical construct that cannot be easily measured. Research in network science and time series analysis suggests that neural network structure, a marker of neural activity, can be measured with electroencephalography (EEG). EEG can be quantified by different methods of analysis to potentially detect brain abnormalities. The aim of this review is to examine evidence for the utility of three methods of EEG signal analysis in the ASD diagnosis and subtype delineation. We conducted a review of literature in which 40 studies were …

Early Psychosis And Trauma-Related Disorders: Clinical Practice Guidelines And Future Directions, Martha Straus Phd, Casey A. Cragin Psyd, Dawn Blacker, Laura M. Tully, Tara A. Niendam

Faculty Articles

No abstract provided.

How Burroughs Plays With The Brain, Or Ritornellos As A Means To Produce Déjà-Vu, Antonio José Bonome

CLCWeb: Comparative Literature and Culture

In his article "How Burroughs Plays with the Brain, or Ritornellos as a Means to Produce Déjà-Vu" Antonio José Bonome discusses how the recurrence and significance of one of William S. Burroughs's most potent refrains, "dim jerky faraway," was inspired by its source text, Paul Bowles's second novel Let It Come Down (1952), where Tangiers-Interzone fuels the unwholesome descent of a US-American expatriate not unlike Bowles or Burroughs himself. "Dim jerky faraway" was used by Burroughs during more than two decades in different contexts, and its textual variations have sparked a mélange of colors, sounds, smells, and feelings oscillating in …

Use Of M-Health Technology For Preventive Medicine In Pakistan, Minaz Mawani, Muhammad Masood Kadir

Section of Internal Medicine

No abstract provided.

Development, Validation And Application Of A New Fornix Template For Studies Of Aging And Preclinical Alzheimer's Disease, Christopher A. Brown, Nathan F. Johnson, Amelia J. Anderson-Mooney, Gregory A. Jicha, Leslie M. Shaw, John Q. Trojanowski, Linda J. Van Eldik, Frederick A. Schmitt, Charles D. Smith, Brian T. Gold

Physical Therapy Faculty Publications

We developed a merged younger-older adult template of the fornix and demonstrated its utility for studies of aging and preclinical Alzheimer's disease (AD). In Experiment 1, probabilistic tractography was used to reconstruct the fornix in younger and older adults and successful streamlines were then averaged to create a merged template in standard space. The new template includes the majority of the fornix from the hippocampal formation to the subcallosal region and the thalamus/hypothalamus. In Experiment 2, the merged template was validated as an appropriate measure for studies of aging, with comparisons against manual tracing measures indicating identical spatial coverage in …

A Dna Methylation Biomarker Of Alcohol Consumption, C. Liu, R. E. Marioni, Å. K. Hedman, L. Pfeiffer, P. -C. Tsai, L. M. Reynolds, A. C. Just, Q. Duan, C. G. Boer, T. Tanaka, C. E. Elks, S. Aslibekyan, J. A. Brody, B. Kühnel, C. Herder, L. M. Almli, D. Zhi, Y. Wang, T. Huan, C. Yao, M. M. Mendelson, R. Joehanes, L. Liang, S. -A. Love, W. Guan, S. Shah, A. F. Mcrae, A. Kretschmer, H. Prokisch, K. Strauch, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

The lack of reliable measures of alcohol intake is a major obstacle to the diagnosis and treatment of alcohol-related diseases. Epigenetic modifications such as DNA methylation may provide novel biomarkers of alcohol use. To examine this possibility, we performed an epigenome-wide association study of methylation of cytosine-phosphate-guanine dinucleotide (CpG) sites in relation to alcohol intake in 13 population-based cohorts (n_total=13 317; 54% women; mean age across cohorts 42–76 years) using whole blood (9643 European and 2423 African ancestries) or monocyte-derived DNA (588 European, 263 African and 400 Hispanic ancestry) samples. We performed meta-analysis and variable selection in …

Administration Of Electroconvulsive Therapy For Depression Associated With Deep Brain Stimulation In A Patient With Post-Traumatic Parkinson's Disease: A Case Study, Miles G. Cunningham, Golnaz Yadollahikhales, Gordana Vitaliano, Craig Van Horne

Neurosurgery Faculty Publications

Background: Deep brain stimulation (DBS) has been shown to be effective for parkinsonian symptoms poorly responsive to medications. DBS is typically well-tolerated, as are the maintenance battery changes. Here we describe an adverse event during a battery replacement procedure that caused rapid onset of severe depression.

Case Presentation: The patient is a 58-year-old woman who was in a serious motor vehicle accident and sustained a concussion with loss of consciousness. Within weeks of the accident she began developing parkinsonian symptoms that progressively worsened over the subsequent 10 years. Responding poorly to medications, she received DBS, which controlled her movement symptoms. …

Detrending Changes The Temporal Dynamics Of A Semantic Fluency Task, Steven Lenio, Frances M. Lissemore, Martha Sajatovic, Kathleen A. Smyth, Curtis Tatsuoka, Wojbor A. Woyczynski, Alan J. Lerner

Faculty Scholarship

Objective: To study the dynamics of clustering semantic fluency responses and switching between clusters. Methods: We conducted a cross-sectional study of participants (N = 60) in a study of patient reported outcomes who were given the Saint Louis University Mental Status test. Sixty-second animal naming tests were scored for the timing of responses as well as the clustering of responses into semantic categories. Time scores were detrended to correct for exponential exhaustion and normalize the time scale across individuals. Results: Grouped by number of responses given, low performers (LP; Carter et al., 2012) switched between clusters fewer times than medium …

Can Academic Medicine Lead The Way In The Refugee Crisis?, Amir A Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

The world is currently in the midst of the largest refugee crisis since World War II, with the highest interval of mass displacement in recorded history according to the United Nations. The United States has pledged to maintain its position as one of the world's top resettlement countries in response to this crisis. These new immigrants will arrive with exceptional chronic and acute medical needs, including higher rates of behavioral health disorders. The author describes the health care challenges experienced by refugees seeking asylum in the United States and outlines the ways in which our health care system is currently …

Recruiting And Retaining Individuals With Serious Mental Illness And Diabetes In Clinical Research: Lessons Learned From A Randomized, Controlled Trial., Stephanie W. Kanuch M.Ed., Kristin A. Cassidy Ma, Neal Dawson Md, Melanie Athey Ms, Edna Fuentes-Casiano Mssw, Martha Sajatovic Md

Journal of Health Disparities Research and Practice

Abstract: Recruitment and retention of individuals with serious mental illness (SMI) and comorbid diabetes mellitus (DM) in research studies can be challenging with major impediments being difficulties reaching participants via telephone contact, logistic difficulties due to lack of transportation, ongoing psychiatric symptoms, and significant medical complications. Research staff directly involved in recruitment and retention processes of this study reviewed their experiences. The largest barriers at the macro, mediator, and micro levels identified in this study were inclement weather, transportation difficulties, and intermittent and inaccessible telephone contact. Barrier work-around practices included using the health system’s EHR to obtain current phone numbers, …

Burnout Et Dépression, Entre Normal Et Pathologique? Histoire D’Une Différenciation Hasardeuse, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Initial described in the 1970s, the burnout syndrome has been difficult to characterize. It has been difficult to distinguish it from both clinical and subclinical depressive syndromes. In this chapter, we present a logical analysis of the distinction between burnout and depression. We synthesize the results of studies that bear on that distinction. We find that methodological and the historical separation of two lines of research as well as the lack of articulation between dimensional and categorical approaches to psychopathology.

Substance Use Disorders In Elderly Admissions To An Academic Psychiatric Inpatient Service Over A 10-Year Period, Dennis Dombrowski, Nelly Norrell, Suzanne Holroyd

Psychiatry

Objective: There is a paucity of research on substance use disorders (SUDs) in the elderly psychiatric population. This study examines SUDs in a geriatric psychiatry inpatient service over a 10-year period.

Methods: Data from 1788 elderly psychiatric inpatients from a ten-year period was collected. Variables collected included psychiatric diagnoses, SUD, number of psychiatric admissions, and length of stay. Those with and without a SUD were compared using Chi-Square or Student’s 𝑡-test as appropriate using SPSS.

Results: 11.7% (𝑁 = 210) of patients had a SUD, and the most common substance was alcohol at 73.3% (𝑁 = 154) or 8.6% of …

Late Life Bipolar Disorder Evolving Into Frontotemporal Dementia Mimic, Martha Sajatovic

Faculty Scholarship

Objectives: Although bipolar disorder has been understood classically as a cyclic disease with full recovery between mood episodes, in the last decade, evidence has accumulated supporting progressive features. The clinical picture of advanced or end-stage bipolar disorder is heterogeneous with possible deficits in cognition and behavior, as illustrated by our case series. Cases: From our neuropsychiatric outpatient clinic, we describe four cases with bipolar disorder gradually developing a clinical syndrome, including apathy, disinhibition, loss of empathy, stereotypical behavior, and compulsiveness, fulfilling the criteria for possible behavioral variant frontotemporal dementia. All cases were diagnosed with bipolar 1 disorder at least 10 …

Comparative Evaluation Of Child Behavior Checklist-Derived Scales In Children Clinically Referred For Emotional And Behavioral Dysregulation, Efstathios Papachristou, Kurt Schulz, Jeffrey Newcorn, Anne-Claude V. Bedard, Jeffrey M. Halperin, Sophia Frangou

Publications and Research

Background: We recently developed the Child Behavior Checklist-Mania Scale (CBCL-MS), a novel and short instrument for the assessment of mania-like symptoms in children and adolescents derived from the CBCL item pool and have demonstrated its construct validity and temporal stability in a longitudinal general population sample.

Objective: The aim of this study was to evaluate the construct validity of the 19-item CBCL-MS in a clinical sample and to compare its discriminatory ability to that of the 40-item CBCL-dysregulation profile (CBCL-DP) and the 34-item CBCL-Externalizing Scale.

Methods: The study sample comprised 202 children, aged 7–12 years, diagnosed with DSM-defined attention deficit …

Symptoms, Contributing Factors, And Screening For Perinatal Mood And Anxiety Disorders In U.S. Latinas: A Literature Review, Jennifer N. S. Massie

Master's Projects and Capstones

This literature review was conducted to gather the published information on the topic of perinatal mood and anxiety disorders in the Latina population in the United States. Academic databases were searched for articles published between 2005 and 2016. 60 articles were considered, and a final sample of 36 articles and websites was included in this review.

Evidence suggests that Latina women in the perinatal period (pregnant and up to one year postpartum) in the United States of America tend to have a higher risk and incidence of perinatal mood and anxiety disorders than White women, and a higher risk and …

Relationship Science And Interventions: Where We Are And Where We Are Going, Kieran T. Sullivan, Erika E. Lawrence

Psychology

Relationship distress and divorce often have profound effects on couples and their children. Relationship science has long sought to prevent and alleviate relationship distress; this chapter is a summary of many important recent developments in the field. Ongoing challenges in studying and assisting intimate relationships are also discussed.

The Calgets Story: The Impact Of 5 Years Of State-Funded Treatment, Timothy W. Fong, Terri Sue Canale-Dalman, Michael Campos, Richard Rosenthal, Rory Reid, Brett Abarbanel

International Conference on Gambling & Risk Taking

This presentation will review the history, development and current state-funded treatment programs offered in California. Treatment outcome data from 5 years of operations will be reviewed highlighting the impact that treatment has had on gambling disorder and affected individuals. Clinical characteristics and predictors of treatment success and treatment failures from both residential treatment and outpatient treatment settings will be presented. This presentation will also describe the pitfalls, successes and lessons learned in creating a statewide treatment program that will help in inform and educate any policy maker, administrator, healthcare provider or legislator who is responsible for creating and delivering government-sponsored …

Association Between Quality Of Life And Anxiety, Depression, Physical Activity And Physical Performance In Maintenance Hemodialysis Patients., Yi-Nan Li, Bryan Shapiro, Jun Chul Kim, Min Zhang, Janos Porszasz, Rachelle Bross, Usama Feroze, Rajeev Upreti, David Martin, Kamyar Kalantar-Zadeh, Joel David Kopple

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: Maintenance hemodialysis (MHD) patients often have impaired quality of life (QOL), anxiety, depression, and reduced daily physical activity (DPA) and physical performance. The contributions of these latter factors to reduced QOL in MHD are poorly understood. We examined the association of QOL with anxiety, depression, DPA, and physical performance.

METHODS: Seventy-two relatively healthy adult MHD patients, vintage ≥6 months, and 39 normals of similar age range and gender distribution were studied. QOL was assessed using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). Anxiety and depression were each evaluated with two questionnaires. DPA and physical performance were assessed with …

Illness Cognitions And Coping Self-Efficacy In Depression Among Persons With Low Vision., Bonnie A Sturrock, Jing Xie, Edith E Holloway, Mark Hegel, Robin J. Casten, David Mellor, Eva Fenwick, Gwyneth Rees

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: To investigate the mediating role of coping self-efficacy (CSE) between two types of illness cognitions (i.e., acceptance and helplessness) and depressive symptoms in persons with low vision.

METHODS: This was a single-group, cross-sectional study. Patients with visual acuity < 6/12 in the better eye and at least minimal depressive symptoms (≥5 on the Patient Health Questionnaire-9 [PHQ-9]) were recruited from vision rehabilitation services and participated in telephone-administered structured interviews at one time point. Measures were the PHQ-9, CSE Scale, and Illness Cognition Questionnaire. Structural equation modeling (SEM) devised the causal flow of illness cognitions and their observed indirect effects on depressive symptoms via the CSE mediators: problem focused, emotion focused, and social support.

RESULTS: The study comprised 163 patients (mean age 62 years; 61% female), most with age-related macular degeneration (26%) and moderate vision impairment (44%, <6/18-6/60). Structural equation modeling indices indicated a perfect fit (χ2 < 0.001, P = 1.00), accounting for 55% of the variance in depressive symptoms. Lower levels of acceptance and higher levels of helplessness illness cognitions were associated with lower self-efficacy in problem-focused coping (β = 0.38, P < 0.001, β = -0.28, P < 0.01, respectively), which in turn was associated with greater depressive symptom severity (β = -0.54, P < 0.001).

CONCLUSIONS: Lack of acceptance and greater helplessness relating to low vision led to a lack of perceived capability to engage in problem-focused coping, which in turn promoted depressive symptoms. Third-wave cognitive-behavioral treatments that focus on acceptance may be …