Mental and Social Health Commons^™

Antidepressant Dosing In Major Depression: A Pharmacogenomic Approach, Morgan Homan, Haval Norman, Victoria Cho, Yousif Rojeab

Pharmacy and Wellness Review

Major depressive disorder (MDD) is the most predominant mental disorder in the United States, with serious and costly health risks if not successfully managed. Pharmacotherapy is a standard option for MDD treatment, but patients often require extensive therapy adjustments to find a suitable regimen. Pharmacogenomics may enable greater precision in antidepressant therapy. Genotypic variations in CYP2D6 and CYP2C19 metabolic enzymes are reliable predictors of serum drug concentration, but the complex dose-response relationship of antidepressants prevents such variations from predicting therapy success. Additionally, ABCBl has been examined for its role in P-glycoprotein efflux of antidepressants in the brain, yet it is …

Latest Trends In The Heroin Epidemic And The Responsibility Of The Pharmacist In Controlling Heroin Abuse, Alexandra Herman, Cassandra Hacker, Emily Wells, Sabrina Hamman, Manoranjan D'Souza

Pharmacy and Wellness Review

Over the last few years, there has been an exponential increase in morbidity and mortality associated with heroin abuse. The current rise in heroin abuse and overdose is attributed to widespread use and abuse of prescription opioids, which can produce significant euphoric effects in humans. In fact, reports suggest that heroin abusers initially become addicted to prescription opioids but subsequently switch to heroin because it is cheaper and more easily available than prescription opioids. Over the years, the purity of heroin available for illicit use has been on the decline. Smugglers and heroin vendors have started mixing heroin with other …

Neonatal Abstinence Syndrome From Selective Serotonin Reuptake Inhibitor Use During Pregnancy, Elizabeth Kramer, Maria Patnella, Rachel Bulko, Allie Harrison, Hannah Lamb, Manoranjan D'Souza

Pharmacy and Wellness Review

Neonatal abstinence syndrome (NAS) is a concern for infants born to mothers receiving treatment with a selective serotonin reuptake inhibitor (SSRI) throughout the pregnancy. The risk of NAS associated with SSRI use during pregnancy varies with the specific SSRI that is used by the patient during pregnancy. Common symptoms of NAS include premature delivery, gastrointestinal disturbances, irritability, low birth weight, short length and lack of response to various stimuli. Neonates that present with these symptoms can be scored using either the Finnegan or Lipsitz scoring tools. Neonates experiencing NAS can be calmed or treated using nonpharmacologic methods such as swaddling, …

The Complex Relationship Between Celebrity-Driven Magazines And Depictions Of Fertility At Advanced Reproductive Ages, Brennan Peterson

Marriage and Family Therapy Faculty Articles and Research

"In this issue of the Journal of Women’s Health, Willson and colleagues explore how age and fertility are portrayed in celebrity-driven magazines.¹ Specifically, they examine if popular media depictions of celebrity pregnancies present accurate information related to age and fertility, the use of assisted reproductive technology (ARTs), and pregnancy-related risks associated with advanced maternal age (AMA >35 years). Their study provides an important viewpoint related to the impact of media on reproductive perceptions, and its potential intersection with delayed childbearing, fertility awareness, and reproductive decision making."

Pharmacogenetics: Cyps, Nat2 And 5-Htt Related To Antidepressants, Molly Kulp, Armond Cosiano, Kevin Krivanek, Amanda Lanker, Taylor Roberson, David F. Kisor

Pharmacy and Wellness Review

Pharmacogenetics (PGt), the study of a gene's influence on patient response to a drug, shows strong potential for explaining issues with efficacy related to antidepressant medications. Each year, antidepressants are one of the most commonly prescribed medications due to the millions of Americans affected by depression. Importantly, it is recognized that there is wide interpatient variability in drug response to antidepressants caused by genetic mutations, which can alter the pharmacodynamic (PD) and pharmacokinetic (PK) properties of various drugs used to treat depression. Proteins that are mainly involved in how patients respond to medications include receptors, drug-targeted proteins, drug transport proteins …

A Review Of The Guidelines And Treatment Options For Major Depressive Disorder In Adolescents, Stacy Henthorne, Joy Hoffman, Albert Bui, Sarah Kradel, Suzanne M. Lifer, Mary Ellen Hethcox

Pharmacy and Wellness Review

Major depressive disorder (MOD) is a disease often underdiagnosed in adolescents. For adolescents in particular, MOD can have far-reaching implications on developmental, social and emotional functioning. Unfortunately, few guidelines detail consistent means by which to evaluate and treat these patients; significantly more information exists that solely pertains to the adult population. Governing bodies such as the American Academy of Child and Adolescent Psychiatry (AACAP) and Resource for Advancing Children's Health (REACH) recommend that primary care physicians be diligent in their psychiatric analyses and follow-ups with young patients who may be experiencing MOD. Both psychotherapy and medications, either as monotherapy or …

Drugs Of Abuse: A Review Of Tramadol Abuse, Brittany Crowe, Tiffany Kneuss, Benjamin Finley, Kelsey Fink, Manoranjan S. D'Souza

Pharmacy and Wellness Review

Prescription drug abuse is the fastest growing drug problem in America. Among the different prescription drugs being abused, analgesics are the most commonly abused group of drugs. In the last few years, there is increasing evidence of abuse of tramadol, which is an atypical, centrally acting opioid analgesic. The increasing abuse of tramadol has prompted regulatory authorities to strengthen the product labeling of tramadol with respect to its abuse potential. Furthermore, several states have added tramadol to their controlled substances list. In this article, we will review the pharmacology of tramadol and some of the preclinical and clinical studies that …

Antidepressant Therapy: A Review Of Current Treatment Options And A Glance At The Future, Brittany Dye, Stacy Henthorne, Molly Kulp, Tristan Maiers, Zachary Crawford, Erin Petersen

Pharmacy and Wellness Review

Depression and anxiety disorders are two of the most common mental illnesses experienced by people within the United States, affecting 6.7 percent of the adult population per year. This article will focus on one specific type of depression, major depressive disorder (MDD), characterized by two or more weeks of depressed mood and/or decreased interest in normally enjoyed activities. Depression complicates treatment of other disease state(s), making successful treatment of depression essential in the management of a patient's overall health. This review will evaluate the pathophysiology, antidepressant treatment, and new approaches to treatment, specifically vortioxetine, for MDD.

Autonomic Response In Autism Spectrum Disorder: Relationship To Social And Cognitive Functioning, Michelle A Patriquin, Elizabeth M Hartwig, Bruce H Friedman, Stephen W Porges, Angela Scarpa

Staff and Researcher Publications

Individuals with autism spectrum disorder (ASD) may exhibit chronic autonomic nervous system (ANS) hyperarousal (e.g., lower respiratory sinus arrhythmia and higher heart rate) compared to their typically developing peers, reflecting a chronic biological threat response. The sustained nature of this cardiac threat suggests tonic nervous system perception of threat in safe contexts. Herein, the cardiac literature in adult and child populations with ASD is reviewed and placed within a continuum of functioning in order to inform the relationship between cardiac response and functioning in ASD. Findings from this review support the relationship between chronic autonomic hyperarousal and emotional and behavioral …

The Study Of Neurological Response In Art Therapy And Trauma: A Literature Review, Kristin Weber

Expressive Therapies Capstone Theses

This review will focus on neurological research and art therapy practice to consider benefits of the integration of science and the creative therapies. These topics will be addressed through a trauma informed theoretical lens, focusing on Post-Traumatic Stress Disorder and Traumatic Brain Injury diagnoses in the US military veteran population. Arts-based, qualitative, and quantitative research were correlated within this review to discover links between neurology and art therapy’s unique impact on trauma, and the outcome of combining these practices. The conclusions found that, with limited research connecting these two fields, there is a possibility for enhanced trauma treatment through the …

Trajectories Of Self-Reported Sleep Disturbance Across Inpatient Psychiatric Treatment Predict Clinical Outcome In Comorbid Major Depressive Disorder And Generalized Anxiety Disorder, Elizabeth M Hartwig, Katrina A Rufino, Cara A Palmer, Christopher Shepard, Candice A Alfano, Bella Schanzer, Sanjay J Mathew, Michelle A Patriquin

Staff and Researcher Publications

Background: As there has been a demonstrated link between sleep disturbance and suicide, the present study investigated the relationship between self-reported sleep disturbance during inpatient psychiatric treatment and clinical outcomes at discharge and six months post-discharge.

Methods: Participants were 2,970 adults receiving care in a long-term inpatient psychiatric hospital. Greater than 90% of inpatients reported at least mild sleep disturbance throughout treatment. Group-based trajectory modeling was used to determine patterns of sleep disturbance changes over time.

Results: Participants fit into distinct categories based on their trajectories of sleep problems across treatment: No Sleep Problems (10.3% of participants, no sleep problems …

Rising Rural Body-Mass Index Is The Main Driver Of The Global Obesity Epidemic In Adults, Con Burns, Tara Coppinger, Janette Walton, Et Al

Publications

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to …

Measuring Neural Time Series Data In A Sensory Deprivation Tank, Jackson Gregory, Tian Lan, Uri Maoz, Amir Raz

Student Scholar Symposium Abstracts and Posters

We are interested in studying the neurological and physiological effects of the float pod, also known as REST therapy, or sensory deprivation tank. Float pods rely on the concept of depriving most senses (from sound and light to temperature and proprioception) in a pool filled with buoyant salt water at body temperature. While float pods are most commonly used in spa environments, we intend to look at the potential benefits of floating under the empirical lens. In this study, we aim to measure neural activity using electroencephalography (EEG). We intend to look at the different levels of relaxation and the …

Probiotic Administration As An Adjuvant Therapeutic Treatment For Anxiety, Depression, And Cognitive Impairment Among Hypothyroid Patients, Erin R. Gorman

Selected Honors Theses

Hypothyroidism is a form of thyroid dysfunction that occurs when the thyroid gland does not make and secrete enough thyroid hormones to regulate certain processes in the body. Because thyroid hormones take part in many bodily functions, hypothyroidism can cause a large range of symptoms. Current research indicates that some strains of probiotics have beneficial effects on certain neurological and inflammatory diseases, leading to the impression that they can be used therapeutically for effective treatment of different mental health issues such as anxiety, stress, depression, and impaired memory. Because hypothyroidism often leads to such mental symptoms, it may be possible …

Do Psychopathic Birds Of A Feather Flock Together? Psychopathic Personality Traits And Romantic Preferences, Ashley L Watts, Jessica C Rohr, Katherine L Mccauley, Sarah Francis Smith, Kristin Landfield Howe, Scott O Lilienfeld

Staff and Researcher Publications

Objective: The goal of the present studies was to investigate whether people are especially attracted to psychopathic traits, and whether there are individual differences in such attraction.

Method: Female undergraduates (N = 270; Mage = 19; 57% White, 20% Asian, 8% Black) and female and male community members (N = 426; Mage = 37; 56% female; 81% Caucasian, 10% African American, 4% Asian) reported on their own personality and constructed their ideal mate for a dating, short-term, and long-term relationship from a list of 70 characteristics drawn from well-validated criteria for psychopathic personality and diagnostic criteria for DSM-5 personality disorders …

The Myth Of "It's All In Your Head"

DePaul Magazine

Researchers at DePaul's Center for Community Research are mapping the brain to uncover the causes of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Psychologist Leonard Jason has been carrying out community-based epidemiology prevalence studies that show that about one million Americans, many of them from ethnic minorities, are afflicted with the condition.

Prefrontal Corticotropin-Releasing Factor (Crf) Neurons Act Locally To Modulate Frontostriatal Cognition And Circuit Function., Sofiya Hupalo, Andrea J Martin, Rebecca K Green, David M Devilbiss, Craig W Berridge

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The PFC and extended frontostriatal circuitry support higher cognitive processes that guide goal-directed behavior. PFC-dependent cognitive dysfunction is a core feature of multiple psychiatric disorders. Unfortunately, a major limiting factor in the development of treatments for PFC cognitive dysfunction is our limited understanding of the neural mechanisms underlying PFC-dependent cognition. We recently demonstrated that activation of corticotropin-releasing factor (CRF) receptors in the caudal dorsomedial PFC (dmPFC) impairs higher cognitive function, as measured in a working memory task. Currently, there remains much unknown about CRF-dependent regulation of cognition, including the source of CRF for cognition-modulating receptors and the output pathways modulated …

Intestinal Parasite Burden And Pre-Departure Treatment Compliance In Kentucky Refugee Children: A Descriptive Study, Collin Russell, Annie H. Rominger

Journal of Refugee & Global Health

Objective: Children are 1/2 of the world’s refugees and often have intestinal parasites. This study seeks to determine the intestinal burden and pre-departure treatment of Kentucky pediatric refugees.

Methods: This is a chart review of Kentucky pediatric refugee health screening data from 2012-2017. Stool culture results from children arriving through refugee camps were compared to non-camp children. They were placed into 3 regional groups and analyzed based on CDC pre-departure treatment recommendations.

Results: Of the 3,199 records, 1,653 had stool testing. 354 (51%) refugee camp children tested positive compared to 326 (33.9%) non-camp children. Giardia and Blastocystis were most commonly …

Pharmacotherapy For Impulsivity-Hyperactivity Behaviors In Autism Spectrum Disorder, Jenna Katnis

Physician Assistant Scholarly Project Posters

Hyperactivity is a shared behavior with ASD and Attention Deficit Hyperactivity Disorder (ADHD). Medications such as Methylphenidate (MPH) and α 2-a adrenergic receptor agonists are used to modify hyperactivity behavior in ADHD and thus have been used as management in ASD. A review of literature was done to evaluate the use of medications typically used for ADHD in the use of ASD. The databases searched included PubMED, PsycINFO, Cochrane, and Clinical Key. After reviewing the literature, it was found that both MPH and 2-a adrenergic receptor agonist have a potential role in pharmacotherapy for ASD. MPH may be slightly more …

Treatment Of Nightmares In Psychiatric Inpatients With Imagery Rehearsal Therapy: An Open Trial And Case Series, Thomas E Ellis, Katrina A Rufino, Michael R Nadorff

Staff and Researcher Publications

Objectives: This study sought to assess the utility of Imagery Rehearsal Therapy (IRT) for nightmares in an inpatient psychiatric setting. Although IRT enjoys a substantial evidence base for efficacy in various populations, data with psychiatric inpatients are lacking.

Participants: Participants were 20 adult psychiatric inpatients (11 male, 9 female; mean age=43.4), in an extended stay psychiatric inpatient facility. All participants were diagnosed with multiple, treatment resistant, comorbid conditions, including mood disorders, anxiety disorders, personality disorders, and substance-related disorders. Patients with active psychosis or significant cognitive impairment were excluded.

Methods: This was an open trial utilizing a case series design. In …

Resting-State Functional Connectivity Of The Habenula In Mood Disorder Patients With And Without Suicide-Related Behaviors, Elisa Ambrosi, David B Arciniegas, Kaylah N Curtis, Michelle A Patriquin, Gianfranco Spalletta, Gabriele Sani, B Christopher Frueh, J Christopher Fowler, Alok Madan, Ramiro Salas

Staff and Researcher Publications

The habenula is a small midbrain structure that is important for brain signaling and learning from negative events. Thus, the habenula is strongly connected to both the reward system and motor regions. Increasing evidence suggests a role for the habenula in the etiology of psychiatric disorders, including mood and substance use disorders. However, no studies to date have investigated habenular resting-state functional connectivity (rsFC) in suicide-related behaviors (SB). The authors enrolled 123 individuals with major depressive disorder (MDD) or bipolar disorder and a history of suicide-related behaviors (SB+), 74 individuals with MDD or bipolar disorder and a history of suicidal …

A Proof-Of-Mechanism Study To Test Effects Of The Nmda Receptor Antagonist Lanicemine On Behavioral Sensitization In Individuals With Symptoms Of Ptsd, Marijn Lijffijt, Charles E Green, Nicholas Balderston, Tabish Iqbal, Megan Atkinson, Brittany Vo-Le, Bylinda Vo-Le, Brittany O'Brien, Christian Grillon, Alan C Swann, Sanjay J Mathew

Faculty, Staff and Students Publications

Background: Individuals with post-traumatic stress disorder (PTSD) have a heightened sensitivity to subsequent stressors, addictive drugs, and symptom recurrence, a form of behavioral sensitization. N-methyl-D-aspartate receptors (NMDARs) are involved in the establishment and activation of sensitized behavior.

Objective: We describe a protocol of a randomized placebo-controlled Phase 1b proof-of-mechanism trial to examine target engagement, safety, tolerability, and possible efficacy of the NMDAR antagonist lanicemine in individuals with symptoms of PTSD (Clinician Administered PTSD Scale [CAPS-5] score ≥ 25) and evidence of behavioral sensitization measured as enhanced anxiety-potentiated startle (APS; T-score ≥ 2.8).

Methods: Subjects (n = 24; age range 21–65) …

Shanghai, China: “Nontraditional” Traditional Chinese Medicine, Joshua Martin

Purdue Journal of Service-Learning and International Engagement

Joshua Martin is a second-year PharmD student in the Purdue University College of Pharmacy. Within the College of Pharmacy, he is the president-elect of the Industry Pharmacist Organization (IPhO), is on the Orientation Steering Committee for newly admitted PharmD students, and preforms nanoparticle research within the Industrial and Physical Pharmacy sector of the College. He hopes to pursue a career in the pharmaceutical industry where he can positively impact patients on a global scale. Josh comes from a family of Boilermakers and avidly supports the Black and Gold. In this article, he describes his experience studying at Shanghai University of …

Oxcarbazepine Overdose In A Polysubstance Related Suicide, Melissa Beals, Robert J. Krumsick, C. Clinton Frazee Iii, Lindsey J. Haldiman, Uttam Garg

Posters

Introduction
Oxcarbazepine is a derivative of carbamazepine that is used primarily in the treatment of epilepsy, and experimentally as a mood-stabilizer in adjunctive therapy for the treatment of bipolar disorder. Oxcarbazepine is converted through oxidation to its pharmacologically active metabolite 10-OH-Carbazepine, which is thought to be responsible for most of the anticonvulsant action of the drug. Adverse effects of oxcarbazepine are generally dose-dependent and may include fatigue, somnolence, dizziness, diplopia, nystagmus, and ataxia. Additive sedative effects have been noted when oxcarbazepine is used in combination with other CNS depressionproducing medications. Furthermore, oxcarbazepine and 10-OH-Carbazepine are powerful CYP2C19 inhibitors, potentially increasing …

Resting-State Functional Connectivity In Youth With Gender Dysphoria, Felix L. Garcia

Dissertations, Theses, and Capstone Projects

Current developmental models of gender identity and gender dysphoria (GD) lack sex-specific profiles of brain function that differentiate between typically-developing and cross-gender identified youth, as postulated by models like the unified theory of the origins of sex differences (Arnold, 2009) and the neurobiological theory of the origins of transsexuality (Swaab & Garcia-Falgueras, 2009). Previously, investigators have used brain imaging modalities such as Resting-State functional Magnetic Resonance Imaging (R-fMRI) to demonstrate differences in resting-state functional connectivity (RSFC) between typically-developing male and female youth, and between typically-developing and GID-diagnosed youth. In the present pilot study, I used R-fMRI to investigate differences in …

Fatigue Associated With Rheumatoid Arthritis In Young Adults, Sydney Van Alstyne

Grace Peterson Nursing Research Colloquium

Background: Often, practitioners do not address their Rheumatoid Arthritis patients' fatigue and do not perceive it as a detriment to the patient's wellness. In actuality, fatigue has been determined to be proportionate to the other variables, such as pain and disease progression, of rheumatoid arthritis.

Objectives: to determine the cause(s) of fatigue in rheumatoid arthritis and determine how fatigue can be used in a clinical setting to determine disease progression and status in patients suffering from chronic illness.

Method: This integrative literature review was conducted using the keywords, “fatigue, rheumatoid arthritis, young adults, perception of fatigue” to search the literature …

An Interprofessional Education Initiative For Allied Health Students Preparing To Serve Individuals With Autism Spectrum Disorders, Brenda L. Beverly, Donna Wooster

University Faculty and Staff Publications

The need for effective services for persons with autism spectrum disorders (ASD) is driving efforts to better prepare teams of allied health professionals. To address this need, an interprofessional graduate course was piloted with students from three allied health professions: physical therapy, occupational therapy, and speech-language pathology. The course aims were to address knowledge and competency in the field of ASD and to promote interprofessional abilities during entry-level preparation. Nine graduate students participated in weekly on-line education and attended a day-long autism conference with local practitioners from seven different professions. Attitude changes toward interprofessional practice were assessed with two pre- …

Body Dissatisfaction And Suicidal Ideation Among Psychiatric Inpatients With Eating Disorders, Katrina A Rufino, Humsini Viswanath, Rebecca Wagner, Michelle A Patriquin

Staff and Researcher Publications

The current study the relationship between eating disorders (EDs) and suicidal ideation and suicide attempt in adult inpatients. In particular, the present study investigated one potential mechanism, body dissatisfaction (BD), which may contribute to increased risk for suicide in adult ED patients. A sample of 432 psychiatric inpatients ranging from 18 to 65 years of age participated in the current study. Findings indicated that patients who have higher levels of BD also had higher levels of passive and active suicidal ideation and previous suicide attempts. Higher levels of BD were also related to increased suicidal ideation after controlling for depression …

Post-Traumatic Stress Disorder: Review Of Dsm Criteria And Functional Neuroanatomy, Cornelius W. Thomas

Marshall Journal of Medicine

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for post-traumatic stress disorder (PTSD) consist of over twenty possible symptoms that can be divided into six broad categories. These categories correlate with specific brain networks that regulate emotions, behaviors, and autonomic function. Normal functioning of these networks depends on two key regions; the prefrontal cortex and the amygdala. The prefrontal cortex provides top-down executive control over amygdala, whereas the amygdala is critical for threat detection and activation of the ‘fight or flight’ response. Events that trigger extreme and/or prolonged fear can cause persisting dysregulation within the prefrontal-amygdala circuit; resulting …

Perceived Stress And Perceived Empathy Reported By Athletic Training Students, Lauren Harris

Student Scholar Showcase

Context: Previous research has been conducted on perceived stress related to perceived empathy within the medical field. About 40% of nurses have self reported occupational burnout, 25% of physicians have multiple factors related to burnout, and over half of psychologists have admitted that they practiced while being distressed to the point of affecting their clinical practice.1,1316 However, there is limited research on how perceived stress affects empathy within athletic training students.

Objective: To examine the perception of stress and the level of empathy towards patients by athletic training students.

Design: Case report.

Setting: Online survey.

Participants: Seventeen professional level athletic …