Psychiatric and Mental Health Commons^™

Utilizing Pupper, A Social Robot Dog, To Increase Happiness And Improve Mood In Pediatric Patients Of A Cardiac Step-Down Unit, Angela Feng Wu

Master's Projects and Capstones

Objective The usage of social robots in pediatrics is an emerging field of study. Preliminary research shows that they are effective at improving the psychosocial well-being of pediatric patients. This quality improvement project focuses on Pupper, a newly developed quadruped social robot dog, and its ability in improving mood and happiness in pediatric patients of a cardiac step-down unit. Aim The aim of this project is to increase average mood scores of pediatric cardiac patients aged 3-25 years by 50% from their baseline of 3.75 to 5.63 on a six-point scale within a one-month time frame. Methods Before intervention and …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Comparison Of Quality Of Life, Anxiety, And Depression Levels Based On Acne Vulgaris Severity, Annisaul Husna, Satya Wydya Yenny, Desmawati Desmawati, Gardenia Akhyar, Masrul Masrul, Yulistini Yulistini

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Acne vulgaris is a chronic inflammation of the pilosebaceous unit. Although acne vulgaris is not fatal, it can cause psychological effects. This study aimed to compare the quality of life, anxiety, and depression levels based on the severity of acne vulgaris among medical students at Andalas University.

Methods: This was an observational-analytic study with a cross-sectional design. It was conducted from May to June 2023. The population included the third-grade students of the Medical Study Program of the Faculty of Medicine, Andalas University, who had acne vulgaris. The respondents were 70 people, recruited with consecutive sampling techniques. This research …

The Role Of Trauma-Related Shame In Ptsd And Dissociation, Alexis Stokes

Bakerman Student Research Awards

Dissociation commonly occurs in response to traumatic events, and a dissociative subtype of PTSD is now recognized in the DSM-5. However, researchers have not established a clear consensus as to what factors separate individuals with general PTSD and PTSD with dissociative symptoms (PTSD-D). Negative affect—specifically shame—has been increasingly examined in psychotraumatology research. There is ample evidence that shame predicts and maintains symptom severity in PTSD patients, as well as that it can induce and maintain dissociative symptoms. The clear connection of shame to PTSD and dissociation suggests that it may be an important factor for conceptualizing PTSD-D; however, there is …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Administration Patterns Of Magnesium Sulphate For Women With Preeclampsia And Immediate Newborn Outcomes In Kawempe National Referral Hospital-Uganda: A Cohort Study, Christopher J. Burant, Shirley Moore, Carol Blixen, Martha Sajatovic

Faculty Scholarship

Background: Preeclampsia is the second leading cause of maternal death in Uganda. WHO recommends using magnesium sulphate (MgSO4) to prevent and treat preeclampsia with severe features (PEC) and eclampsia. MgSO4 is used to prevent eclampsia and treat women who experience an eclamptic convulsion to avoid severe maternal/infant illnesses and death. We set out to assess MgSO4 administration patterns in women with PEC or eclampsia and the immediate newborn outcomes of neonates. Methods: This was an analytical observational cohort study at Kawempe National Referral Hospital in Uganda. Two hundred ten pregnant mothers with PEC or eclampsia were recruited in the study …

Driving Healthy Behaviors Through Social Support: The Role Of Co-Responsibility In Weight Loss And Maintenance, Melanie Knufinke-Meyfroyt, Carlo Lancia, Yentl Lodewijks, Simon Nienhuijs, Eva Deckers

Patient Experience Journal

Objective: The effectiveness of out of hospital lifestyle interventions in healthcare is likely co-dependent on social support from involved one's. We sought to investigate the interrelationships between patient-partner Co-responsibility, Spousal Support, and Self-efficacy and the mechanisms through which they contribute to health behaviors and outcomes relevant to weight loss and maintenance. Methods: Co-responsibility, Spousal Support, self-efficacy, health outcomes and health behaviors like total weight loss, physical activity, OBESI-Q, and health satisfaction were assessed through a questionnaire among 868 individuals attempting to lose weight. Full and semi-partial correlations were used to understand the association between Co-responsibility, Spousal Support, Self-efficacy …

Motivators And Barriers To Help-Seeking And Treatment Adherence In Major Depressive Disorder: A Patient Perspective, Rahn K. Bailey, Kristin M. Clemens, Bex Portela, Hannah Bowrey, Samantha N. Pfeiffer, Gabrielle Geonnotti, Anna Riley, Jay Sminchak, Susan Lakey Kevo, Ronaldo R. Naranjo

School of Medicine Faculty Publications

Understanding patients’ lived experiences can identify knowledge gaps, informing better care. The objective of the study was to gain a better understanding of the lived experiences of patients from diverse backgrounds diagnosed with major depressive disorder (MDD). US patients aged ≥18 years who self-reported having MDD diagnosed by healthcare professionals (HCPs) completed demographic surveys and one-on-one (1:1) semi-structured interviews. Participants were recruited from a Patient Engagement Research Council and the study was classified as market research. Transcripts were evaluated with thematic analyses using the Braun and Clarke approach, quantifying theme frequencies across demographic categories. Among 14 interview respondents, key motivators …

Psychosis And Personality Changes Following Traumatic Brain Injury, David Hanna, Sonya Priven, Nathan Carroll, Heba Ekladios, Adriana Fitzsimmons

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Psychotic disorders following traumatic brain injury (TBI) are a significant concern in psychiatry, with chronic sequelae often overlooked. The pathophysiology of post-TBI psychosis involves neuroplasticity and neuronal remodeling, potentially exacerbating vulnerabilities to chronic psychotic disorders. Differentiating post-TBI psychosis from primary schizophrenia and other psychotic conditions is crucial for appropriate treatment. This case report discusses a 63-year-old male with a history of TBI from a gunshot wound sustained in adolescence, who later developed schizophrenia. The report explores the patient's psychiatric symptoms, cognitive dysfunction, personality changes, and imaging findings. The report examined the complex relationship between TBI and psychotic symptoms, considering genetic, …

Socio-Economic Disparities In Prenatal Prognosis And Intervention Accessibility, Simona Raluca Iacoban, Madalina Piron Dumitrascu, Camil Laurentiu Bohiltea, Ioan Dumitru Suciu, Silviu Cristian Voinea, Nicolae Suciu

Journal of Mind and Medical Sciences

Objectives. This study aimed to assess the impact of socio-economic factors on prenatal care accessibility and outcomes and to evaluate the effectiveness of specialized integrative prenatal care in mitigating these disparities. Materials and Methods. A prospective cohort study was conducted between 2020 and 2023 in Bucharest, Romania, involving 100 pregnant women. Participants were equally divided into two groups that received standard and specialized prenatal care. Data were collected through structured interviews, medical record reviews, and standardized questionnaires at multiple time points during pregnancy and postpartum. Results. Women receiving integrative care had longer gestation periods (37.8 vs. 37.6 weeks), higher average …

The Impact Of Changes In Depression On Cardiovascular Outcomes In Patients With Coronary Heart Disease., Nishant Vatsa, Josiah Bennett, Sonika Vatsa, Alireza Rahbar, Daniel A Gold, Vardhmaan Jain, Matthew E Gold, Alexander Razavi, Adithya Yadalam, Shivang Desai, Muhammad Owais, Joy D Hartsfield, Yi-An Ko, Laurence Sperling, Viola Vaccarino, Puja K Mehta, Arshed A Quyyumi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Depression is associated with major adverse cardiovascular events (MACE). Whether longitudinal changes in depression affect MACE in patients with coronary heart disease (CHD) remains unknown.

OBJECTIVES: The authors evaluated the hypothesis that increasing or persistent depression predicts MACE in patients with CHD.

METHODS: At baseline, 3,483 Emory Cardiovascular Biobank participants (median age 65.5 years, 31.6% female) completed the Patient Health Questionnaire 8 (PHQ8) for depression evaluation. At 1 year, 2,639 of these event-free participants repeated the questionnaire. Depression was defined as a PHQ8 score >9 and change in depressive symptoms (Δ" role="presentation"> PHQ8) was year 1 score minus baseline …

Early Use Of Long-Acting Injectable Antipsychotics In Bipolar Disorder Type I: An Expert Consensus, Martha Sajatovic

Faculty Scholarship

Introduction: Long-acting injectable antipsychotics (LAIs) are not routinely offered to patients living with bipolar disorder type I (BP-I), despite widespread evidence that supports their benefits over oral antipsychotics, particularly in early disease. Methods: A round-table meeting of psychiatrists convened to discuss barriers and opportunities and provide consensus recommendations around the early use of LAIs for BP-I. Results: LAIs are rarely prescribed to treat BP-I unless a patient has severe symptoms, sub-optimal adherence to oral antipsychotics, or has experienced multiple relapses. Beyond country-specific accessibility issues (e.g., healthcare infrastructure and availability/approval status), primary barriers to the effective use of LAIs were identified …

Increasing The Frequency Of Behavior Assessment To Reduce Physical Restraint, Breanne N. Ford

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a system that routinely assesses for behavior changes in psychiatric patients presenting to the emergency department to improve staff intervention of escalating behaviors and decrease physical restraint use.

Background: The project was implemented in a 45-bed emergency department in a community-based hospital affiliated with a large hospital system in Houston, Texas.

Methodology: The project utilizes the Behavioral Activity Rating Scale (BARS) to assess patients' behaviors at routine intervals throughout shifts and a comfort cart that houses several non-pharmacological intervention items to use to de-escalate adverse behaviors. The staff …

A Brief Review Of Zuranolone, Aubrey A. Jackson

Transformative Medicine

Zuranolone, a novel analog of allopregnanolone, has been approved by the U.S. Food and Drug Administration (FDA) as the first oral medication approved for the treatment of postpartum depression in adults. Developed by Sage Therapeutics under the brand name Zurzuvae, zuranolone was approved by the FDA on August 4^th, 2023.¹ Zuranolone is a modified version of brexanolone (sold under the brand name Zulpresso), an intravenously administered allopregnanolone formulation that was previously the only FDA-approved medication for postpartum depression. Zuranolone offers a more accessible treatment option for patients with efficacy established in clinical trials. Its approval expands the …

Clinical Correlates Of Perceived Stigma Among People Living With Epilepsy Enrolled In A Self-Management Clinical Trial, Martha Sajatovic, Martha Sajatovic, Jessica Black, Jacqueline Krehel-Montgomery, Grace Mcdermott, Joy Yala, Richard Barigye, Clara Adeniyi, Farren Briggs

Faculty Scholarship

Background and Purpose: Stigma is a pervasive barrier for people living with epilepsy (PLWE) and can have substantial negative effects. This study evaluated clinical correlates of perceived stigma in a research sample of PLWE considered to be at high risk due to frequent seizures or other negative health events. Methods: Analyses were derived from baseline data from an ongoing Centers for Disease Control and Prevention (CDC)-funded randomized controlled trial (RCT) testing an epilepsy self-management approach. Standardized measures assessed socio-demographics, perceived epilepsy stigma, epilepsy-related self-efficacy, epilepsy self-management competency, health literacy, depressive symptom severity, functional status, social support and epilepsy-related quality of …

Comorbidity Of Mood Disorders And Upper Airway Resistance Syndrome: A Case Report, Abhishekh Pokhrel, Alexa Lissete Zarate, Alcides Amador

Research Colloquium

Background: The comorbidity of mood disorders and Upper Airway Resistance Syndrome (UARS) presents a significant challenge, especially in pediatric populations. UARS, characterized by increased upper airway resistance during sleep, often leads to disrupted sleep and daytime symptoms such as fatigue and cognitive impairment. Studies estimate UARS affects 15-30% of patients undergoing polysomnography for suspected sleep-disordered breathing. Mood & Anxiety Disorders are prevalent in patients with sleep-disordered breathing, with higher rates than in the general population.

Case Presentation: 16-year-old female, with psychiatric history of Bipolar II Disorder current episode depressed, ADHD, and Other Specified Anxiety Disorder presents for a follow-up. Since …

A 6-Month, Prospective, Randomized Controlled Trial Of Customized Adherence Enhancement Versus A Bipolar-Specific Educational Control In Poorly Adherent Adolescents And Young Adults Living With Bipolar Disorder, Jennifer B. Levin, Molly Mcvoy, Joy Yala, Jessica Black, Carla Conroy, Martha Sajatovic

Faculty Scholarship

Objective: Few studies have addressed medication adherence in adolescents and young adults (AYAs) with bipolar disorder (BD). This 6-month prospective randomized-controlled trial (RCT) tested customized adherence enhancement for adolescents and young adults (CAE-AYA), a behavioral intervention for AYAs versus enhanced treatment as usual (ETAU). Methods: Inclusion criteria were AYAs age 13–21 with BD type I or II with suboptimal adherence defined as missing ≥20% of medications. Assessments were conducted at Screening, Baseline, and weeks 8, 12 and 24. Primary outcome was past 7 day self-reported Tablets Routine Questionnaire (TRQ) validated by electronic pillbox monitoring (SimpleMed). Symptom measures included the Hamilton …

Correspondence To "A Preliminary Study Of Collaborative Group Intervention With Recovered Peer Supporters For Eating Disorders: Analyses Including Comparisons Between In-Person And Online Sessions", Nirjal Thapa, Don D Shamilov, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We read with pleasure the article by Mochizuki et al., ¹ titled “A preliminary study of collaborative group intervention with recovered peer supporters for eating disorders: Analyses including comparisons between in‐person and online sessions.” We would like to offer additional commentary on the conclusions regarding group intervention and peer support and its heavy influence on combating eating disorders. We hope these perspectives may provide insight into areas that may require further research and improvement.

Reclaiming Healing Spaces: A Phenomenological Study On The Transformative Power Of Outdoor Therapy From The Lived Experiences Of Black Clinicians Working With Black Clients, Lynn Murphy

Dissertations

This phenomenological study involved assessing the experiences of Black therapists who engaged Black clients in outdoor therapeutic contexts. The study was founded on the existing literature that shows the quality of the therapeutic relationship is pivotal for client retention and the Western standards that have historically favored treatment within indoor environments. To contextualize this research, a comprehensive literature review was commenced, covering topics such as the decolonization of therapy, the historical and present-day relationship between Blacks and the outdoors in the United States, sedentary lifestyles, the psychological benefits of time spent in nature, various types of outdoor therapy, and the …

Infertility’S Impact On Couples’ Functioning, Elizabeth Sanders

Dissertations

Historically, infertility has been a taboo topic of discussion and is often avoided in conversation because of the stigmatization of the diagnosis. According to the World Health Organization (2022), infertility affects 186 million individuals globally. However, there seems to be a gap in the research as it pertains to the psychological well-being and treatment of men and women diagnosed with this condition. While it has become less of a feared topic, it still is not discussed or researched enough, thus further exacerbating the gap in research on mental health and treatment options. The following dissertation completed a critical review of …

Perspectives On The Clinical Use Of Anti-Amyloid Therapy For The Treatment Of Alzheimer's Disease: Insights From The Fields Of Cancer, Rheumatology, And Neurology, Gregory Jicha, Erin Abner, Elif Pinar Coskun, Mark Huffmyer, Thomas Tucker, Peter T. Nelson

Neurology Faculty Publications

Introduction: The advent of disease-modifying therapies for Alzheimer’s disease (AD) has raised many questions and debates in the field as to the clinical benefits, risks, and costs of such therapies. The controversies have resulted in the perception that many clinicians are apprehensive about prescribing these medications to their patient populations. There also remains widespread uncertainty as to the economic impact, cost benefit ratio, and safety oversight for use of these medications in standard clinical care settings.

Methods: To contextualize such issues, the present study compared anti-amyloid biologic therapy (lecanemab) to four commonly used biologic agents in other fields, including trastuzumab …

Centring Youth Mental Health Discourse On Low-Income And Middle-Income Countries, Kelly Rose-Clark, Mary Bitta, Evans-Lacko Sara, Jokinen Tahir, Mark Jordans, Moses Nyongesa, Abhijit Nadkarn, Praveetha Patalay, Indira Pradhan, Atif Rahman

Brain and Mind Institute

Commentwww.thelancet.com/psychiatry Vol 11 September 2024 671 The Lancet Psychiatry Commission on Youth Mental Health heralds a new field of research and practice with a focus on people aged 12–25 years.1 Patrick D McGorry and colleagues assert the global relevance of the field while acknowledging that much of its underpinning evidence comes from high-income countries (HICs). This distribution is problematic because 90% of children and adolescents live in low-income and middle-income countries (LMICs), which are under- represented academically and yet have the highest burden of mental ill health. Extrapolating findings from HICs to LMICs ignores crucial diversity in young people’s socioeconomic …

Exploring Perinatal Ketamine For Postpartum Depression Following Cesarean Section: A Systematic Review, Jaylyn Thompson, David F Lo, Alexis Foschini, Suvan Sundaresh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The aim of this study was to explore the use of perinatal ketamine to see if it can be used for the reduction of postpartum depression (PPD) following cesarean section (C-section). PubMed, Cochrane, and Web of Science were the primary databases used for this review. Search terms used on January 5, 2024 incorporated "ketamine," "C-section," "postpartum depression," and related synonyms. The criteria for inclusion centered on studies published between January 1, 2008 and January 5, 2024. The final selection of articles was screened based on extraction criteria leaving eight randomized control trials in the final review. The selected data from …

It’S More Than Skin Deep: Evaluating Mental Health Care In Dermatology Settings, Emma Kraft

Theses and Graduate Projects

Background: There is a high prevalence of mental health comorbidities in those with dermatologic conditions given the visible nature of many conditions. However, mental health often fails to be addressed due to lack of mental health education, stigma around mental health, and lack of mental health resources for patients. Purpose: This research study aims to assess how patients and providers experience and address mental health in dermatology settings. Methods: A systematic literature review was performed analyzing the relationship between dermatologic conditions and mental health. Additionally, a survey was conducted to assess how dermatology providers approach mental health in dermatology settings. …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

Neuroecological Links Of The Exposome And One Health, Agustin Ibanez, Lucia Melloni, Paweł Świeboda, William Hynes, Burcin Ikiz, Rym Ayadi, Massamba Thioye, Consuelo Walss-Bass, Bahar Güntekin, Jyoti Mishra, Mohamed Salama, Sarah Dunlop, Claudia Duran-Aniotz, Harris A Eyre

Faculty, Staff and Student Publications

This NeuroView assesses the interplay among exposome, One Health, and brain capital in health and disease. Physical and social exposomes affect brain health, and green brain skills are required for environmental health strategies. Ibanez et al. address current gaps and strategies needed in research, policy, and technology, offering a road map for stakeholders.

Investigating The Association Between Metabolic Syndrome Conditions And Perinatal Mental Illness: A National Administrative Claims Study, Karishma Chhabria, Sudhakar Selvaraj, Jerrie Refuerzo, Chau Truong, Cecilia Ganduglia Cazaban

Faculty, Staff and Student Publications

BACKGROUND: Although the association between mental disorder and metabolic syndrome as a bidirectional relationship has been demonstrated, there is little knowledge of the cumulative and individual effect of these conditions on peripartum mental health. This study aims to investigate the association between metabolic syndrome conditions (MetS-C) and maternal mental illness in the perinatal period, while exploring time to incident mental disorder diagnosis in postpartum women.

METHODS: This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum's de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high …

Excess Prevalence Of Preexisting Chronic Conditions In Older Adults With Incident Epilepsy, Siran M. Koroukian, Hannah L. Fein, Long Vu, Wyatt P. Bensken, Nicholas K. Schiltz, Martha Sajatovic

Faculty Scholarship

Objective: Prior studies have examined chronic conditions in older adults with prevalent epilepsy, but rarely among those with incident epilepsy. Identifying the chronic conditions with which older adults present at epilepsy incidence assists with the evaluation of disease burden in this patient population and informs coordinated care development. The aim of this study was to identify preexisting chronic conditions with excess prevalence in older adults with incident epilepsy compared to those without. Methods: Using a random sample of 4 999 999 fee-for-service Medicare beneficiaries aged >65 years, we conducted a retrospective cohort study of epilepsy incidence in 2019. Non-Hispanic Black …

The Fourth Trimester: Embracing The Chaos Of The Postpartum Period, Tabitha M. Quebedeaux, Stacey Holman

School of Medicine Faculty Publications

No abstract provided.