Psychiatric and Mental Health Commons^™

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Systematic Review Of Pathways To Care In The U.S. For Black Individuals With Early Psychosis, Oladunni Oluwoye, Beshaun Davis, Franchesca S. Kuhney, Deidre M. Anglin

Publications and Research

The pathway to receiving specialty care for first episode psychosis (FEP) among Black youth in the US has received little attention despite documented challenges that negatively impact engagement in care and clinical outcomes. We conducted a systematic review of US-based research, reporting findings related to the pathway experiences of Black individuals with FEP and their family members. A systematic search of PubMed, PsycInfo, and Embase/Medline was performed with no date restrictions up to April 2021. Included studies had samples with at least 75% Black individuals and/or their family members or explicitly examined racial differences. Of the 80 abstracts screened, 28 …

Desire For Control Moderates The Relationship Between Perceived Control And Depressive Symptomology, Liam Alexander Mackenzie Myles, Emanuele Maria Merlo, Antonia Obele

Journal of Mind and Medical Sciences

Background. The prevalence of psychological difficulties is rising at an alarming rate, with an increasing number of individuals reporting symptoms of depression. A decline in both perceived control and desire for control has previously been associated with the onset of depression. However, previous research has failed to examine whether perceived control and desire for control interact in their relationship with depressive symptomology. Methods. A sample of 350 participants completed the Spheres of Control Scale, the Desirability of Control Scale and Beck’s Depression Inventory. Process Macro was used to examine whether desire for control moderated the relationship between perceived …

The Functional And Structural Consequences Of Aberrant Microglial Activity In Major Depressive Disorder, Jasmine D. Cakmak

Electronic Thesis and Dissertation Repository

Major depressive disorder (MDD) is a highly debilitating neuropsychiatric illness which has been linked with increases in both peripheral and central inflammation, as well as with changes in connectivity. Although countless studies have investigated these two topics, the relationship between neuroinflammation and functional/structural connectivity has not been explored. Using [¹⁸F]FEPPA PET imaging, we measured translocator protein-related (TSPO) microglial activity in the subgenual anterior cingulate cortex (sgACC) and insula and confirmed significantly increased [¹⁸F]FEPPA uptake in depressed patients (N=12) compared to healthy controls (N=23). Using a seed-based ROI analysis of fMRI data, we found that patients show …

Training And Individual Predictors Of Attitudes Toward Serious Mental Illness Amongst Clinical Psychology Doctoral Students, Lauren K. O'Connor

Dissertations, Theses, and Capstone Projects

Clinical psychologists are grossly underrepresented in treatment provision for individuals with serious mental illness (SMI; Roe, Yanos, Lysaker, 2006). Systemic (e.g., emergence of managed care) and training-based (e.g., limitations to SMI specific training) factors contribute to the establishment of this underrepresentation, while mental health stigma amongst psychologists may play a role in perpetuating it. Many individual and experiential factors have been found to impact clinicians’ attitudes toward those with SMI (Henderson et al., 2014; Schulzes, 2007). Though many of these factors are present and relevant from the beginning of one’s career and may involve elements related to training, little research …

Depression & Anxiety In Brain Vs. Body Trauma Patients, Olivia Mercier

Undergraduate Student Research Internships Conference

No abstract provided.

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Cerebellum-Seeded Functional Connectivity Changes In Trait-Anxious Individuals Undergoing Attention Bias Modification Training, Katherine Elwell

All NMU Master's Theses

Anxiety and anxiety related disorders are increasing at a drastic rate in the past decade, with the NIMH reporting that 31.1% of U.S. adults will experience an anxiety disorder at some point in their lives. Anxiety is commonly characterized by increased attention bias to threat. Attention Bias Modification (ABM) is a new treatment used to reduce individual’s attention bias towards threat. The extent to which ABM leads to underlying neural changes is still unknown. The cerebellum is a neglected brain structure, with new research provides evidence that cerebellum’s functional connectivity and shared networks with threat processing regions has a direct …

Longitudinal Trauma Treatment Outcomes In An Immigrant And Refugee Sample, Shuen-En Ho

Clinical Psychology Dissertations

Refugee and immigrant populations are at an increased risk of having posttraumatic stress disorder (PTSD) and exhibit a significant amount of variance in trauma treatment outcomes that may be impacted by sociocultural factors. This study examines the impact of demographic variables on treatment outcome and trajectory of PTSD symptoms in a clinic setting with trauma-focused treatments in refugee/immigrant and general populations. Data was collected from the electronic medical record at the Harborview Center for Sexual Assault and Traumatic Stress. A total of 817 participants completed intake, 58 of which self-identified as immigrant/refugee. One-way ANOVAs were conducted to examine group differences …

Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra

Expressive Therapies Capstone Theses

This thesis explored which mindfulness meditations or mindfulness practices could be beneficial in the online sessions, the extent to which adults with learning and developmental disabilities could learn the practices remotely, and how stress and anxiety disorders could be reduced through online mindfulness interventions. Furthermore, it was also necessary to address the online sessions as the only mental health treatment possibility during the Coronavirus pandemic for the clients observed and the benefits and limitations of these interventions. Additionally, the importance of structure and routine for this population, the multi-modal structure of the interventions, and how attunement plays an important role …

Reporting Of Eating Disorder Deaths, Katherine Mobley, Amy Hord

Symposium of Student Scholars

Those affected by eating disorders experience disturbances in eating behaviors which are often related to underlying psychiatric disorders such as anxiety, depression, or obsessive-compulsive disorder (Parekh, 2017, Drieberg et al., 1998 p.53). The duplicitous nature of the disorder makes it difficult to diagnose, and the tole it takes on an individual’s physical health makes its mortality rate the second highest among psychiatric disorders (Guinhut et al., 2021 p.130). Even if the correct education and resources are accessible to certain individuals, negative stigmatization about the disorder can make sufferers unlikely to seek help (Becker et al., 2010). Findings from analysis of …

A Terrible Prank Gone Horribly Wrong The Development Of Delusional Infestation As An Adjustment Reaction To A Traumatic Hoax, Timothy Wong, Nardin El-Shammaa, Munaza Khan, Stephen Scheinthal

Rowan-Virtua Research Day

Delusional infestation (DI) is a somatic type delusional disorder, characterized by a fixed belief that one is infested by living or nonliving pathogens (1,3) . DI is a relatively rare disorder (4,5), with an estimated 20-80 cases per million people annually (6). Effective management of patients suffering from DI is crucial, as patients may cause significant harm to themselves in their attempts to remove the pathogens (7,8). Regarding treatment options, antipsychotic medications such as pimozide and risperidone have been promising (8,10). However, there remain many barriers to care (11), and patients are hardly ever seen in psychiatry as they preferably …

Dialectical Behavior Therapy For Dual Diagnosis: Treating Adolescent Substance Use Disorder And Co-Occurring Mood Disorders, Melody R. Gately

Senior Honors Projects

No abstract provided.

Mental Health Of Individuals Within Incarceration: A Systematic Literature Review, Steven I. Valladares

Capstone Experience

Mental Health Illness is on the rise in the United States. About 90% of incarcerated individuals have at least one mental health condition. The current federal and state incarceration systems do not seem to be well-equipped to transition an incarcerated individual to the civilian life. This is so because the incarceration system focuses too much on the punishment rather than rehabilitation. This framework could be deemed unsafe and dangerous to the civilian world once a prisoner gets released, due to incarcerated individuals not receiving adequate mental health treatment. This literature review highlights the flaws of the current incarceration system mental …

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Surface-Eroding Drug Delivery Films For Sequential And/Or Intermittent Release Of Psychoactive Drugs, Jason Price

Honors Theses

ABSTRACT JASON BLAKE PRICE: Surface-Eroding Drug Delivery Films for Sequential and/or

Intermittent Release of Psychoactive Drugs For patients with psychiatric diseases, adherence to medication schedules, medication

errors, and abuse are common issues. Promising new forms of therapy for these patients, such as micro-dosed lysergic acid diethylamide (LSD), where patients receive 10-20% of a full dose every third day, present further drug delivery challenges. Sequential or intermittent release of drugs from an implanted device could ensure long-term drug compliance, automate drug dosing during the life of the implant, and eliminate potential for abuse and medication errors. To this end, we generated …

Alexithymia And Physical Outcomes In Psychosomatic Subjects: A Cross-Sectional Study, Liam Alexander Mackenzie Myles, Emanuele Maria Merlo

Journal of Mind and Medical Sciences

Backgrounds. Alexithymia is a relevant phenomenon, occurring transversally to healthy subjects and individuals affected by several conditions. Its role is considerable, according to current state of the art several conditions emerged as influenced, maintained and worsened by alexithymic structures and figures. The present study was aimed at highlighting the existing relations, the differences and the directions assumed by alexithymic factors and health status in patients affected by psychosomatic conditions. Methods. The sample consisted of 150 participants, 42 males (28.0%) and 108 females (72.0%), aged 26 to 78 years old with a mean of 42.24 years old (SD = 12.39). Subjects …

Reducing Patient Risk For Suicidal Behaviors With A Safety Bundle Of Best Practices With Non-Psychiatric Patients, Olayemi Akindele

Student Scholarly Projects

Practice Problem: Suicide is a public health condition that affects people globally. The increased suicidal behaviors of patients in a medical-surgical unit demanded an effective screening protocol to identify high-risk patients.

PICOT: In patients 18 years and older on a medical-surgical unit, does the implementation of the Columbia Suicide Severity Rating Scale (C-SSRS) tool and application of a Safety Bundle of Best Practices (SBBP) increase early identification of suicide risk with decreased patient self-harm behaviors, compared to the current standard practice of no assessment tool or safety bundle of best practices within 12 weeks?

Evidence: Ten studies served as evidence …

The Experiences Of Iraqi Refugees In Canada: A Life History Study Of War And Resilience In The Aftermath Of Migration, Nada Nessan

Electronic Thesis and Dissertation Repository

This thesis reports on a life history narrative on the experiences of Iraqi refugees who resettled in Canada after living through war. The aim of this study is to help change the narrow perspectives on the mental health of war affected populations to a broader perception shaped by cultural and social aspects and to inform the development of meaningful and cultural relevant programs and policies with a particular attention to the concept of resilience.

The first part of the study presents the chronological narratives, or profiles. of eight participants. The second part of the study is a thematic discussion of …

Comparing The Trends Of Postpartum Depression Screening Scores During And Before The Covid-19 Pandemic, Elif S. Duran, Dung Dang, Tony Ogburn

MEDI 9331 Scholarly Activities Clinical Years

Introduction:

Postpartum depression includes major and minor depressive disorders affecting women in the time period after childbirth. The studies reviewed in our literature found that the COVID-19 pandemic has increased the risk of postpartum depression for women. Our study location, the Rio Grande Valley is one of the hardest-hit locations by the COVID-19 pandemic in the United States. Our patient population is also one with the higher risk factors for postpartum depression. As such, we are expecting the psychological impact of the pandemic to be even more magnified, and thus, actions need to be taken to support the vulnerable population …

Naloxone/Buprenorphine, Methadone, Naltrexone And Their Role In Medication Assisted Treatment, Robert Barrett

Capstone Showcase

Abstract

Opioid use disorder (OUD) is an increasingly common diagnosis that has drastically increased in the last 5 years. Though multiple treatment modalities exist for treating OUD (naltrexone, buprenorphine, methadone), few studies have compared treatment outcomes in adults on long term therapy. This is an important topic to understand as providers as we will undoubtedly come into contact with patients either actively abusing opioid antagonists or in recovery from opioid abuse. Since the introduction of Oxycontin and subsequent over prescription of opioid analgesics, opioid overdoses have increased by over twelve-fold. Once providers began to realize a widespread pattern of abuse, …

A Systematic Review Of Culturally Sensitive Interventions For Ethnic Minority Elders With Mental Illness, Sarah Littlefield, Rosalinda Villareal

Williams Honors College, Honors Research Projects

Honors Research Proposal

Goals and Objectives

Our systematic review asks the question: In ethnic minority elders with mental illness, how does culturally sensitive care, compared to current practices, affect patient outcomes? Our project goal is identifying evidence based practice with the goal of improving patient outcomes for ethnic minority elders with mental illnesses.

Methodology:

We will compile evidence from 20 current peer-reviewed studies. These studies will be selected from the CINAHL Plus med database, and key search terms will include: culturally sensitive care, culture, ethnic, mental health, intervention. All selected articles will be current within the last five years.

Outcomes: …

Differences In Smoking Behaviors And Readiness To Change For Patients With Copd And Differing Categories Of Depression, Jessica M. Floyd

Graduate Theses, Dissertations, and Problem Reports

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. Depression is a common comorbidity of COPD and affects patient outcomes and smoking cessation. The purpose of this study was to explore and describe factors influencing smoking behaviors and readiness to change in patients with comorbid COPD and depression.

Aims: The research question that guided this study was, “What are the relationships among smoking, COPD, and depression?” The following aims stemmed from the research question: to describe the characteristics of a convenience sample of people living with COPD and differing categories of depression who …