Psychiatric and Mental Health Commons^™

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 …

Two Lives, Shruti Trehan Mbbs

Journal of Wellness

A busy oncologist makes a decision to leave her busy, thriving, community practice in the Mid-West and moves to a Veterans Affairs hospital in South Florida in the quest for a better work-life balance.

Impact Of Covid-19 Pandemic On Emergency Department Visits For Opioid Use Disorder Across University Of California Health Centers, Matthew Heshmatipour, Ding Quan Ng, Emily Yi-Wen Truong, Jianwei Zheng, Alexandre Chan, Yun Wang

Pharmacy Faculty Articles and Research

Introduction: Coronavirus 2019 (COVID-19) has had a devastating impact on mental health and access to addiction treatment in the United States, including in California, which resulted in the highest rates of emergency department visits (ED) for opioid poisoning in 2020. As California slowly returns to pre-pandemic normalcy, it remains uncertain whether the rates of opioid-related events have slowed down over time. We hypothesized that the number of opioid-related ED visits were exacerbated after the period of the COVID-19 pandemic and continue at a high rate in the present.

Methods: In this analysis we searched the University of California (UC) Health …

Interprofessional Education To Support Alcohol Use Screening And Future Team-Based Management Of Stress-Related Disorders In Vulnerable Populations, Taylor Fitzpatrick-Schmidt, Scott Edwards

School of Graduate Studies Faculty Publications

Introduction: Alcohol use disorder (AUD) is a psychiatric disease that affects approximately 10% of the population. Individuals suffer from a myriad of causes and consequences of AUD, and team-based management of patients is often required for given the chronic and complex nature of the disease. Interprofessional education (IPE) for biomedical science and health professional students that incorporates patient-centered cases focused on AUD and adjacent stress-related disorders may improve future collaboration in managing these conditions and community outcomes related to wellbeing. Methods: This study assessed the impact of a single, 90-minute IPE exercise on improving confidence in possessing the knowledge and …

Adverse Childhood Experiences And Effects On Delinquency, Katherine Lank

Master of Arts in Human Services

Youth involved in delinquent acts are seen interacting with the juvenile justice system at an alarming rate. Adverse childhood experiences influence the development of behavior and chances of taking risks. Children who grow up in a household with an unfit parent, substance abuse, or mental health disorders are seen turning to delinquent acts for gratification. This can have a higher chance of poor educational performance, unemployment, increased law enforcement interactions, and long-term mental and physical disabilities. Searching literature consisted of finding external factors and their control on brain development and future adult behaviors. Research was conducted on the school-to-prison pipeline, …

The Frequency And Predictive Factors Of Change In Alcohol Consumption During The Covid-19 Pandemic: Results From A Multi-Country Longitudinal Study, Carolien Verhei, Nadja Alexandrov, Erica I. Lubetkin, Gouke J. Bonsel, John N. Yfantopoulos, Mathieu F. Janssen, Stephanie C.E. Schuit, Suzanne Polinder, Pleunie P.M. Rood, Juanita A. Haagsma

Publications and Research

Background: The COVID-19 pandemic has had multiple health and behavioral effects in the general population worldwide, including effects on nutritional and lifestyle behavior such as alcohol consumption. This study aimed to determine the frequency of and predictors for change in alcohol consumption two years after onset of the COVID-19 pandemic among participants from the general population of six countries. Methods: Longitudinal study design with 4999 participants (47% male; aged 18–75 years) from a general population cohort from six countries: Greece, Italy, the Netherlands, Sweden, the United Kingdom (UK) and the United States of America (US). Measurements: Three web-based surveys at …

Application Of An Opioid Risk Assessment Tool For Patients With Pain Presenting To The Emergency Department With Drug-Seeking Behaviors, Darian L. Stephens

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this quality improvement project was to introduce the Screener and Opioid Assessment for Patients with Pain- Revised (SOAPP-R) tool to identify patients in the emergency department (ED) at risk for opioid abuse.

BACKGROUND The project was implemented in a 13-bed freestanding ED that can treat medical emergencies as well as provide substance abuse detoxification services.

METHODOLOGY A systematic approach that combined quantitative and qualitative data was used during the pre-implementation and implementation periods. The clinical staff was educated on the process of implementing the SOAPP-R tool. Those who were identified as at risk for opioid abuse …

Improving Identification Of Complicated Alcohol Withdrawal Syndrome Using The Prediction Of Alcohol Withdrawal Severity Scale, Kristin Hagopian

Dissertations

Problem: Individuals who drink alcohol excessively are at great risk for alcohol withdrawal syndrome (AWS) when hospitalized. Symptoms and their severity differ for everyone, and research shows that the identification and treatment of AWS is challenging and often inadequate. Mild AWS is often overtreated, while moderate to severe AWS is often underdiagnosed and undertreated, placing individuals at risk for longer hospital stays, more time needed in critical care units, and a variety of unintended consequences.

Methods: This evidence-based practice project had a pre-post intervention design in which the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) was implemented to promptly identify …

Implementing A Brief Intervention For Smoking Cessation In An Inpatient Psychiatric Facility, Erika Gotway

Dissertations

Abstract

Problem: Smoking is a leading cause of various preventable diseases, and those who experience mental illness smoke cigarettes at a higher rate than the general population. Brief intervention is a type counseling that has proven successful in encouraging smokers to quit. The “5 A’s” is a type of brief intervention which stands for: Ask, Advise, Assess, Assist, Arrange. Addressing the smoking epidemic among individuals with mental illness is not only essential for improving their overall well-being, but also for reducing health disparities and enhancing the effectiveness of existing mental health interventions.

Methods: The approach to this project was a …

A Cost-Effectiveness Analysis Of Telehealth Vs. Office-Based Delivery Of Buprenorphine At The Addiction And Substance Abuse Program (Asap) Clinic - University Of New Mexico Hospital: A Societal Perspective, Rana Alkhafaji

Pharmaceutical Sciences ETDs

This study evaluates the cost-effectiveness of office-based versus telehealth delivery of buprenorphine treatment for opioid use disorder (OUD). A retrospective chart review of 135 patients at the University of New Mexico Hospital's Addiction and Substance Abuse Program compared retention rates and costs between the two settings. Retention was defined as continuous treatment for at least six months. No statistically significant difference in retention rates was found, with 51% for office-based and 42% for telehealth. However, office-based treatment had higher total costs, with an incremental cost-effectiveness ratio of $3,750 per 1% increase in retention. The findings suggest telehealth is a cost-effective …

Psilocybin Utilization In Alcohol Use Disorder, Hannah Hall, Sarah Turske, Hannah Blake, Abigail Carter, Connor Dains, Haylee Whyde, Brianna Lu, Joshua Honaker, Lindsey Peters

Pharmacy and Wellness Review

Alcohol use disorder (AUD) is a medical condition that arises from the inability to control alcohol consumption regardless of negative consequences. Over 10% of the US population met the diagnostic criteria for having AUD in 2022.1 Each individual presents with symptoms of AUD differently and may therefore need more personalized treatment. Research has shown that using a combination of currently available pharmacological and non-pharmacological treatment options provides the best results for patients with AUD. However, there still remains a pressing need for the development of newer treatment options. Psilocybin, a naturally occurring psychedelic compound, is currently under investigation due to …

Viral Hepatitis And Hiv Screening Amongst Inpatients With Substance Use Disorder, Christine Papastamelos, Md, Elizabeth Novick, Md, Carolyn Kramer, Md, John Zurlo,Md, Nikhil Seval, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• ~67,000 individuals in Philadelphia county are estimated to be living with opioid use disorder (OUD).¹
• Persons who inject drugs (PWID) are at disproportionately greater risk of acquiring HIV and viral hepatitis compared to the general public.²
• PWID are less likely to receive timely HIV and viral hepatitis screening in the outpatient setting given complex biopsychosocial barriers, including homelessness, mental illness, lack of insurance, incarceration, and stigma.^3,4

Spot The Signs- 防范未然，及时干预- 培训, Kenny Kah-Keng Leng, Victoria Wong Murray, Alexus Weatherspoon, Amy Palen, Kenneth W. Stagliano, Stephen M. Scheinthal

Rowan-Virtua Research Day

Opiate overdose is an unfortunately common risk factor for suicide; suicide attempts accounted for an estimated 30% of fatal opioid overdoses during the pandemic, and patients with an episode of opiate overdose were at an 18 times higher risk of suicide in the following year. As a result, the Rowan School of Osteopathic Medicine Department of Psychiatry developed an Integrated Mental Health Awareness and Suicide Prevention program targeted at members of the community and frontline workers to increase awareness and provide brief interventions, which demonstrated an improvement of 89% in our English-speaking attendees.

Chinese is the second-most common non-English language …

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Validation Of A Novel Heritable Rodent Model Of Drug Abuse Vulnerability In Psychosis And Investigation Of Therapeutic Targets, Loren D. Peeters

Electronic Theses and Dissertations

Schizophrenia is a severe neuropsychiatric disorder of largely unknown etiology that is often accompanied by high rates of cigarette smoking, reduced quit success, and high relapse rates. Dysregulated dopamine signaling and aberrant synaptic plasticity in the mesocorticolimbic pathway are implicated in the pathophysiology of schizophrenia and conferred substance abuse disorder and relapse vulnerability. Genetic factors are presumed to play a significant role in the development of schizophrenia, with a 40-50% concordance rate for monozygotic twins, although genetic markers are inconsistent. As such, epigenetic factors have instead been implicated. Specifically, there is strong evidence to suggest DNA methylation at several candidate …

Molecular Mechanisms Of Opioid Use Disorder In Human Brain Models, Emily Mendez

Dissertations and Theses (Open Access)

Opioid use disorder (OUD) is a national and global public health crisis with no end in sight. While studies from animal models hint at widespread epigenetic and transcriptomic alterations of opioid drugs, the molecular consequences of long-term exposure to opioid drugs in human brain is still unclear, and human-centered translational models are necessary to discern the human cell type-specific effects of OUD.

Using postmortem brain Brodmann area 9 (BA9) from the UTHealth Brain Collection for Research on Psychiatric Disorders, I identified angiogenic gene networks perturbed in the RNA and protein of OUD subjects, as well as downregulation of many neuron-correlated …

Medication Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates, Kayla Sherea Williams Bsn, Rn, Hannah Lee Brenner Bsn, Rn, Madison Makenzie Yount Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Background The Centers for Disease Control and Prevention (CDC) found that each day more than 140 U.S. residents die from drug overdoses, specifically due to opioids. Due to this, alternatives were created to reduce overdoses and ensure safety. Medication assistance therapy (MAT) is an effective form of treatment for people with substance use disorders and is defined as the use of medication in conjunction with counseling or therapy for the treatment of substance use disorders. The efficacy of MAT is used adjunctively with psychotropic medications compared to using no MAT and using psychotropic medications alone with individuals who are experiencing …

Predicting Hospitalization Risk Of Schizophrenia Patients In Missouri, Arun Kumar

Theses

Understanding the factors that contribute to the risk of hospitalization among individuals with schizophrenia is crucial for optimizing treatment strategies and improving patient outcomes. In this study, we used recent Medicaid adminis trative claims data in Missouri (from 2016 to 2019) and predicted the risk of hospitalization of patients diagnosed with Schizophrenia (N=143446). We ana lyzed the association between previous hospitalizations and the likelihood of future hospitalizations. We developed machine learning techniques, including logistic re gression and decision tree classifiers, to predict the risk of hospitalization based on demographic factors, clinical variables, and historical hospitalization records. Our findings reveal that …

Adolescent Marijuana Use And The Contribution To The Development Of Schizophrenia, Jocelyn Spandikow

Psychology Student Papers and Posters

Schizophrenia is an often debilitating mental condition that has become a popular topic of psychological research in recent years. Current research examines the correlation between drug use, genetics, and environment on the development of schizophrenia. Research looks at the structure of the brain in individuals with and without schizophrenia. However, research has failed to look at the specific correlation between marijuana use in adolescent youth and the developmental impact on the brain, including in the development of schizophrenia. The legalization of many recreational drugs, including marijuana, has come to fruition in recent years. This has raised concerns over adolescent access …

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

How Do Gender And Childhood Trauma Influence Opioid Misuse And Pain Outcomes Among Patients With Chronic Pain, Grace Ann Newton, Taylor B. Crouch Phd

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

Body-Map Storytelling: A Qualitative Exploration Of The Lived Experiences Of Hospital Care Amongst Street Involved Youth, Chelsey Fedchenko

Theses and Dissertations (Comprehensive)

This social work study explores the experiences of hospital care amongst street-involved (SI) youth. Given that SI youth are at a higher risk for health-related harms and experience significant barriers to health care services, they are at an increased likelihood of hospitalization. Yet, inadequate health care support for SI youth remains a critical problem in Canada. While hospital care amongst adult homeless populations has been well studied interdisciplinary, there is a scarcity of research investigating the hospital care experiences amongst SI youth. The aim of this qualitative, arts-based study was to explore how street-life contributes to hospitalization, how SI youth …

Intermittent Theta Burst Stimulation And Functional Connectivity In People Living With Hiv/Aids Who Smoke Tobacco Cigarettes: A Preliminary Pilot Study, Gopalkumar Rakesh, Thomas G Adams, Rajendra A Morey, Joseph L Alcorn, Rebika Khanal, Amanda E Su, Seth S Himelhoch, Craig R Rush

Faculty, Staff and Student Publications

BACKGROUND: People living with HIV (PLWHA) smoke at three times the rate of the general population and respond poorly to cessation strategies. Previous studies examined repetitive transcranial magnetic stimulation (rTMS) over left dorsolateral prefrontal cortex (L. dlPFC) to reduce craving, but no studies have explored rTMS among PLWHA who smoke. The current pilot study compared the effects of active and sham intermittent theta-burst stimulation (iTBS) on resting state functional connectivity (rsFC), cigarette cue attentional bias, and cigarette craving in PLWHA who smoke.

METHODS: Eight PLWHA were recruited (single-blind, within-subject design) to receive one session of iTBS (n=8) over the L. …

Recovery Capital, Mental Health And Substance Use Among Individuals Initiating Office-Based Buprenorphine Treatment For Opioid Use Disorder, Hannah R. Callahan, Karen Dugosh, Emily Hurstak, Patty Mccarthy, Emily Garber, Daniel Dejoseph, Julia Dejoseph, Michelle R. Lent

The Journal of Integrated Primary Care

Recovery capital refers to the internal and external resources available to support an individual in their recovery from substance use disorders. Using data from an ongoing trial, the current study examined recovery capital among 225 individuals initiating office-based buprenorphine treatment for opioid use disorder (OUD) at Federally Qualified Health Centers in the mid-Atlantic region. At baseline, participants completed the Brief Assessment of Recovery Capital-10 (BARC-10), a validated measure assessing the 4 major domains of recovery capital and completed a urine toxicology screening. Participants reported BARC-10 scores of 49.22 on average (SD = 8.14). Average scores were highest for the …

Reconceptualizing Complex Post-Traumatic Stress Disorder: An Evolutionary Concept Analysis And Clinical Guide, Jessica Livingston

Doctoral Projects

Conflicting models of how trauma manifests into identifiable symptoms have been a source of controversy and perplexity among practicing mental health clinicians and diagnosticians. Complex post-traumatic stress disorder (CPTSD) is now an internationally recognized diagnosis since its inclusion in the 11^th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD-11) in 2018. The American Psychological Association (APA) does not share this recognition of CPTSD as an individual diagnosis and instead opted to update the diagnostic criteria for PTSD to include DSO and a 4^th category of dissociative features rather than include CPTSD as a separate …

Illness Trajectory From Prodromal Symptoms To Incident Bipolar Disorder And Schizophrenia, Manuel A. Gardea Resendez, Javier Ortiz-Orendain, Brandon J. Coombes, Aysegul Ozerdem, Monica J. Taylor-Desir, Balwinder Singh, Alastair J. Mckean, Mark Frye

Research Symposium

Background: The concept of prodrome is highly variable but, when applied retrospectively in cohorts who progress to meet diagnostic criteria for bipolar disorder (BD) and schizophrenia (SZ), it can contribute to clarify early origins and trajectory of the illness. In the context of race and ethnicity, studies with population-based and registry-based cohorts, such as the Rochester Epidemiology Project (REP), can potentially identify, through retrospective assessment of the prodromes of BD and SZ, differences while addressing the heterogeneous nature of the illness.

Objective: We aim to describe and compare the illness trajectories of individuals with BD or SZ prior to the …

Adverse Childhood Experiences And Resilience In Medical School Students: A Scope Of Medical Literature, Andrea Soto Abarca, Yvette Cortino, Juan Carlos Lopez Alvarenga, Maya Guevara

Research Symposium

Background: Adverse childhood experiences (ACEs) represent types of childhood trauma that are associated with long-term negative effects on health and wellbeing. An elevated number of ACEs can lead to depression, suicidality, alcoholism, and substance use. Factors that can protect a person from increased health risks include resilience, which is broadly defined as the ability to bounce back from adversity. Few studies have analyzed the exposure of ACEs in medical students, however, there is extensive literature on how low levels of resilience are linked to higher rates of depression, fatigue, and burnout among medical students. Little is known about the …

Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

Identifying Associations Between The Family Environment And Anxiety And Depression Among Children Ages 0-17 In The United States, Reagan A. Richardson, Nicole M. Holt

OUR Journal: ODU Undergraduate Research Journal

This study analyzes whether physical, emotional & neurological, family environment, or community-related factors display the strongest association with anxiety and depression among children ages 0-17 in the United States.

Using IBM SPSS v. 27, we conducted a univariate and multivariate logistic regression analysis on data from the 2017 National Survey of Children’s Health (NSCH) with a sample size of 21,599. Our independent variables included 30 questions from the NSCH which were compared to a mental health index score.

Our study shows that about 10.6% of children suffer from either anxiety, depression, or both, and the univariate model found that 19 …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …