Psychiatric and Mental Health Commons^™

Exploring The Connection Between Diabetes Distress And Diabulimia, Stephen Poos, Misha Faerovitch, Celeste Pinto, Nima Jamalkhani, Fahad Chaudhri, Satara Khan, David F. Lo, Kaitlin Mcgowan, Ashaki Martin, Don D. Shamilov

Rowan-Virtua Research Day

Diabulimia is a disordered eating behavior that involves an individual with type 1 DM withholding insulin injection to lose weight. Diabetes distress, a term used to describe the psychological stress associated with managing diabetes, is believed to be the cause of this condition. This review aims to assess whether individuals with diabulimia have measurable evidence of diabetes distress. Studies that described patients qualitative experiences with Diabulimia were matched and compared to the criteria in the Diabetes Distress Scale. Over 40 of the 185 individuals across twelve studies were found to meet one or more criteria from the Diabetes Distress Scale. …

Alpha 7 Nicotinic Acetylcholine Receptor Expression In The Hippocampus Of Patients With Schizophrenia, Shruti Varshney, Ananya Nethikunta, Minjal Patel, Mary Kosciuk, Randel L. Swanson, Venkat Venkataraman, Robert Nagele, Eric Goldwaser, Nimish K. Acharya

Rowan-Virtua Research Day

Background: Schizophrenia (SZ) is a heterogenous psychiatric condition characterized by disruptions in cognition, social activity, affect, and perception often associated with a varied combination of positive and negative symptoms. The pathophysiology behind SZ remains poorly elucidated. Earlier reports have cited the importance of the alpha 7 nicotinic acetylcholine receptors (α7nAChR) in the hippocampus and the receptor’s association with auditory sensory gating and cognitive function. Specifically, variations in the expression and functionality of α7nAChR can be linked to auditory hallucinations experienced by patients with SZ and several therapies have been researched that target α7nAChRs. However, there are very few primary research …

Mental Health Differences In Medical Students Based On Curriculum And Gender, Maxim Jestin, Shelly Sharma, Deval Jhaveri, Brittany Mitchell, Dean Micciche, Venkat Venkataraman, Kathryn Lambert

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: The prevalence of mental health struggles among students in medical school is widely reported; however, little is known about how it is impacted by the medical school curriculum. This study aimed to evaluate differences in anxiety, depression, and emotional exhaustion in medical students based on gender, class year, and curriculum.

METHODS: An anonymous online survey consisting of questions from established, validated questionnaires about demographics, anxiety, depression, emotional exhaustion, and personal health behaviors was sent to 817 medical students who attended Rowan-Virtua School of Osteopathic Medicine during the Spring of 2021. When applying to this school, each of these students …

Understanding The Acceptability And Effect Of Psychiatric Care Via Telemedicine As An Alternative Option For Patients Living With Intellectual Disabilities In Group Homes, Brittany M. Johnson, Annabelle J. Rowland, Jacob D. Coeur, Maxwell C. Klapow, Jean F. Pointon

Cooper Rowan Medical Journal

Telemedicine has become a popular alternative to in-person clinic visits in the field of psychiatry, but few studies examine the impact of telemedicine mental healthcare provided to patients with intellectual disabilities living in group homes. Our study aims to fill this gap in the literature. A ten-question survey was designed to evaluate the effect of telemedicine services on access to care, quality of care, and patient and caregiver stress. This survey was distributed to caregivers of patients living in group homes who received care at the University of Alabama Medical Center. The majority of respondents indicated that telemedicine visits improved …

Posttreatment Lyme Disease Syndrome And Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review And Comparison Of Pathogenesis, Natalie Bai, Christie Richardson

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Lyme disease is the most common vector-borne illness in the United States and has been causing significant morbidity since its discovery in 1977. It is well-documented that about 10% of patients properly treated with antibiotics never fully recover, but instead go on to develop a chronic illness dubbed, posttreatment Lyme disease syndrome (PTLDS) characterized by severe fatigue, cognitive slowing, chronic pain, and sleep difficulties. This review includes 18 studies that detail the symptoms of patients with PTLDS and uses qualitative analysis to compare them to myalgic encephalitis/chronic fatigue syndrome (ME/CFS), a strikingly similar syndrome. In the majority of the PTLDS …

Biopsychosocial Impacts Of Social Distancing Due To Covid-19 In People Over 65: A Literature Review, Nicole Lacap

Rowan-Virtua Research Day

Background: Since the beginning of the Covid-19 pandemic in January 2020, elderly populations aged 65+ have been deemed at-risk for severe symptoms and poor prognosis. Because it is important to protect this vulnerable population, policies such as social distancing and shelter-in-place orders have been implemented in the United States in order to prevent the spread of Covid-19. However, many older citizens may live alone or may not have access to technology, and therefore may be limited in their ability to maintain important relationships and social interactions throughout shelter-in-place orders and social distancing. Therefore, it is important to understand the cost …

Mental Health Of Medical Students Regarding The Covid-19 Pandemic, Parth Patel, Richard Jermyn, Arvind Venkataraman

Rowan-Virtua Research Day

Mental health has taken a global priority as more realize that it is just as important as physical health in the overall health of a person. Medical students have faced mental health issues for decades and have been shown to suffer more than the general population. The recent COVID-19 pandemic has only deteriorated this issue. Many primary databases such as PubMed were used. The results indicate that medical students have extremely high rates of depression, burnout, anxiety, and stress that can affect their education but also carry over into their professions. Although many interventions increase mental wellness in medical school, …

Prevalence Of Disordered Eating In Female Athletes Of The New Jersey Athletic Conference, Desiree Brower, Joanna Petrides

Rowan-Virtua Research Day

Background: In 2018, the American Academy of Child and Adolescent Psychiatry published that, 1 out of every 10 adolescent females suffer from an eating disorder in the United States. Although it is known that eating disorders have an impact on the entire population, there are currently no studies on the prevalence of disordered eating in female athletes of the New Jersey Athletic conference (NJAC). This study aims to determine how many athletes in this population are affected.

Methods: This IRB-approved project utilized a survey-based approach to assess the prevalence of disordered eating among female athletes within the NJAC. To participate, …

Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong

Rowan-Virtua Research Day

We present a patient who is a 56-year-old female with a psychiatric history of anxiety disorder and a medical history of hypercholesterolemia and hyperthyroidism, who was admitted to the hospital after a witnessed seizure at an inpatient psychiatric facility. This patient’s family history is significant for her mother experiencing unspecified psychotic disorder that required psychiatric hospitalization. Our patient was first admitted to the psychiatric hospital after exhibiting worsening paranoid delusions and hallucinations that began several months prior. The patient had reportedly begun locking herself in the restroom and screaming “get out, they’re spying on me”, referring to her next-door neighbors …

Correlation Between Gut Biomarkers And Depression, Jianle Gao

Rowan-Virtua Research Day

The correlation between the gut-microbiota- brain axis and mental state in the context of mental disorders such as Major Depressive Disorder (MDD), Schizophrenia, etc. has been well studied. Production of inflammatory and non-inflammatory metabolites by the gut- microbiota directly and indirectly affects the brain and mood. Therefore, colonization by maladaptive, pro-inflammatory bacteria may cause mood dysregulation and depressive features. Metabolites from these bacteria can be quantitatively analyzed for use as biomarkers of Major Depressive Disorder. Biomarkers studied include: serotonin, dopamine, butyrate, acetate, and propionate.

Addressing The Access And Barriers To Mental Health Resources In High School Students, Tainiz Polanco, Ocean Alam, Diana Lopez, Vanessa Pizutelli

Rowan-Virtua Research Day

Minority populations throughout the world are hit with obstacles that interfere with their mental health, especially high school students. The recent COVID-19 pandemic has had drastic effects on the performance of these individuals and their social engagement. As observed, there is a divide amongst different races of students that highlights the lack of mental health resources provided to them and how they are utilized. After conducting further research on such issues, we were able to determine the major barriers existing today that tend to push students away from utilizing existing resources. Some of these barriers could vary from external stress …

Assessing The Need For Mental Health Screenings In A Student-Run Free Clinic And A Family Medicine Office, Sahil Parikh, Emily Forester, Alisha Basak, Jennifer Walpow, Rebecca Chae, Sahiba Gill, Tara Pellegrino

Rowan-Virtua Research Day

Background: The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention, and facilitates treatment. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic who serves patients regardless of patient gender, race, income or insurance status. This study aims to determine if there is a need to build internal infrastructure at RCHC for depression and anxiety management.

Methods: This is an IRB-approved study that began in June 2021. Data was collected from Rowan Community Health Center and Rowan Family Medicine patients. Patients were administered mental …

Impact Of Covid-19 Pandemic On Patients With Depression In Different Socioeconomic Status In Different Age Groups, Alexander Kowalski, Harsh Patel

Rowan-Virtua Research Day

This study aimed to investigate the impact of COVID-19 on depression and how different age groups and socioeconomic classes were affected. The PHQ-9 survey was used to assess depression levels amongst 64 individuals of different age groups and socioeconomic statuses. Results indicated that the higher socioeconomic class had less impact on depression symptoms compared to lower socioeconomic classes. Younger age groups and lower socioeconomic classes were found to have a bigger impact on depression symptoms. However, the study acknowledges that numerous factors, such as lifestyle factors, financial stability, and social support, need to be considered while interpreting the results. Overall, …

Stimulant Prescriptions For Adhd Treatment In Children, Victoria Murray, Miranda Reed, Sonya Priven, Dan Rios, Jan Widerman

Rowan-Virtua Research Day

ADHD has become a much more common neurobehavioral disorder in the US, but access to both psychotherapy and medication remains limited, exacerbating socioeconomic disparities in multiple life domains, including education, employment, and substance use disorder. Equity in access to care is an opportunity to substantially improve care.

Caretaker Burnout In Nj In Response To The Covid-19 Pandemic: A Study Focusing On Quality Of Life, Challenges And Coping Strategies., Abdullah Junayed, Joanna Petrides

Rowan-Virtua Research Day

There is a scarcity of literature regarding caretaker burnout in response to Covid-19, however one cross section survey study in Italy explored the perceived burden of caretakers of patients with Alzheimer’s disease during the pandemic.1 Maria G. Maggio et al showed that an increase in caregiver burden allowed for a deterioration in personal health conditions causing an increase in perceived stress levels. 1 Along with impaired management of stress and low quality of life, many caretakers were found to utilize avoidance strategies.1 However, the authors pointed out that the dysfunctional coping strategies did not affect stress levels and this study …

Exploring Risk Factors For Major Depressive Disorder For Female Patients Aged 18 Or Older Living In Ocean County, New Jersey, James Mack

Rowan-Virtua Research Day

Background: The incidence and prevalence of major depressive disorder has been increasing worldwide, in the United States of America, and on a local level. The population of Ocean County, New Jersey, a predominantly Caucasian, female, middle-aged population, may be at increased risk of developing major depressive disorder.

Purpose: To explore the social determinants of health and risk factors for major depressive disorder for female patients aged 18 or older living in Ocean County, New Jersey.

Methods: This literature review mainly used PubMed and Scopus for journal articles and utilized governmental databases for additional population data.

Results: Analyses conducted on social …

Case Report: Abrupt Psychosis Or Nmda Receptor Encephalitis?, Alexis Dunn, Neelesh Parikh, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 46-year-old female who was initially committed to a psychiatric facility for new onset schizophrenia symptoms. She later had an extensive workup in the hospital due to leukocytosis and was believed to have NMDA Receptor Encephalitis as the cause for her new behavioral symptoms. This case report aims to educate EM (emergency medicine) physicians to keep a broad differential diagnosis on patients who present with new onset, unprovoked psychosis later in life.

Case Series: Continued Remission Of Ptsd Symptoms After Discontinuation Of Prazosin, Christie Richardson, Jonathan Yuh, Jing Su, Martin Forsberg

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Post-traumatic stress disorder is a debilitating chronic illness that affects 6 out of 100 adults after a severe trauma. The alpha-adrenergic antagonist prazosin, which is prescribed off-label for flashbacks and nightmares due to trauma, is often continued indefinitely due to reports of symptoms returning upon discontinuation. There is no standard guidance for a trial of discontinuation of prazosin due to intolerance or side effects. In this case series, three patients are started on prazosin leading to remission of trauma-related symptoms, and symptoms continue to remit after treatment for an average of about 2 years followed by discontinuation of the medication. …

Physician Stress In The Era Of Covid-19 Vaccine Disparity: A Multi-Institutional Survey, Sarah Zahl, Debasis Mondal, David Tolentino, Jennifer A Fischer, Sherry Jimenez

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: Healthcare workers are at a high risk of infection during infectious disease outbreaks, such as the COVID-19 pandemic. Despite the availability of several vaccines against COVID-19, the absence of vaccination in patients and colleagues remains a continuous source of stress in healthcare workers. We conducted a survey of physician preceptors, both MDs and DOs, to explore the impact of differences in the patients' and colleagues' vaccination status on their well-being, stress, and burnout.

OBJECTIVES: The objective of this study is to determine whether exposure to unvaccinated patients and/or colleagues increases stress and burnout in physician preceptors by utilizing a …

Estimating Dementia Risk In An African American Population Using The Dctclock, Marissa Ciesla, Jeff Pobst, Joyce Gomes-Osman, Melissa Lamar, Lisa L Barnes, Russell Banks, Ali Jannati, David Libon, Rodney Swenson, Sean Tobyne, David Bates, John Showalter, Alvaro Pascual-Leone

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The prevalence of Alzheimer's disease (AD) and related dementias (ADRD) is increasing. African Americans are twice as likely to develop dementia than other ethnic populations. Traditional cognitive screening solutions lack the sensitivity to independently identify individuals at risk for cognitive decline. The DCTclock is a 3-min AI-enabled adaptation of the well-established clock drawing test. The DCTclock can estimate dementia risk for both general cognitive impairment and the presence of AD pathology. Here we performed a retrospective analysis to assess the performance of the DCTclock to estimate future conversion to ADRD in African American participants from the Rush Alzheimer's Disease Research …

A Qualitative Exploration Of Social Support In Males And Females Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: The purpose of this study was to qualitatively investigate and compare male and female experiences of infertility in the context of social support.

METHODS: A Qualtrics survey (Qualtrics, Provo, Utah, United States) was posted to online fertility support groups and the responses were thematically analyzed. Only participants that completed the qualitative component of the survey were included in the study. Responses were subsequently thematically analyzed.

RESULTS: A sample of 110 participants (13 males and 97 females) were included in the present study. Thematic analyses revealed that isolation and loneliness, stigma, sentiments of misunderstanding, insensitive reactions, and others' unhelpful attempts …

Possible Gender Differences In The Level Of Perceived Social Support In Couples Who Are Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Objective The purpose of this study is to examine whether there are gender differences in the level of perceived social support in couples experiencing issues with fertility. Methods A total of 938 participants aged 18-47 years, with self-reported issues of infertility, were evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS) which comprises three subscales which correspond with distinct sources of social support: significant other (SO), family, and friends. Differences between sexes for total score and for all subscale scores were subsequently analyzed using SPSS Statistics (IBM Corp, Armonk, USA). Results Mean total scores and scores on all subscales …

Prazosin Dosed 3 Times A Day To Treat Flashbacks Related To Ptsd: A Case Report, Christie Richardson, Alexander Swartz, Martin Forsberg

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Prazosin is an alpha-1 adrenergic receptor antagonist widely known by mental health providers for its off-label use for nightmares in patients with PTSD. Prazosin is lipophilic and crosses the blood-brain barrier to antagonize alpha-1 receptors in the central nervous system, potentially reducing autonomic arousal caused by PTSD. There have been numerous case reports describing the reduction of nightmares and daytime flashbacks due to PTSD with prazosin dosed at night and during the day, respectively. This case report illustrates the resolution of flashbacks related to chronic PTSD with prazosin dosed 3 times a day. As the half-life of prazosin is only …

Phq-2 Scores In Broward County’S Homeless: Prevalence, Barriers, And Proposed Solutions To Mental Health Disparities, Jeena A. Kar, Reeja Raj, Ariba Hashmi, Tahia Hossain, Joshua Berko, Joseph S. Degaetano, Patrick Hardigan

Cooper Rowan Medical Journal

Introduction: Florida ranks 9th in states with highest prevalence of mental illness among homeless individuals. The state also ranks 43rd of 52 states in providing adequate access for mental health concerns in homeless individuals. This study surveyed people experiencing homelessness in Broward County to investigate utilization of healthcare and mental health resources and accessibility of the target population to adequate care.. Aims included a collection of demographics concerning homelessness such as age and gender, prevalence of mental illness, history of substance use and emergency department, and then correlating these with scores from a standardized depression rating scale (PHQ-2). Methods: The …

Telemedicine And Adhd Management In Pediatric Patients In Southern New Jersey: A Retrospective Chart Review, Ami S. Patel, Alison Mancuso

Rowan-Virtua Research Day

Objectives:

• Investigate whether there is a relationship between use of telemedicine and improvement of symptoms of pediatric patients with ADHD
• To see if further study can be done on the use of telemedicine in treating pediatric ADHD patients

The Effect Of Covid-19 On Postpartum Depression Rates In Nj, Kyra Herman

Rowan-Virtua Research Day

• Postpartum Depression (PPD) is defined as depressive symptoms that last >2 weeks after delivery and that interfere with activities of daily living
• Pre-Covid: 13% of women nationwide experienced postpartum depressive symptoms with an estimated 50% of these women not being treated
• Edinburgh Postnatal Depression Scale (EPDS) is the standard survey administered in postpartum period.
• Retrospective chart review of 186 patients
• The pre-Covid timeframe was defined as July 2019 to January 2020 and the intra-Covid timeframe was defined as July 2020 to January 2021.
• While it was hypothesized that the Covid-19 pandemic would cause the risk of PPD to increase, as …

Treating Trichotillomania With Olanzapine, Christopher Lee

Rowan-Virtua Research Day

Trichotillomania (TTM) is characterized by repetitive pulling of one’s hair leading to hair loss and problems in social, occupational, or other important areas of functioning. Often individuals with TTM try to decrease or stop hair pulling, however are often unsuccessful without treatment. Community prevalence studies suggest that TTM is a common disorder with point prevalence estimate of 0.5% to 2.0% and with significant psychological comorbidity. Of note, people with TTM are often embarrassed about their condition, so epidemiology data may be underestimated compared to the true prevalence of this condition. The female to male ratio for this condition is 4:1. …

An Interesting Case Of Factitious Disorder Superimposed On Self: Factitious Disorder Vs Somatic Symptom Disorder, Michaela Margolis, Logan Noone, Jessica Baaklini

Rowan-Virtua Research Day

Factitious disorder superimposed on self (FDIS) was first described in 1951by Richard Asher, who associated the disorder with Baron Munchhausen, who narrated unrealistic and exaggerated stories about his life.

Suspicion for FDIS should be raised when patients with atypical presentations of medical disorders seek excessive use of healthcare services despite ongoing lack of clinical evidence. Patients with FDIS often demand hospitalization for their symptoms, leading to unnecessary tests and treatments. These patients show signs of pathological lying, deceitfulness, are obstinate with medical staff, and display erratic behavior. When medical investigation does not support their symptoms, patients often develop new “symptoms” …

The Need For Depression And Anxiety Screenings At A Student-Run Clinic, Shayna Peterzell, Sahil Parikh, Alicia Podwojniak, Vibha Chauhan, Riya Tandra, Emily Forester, Saumil Parikh, Jessica-Sophie Horoschak, Patrick Pearce, Roma Padalkar, Sobiah Khan, Tara Pellegrino

Rowan-Virtua Research Day

General anxiety and major depressive disorder are common and treatable mental health disorders. The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention and facilitates treatment. Many medical offices use validated screening tools, GAD-7 and PHQ-9, to measure symptom severities and further help guide treatment modalities for patients with anxiety and depression, respectively. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic that serves patients regardless of patient gender, race, income, or insurance status. This study aims to determine if there is a need …

Preferences For Support Resources Among Loved Ones Of Adults Prescribed Opioid Medications, Mansi Patel, Desta M. Pulley, Daniel Manvich

Rowan-Virtua Research Day

The opioid epidemic continues to be a leading cause of overdose and related deaths in America. While most interventions are focused on the individuals with opioid and substance use disorder (OUD/SUD); the impact caregivers and family can have on the treatment of patients with OUD is non-existent. The purpose of this study is to collect pilot data on peers, friends, and family members of patients with SUD/OUD to understand the barriers in psychosocial support and maintaining treatment retention; barriers to accessing medication assisted therapy (MAT) and naloxone; and caregiver fatigue and barriers for caregivers. The collected data will be used …