Psychiatric and Mental Health Commons^™

An Ot Needs Assessment For Children And Families Residing In Shelters, Jessie Siono, Susan Macdermott

Spring 2024 Virtual OTD Capstone Symposium

This study created a needs assessment is to determine the unique occupational deficits of children and their families in California experiencing homelessness within a shelter setting via recording their lived experiences. A local family shelter was analyzed via observation and interviews with staff and residents of the shelter. The results were compiled into a facility assessment to identify supports and barriers to occupation. Results were also utilized to complete an occupational needs assessment for families and children living in homeless shelters. The study determined the occupational needs and occurrences of occupational deficits that were experienced by residents of the family …

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 Faculty Scholarship

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 …

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 Faculty Scholarship

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 …

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 …

Memantine: Can It Be Used To Treat Children With Autism Spectrum Disorder?, Austin Brown, Katherine Liu, Pul Lee, Rachel Muhlenkamp, Manoranjan D'Souza

Pharmacy and Wellness Review

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social, behavior and communicative skills. The current therapy for ASD only targets the associated symptoms such as aggression, self-harming acts or temper tantrums but not the core symptoms of social dysfunction. The pathology of ASD is not fully understood. Interestingly, imaging studies in ASD patients have reported abnormal high levels of glutamate in certain brain regions that play an important role in social interaction and communication. Thus, it has been hypothesized that medications attenuating glutamate transmission may be used as treatment for some of the core symptoms of …

Older Adults' Health Care Utilization A Year After Experiencing Fear Or Distress From Hurricane Sandy, Laura P Sands, Yimeng Xie, Rachel Pruchno, Allison Heid, Yili Hong

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

OBJECTIVE: To determine whether self-reports of disaster-related psychological distress predict older adults' health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

METHODS: Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

RESULTS: In total, 7% (107) of respondents reported they experienced …

Multinational Comparative Cross-Sectional Survey Of Views Of Medical Students About Acceptable Terminology And Subgroups In Schizophrenia, Shanaya Rathod, Muhammad Irfan, Rachna Bhargava, Narsimha Pinninti, Joseph Scott, Haifa Mohammad Algahtani, Zhihua Guo, Rishab Gupta, Pallavi Nadkarni, Farooq Naeem, Fleur Howells, Katherine Sorsdahi, Kerensa Thorne, Victoria Osman-Hicks, Sasee Pallikadavath, Peter Phiri, Hannah Carr, Lizi Graves, David Kingdon

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

AIM: The aim of this study was to inform thinking around the terminology for 'schizophrenia' in different countries.

OBJECTIVES: The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

DESIGN: This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

SETTING: The study …

Agreement Between Clinician-Rated Versus Patient-Reported Outcomes In Huntington Disease, Noelle E Carlozzi, Nicholas R Boileau, Joel S Perlmutter, Kelvin L Chou, Julie C Stout, Jane S Paulsen, Michael K Mccormack, David Cella, Martha A Nance, Jin-Shei Lai, Praveen Dayalu

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Clinician-rated measures of functioning are often used as primary endpoints in clinical trials and other behavioral research in Huntington disease. As study costs for clinician-rated assessments are not always feasible, there is a question of whether patient self-report of commonly used clinician-rated measures may serve as acceptable alternatives in low risk behavioral trials.

AIM: The purpose of this paper was to determine the level of agreement between self-report and clinician-ratings of commonly used functional assessment measures in Huntington disease.

DESIGN: 486 participants with premanifest or manifest Huntington disease were examined. Total Functional Capacity, Functional Assessment, and Independence Scale assessments …

Relationships Among Apathy, Health-Related Quality Of Life, And Function In Huntington's Disease., Nora E Fritz, Nicholas R Boileau, Julie C Stout, Rebecca Ready, Joel S Perlmutter, Jane S Paulsen, Kimberly Quaid, Stacey Barton, Michael K Mccormack, Susan L Perlman, Noelle E Carlozzi

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Up to 90% of individuals with Huntington's disease (HD)-a progressive, inherited neurodegenerative disorder-experience apathy. Apathy is particularly debilitating because it is marked by a reduction in goal-directed behaviors, including self-care, social interactions, and mobility. The objective of this study was to examine relationships between variables of apathy, functional status, physical function, cognitive function, behavioral status/emotional function, and health-related quality of life. Clinician-rated measures of physical, cognitive, and behavioral function, including one clinician-rated item on apathy, and self-reported measures of physical function, health-related quality of life, and emotional, cognitive, and social function were collected in a single session from 487 persons …

Suicidal Ideation Assessment In Individuals With Premanifest And Manifest Huntington Disease., Melissa Wesson, Nicholas R Boileau, Joel S Perlmutter, Jane S Paulsen, Stacey K Barton, Michael K Mccormack, Noelle E Carlozzi

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Huntington disease (HD) is associated with increased risk of suicide.

OBJECTIVE: This study compares suicide ideation in HD to the general population, assesses factors associated with increased prevalence of suicidal thoughts, and compares clinician-rated to self-reported assessments of suicidal ideation.

METHODS: We examined 496 participants with premanifest or manifest HD. Clinician-rated suicidal ideation was measured using the Problem Behaviors Assessment - short form. Self-reported ideation was measured using two items from the HDQLIFE Concern with Death and Dying item bank. Independent sample t-tests were conducted to compare the prevalence of suicidal thoughts between our HD sample and the U.S. …

Adverse Events In Veterans Affairs Inpatient Psychiatric Units: Staff Perspectives On Contributing And Protective Factors., Gala True, Rosemary Frasso, Sara W. Cullen, Richard C. Hermann, Steven C. Marcus

College of Population Health Faculty Papers

OBJECTIVES: This study sought to identify risk factors and protective factors in hospital-based mental health settings in the Veterans Health Administration (VHA), with the goal of informing interventions to improve care of persons with serious mental illness.

METHODS: Twenty key informants from a stratified sample of 7 VHA inpatient psychiatric units were interviewed to gain their insights on causes of patient safety events and the factors that constrain or facilitate patient safety efforts.

RESULTS: Respondents identified threats to patient safety at the system-, provider-, and patient-levels. Protective factors that, when in place, made patient safety events less likely to occur …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Serious Mental Illness Among Young Adult Women Who Use Drugs In The Club Scene: Co-Occurring Biopsychosocial Factors, Maayan Lawental, Hilary L. Surratt, Mance E. Buttram, Steven P. Kurtz

Center for Health Services Research Faculty Publications

Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami’s club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a …

Role Of Pharmacogenetics In Improving The Safety Of Psychiatric Care By Predicting The Potential Risks Of Mania In Cyp2d6 Poor Metabolizers Diagnosed With Bipolar Disorder., Santiago Sánchez-Iglesias, Virginia García-Solaesa, Belén García-Berrocal, Almudena Sanchez-Martín, Carolina Lorenzo-Romo, Tomás Martín-Pinto, Andrea Gaedigk, José Manuel González-Buitrago, María Isidoro-García

Manuscripts, Articles, Book Chapters and Other Papers

One of the main concerns in psychiatric care is safety related to drug management. Pharmacogenetics provides an important tool to assess causes that may have contributed the adverse events during psychiatric therapy. This study illustrates the potential of pharmacogenetics to identify those patients for which pharmacogenetic-guided therapy could be appropriate. It aimed to investigate CYP2D6 genotype in our psychiatric population to assess the value of introducing pharmacogenetics as a primary improvement for predicting side effects.A broad series of 224 psychiatric patients comprising psychotic disorders, depressive disturbances, bipolar disorders, and anxiety disorders was included. The patients were genotyped with the AmpliChip …

Correspondence Between Self-Report And Interview-Based Assessments Of Antisocial Personality Disorder, Laura Guy, Norman Poythress, Kevin Douglas, Jennifer Skeem, John Edens

Norman Poythress

Antisocial personality disorder (ASPD) is associated with suicide, violence, and risk-taking behavior and can slow response to first-line treatment for Axis I disorders. ASPD may be assessed infrequently because few efficient diagnostic tools are available. This study evaluated 2 promising self-report measures for assessing ASPD--the ASPD scale of the Personality Diagnostic Questionnaire-4 (PDQ-4; S. E. Hyler, 1994) and the Personality Assessment Inventory (PAI; L. Morey, 1991, 2007)--as well as the ASPD module of the Structured Clinical Interview for DSM-IV Axis II (SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, J. B. W. Williams, and L. S. Benjamin, 1997). The …

Factors Differentiating Successful Versus Unsuccessful Malingerers, John Edens, Laura Guy, Randy Otto, Jacqueline Buffington, Tara Tomicic, Norman Poythress

Norman Poythress

Relatively little is known about the processes in which "successful" malingerers engage to avoid detection. This study summarizes the response strategies used by participants (N = 540) instructed to feign a specific mental disorder while completing various self-report instruments designed to detect faking. Postexperiment questionnaires indicated that those who were able to appear symptomatic while avoiding being detected as feigning (n = 60) were more likely to endorse a lower rate of legitimate symptoms, to avoid overly unusual or bizarre items, and to base their responses on their own personal experiences.

Is It Abuse? Deaf Female Undergraduates' Labeling Of Partner Violence, Melissa Anderson, Caroline Kobek Pezzarossi

Melissa L. Anderson

The current study investigated the labeling of abuse experiences in a sample of 97 Deaf female undergraduate students, exploring the following questions: What is the prevalence of violent behaviors experienced by Deaf female undergraduates in their past-year relationships, what proportion of these relationships are identified as "abuse," and what scripts and strategies do Deaf female undergraduates utilize to label their experiences of partner violence? Results indicated that over half of the sample chose not to label past-year experiences of psychological aggression, physical assault, and sexual coercion as abuse, even when these experiences included severe violence. Implications for the Deaf education …

Intimate Partner Violence Against Deaf Female College Students, Melissa Anderson, Irene Leigh

Melissa L. Anderson

It has been estimated that roughly 25% of all Deaf women in the United States are victims of intimate partner violence (Abused Deaf Women's Advocacy Services [ADWAS]), a figure similar to annual prevalence rates of 16% to 30% for intimate partners in the general population. One goal of the present study was to ascertain the prevalence of intimate partner violence victimization in a sample of Deaf female college students. When comparing the prevalence of physical assault, psychological aggression, and sexual coercion victimization to hearing female undergraduates, the current sample was approximately two times as likely to have experienced victimization in …

Deaf Students And Their Classroom Communication: An Evaluation Of Higher Order Categorical Interactions Among School And Background Characteristics, Thomas Allen, Melissa Anderson

Melissa L. Anderson

This article investigated to what extent age, use of a cochlear implant, parental hearing status, and use of sign in the home determine language of instruction for profoundly deaf children. Categorical data from 8,325 profoundly deaf students from the 2008 Annual Survey of Deaf and Hard-of-Hearing Children and Youth were analyzed using chi-square automated interaction detector, a stepwise analytic procedure that allows the assessment of higher order interactions among categorical variables. Results indicated that all characteristics were significantly related to classroom communication modality. Although younger and older students demonstrated a different distribution of communication modality, for both younger and older …

Black Deaf Individuals' Reading Skills: Influence Of Asl, Culture, Family Characteristics, Reading Experience, And Education, Candace Myers, M. Diane Clark, Millicent Musyoka, Melissa Anderson, Gizelle Gilbert, Selina Agyen, Peter Hauser

Melissa L. Anderson

Previous research on the reading abilities of Deaf individuals from various cultural groups suggests that Black Deaf and Hispanic Deaf individuals lag behind their White Deaf peers. The present study compared the reading skills of Black Deaf and White Deaf individuals, investigating the influence of American Sign Language (ASL), culture, family characteristics, reading experience, and education. (The descriptor Black is used throughout the present article, as Black Deaf individuals prefer this term to African American. For purposes of parallel construction, the term White is used instead of European American.) It was found that Black Deaf study participants scored lower on …

Telepsychiatric Assessment Of A Mariner Expressing Suicidal Ideation., Alexander Lee, Neal Sikka, Francis O'Connell, Allen Dyer, Keith Boniface, James Betz

Emergency Medicine Faculty Publications

This case report highlights the successful use of telepsychiatric consultation by secure video chat to remotely assess a mariner expressing suicidal ideation. As a result of this intervention, telemedicine providers initiated psychiatric stabilisation while the mariner was still aboard the vessel, determined that he was safe for repatriation under the care of qualified medical escorts, and facilitated admission to a psychiatric facility near his home in the United States. Mental health emergencies are a significant cause of morbidity and mortality among mariners. Telepsychiatry is a validated method of establishing a psychiatric diagnosis and disposition as well as assessing risk of …

Antipsychotic Use In Nursing Homes Varies By Psychiatric Consultant, Jennifer Tjia, Terry Field, Celeste Lemay, Kathleen Mazor, Michelle Pandolfi, Ann Spenard, Shih-Yieh Ho, Abir Kanaan, Jennifer Donovan, Jerry Gurwitz, Becky Briesacher

Jennifer Tjia

BACKGROUND: The relationship between psychiatric consultation and antipsychotic prescribing in nursing homes (NH) is unknown. OBJECTIVE: To identify the association between psychiatric consultant groups and NH-level antipsychotic prescribing after adjustment for resident case-mix and facility characteristics. RESEARCH DESIGN AND SUBJECTS: Nested cross-sectional study of 60 NHs in a cluster randomized trial. We linked facility leadership surveys to October 2009-September 2010 Minimum Data Set, Nursing Home Compare, the US Census, and pharmacy dispensing data. MEASURES: The main exposure is the psychiatric consultant group and the main outcome is NH-level prevalence of atypical antipsychotic use. We calculated annual means and interquartile ranges …

Managed Mental Health Care's Effects On Arrest And Forensic Commitment, William Fisher, Sharon-Lise Normand, Barbara Dickey, Ira Packer, Albert Grudzinskas, Hocine Azeni

Ira K Packer

No abstract provided.

Self-Reported Lifetime Psychiatric Hospitalization Histories Of Jail Detainees With Mental Disorders: Comparison With A Non-Incarcerated National Sample, William Fisher, Ira Packer, Steven Banks, David Smith, Lorna Simon, Kristen Roy-Bujnowski

Ira K Packer

Lack of access to hospitalization is an often-cited risk factor for incarceration among persons with severe mental illness. This proposition is examined by comparing self-reports of lifetime psychiatric hospitalization histories of mentally ill jail inmates with data from a national sample of non-incarcerated mentally ill. Roughly 52% of mentally ill jail detainees reported at least one psychiatric hospitalization, a rate nearly three times that of the comparison group. The data call into question the notion that mentally ill jail inmates have reduced access to psychiatric inpatient treatment, without addressing the adequacy of the treatment received. Longitudinal studies are needed to …

Community Mental Health Services And The Prevalence Of Severe Mental Illness In Local Jails: Are They Related, William Fisher, Ira Packer, Lorna Simon, David Smith

Ira K Packer

The excessive prevalence of severe mental illness noted in correctional settings has sometimes been attributed to the inadequacy of community based mental health services. This study examines the prevalence of severe mental illness in two jails situated within catchment areas featuring markedly different levels of community mental health services. We use these settings to test the hypothesis that greater levels of services in a community are associated with lower prevalence of severe mental illness in the community's jail. An epidemiologic approach, using standardized field instruments, was used to estimate the prevalence of major mental illness in detainees arriving at the …

Relationship Between Altitude And Lithium In Groundwater In The United States Of America: Results Of A 1992–2003 Study, Rebekah S. Huber, Namkug Kim, Carl E. Renshaw, Perry F. Renshaw, Douglas Kondo

Dartmouth Scholarship

Therapeutic dosages of lithium are known to reduce suicide rates, which has led to investigations of confounding environmental risk factors for suicide such as lithium in groundwater. It has been speculated that this might play a role in the potential relationship between suicide and altitude. A recent study in Austria involving geospatial analysis of lithium in groundwater and suicide found lower levels of lithium at higher altitudes. Since there is no reason to suspect this correlation is universal given variation in geology, the current study set out to investigate the relationship between altitude and lithium in groundwater in the United …

Insurance Status And Length Of Stay For Involuntarily Hospitalized Patients, William Fisher, Paul Barreira, Alisa Lincoln, Lorna Simon, Andrew White, Kristen Roy-Bujnowski, Marylou Sudders

Alisa Lincoln

General and private psychiatric hospitals are becoming increasingly common as sites for involuntary hospitalization. Unlike the public facilities that these settings are supplanting, these hospitals must pay strict attention to issues associated with reimbursement, insurance status, and managed care. This article examines the effects of insurance status on length of stay for involuntarily hospitalized patients in general and private hospitals in Massachusetts. Using a two-stage sampling procedure, data on episodes of involuntary hospitalization were gathered and assessed using multiple regression. The primary effect was found between patients with Medicare, who had the longest stays, and individuals who were uninsured, who …

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …

Depressive Symptoms And Marital Satisfaction In The Context Of Chronic Disease: A Longitudinal Dyadic Analysis, Rachel Pruchno, Maureen Wilson-Genderson, Francine P Cartwright

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

These analyses examined the longitudinal relationships between depressive symptoms and marital satisfaction over a 2-year period as experienced by 315 patients with end-stage renal disease and their spouses. Using multilevel modeling, the authors examined both individual and cross-partner effects of depressive symptoms and marital satisfaction on patients and spouses, testing bidirectional causality. Results indicate that mean and time-varying depressive symptoms of both patients and spouses were associated with their own marital satisfaction. Although mean marital satisfaction was associated with own depressive symptoms for both patients and spouses, time-varying marital satisfaction did not affect depressive symptoms for either patients or spouses. …