Psychiatric and Mental Health Commons^™

Psychosocial Predictors Of Depression And Anxiety In Thai Stroke Caregivers, Chanatip Tongyonk, Sorawit Wainipitapong, Chavit Tunvirachaisakul, Aurauma Chutinet, Michael Maes, Thitiporn Supasitthumrong

Chulalongkorn Medical Journal

Background: Caregivers of stroke survivors often face significant psychological challenges, yet limited research in Thailand has explored how patient and caregiver characteristics jointly influence caregiver mental health outcomes.

Objective: To identify characteristics of ischemic stroke patients and their caregivers that may predict distress, sadness, and anxiety symptoms in the caregivers.

Method: To measure caregivers' burden, stress, depression, and anxiety symptoms, the Hospital Anxiety and Depression Scale (HADS), Zarit Burden Interview (22-item ZBI), and Perceived Stress Scale (PSS-10) were utilized. To define a multi-step mediation model, we used partial least squares structural equation modelling (PLS-SEM).

Result: 97 stroke patients and their …

Mental Health Vs Substance Misuse: Predicting Restraint Use In The Emergency Department, Chloe Lafosse Bs, Michael Witt Md, Mph

Rowan-Virtua Research Day

Introduction: Violence in the emergency department affects approximately 30% of hospital staff every 6 months. Presenting complaints may contribute to violence risk, particularly in those with mental health or substance misuse issue where there are heightened risks of cognitive impairment and involuntary holds.

Methods: We conducted a systematic review of literature published between 1957-2025 using multiple databases, identifying studies that observed physical restraint use on adult emergency department patients. All relevant data was recorded and imputed into SPSS for a chi-square test.

Results: Thirteen studies (2019-2025) met inclusion criteria, with sample sizes ranging from 58 to 1,035,522 participants. All studies …

Neuroinflammation And Its Role In Depression– A Review Of Emerging Biomarkers And Therapeutic Targets, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Major depressive disorder (MDD) is a prevalent and debilitating mental illness that affects millions globally. Traditionally, the pathophysiology of MDD was thought to be due primarily neurotransmitter imbalances. However, emerging research highlights the role of neuroinflammation in MDD pathogenesis. Elevated levels of pro-inflammatory cytokines, microglial activation, and blood-brain barrier dysfunction have been implicated in the etiology of MDD. Additionally, biomarkers such as C-reactive protein and neuroimaging findings further support the neuroinflammatory hypothesis. This growing body of evidence has led to increased interest in novel treatment approaches, including anti-inflammatory medications and lifestyle interventions, as potential therapeutic strategies. While selective serotonin reuptake …

Affect Regulation In The Context Of Sexual And Gender Minority Stress: A Scoping Review Protocol, Daphne Y. Liu, Benjamin A. Swerdlow, Shao Yuan Chong, Nadia Kako, Alex Rubin, Nicholas S. Perry

Psychology: Faculty Scholarship

Objective

To provide a broad, comprehensive picture of affect regulation in the context of sexual and gender minority stress, this scoping review aims to identify and synthesize methods, methodologies, and available evidence pertinent to emotion regulation and coping in the context of minority stress among sexual and gender minority (SGM) people.

Introduction

SGM people face disproportionately high rates of mental health problems due to experiences of minority stress and lack of social safety. Theories and growing evidence suggest that affect regulation plays a critical role in SGM people’s well-being in the face of minority stress. Researchers have largely studied emotion …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Implementing Lean Methodology To Decrease Wait Times In A Psychiatric Emergency Department, Kristina S. Baxter

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to implement Lean strategies to optimize the intake process in a psychiatric emergency department, thereby reducing patient wait times, minimizing left-without-being-seen (LWBS) occurrences, and improving access to timely psychiatric care.

Background

The project was conducted in a hospital-based psychiatric emergency department in Southeast Texas, serving adults and children six years and older.

Methodology

Lean methodology and PDSA cycles were employed to refine the intake process and eliminate inefficiencies. Key interventions included patient transport by technicians to minimize delays, using tele-clinicians for assessments to reduce staff burden, and restructuring nursing assessments to prioritize telehealth consultations …

The Role Of Ect In Ocd: A 10-Year Review (2014-2024), Mariana Sales, Tainiz Polanco, Amy Nguyen

Rowan-Virtua Research Day

Background: Obsessive-compulsive disorder (OCD) affects up to 2.5% of the population with significant impacts on everyday functioning and relationships. First-line treatment includes selective serotonin reuptake inhibitors (SSRI) and cognitive behavioral therapy; however, studies have found that up to 40-60% of patients do not respond to SSRIs. ECT is an alternative approach that has demonstrated limited efficacy in OCD.

Objective: The current review aims to summarize the results of published work between 2014-2024 to assess the efficacy of ECT in the treatment of OCD.

Methods: A literature review was conducted using eight studies from 2014-2024 to assess the effectiveness of ECT …

Beyond The Label: Understanding And Addressing Occupational Stigma In Psychiatry, Mahesh Vasudevan, Madeeha Sheriff

Rowan-Virtua Research Day

Introduction:Stigma is a social classification that devalues individuals or groups, and occupational stigma targets entire professions. Psychiatry is particularly affected, often viewed by the public and medical community as lacking scientific rigor and prestige. This negative perception has far-reaching consequences.

Methods:A narrative literature review was conducted to explore the scope, sources, and impact of occupational stigma toward psychiatrists. Peer-reviewed articles and professional resources published between 2002 and 2023 were selected based on relevance to psychiatric stigma, education, and public perception. Databases searched included PubMed, Google Scholar, and professional association websites using keywords such as “psychiatry stigma” and “psychiatrist …

The Profound Role Of An Adult Survivor Program Adaptive Sports Retreat On Quality Of Life And Self Perception For Adult Burn Survivors, Roselle E. Crombie Md/Mph, Facs, Faba, Theresa E. Abrams Lcsw, Phd, Cindy Rutter Bsn, Lmft, Josh Mishell Ba, Philip E. Fidler Md

Posters

Mental health struggles amongst adult burn survivors has recently been documented as an ongoing need for therapy in peer reviewed journals.1 Although there are many robust programs, camps, reintegration programs and support systems through child life for children, the analogous programs for adults are lacking in comparison to the pediatric ones. Ten years ago, a subset of this author group ran an adult adaptive sports survivor program in conjunction with a national burn meeting. At that time, all the participants, mental health providers and participating surgeons were able to experience the profound impact a program like this can have on …

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …

The Impact Of Structured Weekend Group Therapy On Restraints, Seclusion And Length Of Stay On Inpatient Psychiatric Units, Victoria Grau

West Chester University Doctoral Projects

Group therapy is an essential part of inpatient psychiatric treatment, with documented positive effects including better medication compliance, lower readmission rate, and improved self- esteem. Patients who are admitted for an inpatient psychiatric stay have a small window of time in which behavioral health staff can work with them. Group therapy can help patients develop a plan for these issues and provide a foundation for successful discharge and symptom management. The project site is a mid-size teaching hospital in an urban community with higher rates of mental health diagnoses than the national average. Group therapy was conducted initially Monday – …

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

Case Series On Consultation-Liaison Psychiatry In Pain Abdomen With School Refusal Among Children, Jatin Kumar, Aditya Takiar, Kishor M, Sudhamshu K.C, Anil Kumar M.G., Prashanth S.N

Digital Journal of Clinical Medicine

Chronic abdominal pain is one of the most common causes of school refusal in children often leading to multiple hospital visits and expenses. This study was done to assess the psychiatric morbidity underlying functional gastrointestinal complaints in children presenting to paediatric surgery unit. We conducted a prospective case series (N=11; ages 8–13) of children referred from Paediatric Surgery between June and December 2025. All these children presented with idiopathic abdominal pain and a significant period of absence from school. These children were evaluated for any organic causes through the use of various investigations including imaging studies and were referred to …

The Ethics Of Involuntary Psychiatric Hospitalization: A Comprehensive Analysis Of Policies, Practice, And Ethical Oversight, Mariah Chobany

Electronic Theses and Dissertations

As a specialized field of medicine, psychiatry presents unique ethical challenges and dilemmas distinct from other medical disciplines. A particularly complex aspect of psychiatric care involves the involuntary treatment of patients who may be unable to make informed decisions about their care or participation in research due to the debilitating effects of their psychiatric condition. This presents a significant challenge for providers and researchers, particularly concerning capacity issues and the informed consent process. Despite the intricacies and complexities of ethical dilemmas in psychiatric treatment and research, there is a notable lack of comprehensive guidance in policies and practices on addressing …

Study Abroad Angst: A Literature Review On The Mental Health Of International Students During Covid-19, Daisuke Akiba, Michael Perrone, Caterina Almendral

Publications and Research

Background: The COVID-19 pandemic presented unique and unprecedented challenges for international students, those studying at institutions of higher education outside of their home countries, due to their distinct circumstances and vulnerabilities. This literature review examines the multifaceted mental health burdens they experienced and highlights the need for targeted support and interventions. Methods: A rigorous search across three databases (i.e., PubMed, PsycINFO, and ERIC) yielded 50 empirical studies for inclusion in this literature review. A six-phase thematic analysis framework was employed to identify and synthesize key themes. Results: Seven prominent themes emerged: (1) academic and professional disruptions; (2) challenges navigating international …

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

Theses and Graduate Projects

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

Implementing Animal-Assisted Therapy During Psychiatric Intakes, Rebecca Dorne

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based project is to determine if Animal-Assisted Therapy (AAT) causes improvements in veterans’ feelings of anger, anxiety, depression, and suicidality in the acute psychiatric setting during psychiatric evaluations. The project aims to provide veterans with an additional way to experience short-term relief from symptoms while discussing their symptomology with mental health providers.

Background: The prevalence of depression is 20% higher in veterans than in that of the general population. Similarly, it has been shown that 23% of all veterans using VA care have had PTSD at some point in their lives. In the Psychiatric Emergency …

Fregoli Case Report, Don D. Shamilov, David F. Lo, Gaurav Kumar

Rowan-Virtua Research Day

Fregoli Syndrome is a rare delusional disorder in the psychotic spectrum named after Italian actor Leopoldo Fregoli. Existing reports focus on clinical aspects and standard treatments, leaving gaps in understanding complexity and tailored interventions. This case report contributes comprehensive analysis of a young adult male with Fregoli syndrome and emphasizes interplay of psychopathology, neurocognition, and psychosocial factors. This report highlights a holistic approach, including differential diagnosis and psychosocial dynamics and aims to improve diagnostic considerations and personalized treatment strategies for better patient outcomes.

Review Of Psychogenic Nonepileptic Seizures And Patient-Centered Approaches To Care, Rabeel Ahmad, Rebekah Dietrich, Munaza Khan

Rowan-Virtua Research Day

Psychogenic nonepileptic seizures (PNES) are defined as involuntary experiential and behavioral responses to internal or external stimuli. They are behaviors, not associated with pathological alterations in the physiology of the brain. Although some of them mimic syncope, they have historically been regarded to clinically resemble epileptic episodes.

There is a multiplicity of different names for this condition. PNES is the most widely used term, though the term "functional seizures" is increasingly used. Alternatives such as "psychogenic seizures," "dissociative seizures," "psychogenic nonepileptic attacks" (PNEA), and "nonepileptic seizures" are also used.

Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov

Rowan-Virtua Research Day

Ms. R, a 32-year-old Hispanic female, suffers from severe anxiety exacerbated by a car accident and past struggles with depression and substance use. Evaluation reveals hypothyroidism, mild anemia, and GAD as the primary diagnosis. Factors contributing to her condition include genetic predispositions, medical issues, and social stressors. Treatment involves pharmacotherapy, psychotherapy, and monitoring her physiological health. Research on wearable data for GAD severity offers potential insights for her treatment. A holistic approach, considering biological, psychological, and social factors, guides her tailored treatment plan for overall well-being.

Trichotillomania Case Report, Kimberly Kluglein, David F. Lo, Don D. Shamilov

Rowan-Virtua Research Day

Trichotillomania is a psycho-dermatologic disorder involving self-inflicted hair loss through pulling. Often complicated by anxiety and depression. Multifactorial etiology and limited evidence-based treatment options makes management difficult. Treatment approaches include a combination of pharmacotherapy, CBT, HRT, and ACT. Case presentation involves a 24-year-old female, diagnosed with treatment-resistant trichotillomania who achieved remission and hair regrowth through mindset reframing, physical barriers, and community support. Novel approaches focusing on mindset and community support can yield positive outcomes.

Developing An Interprofessional Community Psychiatry Rotation Using An Assertive Community Treatment Team Model: A Preliminary Evaluation, Ruth Frydman

Journal of Maine Medical Center

Introduction: There is a shortage of psychiatric providers trained to work in community settings with people with serious mental illness (SMI) and associated comorbidities. We designed an innovative psychiatry rotation and curriculum for psychiatry residents and other learners.

Methods: The rotation incorporates working with our Assertive Community Treatment team and includes home visits, assertive outreach, and visits in other community settings. It was designed to improve learners’ confidence in their understanding and skill set for working with and treating people with SMI in the community on an interprofessional (IP) team. This pilot quality improvement project evaluated psychiatry resident responses to …

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 …

The End Of Roe V. Wade: Implications For Women's Mental Health And Care, Amalia Londoño Tobón, Eileen Mcnicholas, Camille A Clare, Luu D Ireland, Jennifer L Payne, Tiffany A Moore Simas, Rachel K Scott, Madeleine Becker, Nancy Byatt

Marcus Institute of Integrative Health Faculty Papers

The Supreme Court decision in Dobbs v. Jackson in June 2022 reversed precedent which had previously protected abortion prior to fetal viability as a universal right within the United States. This decision almost immediately led to abortion restrictions across 25 states. The resulting lack of access to abortion care for millions of pregnant people will have profound physical and mental health consequences, the full effects of which will not be realized for years to come. Approximately 1 in 5 women access abortions in the U.S. each year. These women are diverse and represent all American groups. The Supreme court decision, …

Longitudinal Assessment Of Pharmacy Student Attitudes Towards Mental Illness, Jessica Dillon

Honors Scholar Theses

Background: Mental health stigma in providers is one of the greatest barriers in effective care in psychiatric patients. When patients feel stigma towards them, they have lower levels of self-esteem and lower medication adherence. When training healthcare providers, specifically pharmacists, it is important to assess the effectiveness of training at reducing stigma levels. Previous studies have shown that didactic teaching does not significantly decrease stigma in pharmacy students. However, other studies have shown that students who participated in psychiatric rotations have less stigma surrounding mental health following the rotation. Currently there are no studies that assess the same students’ stigma …

Treatment Of Anxiety By Transcutaneous Vagus Nerve Stimulation: A Retrospective Chart Review, Rhea Gandhi

CMC Senior Theses

Surgical vagus nerve stimulation (VNS) was FDA cleared for depression (2005) and epilepsy. (1997). In the surgical procedure, a pacemaker is implanted below the collarbone (clavicle) and connected to the vagus nerve in the neck. Transcutaneous vagus nerve stimulation (tVNS) is a non-surgical alternative to VNS and there is evidence supporting its effectiveness for several conditions. Advantages include lower cost and fewer adverse side effects.

Anxiety is tied to excess or unopposed sympathetic nervous system activity, while the parasympathetic nervous system, especially the vagus nerve, is relatively underactive. This study aimed to investigate a potential impact of regular tVNS stimulation …

Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi

Community Health Sciences

Objectives: A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.
Design: An exploratory qualitative study.
Setting: Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.
Participants: In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.
Results: …

Implementation Of Nurse Navigators For Behavioral Health, Theresa Papagna

Seton Hall University Dissertations and Theses (ETDs)

Mental health patients have been notoriously non-adherent with diligent medication conformity, office visit fidelity, candor about side effects, use of illegal substances for self-medication, and truthfulness about co-occurring conditions. This non-adherence makes treatment difficult for psychiatric providers, and all those who participate in the care of patients with mental illness. Patient non-adherence can cause frustration and can lead to provider burnout, which affects patients as well as providers. Also, there are concerning financial implications of excessive time and resources needed to adequately monitor mental health patients. Implications regarding 30- day re-admissions are tantamount to consideration of financial strains put on …

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 …

Seizure To Drug Induced Schizophrenia: A Rare Case Of Keppra-Induced Psychosis, Shadi Shams, Riddhima Issar, Nardin El-Shammaa, Munaza Khan

Rowan-Virtua Research Day

Levetiracetam is a broad-spectrum antiseizure medication and is approved as adjunctive therapy to treat focal-onset seizures in children and adults with epilepsy. Levetiracetam has a wide margin of safety and patient-friendly pharmacokinetics that distinguish it from other currently available antiepileptic drugs.

Most common side effects are fatigue, somnolence, dizziness, and upper respiratory infection. Neuropsychiatric symptoms are reported. Psychotic symptoms, paranoid ideation, hallucinations, and behavioral problems may occur in adult and pediatric patients. Among all adverse effects, the rate of psychosis is very low and ranges from less than 1% to 1.4%. A retrospective study showed that this rate is higher …