Psychiatry and Psychology Commons^™

Current Curricular Trends After The Covid-19 Pandemic: A National Survey Of Psychiatry Residency Programs, Jeff Wang Jin, Kacy Smith, Amanda Helminiak, Vineeth John, Hanjing Emily Wu

Faculty, Staff and Student Publications

OBJECTIVES: During the COVID-19 pandemic, many psychiatry residencies (academic, community, and hybrid programs) have adopted different learning modalities to preserve a high quality of educational training. There is minimal data on specific program adaptations, related change perspectives, and program type stratification. This study sought to examine trends in curriculum changes in accredited psychiatry residency programs in the United States.

METHODS: Program directors of accredited general psychiatry programs in the United States were surveyed to assess both general program details and changes in educational content, delivery, and perspectives with regard to program curricula.

RESULTS: A total of 63 program directors out …

Effect Of Positive Emotion Intervention During Late Pregnancy On Improving Colostrum Secretion: A Randomised Control Trial Protocol, Kechen Xu, Ying Xie, Xiujun Han, Ying Yu, Suqing Liu, Suliu Wu, Qian Yang, Qi Zhang

Community & Environmental Health Faculty Publications

Introduction Though evidence has revealed the beneficial effects of cognitive improvement interventions on breastfeeding, the effect of psychological interventions has rarely been studied. This study aims to test whether promoting a positive emotion intervention, 'Three Good Things' intervention, during the last trimester of pregnancy can enhance early colostrum secretion and breastfeeding behaviours by modulating the hormones associated with lactation (prolactin and insulin-like growth factor I). We will attempt to promote exclusive breastfeeding by using physiological behavioural measures.

Methods and analysis This study is designed as a randomised controlled trial conducted in the Women's Hospital School of Medicine at Zhejiang University …

Nourishing The Brain On Deep Space Missions: Nutritional Psychiatry In Promoting Resilience, Nihar N Pathare, Flavia Fayet-Moore, Jennifer A Fogarty, Felice N Jacka, Philip Strandwitz, Gary E Strangman, Dorit B Donoviel

Faculty, Staff and Students Publications

The grueling psychological demands of a journey into deep space coupled with ever-increasing distances away from home pose a unique problem: how can we best take advantage of the benefits of fresh foods in a place that has none? Here, we consider the biggest challenges associated with our current spaceflight food system, highlight the importance of supporting optimal brain health on missions into deep space, and discuss evidence about food components that impact brain health. We propose a future food system that leverages the gut microbiota that can be individually tailored to best support the brain and mental health of …

Depression Secondary To Isotretinoin – A Case Report, Rohan Karkra, Megha Sadashiv, Kishor M

Digital Journal of Clinical Medicine

Depression is one of the leading causes of morbidity in the world and significantly affects the lives of people suffering from it. The exact cause of depression has not been established and it is believed to be a complex play between various social, biological, environmental, personal factors. A relatively rare but distinct cause includes pharmacological agents.

In this case report, we describe the case of a 17-year-old girl who developed depression with psychotic symptoms on two occasions, both preceded by a history of Isotretinoin use. She was admitted and treated with anti-psychotics and psychotherapy with significant improvement in her mental …

Patterns Of Suicide And Self-Harm In Pakistan: A Retrospective Descriptive Study Protocol, Nargis Asad, Shahina Pirani, Summaiya Tariq, Asra Qureshi, Mohammad Zaman, Mustafa Aslam, Farhat Mirza, Murad M. Khan

Department of Psychiatry

Introduction: Suicide is a major global public health problem. Low-income and middle-income countries contribute 78% of all suicidal deaths. Pakistan, a South Asian country, lacks official statistics on suicides at national level. Statistics on suicide are neither collected nationally nor published in the annual national morbidity and mortality surveys. Medicolegal reports on suicides and self-harm are extremely rich and important source of information but greatly underused in Pakistan. We aim to examine the patterns of suicides and self-harm retrospectively in patients who were registered with medicolegal centres (MLCs) in Karachi, during the period January 2017 to December 2021.
Methods and …

Systematic Suicide Screening In A General Hospital Setting: Process And Updated Results 10-Year Data Review, Evan Becker, Sarah Williams, Udema Millsaps, Andres Pumariega, Kolin Good, Eduardo Espiridion

Tower Health Research Day

No abstract provided.

Homoeopathy As An Add-On Treatment For Schizophrenia - A Case Series, S Karunakara Moorthi, Radhika P, Mohan N. Devasia

Indian Journal of Research in Homoeopathy

Introduction: Schizophrenia is a complex, progressive and severe mental disorder characterised by distortions in thinking, perception, emotions, language, sense of self and behaviour. Conventional medication and cognitive behaviour therapy are used in the treatment of schizophrenia. Homoeopathy can also offer promising results in schizophrenia as evident from the previous studies. Case Summary: Five patients reported at the outpatient department of National Homoeopathy Research Institute in Mental Health, Kerala, India, with symptoms of schizophrenia were treated with individualised homoeopathic medicine as an add-on therapy to conventional medicines. Assessment of the patients was done using three scales: Positive and Negative Syndrome Scale, …

Psychedelic Psychiatry, Neil Harjai

Advances in Clinical Medical Research and Healthcare Delivery

We are amidst a 'Renaissance' in the field of psychedelic psychiatry. For several decades, following a period of promising research, governmental barriers and regulations halted any research into the utility of these substances in psychiatry. Over the past few decades, however, we are seeing a revival of these studies due to an abundance of positive findings as well as the need for improved psychiatric treatments. Studies have established substances such as psilocybin and LSD to be effective in treating depressive disorders, sometimes even more so than current 'gold standards'. MDMA is being recognized as a powerful tool, in conjunction with …

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 …

The Brain Scan As Ideograph, Paige Welsh

English (MA) Theses

Medical imaging devices have enabled doctors to render images of the brain without cutting into the body. These images are colloquially called “brain scans.” Through journalism and mass dissemination online, brain scans have become an example of Michael Calvin McGee’s “ideograph,” a language term that subtly takes on outsized political and symbolic meaning to enforce state power. In conversation with theories of new materialism, I situate the brain scan as an ideograph within Jenny Edbauer’s model of rhetorical ecologies. The rhetorical force of the brain scan comes out of a collision between René Descarte’s mind/body dualism, the medical model of …

Artificial Intelligence And Chatbots In Psychiatry, Kay T Pham, Amir Nabizadeh, Salih Selek

Faculty, Staff and Student Publications

The utilization of artificial intelligence (AI) in psychiatry has risen over the past several years to meet the growing need for improved access to mental health solutions. Additionally, shortages of mental health providers during the COVID-19 pandemic have continued to exacerbate the burden of mental illness worldwide. AI applications already in existence include those enabled to assist with psychiatric diagnoses, symptom tracking, disease course prediction, and psychoeducation. Modalities of AI mental health care delivery include availability through the internet, smartphone applications, and digital gaming. Here we review emerging AI-based interventions in the form of chat and therapy bots, specifically conversational …

Effect Of Computer-Assisted Cognitive Behavior Therapy Vs Usual Care On Depression Among Adults In Primary Care: A Randomized Clinical Trial, Jesse H. Wright, Jesse J. Owen, Tracy D. Eells, Becky F. Antle, Laura B. Bishop, Renee Girdler, Lesley M. Harris, R. Brent Wright, Michael J. Wells, Rangaraj Gopalraj, Michael E. Pendleton, Shehzad Ali

Counseling Psychology: Faculty Scholarship

Importance Depression is a common disorder that may go untreated or receive suboptimal care in primary care settings. Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression.

Objectives To evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.

Design, Setting, …

Examination Of Common And Rare Variant Genetic Architecture Of Psychiatric Disorders, Mohammad Ahangari

Theses and Dissertations

Psychiatric disorders are often heterogenous in their manifestation and genome-wide association studies have identified many common risk variants involved in their polygenic architectures with varying degrees of pleiotropy. In recent years, large-scale biobanks have also begun sequencing the genome of their participants to elucidate the role of rare risk variation in the genetic architecture of complex phenotypes, including psychiatric traits. This dissertation sought to better understand the role of both common and rare risk variation in the genetic architecture of psychiatric disorders with a particular focus on schizophrenia and alcohol problems. In the first three analyses, we focused on characterizing …

Lessons Of The Opioid Epidemic - December 3, 2021, Mitchell J. Cohen, Md, Joey Flaxer, Md, Phd, Marianna Lanoue, Phd

Department of Psychiatry and Human Behavior Grand Rounds

No abstract provided.

Bipolar I And Bipolar Ii Subtypes In Older Age: Results From The Global Aging And Geriatric Experiments In Bipolar Disorder (Gage-Bd) Project, Farren Briggs, Martha Sajatovic, Kaylee Sarna, Joy Yala

Faculty Scholarship

Objectives: The distinction between bipolar I disorder (BD-I) and bipolar II disorder (BD-II) has been a topic of long-lasting debate. This study examined differences between BD-I and BD-II in a large, global sample of OABD, focusing on general functioning, cognition and somatic burden as these domains are often affected in OABD. Methods: Cross-sectional analyses were conducted with data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database. The sample included 963 participants aged ≥50 years (714 BD-I, 249 BD-II). Sociodemographic and clinical factors were compared between BD subtypes including adjustment for study cohort. Multivariable analyses were conducted …

Examining The Viability Of Computational Psychiatry: Approaches Into The Future, Mitchell Ostrow

The Yale Undergraduate Research Journal

As modern medicine becomes increasingly personalized, psychiatry lags behind, using poorly-understood drugs and therapies to treat mental disorders. With the advent of methods that capture large quantities of data, such as genome-wide analyses or fMRI, machine learning (ML) approaches have become prominent in neuroscience. This is promising for studying the brain’s function, but perhaps more importantly, these techniques can potentially predict the onset of disorder and treatment response. Experimental approaches that use naive machine learning algorithms have dominated research in computational psychiatry over the past decade. In a critical review and analysis, I argue that biologically realistic approaches will be …

Music As A Gateway To Healing Speech Disorders And Mental Health Holistically In The Patient With Aphasia: A Literature Review, Susan Warren

Expressive Therapies Capstone Theses

People with some types of post-stroke aphasia often experience depression as well as loss of speech. Music therapy has unique properties that allow it to be used therapeutically to treat both speech impairment and depression yet it is rarely used to treat both disorders. This literature review seeks to examine the underlying causes for this discrepancy, review methods used by practitioners to treat both disorders and suggest future directions for additional research and implications for the treatment of patients with aphasia who have both language impairment and depression.

Educating Providers To Screen For Post-Traumatic Stress Disorder, Alyssa Fraino

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this evidence-based change in practice is to increase the knowledge base of psychiatric providers in outpatient psychiatric settings, by educating clinicians regarding the significance of implementing a post-traumatic stress disorder (PTSD) screening tool during the initial evaluation of patients. This can help to identify patients with PTSD that may not have been identified on initial visit, and may otherwise go unrecognized or untreated for PTSD, without the inclusion of a PTSD screening tool.

Problem: Evidence suggests that PTSD is underreported and overlooked in most populations. However, there is no standardized practice surrounding the routine use of …

Do Atypical Antipsychotics Trigger Manic Switching In Patients With Bipolar I Disorder?, Hilary P. Stevenson Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

A 22-year-old newly diagnosed patient with bipolar is discussing with her doctor the safety of starting an atypical antipsychotic as part of her treatment plan for depression. The patient was recently diagnosed with bipolar disorder after years of ups and downs making school and her relationship especially difficult. After seeking out a university student health psychiatrist for a severe depressive episode she was prescribed an antidepressant, which within a few weeks triggered a manic episode that required hospitalization. Since that time she has been compliant with her medications but has fallen into another depressive episode. Her psychiatrist encourages her to …

An Exploration Of Neuroanatomical Signatures Of Pediatric Bipolar Disorder Using Structural Neuroimaging, Jonika Tannous

Dissertations and Theses (Open Access)

Bipolar Disorder (BD) is diagnosed using the Diagnostic and Statistical Manual (DSM) criteria, which relies heavily on symptomatology. This method, however, lends itself to error due to variance in symptom expression and is further complicated during childhood and adolescence- a period marked by major anatomical and behavioral changes. Therefore, in order to institute early and effective interventions, it is imperative that we develop more objective methods of mood disorder characterization and diagnosis. Two proposed solutions for accomplishing this task include 1) the generation of normative development models to assess BD risk and 2) data-driven clustering of patients based on specific …

Somatic Symptoms And Binge Eating In Women's Daily Lives, Kelly A. Romano, Kristin E. Heron, Kathryn E. Smith, Ross D. Crosby, Scott G. Engel, Stephen A. Wonderlich, Raina D. Pang, Tyler B. Mason

Psychology Faculty Publications

Objective

The present study aimed to determine whether the momentary severity of women's somatic symptoms was concurrently and prospectively associated with their engagement in binge eating in naturalistic settings.

Method

Thirty women (M_age = 34.13, SD = 13.92) who had engaged in binge eating at least once over the month prior to study entry completed a 14-day ecological momentary assessment (EMA) protocol. During each of the 14 days, participants received five semi-random surveys via text message that assessed momentary somatic symptom severity (i.e., headaches, stomachaches/pain, chest/heart pain, faintness/dizziness, shortness of breath, fatigue) and disordered eating behaviors. Generalized estimating equations …

Trajectories Of Self-Reported Sleep Disturbance Across Inpatient Psychiatric Treatment Predict Clinical Outcome In Comorbid Major Depressive Disorder And Generalized Anxiety Disorder, Elizabeth M Hartwig, Katrina A Rufino, Cara A Palmer, Christopher Shepard, Candice A Alfano, Bella Schanzer, Sanjay J Mathew, Michelle A Patriquin

Staff and Researcher Publications

Background: As there has been a demonstrated link between sleep disturbance and suicide, the present study investigated the relationship between self-reported sleep disturbance during inpatient psychiatric treatment and clinical outcomes at discharge and six months post-discharge.

Methods: Participants were 2,970 adults receiving care in a long-term inpatient psychiatric hospital. Greater than 90% of inpatients reported at least mild sleep disturbance throughout treatment. Group-based trajectory modeling was used to determine patterns of sleep disturbance changes over time.

Results: Participants fit into distinct categories based on their trajectories of sleep problems across treatment: No Sleep Problems (10.3% of participants, no sleep problems …

Contextual Factors Associated With County-Level Suicide Rates In The United States, 1999 To 2016, Danielle L. Steelsmith, Cynthia A. Fontanella, John V. Campo, Jefferey A. Bridge, Keith L. Warren, Elisabeth D. Root

Faculty & Staff Scholarship

Importance Understanding geographic and community-level factors associated with suicide can inform targeted suicide prevention efforts.

Objectives To estimate suicide rates and trajectories, assess associated county-level contextual factors, and explore variation across the rural-urban continuum.

Design, Setting, and Participants This cross-sectional study included all individuals aged 25 to 64 years who died by suicide from January 1, 1999, to December 31, 2016, in the United States. Spatial analysis was used to map excess risk of suicide, and longitudinal random-effects models using negative binomial regression tested associations of contextual variables with suicide rates as well as interactions among county-level contextual variables. Data …

Order From Order Sets: Analysis Of Ordering Patterns And Patient Outcomes Before And After Order Set Changes On The Inpatient Psychiatry Units At Tjuh, David Halpern, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Aims

Short Term

To decrease the total number of times one-time orders were added for patients for Vistaril, Remeron, Melatonin, Colace, Senna, and MiraLAX. Increase number of times urine PCP and urine oxycodone added to the urine drug screen.

Long Term

To decrease overall length of stay and improve treatment outcomes

Hear Me When I’M Well: A Convergent Parallel Mixed Methods Study Of Psychiatric Advance Directives In Virginia, Anne Metz

Dissertations, 2014-2019

Psychiatric advance directives (PADs) are legal documents that allow individuals to express their wishes and desires regarding potential future psychiatric care. PADs have been theorized as a way to empower individuals through improved clinical outcomes, reduced coercion, and minimized involvement of individuals with mental illness in the criminal justice system. Since 2010, the Commonwealth of Virginia has had legislation in place to support the use of these advance planning documents. The purpose of this convergent parallel mixed methods study was to enhance our understanding of PADs in Virginia. Quantitative and qualitative data were collected concurrently via survey and follow-up interview …

Neurofeedback With Fmri: A Critical Systematic Review, Robert T. Thibault, Amanda Macpherson, Michael Lifshitz, Raquel R. Roth, Amir Raz

Psychology Faculty Articles and Research

Neurofeedback relying on functional magnetic resonance imaging (fMRI-nf) heralds new prospects for self-regulating brain and behavior. Here we provide the first comprehensive review of the fMRI-nf literature and the first systematic database of fMRI-nf findings. We synthesize information from 99 fMRI-nf experiments—the bulk of currently available data. The vast majority of fMRI-nf findings suggest that self-regulation of specific brain signatures seems viable; however, replication of concomitant behavioral outcomes remains sparse. To disentangle placebo influences and establish the specific effects of neurofeedback, we highlight the need for double-blind placebo-controlled studies alongside rigorous and standardized statistical analyses. Before fMRI-nf can join the …

The Goldwater Rule: Perspectives From, And Implications For, Psychological Science, Scott O. Lilienfeld, Joshua D. Miller, Donald R. Lynam

Department of Psychological Sciences Faculty Publications

When, if ever, should psychological scientists be permitted to offer professional opinions concerning the mental health of public figures they have never directly examined? This contentious question, which attracted widespread public attention during the 1964 U.S. presidential election involving Barry Goldwater, received renewed scrutiny during and after the 2016 U.S. presidential campaign, when many mental health professionals raised pointed questions concerning the psychiatric status of Donald Trump. Although the Goldwater Rule prohibits psychiatrists from offering diagnostic opinions on individuals they have never examined, no comparable rule exists for psychologists. We contend that, owing largely to the Goldwater Rule’s origins in …

Finasteride As A Model For Personalized Medicine, Ion G. Motofei, David L. Rowland, Ioana Păunică, Octavian C. Tănăsescu, Petrişor Banu, Stana Păunică

Journal of Mind and Medical Sciences

The side effects of Finasteride are currently a subject of controversy. Some studies report minor or acceptable adverse effects, which decrease after a variable period of time so that they do not necessitate terminating Finasteride administration. However, several clinical and neuro-endocrine studies show that some adverse effects persist indefinitely in the form of post-Finasteride syndrome, even after the drug cessation. This paper presents a possible explanation for these inconsistent findings. First, the study design of either informing or not informing patients prior therapy about possible adverse effects can influence the incidence and magnitude of reported adverse effects. Second, structural and …

The Dual Faces Of Misery, Arden Moscati

Theses and Dissertations

Major Depression (MD) and Generalized Anxiety Disorder (GAD) are psychiatric disorders that arise from dysfunction of the core human capacities for emotion. Sapience is inextricably bound up with the potential for feelings of regret, worry and concern. When these emotions lead to clinically significant impairment or distress, they may result in one or both of the disorders of MD and GAD. The occurrence of MD and GAD in the same person, known as comorbidity, is remarkably high; substantially higher than would be expected by chance.

MD and GAD have been studied since the mid-20^th century, resulting in a substantial …

Protective Behavioral Strategies As A Context-Specific Mediator: A Multilevel Examination Of Within- And Between-Person Associations Of Daily Drinking, Abby L. Braitman, Ashley N. Linden-Carmichael, James M. Henson

Psychology Faculty Publications

Research indicates that a drinker’s environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one’s drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different …