Psychiatry Commons^™

The Psychological Burden Of Nmosd - A Mixed Method Study Of Patients And Caregivers, Darcy C. Esiason, Nicole Ciesinski, Chelsi N. Nurse, Wendy Erler, Tom Hattrich, Ankita Deshpande, C. Virginia O'Hayer

Department of Psychiatry and Human Behavior Faculty Papers

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved …

Bipolar Symptoms, Somatic Burden And Functioning In Older-Age Bipolar Disorder: A Replication Study From The Global Aging & Geriatric Experiments In Bipolar Disorder Database (Gage-Bd) Project, Martha Sajatovic, Farren B.S Briggs, Kaylee Sarna, Joy Yala

Faculty Scholarship

Objectives: The Global Aging & Geriatric Experiments in Bipolar Disorder Database (GAGE-BD) project pools archival datasets on older age bipolar disorder (OABD). An initial Wave 1 (W1; n = 1369) analysis found both manic and depressive symptoms reduced among older patients. To replicate this finding, we gathered an independent Wave 2 (W2; n = 1232, mean ± standard deviation age 47.2 ± 13.5, 65% women, 49% aged over 50) dataset. Design/Methods: Using mixed models with random effects for cohort, we examined associations between BD symptoms, somatic burden and age and the contribution of these to functioning in W2 and the …

Reliability And Validity Of The Patient Health Questionnaire-4 Scale And Its Subscales Of Depression And Anxiety Among Us Adults Based On Nativity, David Adzrago, Timothy J Walker, Faustine Williams

Faculty, Staff and Student Publications

BACKGROUND: The burdens of anxiety and depression symptoms have significantly increased in the general US population, especially during this COVID-19 epidemiological crisis. The first step in an effective treatment for anxiety and depression disorders is screening. The Patient Health Questionnaire-4 (PHQ-4, a 4-item measure of anxiety/depression) and its subscales (PHQ-2 [a 2-item measure of depression] and Generalized Anxiety Disorder [GAD-2, a 2-item measure of anxiety]) are brief but effective mass screening instruments for anxiety and depression symptoms in general populations. However, little to no study examined the psychometric properties (i.e., reliability and validity) of the PHQ-4 and its subscales (PHQ-2 …

Association Of Semaglutide With Reduced Incidence And Relapse Of Cannabis Use Disorder In Real-World Populations: A Retrospective Cohort Study, William Wang, Nathan A. Berger, Pamela B. Davis, David C. Kaelber, Rong Xu

Faculty Scholarship

Cannabis is the most frequently used illicit drug in the United States with more than 45 million users of whom one-third suffer from a cannabis use disorder (CUD). Despite its high prevalence, there are currently no FDA-approved medications for CUD. Patients treated with semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA) approved for treating type 2 diabetes (T2D) and for weight management have reported reduced desire to drink and smoke. Preclinical studies have shown that semaglutide decreased nicotine and alcohol consumption. Preclinical and preliminary clinical evidence of semaglutide’s potential beneficial effects on various substance use disorders led us to evaluate if …

Balancing The Medical, Psychiatric, And Ethical Considerations In The Inpatient Treatment Of Extreme Anorexia Nervosa: A Case Report, Carter A. Schulz, Carolyn A. Kennedy

Aesculapius Journal (Health Sciences & Medicine)

Introduction: Anorexia nervosa (AN) is a psychiatric illness characterized by restricted energy intake, intense fear of gaining weight, and a disturbance in body image. A 2011 meta-analysis estimated the mortality rate for anorexia nervosa to be over 5 times that of the general population, with one-fifth of deaths in AN patients being due to suicide. Treating this disease is notoriously difficult, and treatment is complicated by these patients’ characteristically poor insight.

Case summary: Here we present the case of a 37 year old woman who visited the ED with complaints of nausea and weakness; she was admitted due to hypoglycemia, …

Catatonia As A Result Of A Traumatic Brain Injury, Jessica Berthelot, Jacob Cambre, Madeline Erwin, Jennifer Phan

School of Medicine Faculty Publications

Catatonia is a neuropsychiatric syndrome typically marked by disturbances in motor activity, speech, and behavior. It has historically been associated with psychiatric illness, but acute medical illness, neurocognitive disorders, and neurodevelopmental disorders can cause catatonia as well. Catatonia is likely underrecognized and underdiagnosed in the general medical hospital, despite high risks of morbidity and mortality and the availability of rapidly effective treatment. Here, we present a case of catatonia secondary to traumatic brain injury that responded to lorazepam after a delayed diagnosis. A young male patient who was incarcerated and assaulted was sent to the emergency department multiple times for …

Neural Correlates Of Fear Extinction: Investing The Impact Of Puberty And Sex In Children And Adolescents Through Neuroimaging, Sneha Bhargava, Clara Zundel, Samantha Ely, Carmen Carpenter, Reem Tamimi, Leah Gowatch, Mackenna Shampine, Emilie-Clare O'Mara, Jovan Jande, Shravya Chanamolu, Ahmad Almaat, Hilary Marusak

Medical Student Research Symposium

Fear-based disorders, including anxiety and posttraumatic stress disorder, are more prevalent in females than males. Steroid hormones (e.g., estradiol) are involved in fear extinction learning and later recall—a process implicated in the pathophysiology of fear-based disorders. Fear-based disorders commonly emerge during the transition from childhood to adolescence, a period marked by the onset of puberty and a natural increase of steroid hormones. Here, we examined the effects of puberty, sex, and their interaction on extinction recall and underlying neural circuitry in youth. Eighty-five youth (6-17 years, 46% female) completed a two-day Pavlovian fear extinction paradigm while undergoing functional magnetic resonance …

A Systematic Review Of Digital Technology Use For The Treatment And Management Of Ptsd, Liam Browning, Arash Javanbakht, Imran Rashid

Medical Student Research Symposium

The COVID-19 pandemic led to rapid growth in telemental health services and investment in digital mental health technologies. Digital mental health technologies could expand access to mental health care in a time of increasing provider deficit by providing tools for expedited psychiatric symptom assessment and management. This systematic review explores the current evidence for the use of scalable digital treatment modalities, including virtual reality (VR), machine learning, wearables, mobile apps, and neurofeedback training in the diagnosis and treatment of PTSD. Our findings support the current literature suggesting VR interventions are efficacious for combat-related PTSD treatment and that conclusions of studies …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

Trauma-Related Shame Predicts Daily Non-Medical Prescription Opioid Use Among Individuals With Ptsd Symptoms, Tanya C. Saraiya, Alyssa C. Jones, Teresa Lopez-Castro, Caitlyn O. Hood, Jessica Flores, Christal L. Badour

UK CARES Faculty Publications

Non-medical prescription opioid use (NMPOU) is the use of opioids without a prescription or in a way different from how they were prescribed and is the fourth most common type of drug use in the United States. Separate research has shown that trauma-related shame is linked to posttraumatic stress disorder (PTSD) and, respectively, opioid use. However, no study to date has empirically examined the association between trauma-related shame and NMPOU among individuals with PTSD symptoms. Forty adults with clinical or subclinical PTSD who reported engaging in NMPOU at least one day in the prior month before the study completed 28 …

Understanding The Impact Of Adverse Childhood Experiences On Non-Suicidal Self-Injury In Youth: A Systematic Review, Sadia Suhail Usmani, Meghana Mehendale, Mahnoor Yousif Shaikh, Sourav Sudan, Prathima Guntipalli, Lara Ouellette, Anem Sajid Malik, Naila Siddiqi, Namrata Walia, Kaushal Shah, Fahimeh Saeed, Domenico De Berardis, Sheikh Shoib

Library Staff Publications

OBJECTIVE: Non-suicidal self-injury (NSSI), defined as a deliberate destruction of one's own body without a suicidal intent, is a global public health issue. Adverse childhood events (ACEs) have been shown to be associated with various mental illnesses; however, to date the impact of such events on NSSI in youth has not been reviewed.

METHODS: We conducted a systematic review, searched 5 databases for published articles evaluating ACE and NSSI in youth less than or equal to 21 years of age. After screening 247 articles, we included 21 unique articles in this systematic review.

RESULTS: Increasing ACE score, physical, sexual or …

The Use Of Optical Coherence Tomography (Oct) And Oct Angiography In Borderline Personality Disorder Compared To Health Control Subjects, Bei Xu, Fangling Li, Zhejia Zhang, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND: Optical coherence tomography (OCT) or OCT angiography (OCTA) has been investigated in few research studies of psychiatric disorders. No research has been done using OCT or OCTA in patients with borderline personality disorder (BPD).

METHODS: OCTA measured foveal avascular zone (FAZ), macular vessel density (MVD), and peripapillary vessel density (PVD). OCT measured the peripapillary retinal fiber layer (RNFL) and central retinal thickness (CRT). The study utilized the Ottawa Self-Injury Inventory, Hamilton Anxiety Rating Scale (HAMA), and Global Assessment of Functioning (GAF) to assess the symptom characteristics of individuals with BPD.

RESULTS: Fifty-nine eyes of BPD patients and 58 eyes …

Sociodemographic And Clinical Characteristics Of People With Oldest Older Age Bipolar Disorder In A Global Sample: Results From The Global Aging And Geriatric Experiments In Bipolar Disorder Project, Peijun Chen, Martha Sajatovic, Joy Yala, Kaylee Sarna

Faculty Scholarship

Objects: Studies of older age bipolar disorder (OABD) have mostly focused on “younger old” individuals. Little is known about the oldest OABD (OOABD) individuals aged ≥70 years old. The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) project provides an opportunity to evaluate the OOABD group to understand their characteristics compared to younger groups. Methods: We conducted cross-sectional analyses of the GAGE-BD database, an integrated, harmonized dataset from 19 international studies. We compared the sociodemographic and clinical characteristics of those aged <50 (YABD, n = 184), 50–69 (OABD, n = 881), and ≥70 (OOABD, n = 304). To standardize the comparisons between age categories and all characteristics, we used multinomial logistic regression models with age category as the dependent variable, with each characteristic as the independent variable, and clustering of standard errors to account for the correlation between observations from each of the studies. Results: OOABD and OABD had lower severity of manic symptoms (Mean YMRS = 3.3, 3.8 respectively) than YABD (YMRS = 7.6), and lower depressive symptoms (% of absent = 65.4%, and 59.5% respectively) than YABD (18.3%). OOABD and OABD had higher physical burden than YABD, especially in the cardiovascular domain (prevalence = 65% in OOABD, 41% in OABD and 17% in YABD); OOABD had the highest prevalence (56%) in the musculoskeletal domain (significantly differed from 39% in OABD and 31% in YABD which didn't differ from each other). Overall, OOABD had significant cumulative physical burden in numbers of domains (mean = 4) compared to both OABD (mean = 2) and YABD (mean = 1). OOABD had the lowest rates of suicidal thoughts (10%), which significantly differed from YABD (26%) though didn't differ from OABD (21%). Functional status was higher in both OOABD (GAF = 63) and OABD (GAF = 64), though only OABD had significantly higher function than YABD (GAF = 59). Conclusions: OOABD have unique features, suggesting that (1) OOABD individuals may be easier to manage psychiatrically, but require more attention to comorbid physical conditions; (2) OOABD is a survivor cohort associated with resilience despite high medical burden, warranting both qualitative and quantitative methods to better understand how to advance clinical care and ways to age successfully with BD.

Conceptualizing Care Partners' Burden, Stress, And Support For Reintegrating Veterans: A Mixed Methods Study, Nicholas A. Rattray, Mindy Flanagan, Allison Mann, Leah Danson, Ai-Nghia Do, Diana Natividad, Katrina Spontak, Gala True

School of Medicine Faculty Publications

BACKGROUND: People who support Veterans as they transition from their military service into civilian life may be at an increased risk of psychological distress. Existing studies focus primarily on paid family caregivers, but few studies include spouses and informal non-family "care partners." We sought to identify key challenges faced by care partners of Veterans with invisible injuries. METHODS: Semi-structured interviews were conducted with 36 individuals involved in supporting a recently separated US military Veteran enrolled in a 2-year longitudinal study. CPs completed validated measures on perceived stress, caregiving burden, quality of their relationship, life satisfaction, and flourishing. Independent -tests were …

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

Making Cities Mental Health Friendly For Adolescents And Young Adults, Pamela Y. Collins, Moitreyee Sinha, Tessa Concepcion, George Patton, Thaisa Way, Layla Mccay, Augustina Mensa-Kwao, Helen Herrman, Evelyne De Leeuw, Lukoye Atwoli

Brain and Mind Institute

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for …

Biological Aging Markers In Blood And Brain Tissue Indicate Age Acceleration In Alcohol Use Disorder, Lea Zillich, Metin Cetin, Elisabeth M Hummel, Eric Poisel, Gabriel R Fries, Josef Frank, Fabian Streit, Jerome C Foo, Lea Sirignano, Marion M Friske, Bernd Lenz, Sabine Hoffmann, Kristina Adorjan, Falk Kiefer, Georgy Bakalkin, Anita C Hansson, Falk W Lohoff, Olli Kärkkäinen, Eloise Kok, Pekka J Karhunen, Greg T Sutherland, Consuelo Walss-Bass, Rainer Spanagel, Marcella Rietschel, Dirk A Moser, Stephanie H Witt

Faculty, Staff and Student Publications

Background: Alcohol use disorder (AUD) is associated with increased mortality and morbidity risk. A reason for this could be accelerated biological aging, which is strongly influenced by disease processes such as inflammation. As recent studies of AUD show changes in DNA methylation and gene expression in neuroinflammation-related pathways in the brain, biological aging represents a potentially important construct for understanding the adverse effects of substance use disorders. Epigenetic clocks have shown accelerated aging in blood samples from individuals with AUD. However, no systematic evaluation of biological age measures in AUD across different tissues and brain regions has been undertaken.

Methods: …

Impact And Efficiency Of Treatment Across Two Ptsd Clinical Trials Comparing In-Person And Telehealth Service Delivery Formats, Cindy A Mcgeary, Leslie A Morland, Patricia A Resick, Casey L Straud, John C Moring, Min Ji Sohn, Margaret-Anne Mackintosh, Stacey Young-Mccaughan, Ron Acierno, Sheila A M Rauch, Jim Mintz, Donald D Mcgeary, Stephanie Y Wells, Kathleen Grubbs, Paul S Nabity, Chelsea J Mcmahon, Brett T Litz, Dawn I Velligan, Alexandra Macdonald, Emma Mata-Galan, Stephen L Holliday, Kirsten H Dillon, John D Roache, Alan L Peterson

Faculty, Staff and Student Publications

The intent of this study is to examine treatment impact and efficiency observed when cognitive behavioral treatments for posttraumatic stress disorder (PTSD) are delivered in-person or using telehealth. This study pooled data from 268 veterans enrolled in two PTSD clinical trials. In both trials, treatment was delivered using in-home telehealth (telehealth arm), in-home in-person (in-home arm), and in-office care, where patients traveled to the Department of Veterans Affairs for either office-based telehealth or office-based in-person care (office arm). Average age was 44 (SD = 12.57); 80.9% were males. The PTSD Checklist for DSM-5 (PCL-5) was used …

Comparing The Trends Of Postpartum Depression Screening Scores During And Before The Covid-19 Pandemic, Elif S. Duran, Dung Dang, Tony Ogburn

Research Colloquium

Introduction: Postpartum depression includes major and minor depressive disorder affecting women in the time period after childbirth. The studies reviewed in our literature found that the COVID-19 pandemic has increased the risk of postpartum depression for women. Our study location, the Rio Grande Valley is one of the hardest hit locations by the COVID-19 pandemic in the United States. Our patient population is also one with the higher risk factors for postpartum depression. As such, we are expecting the psychological impact of the pandemic to be even more magnified and thus, actions need to be taken to support the vulnerable …

Assessing Influence Of Immigrant Status And Other Social Determinants Of Health On Community Psychiatry, Agnes M. Cruz, Jorge A. Romero Ortiz, Diana Chapa

Research Symposium

Background/purpose: Social determinants of health are fundamental and structural factors that affect people’s lives and impact their health and longevity. Differences in social determinants of health across populations and communities account for major health disparities between them. The purpose of this paper is to assess how social determinants of health have impacted the health outcomes in patients from our community psychiatry clinics, to evaluate the impact of irregular immigration status as an independent social determinant of health, and to investigate the use of SDOH screening instrument in our clinics.

Methods: An online questionnaire was sent to community psychiatry providers in …