Psychiatry Commons^™

Postpartum Psychosis In A Non-Native Language-Speaking Patient: A Perspective On Language Barriers And Cultural Competency., Tatsuhiko Naito, Justin Chin, Jun Lin, Pritesh J Shah, Christine M. Lomiguen

Touro College of Osteopathic Medicine (New York) Publications and Research

Postpartum psychosis is a condition characterised by rapid onset of psychotic symptoms several weeks after childbirth. Outside of its timing and descriptions of psychotic features, minimal research exists due to its relative rarity (1 to 2 per 1000 births in the USA), with greater emphasis on postpartum sadness and depression. With the existing literature, cultural differences and language barriers previously have not been taken into consideration as there are no documented cases of postpartum psychosis in a non-English-speaking patient. Correctly differentiating postpartum psychosis from other postpartum psychiatric disorders requires adeptly evaluating for the presence of psychotic symptoms with in-depth history …

The "M" Word: Accusations Of Malingering Are Harmful To Patient Care, Joshua S. Ellis

Cooper Rowan Medical Journal

It starts as a small seed of doubt. It can be planted by anyone: the physician, the nurse, a family member, or even the patient. But once the seed gets planted in the minds of those involved in caring for the patient, every word and action from the patient function as water and sunshine, encouraging the seed to grow. The seed of doubt grows into a small tree of criticism which blooms into a collection of judgment and prejudice that prevent the patient from receiving the care that he or she deserves. All of this can happen after a patient …

Obstetrical Providers’ Comfort And Knowledge Of Screening, Brief Intervention, And Referral To Treatment, Dennis J. Hand, Aasta Mehta, Emily Rosenthal, Alice C. Fischer, Tamara Tatevosian, Carrie Malanga, Laura Hart, Debra Dalessandro, Kristin Walker

Department of Obstetrics and Gynecology Posters

Background

Rates of substance use during pregnancy have continued to rise through 2017. It is likely that obstetrical providers are encountering many pregnant persons who use substances either during prenatal care or postpartum. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based model that has been successfully implemented in some obstetrical settings, but its implementation has been sporadic. The objective of this study was to determine the baseline level of familiarity and use of SBIRT elements among obstetrical providers to identify needs for future SBIRT implementation efforts.

Methods

Participants were physicians, medical students, nurses, and other staff attending …

Nash-Wo-Numa (Childhood Growth & Development) Study Protocol: Factors That Impact Linear Growth In Children 9 To 15 Years Of Age In Matiari, Pakistan, Susan C. Campisi, Yaqub Wasan, Sajid Bashir Soofi, Suneeta Monga, Daphne J. Korczak, Wendy Lou, Olle Soder, Ashley Vandermorris, Khadija N Humayun, Ayesha Mian, Peter Szatmari, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Introduction: Adolescence is a time of significant physical and emotional change, and there is emerging concern that adolescents living in low- and middle-income countries (LMIC) may face substantial challenges in relation to linear growth and mental health. Data on the global burden of stunting after 5 years of age are limited, but estimates suggest up to 50 per cent of all adolescents in some LMIC are stunted. Additionally, many LMIC lack robust mental health care delivery systems. Pakistan has one of the world's largest populations of adolescents (10 to 19 years) at approximately 40 million. The Nash-wo-Numa study's primary objective …

Determining A Clinical Role For Digital Apps For Mental Health, Hephsibah Loeb, Md, Ann Chandy, Md

Department of Psychiatry and Human Behavior Posters

In 2017, the FDA approved the first app for treatment of alcohol, cocaine, marijuana and stimulant use disorders. In a preceding randomized controlled trial, mobile software Therapeutic Education System (TES) was found to reduce dropout from treatment and to increase patients’ rates of abstinence from substance abuse. Another study showed that PRIME-D, a mobile-based treatment for depression, positively affected symptoms of depression and disability. Many individuals seek out self-help apps for psychiatric complaints, although, in general, little evidence exists for evaluation of the most accessible mobile apps for self-help. What are the strengths and weaknesses of digital apps for treatment …

Affective Disturbance In Mild Cognitive Impairment, Jason Greenhagen, Emily Matusz, Sheina Emrani, David Libon, Sherry Pomerantz

Rowan-Virtua Research Day

Mild cognitive impairment (MCI) is an identifiable, prodromal stage of cognitive impairment and has been further defined into subtypes: amnestic, language, executive functioning, and multi domain/mixed MCI (Jak et al. 2009 ). The purpose of this study is to (1) examine the differences in depression, anxiety, and apathy between MCI subtypes; and (2) assess the relationship between the neurocognitive domains (executive functioning, language, and memory and affective symptoms. We hypothesize that apathy will be greater in dysexecutive/mixed MCI (dys/mixed MCI) and be more highly correlated to neurocognitive deficits compared to depression or anxiety. This is a retrospective study of 113 …

Survey Of Primary Care Physicians’ And Pediatricians’ Competency In Identifying Prodromal Symptoms In Schizophrenia And Psychotic Disorders, Mark Shephard, Joanna Petrides

Rowan-Virtua Research Day

• To address whether primary care physicians and pediatricians are equipped to recognize the prodromal symptoms of psychotic disorders

• Patients of primary care physicians exhibited increased help seeking behaviors prior to schizophrenia diagnosis [1]

• Primary care physicians in numerous countries have shown a lack of sufficient knowledge related to diagnosing and treating schizophrenia [2,3,4,5,6]

• Unclear if primary care physicians in the United States are adequately trained and prepared to recognize prodromal signs of schizophrenia, and diagnose and treat a variety of psychotic disorders

Omt For The Treatment Of Depression And Anxiety, Zachary Winchell

Rowan-Virtua Research Day

Osteopathic manipulative therapy (OMT) fundamentally aims to remedy somatic dysfunction through the manipulation of the patient. In this regard, OMT is a particularly viable non-pharmacological adjunct for patients with depressive and generalized anxiety disorder (GAD).

In both of these disorders, the hypothalamic-pituitary-adrenal axis has an interdependent relationship with physiological stress that feed one another to both increase symptomology and leave patients vulnerable to negative life events. Additionally, pro-inflammatory cytokines acting on the brain over long periods of time can lead to exacerbation of disease and the development of depression in susceptible individuals. Altered cytokine balance has also been found in …

Effects Of The Kcnq Channel Opener Ezogabine On Functional Connectivity Of The Ventral Striatum And Clinical Symptoms In Patients With Major Depressive Disorder, Aaron Tan, Sara Costi, Laurel S. Morris, Nicholas T. Van Dam, Marin Kautz, Alexis E. Whitton, Allyson K. Friedman, Katherine A. Collins, Gabriella Ahle, Nisha Chadha, Brian Do, Diego A. Pizzagalli, Dan V. Iosifescu, Eric J. Nestler, Ming-Hu Han, James W. Murrough

Publications and Research

Major depressive disorder (MDD) is a leading cause of disability worldwide, yet current treatment strategies remain limited in their mechanistic diversity. Recent evidence has highlighted a promising novel pharmaceutical target—the KCNQ-type potassium channel—for the treatment of depressive disorders, which may exert a therapeutic effect via functional changes within the brain reward system, including the ventral striatum. The current study assessed the effects of the KCNQ channel opener ezogabine (also known as retigabine) on reward circuitry and clinical symptoms in patients with MDD. Eighteen medication-free individuals with MDD currently in a major depressive episode were enrolled in an open-label study and …

Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, Olivia Kaminsky, Michelle Fortier, Brooke N. Jenkins, Robert S. Stevenson, Jeffrey I. Gold, Jeannie Zuk, Brenda Golianu, Sherrie H. Kaplan, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.

Methods

This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain …

Need Of Physical And Chemical Restraints: Experiences At Inpatient Psychiatric Ward In A Tertiary Care Hospital In Karachi, Pakistan, Humera Saeed, M. Shameel Khan, Syeda Maheen Batool, Asma Akbar Ladak, Nadia Karim, Rabeeka Aftab

Department of Psychiatry

In psychiatry, agitated / aggressive patients are often treated with de-escalation techniques. If this does not work, physical or chemical restrains are required; but in the event of resistance, seclusion is applied. We report the findings of baseline study of experiences of physical and chemical restraints in a tertiary care hospital in Karachi, where 104 files were evaluated retrospectively. The mean age of patients was 32.5 ±14.3 years with 54.8% men, while the average length of stay was 11.5 ±9.3 days. Agitation, violent behaviour, and aggression were the most common indications for restraints. In total, 94.5% of patients had both …

Trust And Glycemic Control In Black Patients With Diabetic Retinopathy: A Pilot Study, Barry W. Rovner, Robin J. Casten

Department of Psychiatry and Human Behavior Faculty Papers

Diabetic retinopathy (DR) is more prevalent in blacks than whites because, compared to whites, blacks on average have worse glycemic control. Both of these racial disparities reflect differences in sociocultural determinants of health, including physician mistrust. This randomized, controlled 6-month pilot trial compared the efficacy of a culturally tailored behavioral health/ophthalmologic intervention called Collaborative Care for Depression and Diabetic Retinopathy (CC-DDR) to enhanced usual care (EUC) for improving glycemic control in black patients with DR (n = 33). The mean age of participants was 68 years (SD 6.1 years), 76% were women, and the mean A1C was 8.7% (SD 1.5%). …

Social Influence And Moment-To-Moment Changes In Young Adults’ Mood And Psychotic Symptoms, K Powers, K A. Johnson, M Graham, A Cloutier, K Stewart, S Lynch, D Robbins, R Mesholm-Gately, K A. Woodberry

MaineHealth Maine Medical Center

Background:

• Social situations can have a significant impact on young people’s mood and mental experiences.

• More specifically, we want to know how someone’s perceived social influence in social situations relates to their mood and psychotic symptoms.

• Past studies have found connections between lower perceived social status (rank, comparison, and related concepts) and psychotic symptoms anxiety, depression, and other mood related psychopathology.

• We use experience sampling methods to capture moment-to-moment changes in mood and psychotic symptoms in a variety of social settings.

Identifying Youth At Clinical High Risk: What’S The Emotional Impact?, K A. Woodberry, K S. Powers, C Bryant, D Downing, M Verdi, L Kennedy, D I. Shapiro, R Girgis, G Brucato, D Huang, F M. Crump, C M. Corcoran, L I. Seidman, B Link, W R. Mcfarlane, L Yang

MaineHealth Maine Medical Center

Background:

Early intervention in major mental illness promises to improve the lives of those identified.

• But could identifying youth as at clinical high risk (CHR) for psychosis also do harm given that the majority never develop a psychotic disorder?

• Could telling someone they are at risk for psychosis activate internalized stigma that has been associated with increased emotional distress, social withdrawal, non-engagement in treatment, and suicide risk in CHR youth?

• Within the context of a larger study of stigma in CHR, we compared emotional responses to the CHR concept assessed before and after clinical feedback by study …

Reducing Length Of Stay For Mental Health Patients, Faye Collins, Nancijean Goudey

MaineHealth Maine Medical Center

Background:

Our facility sees an average of over 200 mental health patients every month, with limited community resources. The length of stay (LOS) for these patients had slowly risen to unacceptable levels; the number of patients whose LOS was greater than 24 hours increased in fiscal year (FY) 2017, from 633 patients to 1145. Patients in crisis require expedited transfer to appropriate care locations. Our goal was to decrease the overall length of stay for mental health patients in the Emergency Department.

Postpartum Depression And Thyroid Dysfunction– Should Pregnant Women Be Screened For Thyroid Disorders?, Anca A. Simionescu, Erika Marin

Journal of Mind and Medical Sciences

The relationship between thyroid dysfunction and postpartum depression has been investigated for quite some time now, but no consensus has been reached regarding the need for screening for thyroid function during pregnancy. This paper aims to investigate whether thyroid hormone screening in pregnancy might contribute to the diagnosis of postpartum depression.

Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) - one of the most widely used measures in detecting postpartum depression and anxiety. Thyroid function was measured using the commonly recommended thyroid laboratory tests.

A structured questionnaire was given to 61 patients closely monitored during their pregnancy and …

The Risk Of Bleeding And Encephalopathy In Surgical Patients With Liver Cirrhosis, Petrișor Banu, Salvatore Settineri, Emanuele Maria Merlo, Maria Rosaria Anna Muscatello, Nicolae Bacalbașa, Carolina Negrei, Bianca Gălățeanu, Octav Ghinghină, Ioana Păunica, Cristian Bălălău

Journal of Mind and Medical Sciences

Liver cirrhosis is a disease with an increasing incidence. Surgical procedures in patients with cirrhosis are also increasing, due to a longer life expectancy in these patients and also to the improvement of therapeutic and diagnostic resources.

Digestive hemorrhage in the cirrhotic patient requires emergency medical intervention (intensive therapy, endoscopic or even surgical approaches), being at the same time a factor that precipitates episodes of encephalopathy, i.e. the conventional complication of cirrhosis. Hepatic encephalopathy represents one of the most severe clinical events of cirrhosis, being associated with high morbidity and mortality. The causes of hepatic encephalopathy are briefly presented in …

Comparing Psychiatric Care Experiences Shared Online With Validated Questionnaires; Do They Include The Same Content?, Rebecca Baines, John Donovan, Samantha Regan De Bere, Julian Archer, Ray Jones

Patient Experience Journal

Patient feedback is considered integral to patient safety and quality of care. However, limited research has compared the content of validated questionnaires with subjective patient experiences shared online. The aim of this study was to therefore identify and compare the content of psychiatric care experiences shared online with validated questionnaires. All research was conducted in co-production with a volunteer mental-health-patient-research-partner. We analysed all reviews published on the United Kingdom’s leading health and social care feedback platform Care Opinion, between 2005-2017 that discussed adult psychiatric care and compared findings with two validated questionnaires (ACP360 and General Medical Council patient feedback questionnaire). …

Forgotten Children & Bonds That Heal: The Critical Nature Of Attachment, August Ashbaker

Lesley University Community of Scholars Day

Human attachment is one of the most critical factors in proper neurological and physiological development. Attachment is built through the mutuality of emotional impact, as well as the regular reception of physical touch. Infants and children who have been deprived of these vital necessities through the lacking initiatives of their caregivers—through neglect—display visible signs of its physiological, cognitive, emotional, and behavioral impact. Research has found neglect to be the highest risk factor for permanent damage to brain development in comparison to other forms of complex trauma (i.e. chronic caregiver interpersonal trauma in childhood); it is also the most prevalent …

Mental Health Services For Youth In The Eastern Mediterranean Region: Challenges And Opportunities (Editorial), Atif Rahman, Hesham M. Hamoda, Afarin Rahimi-Movaghar, Murad M. Khan Dr., Khalid Saeed

Department of Psychiatry

The Global Burden of Disease study shows that the burden from mental and substance use disorders, measured in Disability Adjusted Life Years (DALYs), has steadily risen in the Eastern Mediterranean Region (EMR) over the last three decades and is higher than the global average for almost all EMR countries). Even more alarming is the finding that depression, self-harm, anxiety and conduct disorders constitute four of the top 10 causes of DALYs among girls and boys aged 15-19 years and suicide is a leading cause of adolescent mortality.