Psychiatry Commons^™

Addressing Culture And Context In Humanitarian Response: Preparing Desk Reviews To Inform Mental Health And Psychosocial Support., M Claire Greene, Mark J D Jordans, Brandon A Kohrt, Peter Ventevogel, Laurence J Kirmayer, Ghayda Hassan, Anna Chiumento, Mark Van Ommeren, Wietse A Tol

Psychiatry and Behavioral Sciences Faculty Publications

Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners …

Addressing Culture And Context In Humanitarian Response: Preparing Desk Reviews To Inform Mental Health And Psychosocial Support., M Claire Greene, Mark J D Jordans, Brandon A Kohrt, Peter Ventevogel, Laurence J Kirmayer, Ghayda Hassan, Anna Chiumento, Mark Van Ommeren, Wietse A Tol

Psychiatry and Behavioral Sciences Faculty Publications

Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners …

Elucidating Adolescent Aspirational Models For The Design Of Public Mental Health Interventions: A Mixed-Method Study In Rural Nepal, Sauharda Rai, Safar Bikram Adhikari, Nanda Raj Acharya, Bonnie N. Kaiser, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

Background

Adolescent aspirational models are sets of preferences for an idealized self. Aspirational models influence behavior and exposure to risk factors that shape adult mental and physical health. Cross-cultural understandings of adolescent aspirational models are crucial for successful global mental health programs. The study objective was elucidating adolescent aspirational models to inform interventions in Nepal.

Methods

Twenty qualitative life trajectory interviews were conducted among adolescents, teachers, and parents. Card sorting (rating and ranking activities) were administered to 72 adolescents aged 15–19 years, stratified by caste/ethnicity: upper caste Brahman and Chhetri, occupational caste Dalit, and ethnic minority Janajati. …

Translating Mental Health Diagnostic And Symptom Terminology To Train Health Workers And Engage Patients In Cross-Cultural, Non-English Speaking Populations, Bibhav Acharya, Madhur Basnet, Pragya Rimal, David Citrin, Soniya Hirachan, Brandon Kohrt, +Several Additional Authors

Psychiatry and Behavioral Sciences Faculty Publications

Although there are guidelines for transcultural adaptation and validation of psychometric tools, similar resources do not exist for translation of diagnostic and symptom terminology used by health professionals to communicate with one another, their patients, and the public. The issue of translation is particularly salient when working with underserved, non-English speaking populations in high-income countries and low- and middle-income countries. As clinicians, researchers, and educators working in cross-cultural settings, we present four recommendations to avoid common pitfalls in these settings. We demonstrate the need for: (1) harmonization of terminology among clinicians, educators of health professionals, and health policymakers; (2) distinction …

Do Pediatric Gastroenterology Doctors Address Pediatric Obesity?, Suruchi Batra, Caitlin Yee, Bernadette Diez, Nicholas Nguyen, Michael J Sheridan, Mark Tufano, Natalie Sikka, Stacie Townsend, Suchitra Hourigan

Psychiatry and Behavioral Sciences Faculty Publications

Objectives:

To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits.

Methods:

A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher’s exact tests were used to examine statistical associations.

Results:

Only 49% of children were given a diagnosis of obesity. In total, 52% of children were given a body mass index reduction plan. Those diagnosed with obesity were more likely to …

Situational Analysis To Inform Development Of Primary Care And Community-Based Mental Health Services For Severe Mental Disorders In Nepal, Mangesh Angdembe, Brandon A. Kohrt, Mark Jordans, Damodar Rimal, Nagendra Luitel

Psychiatry and Behavioral Sciences Faculty Publications

Background

Nepal is representative of Low and Middle Income Countries (LMIC) with limited availability of mental health services in rural areas, in which the majority of the population resides.

Methods

This formative qualitative study explores resources, challenges, and potential barriers to the development and implementation of evidence-based Comprehensive Community-based Mental Health Services (CCMHS) in accordance with the mental health Gap Action Programme (mhGAP) for persons with severe mental health disorders and epilepsy. Focus Group Discussions (FGDs, n = 9) and Key-Informant Interviews (KIIs, n = 26) were conducted in a rural district in western Nepal. Qualitative data were coded using …

A Case Of Successful Treatment Of Skin Excoriation Disorder With N-Acetyl Cysteine, Nauman Khan M.D., Priya Mahajan M.D., Sadia Shaukat M.D., Matthew Lacasse D.O., Mark Kanzawa D.O.

Research Day

Introduction: We present a case of a middle age patient with skin excoriation disorder since age 15 who experienced significant improvement with augmentation of her treatment regimen with N-acetyl cysteine. This improvement occurred despite a recurrence of her depression, alcohol use disorder, and stimulant use disorder. Case Presentation: A 59 year-old-female with 44 years of unsuccessful treatment of self-excoriation disorder presented with symptoms of unspecified depression, OCD and stimulant use disorder. She was referred by her surgeon who had to postpone a revision of her hip replacement as she was self-excoriating the right axillary lymphadenectomy site. Initial administration of PHQ-9 …

Speed Of Processing Training Results In Lower Risk Of Dementia, Jerri D. Edwards, Huiping Xu, Daniel O. Clark, Lin T. Guey, Lesley A. Ross, Frederick W. Unverzagt

Psychiatry & Behavioral Neurosciences Faculty Publications

Introduction: Cognitive training improves cognitive performance and delays functional impairment, but its effects on dementia are not known. We examined whether three different types of cognitive training lowered the risk of dementia across 10 years of follow-up relative to control and if greater number of training sessions attended was associated with lower dementia risk.

Methods: The Advanced Cognitive Training in Vital Elderly (NCT00298558) study was a randomized controlled trial (N = 2802) among initially healthy older adults, which examined the efficacy of three cognitive training programs (memory, reasoning, or speed of processing) relative to a no-contact control condition. …

Can Coloring Pre-Structured Designs That Have Complexity Aid In Reducing Anxiety In Those Greater Than 17 Years Of Age?, Kaitlyn P. Probasco

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine (EBM) review is to determine whether or not coloring mandalas or designs that have complexity and structure can aid in reducing anxiety in those greater than 17 years of age.

Study Design: Review of three English language randomized controlled trials (RCTs), published in 2007, 2012, and 2015.

Data Sources: Three randomized controlled trials published in peer-reviewed journals obtained using PubMed and EBSCOhost.

Outcomes Measured: The Curry and Kasser study and the van dV and Serice7study both used the State Anxiety Inventory (SAI) to record anxiety. The Henderson …

Is Aristada (Aripiprazole Lauroxil) A Safe And Effective Treatment For Schizophrenia In Adult Patients?, Kyle J. Knowles

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Aristada (aripiprazole lauroxil) a safe and effective treatment for schizophrenia in adult patients?”

STUDY DESIGN: Review of three randomized controlled studies. All three trials were conducted between 2014 and 2015.

DATA SOURCES: One randomized, controlled trial and two randomized, controlled, doubleblind trials found via Cochrane Library and PubMed.

OUTCOMES MEASURED: The outcomes that were measured include adverse events (pain at injection site, insomnia, headache, toothache, abdominal discomfort, constipation, diarrhea, akathisia, back pain, dyskinesia, dystonia, nasopharyngitis) measured by vital signs, physical examination, …

Is Lisdexamfetamine Dimesylate Safe And Effective In Reducing Adhd Symptoms?, Jordan A. Drelich

PCOM Physician Assistant Studies Student Scholarship

Objective: The purpose of this careful EBM review is to determine whether lisdexamfetamine dimesylate (LDX) is safe and effective in reducing attention-deficit/hyperactivity disorder (ADHD) symptoms.

Study Design: A systematic review of two randomized controlled studies and one double-blind, 2-arm, parallel-group placebo-controlled RWP published between 2011-2014, all in the English language.

Data Sources: Two randomized controlled trials and one double-blind, 2-arm, parallel-group placebo-controlled RWP published between 2011 and 2014 which were found using PubMed and Cochrane databases.

Outcomes Measured: ADHD global symptomatic improvement was measured using Clinical Global Impressions – Severity of Illness (CGI-S), Clinical Global Impression-Improvement …

Is Mindfulness-Based Therapy Effective In Increasing Total Sleep Time In Adults?, Johanna F. Detwiler

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine review is to determine whether or not mindfulness-based therapy is effective in increasing total sleep time in adults.

Study design: Review of three randomized controlled trials published in 2011, 2014 and 2015, all English language.

Data source-The three randomized controlled trials that were used in this review were found using PubMed.

Outcomes measured: Total sleep time, sleep onset latency, wake after sleep onset, number of awakenings, time in bed, subjective sleep quality, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medications, and daytime dysfunction were …

Is Botox A Safe And Effective Treatment To Reduce Symptoms Of Depression?, Bradin T. Carter

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Botox is a safe and effective treatment to reduce symptoms of depression?

Study Design: The review is based on three Randomized Control Trials that were double-blind and placebo controlled clinical trials.

Data Source: All articles were researched and found using PubMed and Medline. The articles were selected based on the relevance to my clinical question and if the articles included patient oriented outcomes (POEMS).

Outcomes Measured: The outcomes were measured by the improvement of depressive symptoms (sleep disturbances, suicide ideations, change in …

Is L-Theanine An Effective Treatment For Reducing Anxiety In Patients Ages 18-25?, Nicole Bubes

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not L-theanine, an amino acid analogue found in green tea leaves, is an effective treatment for reducing anxiety in patients ages 18-25.

Study design: Review of two double-blind, randomized controlled studies and one single-blind, randomized controlled study published in 2007, 2012 and 2013 respectively.

Data sources: PubMed

Outcome(s) measured: Each study measured L-theanine’s ability to reduce acute anxiety with a series of self-report measures assessing acute anxiety and stress, including the Profile of Mood States (POMS), the visual analogue scales (VAS), State-Trait Anxiety …

Is Oral Vitamin D Supplementation Safe And Effective For Adults As Therapy To Improve Symptoms Associated With Seasonal Affective Disorder (Sad) During Wintertime?, James Berking

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not oral vitamin D supplementation is safe and effective for adults as therapy to improve symptoms associated with seasonal affective disorder (SAD) during wintertime.

Study Design: This review is based on three randomized controlled trials (RCTs) which were published in 2006, 2012, 2014. Two of the studies were double blind and placebo controlled. The studies evaluated the efficacy of oral vitamin D supplementation for improvement of seasonal affective disorder (SAD) symptoms. One of the studies also evaluated safety.

Data Sources: All articles used were …

Is Ginkgo Biloba Effective In Managing The Symptoms Of Adhd And Does It Exhibit Lower Adverse Side Effects As Compared To The Current Standard Of Treatment?, Joshua Meir Alge

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine review is to determine whether or not ginkgo biloba is effective in managing the symptoms of ADHD and if it exhibits lower adverse side effects as compared to the current standard of treatment.

Study Design: Systematic review of three English language studies, two of which were randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study, published between 2009-2015.

Data Source: Two randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study. In one …

Is Cariprazine Effective And Safe In Treating Acute Mania In Bipolar I Disorder?, Evan A. Reaume

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is cariprazine effective and safe in treating acute mania in bipolar I disorder?”

Study Design: This review is based on three double-blind, randomized controlled trials (RCTs) published in English, in 2015. These studies compared both the efficacy, safety, and tolerability of cariprazine in the treatment of acute mania in bipolar I disorder.

Data sources: Three double-blind, placebo-controlled, RCTs published in English, in peer-reviewed journals, and found using Medline, Pubmed, and Cochrane Review databases.

Outcomes Measured: The primary efficacy scale used in all …

Does Increasing Speech Production And Language Acquisition Through Therapies Aimed At Emphasizing Speech Therapy Improve The Verbal Communication Capabilities In Autistic Children?, Jessica Olejnik

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this EBM review was to determine if increasing speech production & language acquisition through therapies which emphasized speech therapy, would improve verbal communication skills in autistic individuals.

Study Design: Three RCTs selected due to relevance to the proposed question and fulfillment of the requirement of measuring POEMs.

Data Sources: All articles were published in peer-reviewed journals via PubMed.

Outcome Measures: The Preschool Language Scale 4 and Comprehensive Assessment of Spoken Language was measured pre-intervention and 12 months later. The verbal production evaluation scale which measured phonology, pragmatics, prosody, and sematic features. The …

Investigation On Genetic Modifiers Of Age At Onset Of Major Depressive Disorder, Huseyin Gedik

Theses and Dissertations

Major Depressive Disorder (MDD) is a complex multifactorial disorder, which would lead to disability. Environmental and genetic factors are involved in MDD etiology. The aim of this project was to identify loci modifying age at onset (AAO) of MDD using survival models after adjusting for Childhood Sexual Abuse (CSA). To achieve this aim, a dataset was made available by the China Oxford and VCU Experimental Research on Genetic Epidemiology (CONVERGE) consortium. The study population had 5,220 controls and 5,282 cases with MDD. We performed two univariate association analyses using Cox Proportional Hazard (Cox PH) models. These two are Full Sample …

Epigenetic Editing To Validate Findings From Methylome-Wide Association Studies Of Neuropsychiatric Disorders, Robin F. Chan

Theses and Dissertations

DNA methylation is necessary for learning, memory consolidation and has been implicated in a number of neuropsychiatric disorders. Obtaining high quality and comprehensive data for the three common forms of methylation in brain is challenging for methylome-wide association studies (MWAS). To address this we optimized a panel of enrichment methods for screening the brain methylome. Results show that these enrichment techniques approach the coverage and fidelity of the current gold standard bisulfite based techniques. Our MBD-based method can also be used with low amounts of genomic material from limited human biomaterials. Psychiatric disorders have high prevalence and are often chronic …