Psychiatric and Mental Health Commons^™

Early Use Of Long-Acting Injectable Antipsychotics In Bipolar Disorder Type I: An Expert Consensus, Martha Sajatovic

Faculty Scholarship

Introduction: Long-acting injectable antipsychotics (LAIs) are not routinely offered to patients living with bipolar disorder type I (BP-I), despite widespread evidence that supports their benefits over oral antipsychotics, particularly in early disease. Methods: A round-table meeting of psychiatrists convened to discuss barriers and opportunities and provide consensus recommendations around the early use of LAIs for BP-I. Results: LAIs are rarely prescribed to treat BP-I unless a patient has severe symptoms, sub-optimal adherence to oral antipsychotics, or has experienced multiple relapses. Beyond country-specific accessibility issues (e.g., healthcare infrastructure and availability/approval status), primary barriers to the effective use of LAIs were identified …

Young Children’S Mental Well-Being In Low-Income South African Settings: A Qualitative Study, Catherine E. Draper, Caylee J. Cook, Elizabeth A. Ankrah, Jesus A. Beltran, Franceli L. Cibrian, Jazette Johnson, Kimberley D. Lakes, Hanna Mofid, Lucretia Williams, Gillian R. Hayes

Engineering Faculty Articles and Research

This qualitative study aimed to capture community perspectives of the risks and protective factors for social emotional development and mental health of young children in low-income South Africa settings, and was conducted as one component of a larger study with the ultimate aim of co-designing the Mazi Umntanakho (‘know your child’) digital tool. Twenty focus group discussions (n = 154, 97% female) were held with staff of community-based organisations (CBOs) and community health worker (CHW) programmes in urban and rural sites from four geographical regions. Data were analysed thematically, and grouped according to components of nurturing care (responsive caregiving, safety …

Neural Correlates Of Socially Rewarding Memories In Posttraumatic Stress Disorder, Kyle P. Blidy

MUSC Theses and Dissertations

Significance. Memory disturbances for emotional content are central to PTSD, yet most research focuses on trauma memories. Recent evidence suggests that enhancing access to positive memories could improve mood, affect regulation, self-esteem, and integration of trauma memories. However, the neurocognitive mechanisms underlying positive memory encoding in PTSD are poorly understood. No study has examined memory for positive social items in PTSD, which is important because PTSD entails social withdrawal and reduced accessibility to positive memory. Additionally, positive memories embedded in a social context have enhanced subjective value and strengthening their accessibility may confer greater benefits to wellbeing compared to non-social …

Digital Assessments For Children And Adolescents With Adhd: A Scoping Review, Franceli L. Cibrian, Elissa M. Monteiro, Kimberley D. Lakes

Engineering Faculty Articles and Research

Introduction: In spite of rapid advances in evidence-based treatments for attention deficit hyperactivity disorder (ADHD), community access to rigorous gold-standard diagnostic assessments has lagged far behind due to barriers such as the costs and limited availability of comprehensive diagnostic evaluations. Digital assessment of attention and behavior has the potential to lead to scalable approaches that could be used to screen large numbers of children and/or increase access to high-quality, scalable diagnostic evaluations, especially if designed using user-centered participatory and ability-based frameworks. Current research on assessment has begun to take a user-centered approach by actively involving participants to ensure the development …

Two Lives, Shruti Trehan Mbbs

Journal of Wellness

A busy oncologist makes a decision to leave her busy, thriving, community practice in the Mid-West and moves to a Veterans Affairs hospital in South Florida in the quest for a better work-life balance.

Impact Of Covid-19 Pandemic On Emergency Department Visits For Opioid Use Disorder Across University Of California Health Centers, Matthew Heshmatipour, Ding Quan Ng, Emily Yi-Wen Truong, Jianwei Zheng, Alexandre Chan, Yun Wang

Pharmacy Faculty Articles and Research

Introduction: Coronavirus 2019 (COVID-19) has had a devastating impact on mental health and access to addiction treatment in the United States, including in California, which resulted in the highest rates of emergency department visits (ED) for opioid poisoning in 2020. As California slowly returns to pre-pandemic normalcy, it remains uncertain whether the rates of opioid-related events have slowed down over time. We hypothesized that the number of opioid-related ED visits were exacerbated after the period of the COVID-19 pandemic and continue at a high rate in the present.

Methods: In this analysis we searched the University of California (UC) Health …

Residency Reflections, Naleen Patel Md

Journal of Wellness

No abstract provided.

The Role Of Nutrition In Modulating Neurodevelopmental And Mental Health Outcomes In Pediatric Populations: A Review, Athul M. Vikas

Senior Theses

Introduction: Neurodevelopmental and mental health disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety, and depression, have risen sharply in prevalence among children and adolescents, creating substantial public health concerns. Traditional interventions, primarily pharmacological and behavioral, offer critical but limited support, underscoring the need for integrated approaches. Recent findings suggest that nutrition may play a significant role in supporting brain development and mitigating mental health risks, offering preventive benefits that complement conventional therapies. This review aims to evaluate the influence of specific nutrients—such as folate, iron, DHA, zinc, and vitamin B12—on neurodevelopmental outcomes, emphasizing the importance of these nutrients during critical growth …

Efficacy Of, And Barriers To, Treatment Options For Pans/Pandas, Kayla E. Pray

Senior Theses

Background: PANS/PANDAS are pediatric autoimmune disorders that cause an acute-onset of OCD-like symptoms and/or severe restricted eating, as well as anxiety, irritation, deterioration of fine motor skills, hyperactivity, and other psychiatric symptoms. An estimated 1-2% of the pediatric population is affected. Currently, there is little research published on the treatment options for PANS/PANDAS and there is no evidence-based consensus on the best treatment option.

Purpose: This study aimed to discover the efficacy of, and barriers to, available treatment options for PANS/PANDAS.

Methods: A convenience sample of individuals diagnosed with PANS/PANDAS or their parent/caregiver was recruited anonymously through Facebook support groups. …

The Role Of The Basolateral Nuclear Complex & Central Nucleus Of The Amygdala In Fear-Conditioned Responses To External Stimuli And Anxiety Responses, Oluwaseyi A. Adelakun

Senior Theses

This thesis reviews the role of the amygdala, particularly the basolateral nuclear complex (BLA) and central nucleus (CeA), in fear-conditioned responses and generalized anxiety disorder (GAD). By investigating the neurological and physiological mechanisms that influence the amygdala’s fear and anxiety responses, further connections can be made between this region and other notable brain regions, like the prefrontal cortex (PFC). We review both human and rodent models to explore the overlap between the two and explore various therapeutic interventions that regulate amygdalar activity and therefore mitigate anxiety symptoms. Key research into the patient SM, who lacks fear responses due to bilateral …

Increasing The Frequency Of Behavior Assessment To Reduce Physical Restraint, Breanne N. Ford

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a system that routinely assesses for behavior changes in psychiatric patients presenting to the emergency department to improve staff intervention of escalating behaviors and decrease physical restraint use.

Background: The project was implemented in a 45-bed emergency department in a community-based hospital affiliated with a large hospital system in Houston, Texas.

Methodology: The project utilizes the Behavioral Activity Rating Scale (BARS) to assess patients' behaviors at routine intervals throughout shifts and a comfort cart that houses several non-pharmacological intervention items to use to de-escalate adverse behaviors. The staff …

Use Of The Integrated Practice Assessment Tool (Ipat) To Evaluate The Clinical Learning Environment For Counselors-In-Training, Jessica Lloyd-Hazlett, Stacy Ogbeide, Heather Trepal, Mercedes Ingram, Swathi Weaver

Journal of Human Services Scholarship and Interprofessional Collaboration

The need for behavioral health integration (BHI) in primary care continues to grow to address the behavioral health needs of patients and families. Developing a competent interprofessional workforce to operate in primary care behavioral health settings necessitates BHI-literate clinical learning environments, as well as tools to evaluate and assist in the integration of services appropriate for BHI training and supervision. The Integrated Practice Assessment Tool (IPAT; Waxmonsky et al., 2014) is an instrument that assesses the level of BHI at a primary care clinic. This paper discusses an example of an implementation approach to examine BHI levels with the IPAT …

A Brief Review Of Zuranolone, Aubrey A. Jackson

Transformative Medicine

Zuranolone, a novel analog of allopregnanolone, has been approved by the U.S. Food and Drug Administration (FDA) as the first oral medication approved for the treatment of postpartum depression in adults. Developed by Sage Therapeutics under the brand name Zurzuvae, zuranolone was approved by the FDA on August 4^th, 2023.¹ Zuranolone is a modified version of brexanolone (sold under the brand name Zulpresso), an intravenously administered allopregnanolone formulation that was previously the only FDA-approved medication for postpartum depression. Zuranolone offers a more accessible treatment option for patients with efficacy established in clinical trials. Its approval expands the …

Building Confidence, Diminishing Stress: A Clinical Incivility Management Initiative For Nursing Students, Younglee Kim, Phoebe (Yeon) S. Kim, Henrietta Nwamu, Anne Lama

Nursing Faculty Publications

Objective: The aim of this study was to evaluate the effectiveness of an interactive program designed to reduce nursing students’ perceived stress and improve self-efficacy and readiness to professionally address incivility during clinical practice. Background: Incivility in clinical settings adversely impacts learners, educators, institutions, and healthcare systems, undermining safety and the teaching–learning process. Despite its increasing global prevalence, effective interventions remain largely unexplored. Methods: Our mixed-methods study, conducted from March to April 2024, involved senior baccalaureate pre-licensure nursing students (N = 35) from a California State University. The three-week, one-hour-per-week, interactive clinical incivility management program was developed through an extensive …

Interprofessional Education To Support Alcohol Use Screening And Future Team-Based Management Of Stress-Related Disorders In Vulnerable Populations, Taylor Fitzpatrick-Schmidt, Scott Edwards

School of Graduate Studies Faculty Publications

Introduction: Alcohol use disorder (AUD) is a psychiatric disease that affects approximately 10% of the population. Individuals suffer from a myriad of causes and consequences of AUD, and team-based management of patients is often required for given the chronic and complex nature of the disease. Interprofessional education (IPE) for biomedical science and health professional students that incorporates patient-centered cases focused on AUD and adjacent stress-related disorders may improve future collaboration in managing these conditions and community outcomes related to wellbeing. Methods: This study assessed the impact of a single, 90-minute IPE exercise on improving confidence in possessing the knowledge and …

Screening, Brief Intervention, And Referral To Treatment For Pregnant Women, Rebekah Feeney

Dissertations

Abstract

Background: In the United States, 10-20% of pregnant women reported using drugs during pregnancy. Current recommendations are to screen for drug use in all patients and provide a brief intervention and referral to treatment. The purpose of this quality improvement project was to evaluate the impact of implementing a standardized screening, brief intervention, and referral to treatment (SBIRT) protocol for first-trimester pregnant patients who are seen in the obstetrical department.

Methods: The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) screening tool was administered to first-trimester pregnant women, 13-45 years of age, seen in the obstetrical department from …

Clinical Correlates Of Perceived Stigma Among People Living With Epilepsy Enrolled In A Self-Management Clinical Trial, Martha Sajatovic, Martha Sajatovic, Jessica Black, Jacqueline Krehel-Montgomery, Grace Mcdermott, Joy Yala, Richard Barigye, Clara Adeniyi, Farren Briggs

Faculty Scholarship

Background and Purpose: Stigma is a pervasive barrier for people living with epilepsy (PLWE) and can have substantial negative effects. This study evaluated clinical correlates of perceived stigma in a research sample of PLWE considered to be at high risk due to frequent seizures or other negative health events. Methods: Analyses were derived from baseline data from an ongoing Centers for Disease Control and Prevention (CDC)-funded randomized controlled trial (RCT) testing an epilepsy self-management approach. Standardized measures assessed socio-demographics, perceived epilepsy stigma, epilepsy-related self-efficacy, epilepsy self-management competency, health literacy, depressive symptom severity, functional status, social support and epilepsy-related quality of …

Comorbidity Of Mood Disorders And Upper Airway Resistance Syndrome: A Case Report, Abhishekh Pokhrel, Alexa Lissete Zarate, Alcides Amador

Research Colloquium

Background: The comorbidity of mood disorders and Upper Airway Resistance Syndrome (UARS) presents a significant challenge, especially in pediatric populations. UARS, characterized by increased upper airway resistance during sleep, often leads to disrupted sleep and daytime symptoms such as fatigue and cognitive impairment. Studies estimate UARS affects 15-30% of patients undergoing polysomnography for suspected sleep-disordered breathing. Mood & Anxiety Disorders are prevalent in patients with sleep-disordered breathing, with higher rates than in the general population.

Case Presentation: 16-year-old female, with psychiatric history of Bipolar II Disorder current episode depressed, ADHD, and Other Specified Anxiety Disorder presents for a follow-up. Since …

Preferences For Attributes Of Oral Antipsychotic Treatments: Results From A Discrete-Choice Experiment In Respondents With Schizophrenia Or Bipolar I Disorder, Martha Sajatovic

Faculty Scholarship

Background: Antipsychotic medications are effective treatments for schizophrenia (SZ) and bipolar I disorder (BD-I), but when presented with different treatment options, there are tradeoffs that individuals make between clinical improvement and adverse effects. As new options become available, understanding the attributes of antipsychotic medications that are valued and the tradeoffs that individuals consider when choosing among them is important. Methods: A discrete-choice experiment (DCE) was administered online to elicit preferences across 5 attributes of oral antipsychotics: treatment efficacy (i.e., improvement in symptom severity), weight gain over 6 months, sexual dysfunction, sedation, and akathisia. Eligible respondents were aged 18–64 years with …

Smart Toys For Sensing And Soothing Distress In Pediatric Patients, Jonathan Daniel Bonilla

Dartmouth College Master’s Theses

This thesis develops and evaluates child-centered technologies to support remote monitoring of pediatric patients, with an emphasis on childhood cancer and pediatric chronic pain. For these and many other health conditions, current therapies tend to focus on treating physical symptoms yet neglect the psycho-emotional aspects of managing the illness. However, such mental states play a major role in recovery. Research has shown that cancer patients with better mental health have better prognoses, higher possibilities of remission, and faster healing processes, while chronic pain patients with better mental health report lower levels of pain. To enable more personalized, continuous, and scalable …