Professor Of Psychiatry Research Articles

Editorial introductions.

Current Opinion in Psychiatry was launched in 1988. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of psychiatry is divided into 13 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Perminder S. SachdevPerminder S. SachdevPerminder S. Sachdev AM, MBBS, MD, FRANZCP, PhD, FAHMS, is Scientia Professor of Neuropsychiatry, Co-Director of the Centre for Healthy Brain Ageing (CHeBA) in the School of Psychiatry, UNSW Sydney, Australia, and Clinical Director of the Neuropsychiatric Institute (NPI) at the Prince of Wales Hospital, Sydney, Australia. He is co-chair of the Australian Dementia Network (ADNeT), and director of the Centre of Research Excellence in Vascular Contributions to Dementia. His major areas of research are drug-induced movement disorders, brain imaging, cognitive ageing and dementia. He has published over 700 peer-reviewed journal papers and six books, including one for lay readers (The Yipping Tiger and Other Tales from the Neuropsychiatric Clinic) and a book of poems (A Migrant's Musings). He was named NSW Scientist of the Year for Biomedical Sciences in 2010. In 2011, he was appointed Member of the Order of Australia (AM) for services to medical research. In 2018, he won the DARF-Yulgilbar Innovation Award for dementia research. In 2022, he was awarded the Ryman Prize for research concept or initiative that has enhanced quality of life for older people. Roma VasaRoma VasaDr Roma Vasa is an internationally recognized developmental neuropsychiatrist and the Director of Psychiatric Services at the Center for Autism and Related Disorders at the Kennedy Krieger Institute. She is an Associate Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. Dr Vasa is co-chair of the Autism and Intellectual Disability Committee of American Academy of Child and Adolescent Psychiatry. Within the field of developmental neuropsychiatry, Dr Vasa specializes in the assessment and treatment of neurodevelopmental disorders and their associated psychiatric conditions, as well as neuropsychiatric outcomes after pediatric traumatic brain injury. Her research focuses on investigating the phenotype and underlying transdiagnostic constructs of anxiety in autism spectrum disorder, notably intolerance of uncertainty. Dr Vasa is committed to training the next generation of psychiatrists, students, and other professionals in developmental neuropsychiatry and has developed innovative educational models in this area. She recently launched the Developmental Neuropsychiatry Scholar Program at the Kennedy Krieger Institute, which provides advanced specialty training to child and adolescent psychiatrists.

Psychedelic Renaissance: Clinical Health Justice, Patient Safety, and Equity Need to Be Put First

Psychedelic Renaissance: Clinical Health Justice, Patient Safety, and Equity Need to Be Put First

Iowa Funds Expansion of Rural Psychiatry Training, Services for Underserved Populations

Iowa Funds Expansion of Rural Psychiatry Training, Services for Underserved Populations

Study Finds Childhood Adversity Linked to Brain Differences in White, Black Children

Study Finds Childhood Adversity Linked to Brain Differences in White, Black Children

FDA Approves Second Antibody Therapy for Alzheimer’s

FDA Approves Second Antibody Therapy for Alzheimer’s

APA Releases Updated Guideline for Treating Eating Disorders

Back to table of contents Next article Clinical & ResearchFull AccessAPA Releases Updated Guideline for Treating Eating DisordersNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:25 Jan 2023https://doi.org/10.1176/appi.pn.2023.02.2.8AbstractThe new practice guideline focuses on evidence-based pharmacological, psychotherapeutic, and other nonpharmacological treatments for eating disorders in adolescents and adults.APA has released an updated practice guideline on how to treat patients with eating disorders— the first full update since 2006.There have been many clinical advances and diagnostic changes related to eating disorders in the past 17 years, noted Laura Fochtmann, M.D., M.B.I., a professor of psychiatry, pharmacological sciences and biomedical informatics at Stony Brook University School of Medicine and the medical editor for APA’s practice guidelines. Fochtmann was also the vice-chair of the writing group for this newest practice guideline.Notably, the publication of DSM-5 in 2013 and DSM-5-TR in 2022 resulted in broader diagnostic criteria for both anorexia nervosa and bulimia nervosa as well as the additions of binge-eating disorder and avoidant/restrictive food intake disorder (ARFID) categories. Binge-eating and avoidant/restrictive food intake disorders are both referenced in the updated guideline: There is a comprehensive section on assessing and treating binge-eating disorder, and there is also information on assessing patients with ARFID, Fochtmann noted. (Due to limited clinical data, there are no specific recommendations for how to treat patients with ARFID.)The fourth edition of APA’s practice guideline for eating disorders includes 16 clinical recommendations or suggestions, depending on the level of scientific evidence. Here are some of the recommendations:Screening for the presence of an eating disorder as part of an initial psychiatric evaluation.Conducting comprehensive patient evaluations, including laboratory tests such as electrocardiograms.Ensuring the treatment plan is patient-centered and culturally sensitive.Setting individualized weight goals for patients with anorexia.Treating patients with anorexia, bulimia, and binge-eating disorders with eating disorder–focused psychotherapy.Including family-based therapy as part of a treatment plan for adolescents with anorexia or bulimia.In addition to the guideline, APA has developed supplemental materials to help both health professionals and patients and families, such as a clinician pocket guide and educational slides. The centerpiece of these resources is an online tool that offers a step-by-step guide on how to assess symptoms and screen patients for a potential eating disorder. This clinical decision tool will be customized for different professionals (for example, psychiatrists, psychologists, and pediatricians) to match their skillsets and the symptoms they might expect when encountering someone with an eating disorder.The development of the online toolkit and other supporting resources was made possible through a grant from the Council of Medical Specialty Societies.The release of this new practice guideline comes at an important juncture for people with eating disorders (“Special Report: Youth With Eating Disorders—Time Is of the Essence in Achieving Remission”). Studies have reported upticks in individuals developing symptoms of and requiring hospitalization for disordered eating since the start of the COVID-19 pandemic in 2020. As noted in the guideline, maintaining a structured plan for meals and snacks is an important component of treatment, and the pandemic disrupted normal routines and increased stress and anxiety.“Early identification and treatment of an eating disorder is critical for achieving positive long-term outcomes,” said Joel Yager, M.D., a professor emeritus of psychiatry at the University of Colorado School of Medicine and the chair of the writing group for all three previous editions of the eating disorder practice guideline. “We hope that this tool will help anyone make an informed diagnosis regardless of their previous experience with eating disorders.” ■“The American Psychiatric Association Practice Guideline for the Treatment of Patients With Eating Disorders, Fourth Edition”Practice Guideline for Treatment of Patients with Eating Disorders. ISSUES NewArchived

Psychiatrists Explore Their Inner Hemingway

Psychiatrists Explore Their Inner Hemingway

Evaluating a novel treatment for opioid use disorder based on dual-brain psychology and photobiomodulation

Evaluating a novel treatment for opioid use disorder based on dual-brain psychology and photobiomodulation Opioid Use Disorder or opioid addiction is a devastating illness that leads to failed lives, overdoses and other medical catastrophes, family agony, crime, and social dysfunction. Although we have medications such as methadone, buprenorphine and naloxone) and self-help associations (such as Alcoholics Anonymous and Narcotics Anonymous), still the epidemic is only growing with a skyrocketing number of overdose deaths. In this article, Dr. Fredric Schiffer, founder and CEO of MindLight, LLC, looks at treatments for opioid use disorder based on Dual-Brain Psychology and photobiomodulation. Dr. Schiffer is also a part-time assistant professor in psychiatry at Harvard Medical School.

Editorial introductions.

Editorial introductions.

For ASD, Psychiatrists Must Continuously Monitor Patients, Assess Therapies

For ASD, Psychiatrists Must Continuously Monitor Patients, Assess Therapies

After 988’s Launch, Experts Emphasize More Work Needed

After 988’s Launch, Experts Emphasize More Work Needed

Experts Share Advice for Post-Roe World: ‘We Have to Be Proactive’

Experts Share Advice for Post-<i>Roe</i> World: ‘We Have to Be Proactive’

Partnership Between Psychiatrists, Faith Leaders Untapped Key to Expanding Reach of MH Care

Partnership Between Psychiatrists, Faith Leaders Untapped Key to Expanding Reach of MH Care

Personal Psychotherapy Prepares Trainees to Be Better Psychiatrists, Educators Say

Personal Psychotherapy Prepares Trainees to Be Better Psychiatrists, Educators Say

Altha Stewart, M.D., Honored With Pardes Humanitarian Prize

Altha Stewart, M.D., Honored With Pardes Humanitarian Prize

Retaining Psychodynamic Thought in Contemporary Psychiatry

Back to table of contents Previous article Next article Psychiatry & PsychotherapyFull AccessRetaining Psychodynamic Thought in Contemporary PsychiatryRandon S. Welton, M.D.Randon S. WeltonSearch for more papers by this author, M.D.Published Online:30 Nov 2022https://doi.org/10.1176/appi.pn.2022.12.11.30AbstractPsychodynamic psychotherapy was once a cornerstone of psychiatric training and practice. Historically, most psychiatrists would have felt comfortable exploring patients’ unconscious and interpersonal issues in weekly therapy sessions. In contemporary psychiatry, however, psychodynamic thought has lost its preeminence. Managed care’s preferential reimbursement of psychopharmacology and reliance on lower-cost therapists compounded by the mistaken belief that psychodynamic psychotherapy lacks empirical support led to a steady decline in psychiatrists providing psychodynamic psychotherapy. Ironically this occurred simultaneously with the emergence of a literature demonstrating the efficacy and cost-effectiveness of psychodynamic psychotherapy in managing personality disorders, chronic depression, and anxiety. What can psychiatry do to preserve the benefits engendered by a psychodynamic understanding of patients?In addition to promoting psychodynamic psychotherapy, psychiatric training should focus on the advantages of incorporating psychodynamic thought into a wider range of patient interactions. Psychodynamically informed psychiatrists can emphasize once commonly held beliefs such as these:Everyone has an active unconscious that in part dictates their desires, reactions, and behaviors.Past experiences shape one’s current relationships, emotions, and decisions.People tend to form recurring patterns of relationships often based on early childhood models.The relationship between the psychiatrist and patient contains both diagnostic and therapeutic potential.We must act quickly, however, if we want a psychodynamic orientation to remain a core feature of psychiatry; the last generation of psychiatrists who were steeped in psychodynamic thought are rapidly reaching retirement age. Some psychiatrists, especially those in private practice, are able to offer traditional psychodynamic psychotherapy, but all psychiatrists can still inculcate a psychodynamic understanding into routine clinical care. Consider the following example:A young man was seen in the ICU by the consultation/liaison team. He had cut his wrist and taken an overdose of acetaminophen. When the resident sat down with him, the patient was curt and dismissive. “Let’s get this over with. ... I was suicidal, but I am not anymore. I have seen the error of my ways. I promise.”Despite the aggressiveness of these remarks, the resident sensed the patient was more scared than angry. She asked why he was trying to push her away when she was trying to help him. He became suddenly tearful, “That is what they always say. You pretend to care, but when I need you, no one is there for me.” Recognizing that the intensity of his response came from previous disappointments, she tried to reassure him of her desire to help and said, “It sounds like people have let you down before. I wonder if that had something to do with you trying to kill yourself.” This led to a conversation about his chronic relationship struggles and the argument with a close friend that had precipitated the suicide attempt.A minimal psychiatric response to this situation would be to thoroughly document a risk assessment and make recommendations about psychopharmacology. A psychodynamic psychiatrist would reflect on what these interactions say about the patient’s past experiences and inner life and how those factors should guide her approach to the patient.The consultation/liaison resident encouraged the patient to discuss the relationship with his friend and their distressing conversation. She then asked him to consider a different perspective.“You two sound very close. You have felt rejected by many people in your life, but maybe his spending time with other people is not a rejection of you. I wonder if there are parts of his life that don’t involve you, just like there are parts of your life that don’t involve him.” The patient nodded. “Well, he was going over to play some stupid online game. He knows that I get bored with that stuff. He has asked me before, and I have always said ‘no.’ ” The resident suggested, “So maybe he didn’t invite you because he knew you wouldn’t want to go.”The resident’s understanding of the patient’s interpersonal vulnerabilities allowed her to strengthen their therapeutic alliance and to help the patient re-examine long-standing, unconscious beliefs about his relationships. She continued his current medications without change and arranged for a next-day appointment with his outpatient therapist.Retaining a psychodynamic orientation can deepen our understanding of patients and guide our interactions wherever we work. We should not settle for a reductionistic view of patients’ symptoms, as if their primary problem was a medication deficiency. Today’s psychiatrists can incorporate these practical psychodynamic principles into their everyday work and thereby provide the comprehensive care that patients need and deserve ■Randon S. Welton, M.D., is an associate professor of psychiatry and director of the psychiatry residency program at Wright State University School of Medicine. He is also a member of the Committee on Psychotherapy of the Group for the Advancement of Psychiatry (GAP). ISSUES NewArchived

In Case You Haven't Heard…

Could video games improve kids’ brains? A new study published in JAMA suggests that there may be cognitive benefits associated with the popular pastime, Medical Xpress reported Oct. 29. For the new research, lead author Bader Chaarani, an assistant professor of psychiatry at the University of Vermont, and colleagues analyzed data from the large and ongoing Adolescent Brain Cognitive Development Study, funded by the National Institutes of Health. They looked at survey answers, cognitive test results, and brain images from around 2,000 children ages 9 and 10 who were separated into two groups: those who never played games, and those who played for three hours or more a day. As the children performed tasks, the children's brains were scanned using functional magnetic resonance imaging. Video gamers’ brains showed more activity in regions associated with attention and memory. “The results raise the intriguing possibility that video gaming may provide a cognitive training experience with measurable neurocognitive effects,” the authors concluded. Right now, it's not possible to know whether better cognitive performance drives more gaming, or is its result, said Chaarani. The team hopes to get a clearer answer as the study continues and they look again at the same children at older ages.

Judges, Psychiatrists Trained to Share Education About MH in Justice System

Judges, Psychiatrists Trained to Share Education About MH in Justice System

Neural Organoids Making Connections, Getting Real

Neural Organoids Making Connections, Getting Real

Novel Therapies Aim to Boost Teen Sleep and Mood

Back to table of contents Previous article Next article Clinical & ResearchFull AccessNovel Therapies Aim to Boost Teen Sleep and MoodLynne LambergLynne LambergSearch for more papers by this authorPublished Online:24 Oct 2022https://doi.org/10.1176/appi.pn.2022.11.11.26AbstractLight flashes and text messages were among the innovative approaches described at a sleep meeting to improve adolescent sleep and well-being.iStock/RiskaFour weeks of nightly exposure to extremely short light flashes during sleep combined with weekly cognitive-behavioral therapy (CBT) sessions aimed at promoting earlier bedtimes helped sleep-deprived adolescents go to bed earlier and sleep longer, researchers at Stanford University School of Medicine found.This strategy was one of several novel interventions that improved adolescent sleep and mental health reported at the annual meeting of the American Academy of Sleep Medicine and the Sleep Research Society last summer.Jamie M. Zeitzer, Ph.D., an associate professor of psychiatry and behavioral sciences and co-director of Stanford’s Center for Sleep and Circadian Sciences, and his team recruited 102 adolescents in grades 9 to 12 who went to bed late and had trouble getting up in the morning.The researchers compared active light therapy with sham light therapy, both described below, with and without CBT focused on sleep, in a four-week double-blind, randomized placebo-controlled trial conducted during the school year.Every night for four weeks, the active light therapy groups received a 3-millisecond light flash every 20 seconds starting three hours before their target weekday wake time (without CBT) or two hours before wake time (with CBT). Those assigned to sham therapy received three 1-minute light pulses an hour starting three hours before their target weekday wake time (without CBT) or two hours before wake time (with CBT). Those receiving CBT attended 50-minute in-person sessions once a week for four weeks.Teens receiving the combination therapy fell asleep 50 minutes earlier and slept 43 minutes longer each night, Zeitzer said. Few reported being aware of the light flashes. Neither light therapy alone nor CBT alone affected bedtime or sleep duration.“Our data are consistent with the theory that flash therapy advanced the timing of the circadian clock, enabling teenagers to initiate sleep at an earlier clock hour,” Zeitzer and colleagues wrote in JAMA Network Open in September 2019.“The circadian clock elicits a strong wake-promoting signal in the hours immediately before normal bedtime,” the researchers noted. “Those in the light plus CBT group had greater sleepiness in the late evening, consistent with having their internal clock moved to an earlier time.”Long-term monitoring would be an important next step, they said, to assess ongoing acceptance of the light intervention therapy and to determine if the beneficial effects of light plus CBT can be maintained for months or years.Grants from the National Institute of Child Health and Human Development (NICHD), Lucille Packard Foundation for Children’s Health, and Stanford Child Health Research Institute supported this research.In an NICHD-funded study that started in September, Zeitzer and his team will assess the impact of light flash therapy and CBT on adolescents’ sleep, academic performance, and mood regulation for an entire year.Applying Habit Formation ScienceUnhealthy sleep habits often need to be dismantled before healthier ones can be adopted, Allison G. Harvey, Ph.D., said at the meeting.Habits such as starting to watch a movie or looking at email near bedtime are hard to abandon, said Harvey, a professor of psychology and director of the Golden Bear Sleep and Mood Research Clinic at the University of California, Berkeley. Clinicians often need to work with teens individually to develop attractive substitutes, such as journaling or practicing yoga at bedtime. “Instilling a new habit requires repetition,” she said, “lots of repetition.” A spinoff from Harvey’s habit-formation studies encourages good sleep habits via text messages provided on a mobile phone. Lauren Asarnow, Ph.D., an assistant professor of psychiatry at the University of California, San Francisco, School of Medicine and colleagues developed their BrightMobile program to help youth in low-income communities. This population, Asarnow said, has a higher prevalence of sleep problems and lower access to services than peers in higher income areas.They recruited 52 adolescents aged 12 to 18 from a primary care clinic and the community at large to use BrightMobile for eight weeks. Participants watched videos on sleep and mood, kept a sleep diary, and received text messages congratulating them for sticking to their self-selected bedtime the previous night or offering recommendations to support their goals, for example.Most participants completed the program and reported they slept longer and more soundly on more regular schedules. Depression symptoms declined in both the subset of adolescents with clinically significant depression symptoms at the outset and the others three months after treatment ended, Asarnow told Psychiatric News. The researchers are patenting their program. ■ResourcesEffect of Light Flashes vs Sham Therapy During Sleep With Adjunct Cognitive Behavioral Therapy on Sleep Quality Among Adolescents: A Randomized Clinical Trial ISSUES NewArchived