Nov 22, 2019 | Psychiatry
This year’s American College of Neuropsychopharmacology (ACNP) conference takes place December 8-11 in Orlando, Florida. Faculty from the Department of Psychiatry will be contributing via the president’s plenary, panels, study groups, and posters. The schedule of talks is listed below.
President’s Plenary
Cannabinoids: Addiction, Mental Health and Therapeutics
Speaker: Yasmin Hurd, PhD
When: Sunday, 8:00-11:30 am; Dr. Hurd will speak at 8:30 am on unlocking the neurobiological impact of developmental cannabis and psychiatric risk
Where: Bonnet Creek I-VI
Panels
Using Stem Cell Models to Explore Polygenic Risk for Psychiatric Disease
Chair and presenter: Kristen Brennand, PhD
When: Monday, 8:30-11:00 am; Dr. Brennand presents at 8:40 am on exploring synergistic effects of schizophrenia risk variants using stem cells
Where: Grand Ballroom 2
Clinical and Pre-Clinical Implications for Ion Channels in Psychiatric Disorders
Presenter: James Murrough, MD, PhD
When: Monday, 3:00-5:30 pm; Dr. Murrough presents at 4:55 pm on targeting KCNQ channels for the treatment of depression
Where: Bonnet Creek XII
Recent Advances in the Role of Social Factors in Drug addiction: Preclinical and Clinical Studies
Co-chair and presenter: Keren Bachi, PhD
When: Monday, 3:00-5:30 pm; Dr. Bachi presents at 4:20 pm on neurocircuitry of simulated social interactions in cocaine addiction: implications for real-world social competence
Where: Grand Ballroom 2
Toward Precision Psychiatry in Eating Disorders – Computational Modeling of Brain Response and Behavior for Diagnostic Classification, Disease Model Development, and Outcome Prediction
Presenter: Laura Berner, PhD
When: Tuesday, 8:30-11:00 am; Dr. Berner presents at 9:50 am on neural computations of inhibitory control after remission from bulimia nervosa
Where: Bonnet Creek VII
Neuroimmune Signaling in Mental and Physical Health: Mechanisms and Interventions
Presenter: Vilma Gabbay, MD
When: Tuesday, 8:30-11:00 am; Dr. Gabbay presents at 9:50 am on neuroimmunological correlates of reward function in youth across psychiatric conditions
Where: Bonnet Creek IX
The Power of Transdiagnostic Circuit, Physiologic, and Behavioral Data to Support and Refine Critical RDoCs Domains
Chair and presenter: Harold W. Koenigsberg, MD
When: Tuesday, 8:30-11:00 am; Dr. Koenigsberg presents at 9:50 am on examining impaired emotion regulation as a transdiagnostic domain
Where: Bonnet Creek XII
Targeting Balance Among Limbic and Cortical Networks to Prevent Suffering and Suicide
Presenter: Helen Mayberg, MD
When: Tuesday, 3:00-5:30 pm; Dr. Mayberg presents at 4:55 pm on searching for a depression switch: electrophysiological changes with initial exposure to therapeutic subcallosal cingulate DBS
Where: Bonnet Creek VII
Biomarkers in Autism Spectrum Disorder: Promise for Differentiation, Subtyping, and Treatment
Presenter: Jennifer Foss-Feig, PhD
When: Wednesday, 8:30-11:00 am; Dr. Foss-Feig presents at 9:50 am on EEG response to simple sensory stimuli as a potential biomarker for predicting outcomes and differentiating syndrome-specific profiles in autism
Where: Grand Ballroom 2
Modeling and Dissection of Decision-Making Deficits Across Mood, Anxiety, Substance, and Psychotic Disorder
Presenter: Vincenzo Fiore, PhD
When: Wednesday, 2:30-5:00 pm; Dr. Fiore presents at 3:50 pm on modelling addiction in the intersection between endophenotypes and the role of environment complexity
Where: Bonnet Creek VII
Using Genome Editing Technologies to Understand the Mechanisms of Neuropsychiatric Disorders
Presenter: Peter Hamilton, PhD
When: Wednesday, 2:30-5:00 pm; Dr. Hamilton presents at 3:50 pm on CREB-mediated activation of Zfp189 in nucleus accumbens and how it drives behavioral responses to psychostimulants, but not opiates
Where: Bonnet Creek XI
Shared Risks for Brain and Heart Across the Lifespan: Impact of Sex
Presenter: Thalia Robakis, MD, PhD
When: Wednesday, 2:30-5:00 pm; Dr. Robakis presents at 2:40 pm on multi-morbidities of insulin resistance: diabetes, dementia, and depression
Where: Bonnet Creek XII
Study groups
ABCD Data Use: Challenges and Opportunities for Prospective and Current ABCD Data Users
Co-chair: Muhammad Parvaz, PhD
When: Sunday, 3:00-5:30 pm
Where: Bonnet Creek X
Should MDMA and Psilocybin be Used for the Treatment of PTSD?
Co-chair and participant: Rachel Yehuda, PhD
When: Tuesday, 3:00-5:30 pm
Where: Bonnet Creek XI
What Should the General Psychiatrist Know About Genetics?
Co-chair: Dorothy Grice, MD
Participant: Antonia New, MD
When: Tuesday, 3:00-5:30 pm
Where: Bonnet Creek X
Teaching Day Session
Neural-Immune Interactions
Speaker: Scott Russo, PhD
When: Wednesday, 11:30 am–1:30 pm; Dr. Russo will speak on neuroinflammatory mechanisms in depression
Where: Bonnet Creek I-VI
Nov 12, 2019 | Psychiatry
From left to right: Dennis S. Charney, MD, Nora Volkow, MD; Yasmin Hurd, PhD; Sabina Lim, MD, MPH; and Eric Nestler, MD, PhD.
On October 30, the Addiction Institute of Mount Sinai hosted a full day of lectures, posters, and discussions by prominent scientists, clinicians, and policymakers tackling addiction from all angles: across the lifespan, psychosocial, epidemiology, policy, neurobiology, neuroimaging, prevention, treatment, big data, and more, with a focus on addiction solutions.
Yasmin Hurd, PhD, Director of the Addiction Institute of Mount Sinai (AIMS), opened the day with a welcome address setting the scene for the day’s discussions. “The health care system for addiction is under siege,” she said. “Today is about solutions. Our objective is to start a dialogue between scientists, policymakers, and clinicians, holding everyone’s feet to the fire so we can create more opportunities to collaborate and work in tandem toward developing more effective treatment strategies, support structures, and policy infrastructure for people and families struggling with addiction.”
Her remarks were followed by introductions from Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs for the Mount Sinai Health System, and Eric Nestler, MD, PhD, Dean of Academic and Scientific Affairs and Director of The Friedman Brain Institute at the Icahn School of Medicine at Mount Sinai. “Ultimately, the management of an illness—indeed, its perception by the public—is driven by a fundamental understanding of its causes,” said Dr. Nestler. “Society’s view of an illness depends on what we know about it, and we can rebrand addiction when we can explain it better and develop definitive treatments.”
Nora Volkow, MD, Director of the National Institute on Drug Abuse (NIDA), gave the keynote lecture on drugs and addiction in the United States. “When I first came to Washington, D.C., as director of NIDA, one of the most frustrating things was my naïve perception that policy would be guided by science—and it’s not,” she said. “So what do we need to do make sure it’s not ignored? What can we, as scientists, do to increase the likelihood that our evidence-based findings are implemented into policy?”
Dr. Volkow giving her keynote on drugs and addiction in the United States.
She emphasized the critical importance of adolescence, as this is a time of life when the brain is undergoing rapid and major development while exposed to many experiences and influences. She discussed studies showing that social and emotional deprivation increases risk for substance abuse and mental illnesses and that early drug use can modify brain development, which is why the National Institutes of Health has funded the Adolescent Brain Cognitive Development (ABCD) Study. The study examines how experiences (such as playing sports, using social media, and smoking) affect developing brains and lifelong health and wellbeing. She also showed that pain, depression, and opioid addiction are connected—16 percent of adults in the United States have a mental health disorder (mostly mood disorders) and receive more than 50 percent of prescribed opioids. She concluded by emphasizing the power of language to reduce stigma, and also highlighted that loneliness is a huge factor. “Addiction isolates, and the isolation is one of the highest hurdles that people suffering from addiction have to jump,” she said.
After the keynote, the event featured four “showcases” consisting of talks from experts followed by panel discussions: taking addiction policy into the 21st century; early predictors of addiction; objective assessment of addiction symptoms and treatment outcomes; and new frontiers in addiction treatment.
Dr. Hurd’s closing remarks included a call for translating the day’s concepts to action. “Today’s discussion provided a foundation of focused topics for future town halls, workshops, and conferences. I hope that today is just the beginning of our work in taking a more integrated and multipronged approach toward confronting addiction,” she said. The day concluded with a networking reception with posters on science, policy, and care.
Oct 29, 2019 | Psychiatry
In October 2018, the Addiction Institute of Mount Sinai (AIMS) announced its strategic alliance with Center on Addiction (CoA), formerly known as The National Center on Addiction and Substance Abuse or CASA. The alliance combines AIMS’ clinical expertise with CoA’s research, policy, and advocacy resources to design innovative and effective models of treatment for addiction for adolescent and young adult populations.
Shilpa Taufique, PhD, has been named the Director of the Alliance. In this role, Dr. Taufique will drive the Alliance’s initiatives to develop, implement, and measure the efficacy of new interventions for opioid use disorder across the Mount Sinai Health System, with a focus on adolescents and young adults. She will also develop and implement the clinical arm of Alliance projects and ensure achievement of clinical intervention-related milestones; participate in research and efficacy measurement related to the Alliance projects; and serve as primary spokesperson and liaison of the Alliance to internal and external stakeholders. Dr. Taufique will also maintain her roles as the Director of the Division of Psychology for the Mount Sinai Health System, and as the Director of the Comprehensive Adolescent Rehabilitation and Education Service at Mount Sinai St. Luke’s.
Kara Bagot, MD, joined Mount Sinai in October 2019 and will be the Medical Director of the AIMS-CoA Alliance. In this role, she will focus on assessing the efficacy of the clinical Alliance initiatives, serve as the physician expert, and work with Dr. Taufique in the engagement and liaison work with internal and external stakeholders. Dr. Bagot is a child and adolescent psychiatrist, and her research background is in adolescent substance use disorders (SUDs) and overlapping childhood psychopathology. She completed her adult and child and adolescent psychiatry and clinical research training at Yale University School of Medicine Child Study Center. Dr. Bagot’s current work focuses on the effects of technology (e.g. social media, video gaming, internet use) on development of SUDs and psychiatric illness in children and adolescents, and ways to use mobile and digital technologies to improve assessment, monitoring, and treatment of SUDs in adolescents.
In addition, Rachel Weller, PsyD, has been appointed as the Project Manager for the AIMS-CoA alliance. In this role, Dr. Weller will be responsible for all project management administration, and will support the director and research director to ensure successful operational execution of the projects. She will also assist Drs. Taufique and Bagot with development and implementation of the clinical arm of Alliance projects and with monitoring achievement of clinical intervention-related milestones. Dr. Weller is a licensed clinical psychologist whose clinical interests include trauma and resilience, co-occurring disorders (mental health and chemical dependency), diversity issues, and program development.
“It is our hope that, through this partnership, we will gain information about how we can offer useful and relevant information, resources, and services to students and their families, faculty, and the schools, at large,” said Dr. Taufique.
Oct 2, 2019 | Psychiatry
This year’s Mental Health Services Conference (IPS), put on by the American Psychiatric Association (APA), takes place October 2-6 at the Sheraton New York Times Square in Manhattan. This years’ conference focuses on four core tracks: addiction psychiatry, collaborative and interdisciplinary care, community psychiatry, and diversity and health equity.
The schedule of sessions presented by faculty from the Department of Psychiatry is listed below.
Thursday, October 3
Bipolar and Related Disorder Due to Another Medical Condition: A Case of Mania in the Setting of Glioblastoma Multiforme
Poster number: P1-022
When: 2:30-4:00 pm
Where: Poster Hall in Central Park West, Second Level
Presenters: Xavier Diao, MD; Omar Mirza, DO; and Xiteng Yan (medical student at Icahn School of Medicine at Mount Sinai)
Friday, October 4
The Engagement Challenge: Lessons From a High Utilizer Pilot
When: 10:00-11:30 am
Where: New York Ballroom West
Chair: Sabina Lim, MD, MPH
The Role of Mental Health in Getting to Zero New HIV Infections: The Science, Psychosocial Issues, and Disparities
When: 1:00-2:30 pm
Where: Riverside Suite, Third Level
Chair: Kenneth Ashley, MD
Presenter: Carmen Casasnovas, MD
Conversion Therapy: Boy Erased, Can It Alter Sexual Orientation Without Causing Harm?
When: 1:00-4:00 pm
Where: Empire Ballroom East
Presenter: Daniel Safin, MD
The Launch of a Substance Use Disorder Initiative in a Student-Run Free Clinic
Poster Number: P3-026
When: 2:30-4:00 pm
Where: Poster Hall in Central Park West, Second Level
Presenter: Ben Shuham, medical student
Co-Authors: Craig Katz, MD; Co-Author: Samuel Powell, MD/PhD student
Saturday, October 5
Controversies in Adult Psychopharmacology
When: 8:00 am–12:00 pm
Where: Columbus Circle, Lower Level
Director: Joseph Goldberg, MD
Faculty: Carrie Ernst, MD; Shari Lusskin, MD
Improving Access through a Proactive Behavioral Health Team’s Collaborative Consultation Model
When: 10:00-11:30 am
Where: Union Square, Lower Level
Chair: Marisa Schwartz, MSN
Presenters: Victoria Azzopardi, LMSW; Omar Mirza, DO
The Impostor Syndrome: International Medical Graduates Navigating Immigration Challenges and Beyond
When: 10:00-11:30 am
Where: Flatiron, Lower Level
Presenter: Ali Maher Haidar, MD
Medical History Mystery Lab
When: 3:00-4:30 pm
Where: Riverside Ballroom, Third Level
Chair: Kenneth Ashley, MD
Presenters: Carmen Casasnovas, MD; Daniel Safin, MD
Sunday, October 6
Update on Mental Health Issues in LGBTQ Youth
When: 10:00-11:30 am
Where: Riverside Ballroom, Third Level
Chair: Kenneth Ashley, MD
Presenters: Gabrielle Shapiro, MD; Ali Maher Haidar, MD
Sep 27, 2019 | Psychiatry
“With more education about opioids and medication-assisted treatment, we will make it through this crisis,” says Anita Kennedy, a certified recovery peer advocate and a peer engagement specialist.
In November 2016, Mount Sinai Beth Israel hired Anita Kennedy, a certified recovery peer advocate, as a peer engagement specialist in East Harlem. The role is funded by a grant from the New York State Office of Alcoholism and Substance Abuse Services (OASAS). Peer engagement specialists (Anita is one of two in New York City) use their personal experiences recovering from addiction to serve as a supportive resource for people seeking recovery. Her role was initially created in response to the neighborhood’s synthetic marijuana (known as “K2”) epidemic, but she covers addiction across the board, especially opioids.
Anita’s job involves going out into the community, including emergency rooms and on the streets, to engage with people struggling with substance abuse. Over the last couple of years, she has gained a reputation on the streets of East Harlem as someone people can turn to if they are ready to seek treatment. She says people routinely approach her on the streets or even on the subway in other parts of the city. “I don’t know how they know to talk to me,” she said. “People see me and, for whatever reason, they know I’ll be able to help them out.” And she and the city seem to be making inroads—in 2018, the number of deaths in New York City from opioid overdose fell from 1,082 to 1,044.
Once an individual has expressed an interest in recovery, Anita helps them get to a detox or inpatient rehabilitation program as well as to outpatient programs. She keeps in touch with them throughout the process, checking in regularly and building rapport. As they move through the system, Anita helps them build a recovery plan. The individuals decide how they define success, and Anita helps them achieve their goals by connecting them with the necessary services to make it happen. The recovery plan could include anything from setting up housing to scheduling dental work—anything that they see as a barrier to being successful, as defined on their own terms. She helps them monitor progress, following up to ask how to ensure their success will continue and what can be done next.
To achieve these goals, Anita helps peers learn and practice new skills such as how to use public transportation, parenting tips, and progressing with education like getting their GED degree. She also helps them learn and practice coping skills, like how to calm anger or how to deal with a triggering event via breathing exercises, journaling, reading, or taking a walk. She encourages them to re-engage in hobbies that they may have forgotten about that used to bring them pleasure and fulfillment. She also shows up to offer support when needed, such as court appearances and Social Security meetings, liaises with parole and probation officers, and facilitates support groups.
Anita’s role has expanded beyond helping individuals. She also spreads the word about Mount Sinai’s addiction treatment services at City Hall, health fairs, soup kitchens, the New York Public Library, halfway houses, and local police precincts. She routinely provides overdose prevention trainings by distributing Naloxone kits and showing people how to use them—in the month of June, she completed 143 of these trainings. “There’s nothing better than hearing that an organization was prepared for overdoses and saved someone’s life because of these trainings,” she said. She has administered Naloxone six times since she started. “They’re not pleased with you for saving their life,” she said. “You’ve basically ruined the best high they’ve ever had, so you need to be prepared for them to be combative.” In spite of this, all six people she rescued reached out to her for assistance, and she remained involved with their journey to recovery and rebuilding their lives.
“I vividly remember the first time I had to administer Nalaxone,” Anita said. “The person was taken to the hospital and entered a detox program, and is now in recovery. It was inspiring to see that I could help someone begin to get back to a more normal life, though I know it can be difficult and take time and support.” She added, “We are turning the tide with regard to opioid overdose deaths. With more education about opioids and medication-assisted treatment, we will make it through this crisis.”
Sep 24, 2019 | Diversity and Inclusion, Featured, Psychiatry, Research
The research team from the Icahn School of Medicine at Mount Sinai included, from left, Priscilla O. Agyeman, MPH, research coordinator, Division of Liver Diseases; Principal Investigator Craig L. Katz, MD; and Sarah MacLean, third-year medical student.
Mount Sinai researchers found that children being held in an immigration detention center experienced high levels of mental health distress, with 44 percent demonstrating at least one significant emotional or behavioral symptom. The report was the first large, empirical study examining the mental health of children in U.S. immigration detention, says the Principal Investigator, Craig L. Katz, MD, Clinical Professor of Psychiatry, Global Health, and Medical Education, Icahn School of Medicine at Mount Sinai.
“Perhaps our findings should not really be a surprise,” says Dr. Katz, who considers the study a valuable baseline for further research. “Kids who had been previously separated from their parents had higher rates of emotional problems, compared to those who were always detained with a parent. And the detained children overall had higher rates of distress compared to the general population in the U.S.”
The research team from Mount Sinai spent two months in summer 2018 at a detention center in the Southwestern United States. speaking to women and children, most of whom had fled Honduras, Guatemala, or El Salvador. The researchers were not allowed to use telephones or take photographs while interviewing the families in a visitation trailer. The study was published in June 2019 in the journal Social Science and Medicine.
The mothers told stories of escaping gang violence or domestic violence in their home countries, where government and police officials often turned a blind eye. The team interviewed 425 women about their eldest child, using the standard Parent-Report Strengths and Difficulties Questionnaire. Among those 425 children, 32 percent had elevated scores for emotional problems, and the rate was 49 percent for those who had previously been separated from their parent. A subset of 150 children who were age 9 or older also completed the UCLA Post-Traumatic Stress Disorder Reaction Index. Seventeen percent of those children had a probable diagnosis of PTSD, compared with 4.7 percent in the general population of U.S. children.
“Children with emotional distress showed symptoms like wanting to cry all the time; problems with conduct, such as fighting with other kids or having temper tantrums; and peer problems like not having a lot of friends or only wanting to interact with adults,” says Sarah MacLean, lead author of the study and a third-year medical student at the Icahn School of Medicine who was part of the field team. “The children with symptoms of PTSD reported having flashbacks or nightmares about a trauma, or feeling depressed or sad.”
The field research for the study was conducted by Kim A. Baranowski, PhD, Associate Director of the Mount Sinai Human Rights Program; Priscilla O. Agyeman, MPH, a research coordinator in the Division of Liver Diseases, Icahn School of Medicine; Ms. MacLean; and Joshua Walther, a fourth-year medical student at the University of Texas Health Science Center in San Antonio, Texas. Authors of the report were the field team; Dr. Katz; and Elizabeth K. Singer, MD, MPH, Assistant Professor of Emergency Medicine, and Medical Education, Icahn School of Medicine, and Director of the Mount Sinai Human Rights Program.
Dr. Katz hopes to expand on the research, which had certain limitations. The subjects were a “convenience sample,” meaning they were the families who were accessible for interviews in the center’s visitation trailer, as opposed to a randomly selected sample. Because of the setting, some mothers completed the forms in their child’s presence, which may have influenced their responses.
The study also could not pinpoint the cause of the children’s distress, whether it was detention, or the journey to the U.S. border, or the violence they faced in their home countries, says Dr. Katz, who is also an Associate Director of the Mount Sinai Human Rights Program. Regardless of the cause, the study concluded that the children “would benefit from culturally responsive and trauma-informed mental health care.” Dr. Katz says that ideally, the mothers and children would receive appropriate psychiatric support once they settle into a community. “But even if they don’t get psychiatric help, social support helps,” he says. “Making sure people have clothes, a backpack, a phone, know how to take a bus. That support is going to make an enormous different in the trajectory of their recovery.”
Despite their higher rates of emotional distress, 98 percent of the children studied had normal scores on the “prosocial” scale, which included being considerate of other’s feelings and volunteering to help others. The team found signs of hope and humanity at the center, a broad expanse of trailers surrounded by a barbed wire fence. One boy from Honduras drew a picture and shyly presented it to Ms. Agyeman, and she intends to keep it forever. “The picture gave me a bittersweet message,” she says, “that a little boy can do the things any other kid would do, laughing and playing, even in an otherwise very sad environment.”
