APA 2019: Mount Sinai’s Presentations

This year’s American Psychiatric Association (APA) conference takes place May 18-22 in San Francisco. The schedule of sessions presented by faculty from the Department of Psychiatry is listed below.

Veerle Bergink, MD, PhD, will speak on psychiatric illness during and after pregnancy on Tuesday, May 21.

Saturday, May 18

Computers and Psychiatry: How Might Our Practice Change?
Chair: Cheryl Corcoran, MD
When: 8:00-9:30 am
Where: Room 158, Upper Mezzanine, Moscone South

Creating and Implementing a Program for the Mental Health and Wellbeing of Medical Students and Trainees: The Mount Sinai Health System Experience
Chairs: Jeffrey Newcorn, MDPaul Rosenfield, MD
Presenters: Sabina Lim, MD, MPHDaniel Safin, MDJonathan Ripp, MD, MPH
When: 10:00-11:30 am
Where: Room 151, Upper Mezzanine, Moscone South

Sunday, May 19

Sex, Drugs, and Culturally-Responsive Treatment: Addressing Substance Use Disorder in the Context of Sexual and Gender Diversity
Presenter: Faye Chao, MD
When: 8:00-9:30 am
Where: Room 24, Exhibition Level, Moscone North

Advances in the Understanding and Treatment of Treatment Resistant Depression
Chair: James Murrough, MD, PhD
Presenter: Martijn Figee, MD, PhD
When: 8:00-9:30 am
Where: Room 156, Upper Mezzanine, Moscone South

Imminent Suicide Risk Assessment in High-Risk Individuals Denying Suicidal Ideation or Intent
Director: Igor Galynker, MD, PhD
Faculty: Paul Rosenfield, MD
When: 8:00 am-12:00 pm
Where: Room 7, Exhibition Level, Moscone South

The Multiple Faces of Deportation: Being a Solution to the Challenges Faced by Asylum Seekers, Mixed Status Families, and Dreamers
Presenter: Gabrielle Shapiro, MD
When: 10:00-11:30 am
Where: Room 308, Third Level, Moscone South

Disrupting the Cycle of HIV Transmission: The Role of Mental Health Providers in the Inclusive Use of PrEP to Address Disparities
Chair: Kenneth Ashley, MD
When: 3:00-4:30 pm
Where: Rooms 310/311, Third Level, Moscone South

Transitioning from Methadone to Buprenorphine At An Urban Opioid Treatment Program
Chair: Timothy Brennan, MD
Presenters: Annie Levesque, MDPrameet Singh, MD
When: 3:00-4:30 pm
Where: Room 25, Exhibition Level, Moscone North

Monday, May 20

Trauma Inflicted to Immigrant Children and Parents Through Policy of Forced Family Separation
Chair: Gabrielle Shapiro, MD
When: 8:00-9:30 am
Where: Room 303, Third Level, Moscone South

Medical History Mystery Lab
Presenter: Kenneth Ashley, MD
When: 8:00-11:00 am
Where: Room 22, Exhibition Level, Moscone North

A Blueprint for Providing Free, Comprehensive, Integrated Adolescent Health, Transgender Services and Mental Health Care in NYC for $1,000 per Patient
Chair: Kashmira Rustomji, MD
Presenter: John Steever, MD
When: 8:00-9:30 am
Where: Room 314, Third Level, Moscone South

Facing the Challenges of Misuse and Abuse of Stimulant Medications for ADHD: From Neurobiology to Clinical Care
Chair: Jeffrey Newcorn, MD
Presenters: Iliyan Ivanov, MDJeffrey Newcorn, MD
When: 8:00-9:30 am
Where: Room 25, Exhibition Level, Moscone North

Rebels With a Cause: Nurturing the Provider for Successful Program Evolution
Chair: Shilpa Taufique, PhD
Presenter: Brandon Johnson, MD
When: 8:00-9:30 am
Where: Room 206, Second Level, Moscone South

Diagnostic Categories or Dimensions? How Studying the Neural and Genetic Bases of Dimensional Traits Can Help Us Find New Treatments
Chair and presenter: Maria de las Mercedes Perez-Rodriguez, MD, PhD
When: 8:00-9:30 am
Where: Room 213, Second Level, Moscone South

Walking the Walk: Resident Roadmap to Leadership in Psychiatry
Presenter: Adjoa Smalls-Mantey, MD, DPhil
When: 10:00-11:30 am
Where: Room 208, Second Level, Moscone South

No Blacks, Fats, or Femmes: Stereotyping in the Gay Community and Issues of Racism, Body Image, and Masculinity 
Chair: Kenneth Ashley, MD
When: 3:00-4:30 pm
Where: Room 214, Second Level, Moscone South

Training the Next Generation of Community Psychiatrists: Science and Recovery
Chair: Paul Rosenfield, MD
Presenters: Joy Choi, MD;  Tomas Felipe Restrepo Palacio, MD
When: 3:00-4:30 pm
Where: Room 210, Second Level, Moscone South

Tuesday, May 21

Scaling Behavioral Health Integration: One Academic Health Care System’s Approach
Chair: Sabina Lim, MD, MPH
Presenters: Hansel Arroyo, MDKimberly Klipstein, MDRajvee Vora, MD
When: 10:00-11:30 am
Where: Room 314, Third Level, Moscone South

Management of Psychiatric Illness During Pregnancy and Postpartum: What Every Psychiatrist Needs To Know
Chair: Verlee Bergink, MD, PhD
When: 1:00-2:30 pm
Where: Rooms 201/209, Second Level, Moscone South

Typical or Troubled?®: Program Update and Further Development Discussion
Presenter: Gabrielle Shapiro, MD
When: 1:00-2:30 pm
Where: Room 308, Third Level, Moscone South

A Patient-Centered Approach to School Refusal: A Day Program’s Guide to Tackling One of Child and Adolescent Psychiatry’s Most Difficult Problems
Chair: Brandon Johnson, MD
Presenter: Shilpa Taufique, PhD
When: 3:00-4:30 pm
Where: Room 158, Upper Mezzanine, Moscone South

Separating Parents and Children: Impact on Mental Health and Resilience
Chairs: Adriana Feder, MDRachel Yehuda, PhD
When: 3:00-4:30 pm
Where: Room 204, Second Level, Moscone South

From Genetics to Stress Response to Treatment of Personality Disorders
Chair: Maria de las Mercedes Perez-Rodriguez, MD, PhD
When: 3:00-4:30 pm
Where: Room 153, Upper Mezzanine, Moscone South

Wednesday, May 22

New Onset Psychosis: What Trainees, Residents and Early Career Psychiatrists Should Know
Presenters: Cheryl Corcoran, MDIliyan Ivanov, MDDolores Malaspina, MD, MS, MSPHGabrielle Shapiro, MD
When: 8:00-9:30 am
Where: Room 156, Upper Mezzanine, Moscone South

Training Physician-Scientists in Psychiatry: A Road Map to Academic Success
Chairs: Antonia New, MDMaria de las Mercedes Perez-Rodriguez, MD, PhD
Presenters: Kenechi Ejebe, MD, PhDRene Kahn, MD, PhDDrew Kiraly, MD, PhD
When: 3:00-4:30 pm
Where: Room 208, Second Level, Moscone South

NARSAD Awardees

The 2018 NARSAD Young Investigator grantees from the Brain and Behavior Research Foundation include four faculty members from the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai. Their research aims are listed below.

 

Michael Sean Breen, PhD, will leverage an established cohort of mothers and infants to investigate the effects of maternal PTSD. Using samples of the newborns’ umbilical cord blood, Dr. Breen will examine the patterns of gene expression in babies born to mothers with and without PTSD. The study will also include analysis of gene expression in samples from the babies at two years of age, providing measurements of the effects of maternal PTSD on children over time.

 

Alexander William Charney, MD, envisions a future in which it is possible to assess mental illnesses via a routine blood draw, and will search for cues from immune system that may aid to make this concept feasible. These cues, Dr. Charney believes, may be found in genetic messages floating around patients’ cells, presumably in transit to help accomplish immune-related tasks. To find them, Dr. Charney will draw genetic information from single cells in blood and brain samples in psychiatric patients, revealing additional insights into whether certain cell subtypes regulate interactions between the brain and the rest of the body.

 

 

Rebecca Sue Hofford, PhD, hopes to lay the groundwork for a drug to treat addiction to cocaine and other psychostimulants. She previously found a link between cocaine-induced behaviors and the activity of granulocyte-colony stimulating factor, or G-CSF, which is a cytokine—a signaling protein released by the immune system. Her team now hopes to identify which neurons are affected by G-CSF in the nucleus accumbens, a brain region that is associated with reward processing and involved in addiction. They will study how affected neurons change their activity in response to G-CSF.

 

Eva Velthorst, PhD, will explore how parental genes that are not passed on to the child may nevertheless help explain the link between childhood adversity and the development of psychosis. It is theorized that such non-inherited genes are able to affect the child through their parents’ contribution to the child’s environment. This phenomenon, called “genetic nurturing,” has been largely ignored in genetic studies but may point to preventable exposures, Dr. Velthorst suggests. Leveraging the Avon Longitudinal Study of Parents and Children study, the team will integrate genetic and developmental data on 3,000+ individuals followed from birth up to age 24, and their parents. This will provide the opportunity to examine the effect of non-transmitted genes of the mother and father separately (accounting for the transmitted genes) in the childhood adversity-psychosis relationship.

CARES: A Unique Program for Teens

CARES at Mount Sinai Morningside offers high school students mental health and substance abuse treatment plus academics—all in one setting.

For more than three decades, the Comprehensive Adolescent Rehabilitation and Education Service (CARES) at Mount Sinai Morningside has been helping high school students with mental health and/or substance abuse issues turn their lives around. The program integrates intensive psychological treatment with a complete high school education through the New York City Department of Education’s ReStart Academy (District 79), and it is the only one of its kind in the country, according to Shilpa Taufique, PhD, the program’s director.

Adolescents experiencing emotional problems and/or or dabbling in substance use are at extreme risk of adverse effects on their brain development, along with decreased academic performance and lifelong domino effects. CARES seeks to mitigate these effects with its educational and therapeutic components, including substance abuse treatment.

Therapy

The team of psychiatrists, psychologists, social workers, creative arts therapists, and substance abuse clinicians provide individual therapy (twice a week), group therapy (five times per week), family therapy (once a week), medication management, crisis intervention, case management, and academic achievement services. The program uses dialectical behavior therapy, motivation enhancement therapy, cognitive behavior therapy, and the Transtheoretical Model for Change, among others. Alcoholics Anonymous, Narcotics Anonymous, and community meetings are also part of the program.

Academics

CARES provides a full-time, diploma-granting high school education curriculum through the New York City Department of Education. Students attend daily academic classes taught by Department of Education teachers, and clinical staff work closely with the teachers to ensure that students are attending their classes, working well with teachers and peers, and participating. Some students have the option to opt for a High School Equivalency Diploma based on their needs and preferences. Following New York State Education Department mandates, the diploma program enables students to earn and accumulate credits, as well as prepare for Regents exams.  In addition to academics and therapy, CARES provides students with extracurricular activities such as a talent show, spelling bee, field trips to museums, yearbook club, music club, holiday parties, and prom.

Two Tailored Tracks

CARES branches into two programs: one for mood and anxiety issues, and the other for substance abuse.

AADP: The Adolescent Alternative Day Program (AADP) addresses problems with social skills, anxiety, and/or mood changes. “Alternative” refers to the more focused, individualized, safe, and respectful school environment that students are seeking when they apply from regular high school settings. AADP uses a milieu treatment model integrating therapeutic and educational components, and provides a unique opportunity to treat students aged 14-18 with severe emotional problems and school truancy.

CAPA:  The Comprehensive Addiction Program for Adolescents (CAPA) serves teens aged 14-19 who are struggling with substance abuse. Co-occurring problems may include depression and other mood-related disorders; mild to moderate behavior problems (angry outbursts, disrespect, breaking family rules, lying, truancy, early run-ins with the police); school problems;  and/or legal problems. A combined substance abuse/mental health model helps identify and treat all related issues. The program uses a harm-reduction model to help students reduce and ultimately abstain from substance use. CAPA is run in collaboration with the Addiction Institute of Mount Sinai and provides an alternative for teenagers who have just started abusing substances or who have already been in significant substance-related trouble.

CARES is located at Mount Sinai Morningside. For more information or to make a referral, please call (212) 523-3083. The application can be found here.

Shilpa Taufique, PhD, is the director of the Comprehensive Adolescent Rehabilitation and Education Service (CARES) at Mount Sinai Morningside. She is also the Director of the Division of Psychology for the Mount Sinai Health System and Chief Psychologist at Mount Sinai Morningside.

ACNP: Mount Sinai’s Panels, Study Groups, and Posters

This year’s American College of Neuropsychopharmacology (ACNP) conference takes place December 9-13 in Hollywood, Florida. Faculty from the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai will be contributing via panels, study groups, and posters. The schedule of panels and study groups is listed below.

René Kahn, MD, PhD, left, and Dolores Malaspina, MD, MPH, MSc

Panels

Novel Technological Strategies to Assess Suicidality and Develop Suicidal Phenotypes
Co-chair: M. Mercedes Perez-Rodriguez, MD, PhD
When: Monday, 3 – 4:15 pm
Where: Diplomat 1-2

Neural Computations as Markers of Stress, Anxiety, and Trauma
Co-chair and presenter: Daniela Schiller, PhD
When: Monday, 3 – 5:30 pm; Dr. Schiller presents 4:20 – 4:55 pm
Where: Atlantic Ballroom 3

Larger-Scale Transcriptome and Epigenome Mappings, Modeling and Analyses in Developing and Diseased Human Brain
Presenters: Schahram Akbarian, MD, PhD, and Kiran Girdhar, PhD
When: Tuesday, 8:30 – 11 am; Dr. Akbarian presents 8:30 – 8:40 am; Dr. Girdhar presents 9:50 – 10:25 am
Where: Atlantic Ballroom 2

Neuroimaging as a Novel Tool to Enhance the Development of Psychotherapeutic Strategies
Chair: Harold Koenigsberg, MD
When: Thursday, 8 – 8:10 am; Dr. Koenigsberg presents 8:10 – 8:45 am
Where: Diplomat 1-2

Genomic Mechanisms in the Etiology of Bipolar Disorder
Presenter: Eli Stahl, PhD
When: Thursday, 8 – 10:30 am; Dr. Stahl presents 9:20 – 9:55 am
Where: Atlantic Ballroom 2

Challenges and Solutions to Elucidating Psychiatric Disease Biology From Genomic Association Using Human Induced Pluripotent Stem Cell-Based Assays
Presenter: Kristen Brennand, PhD  
When: Thursday, 12 – 2:30 pm; Dr. Brennand presents 12:10 – 12:45 pm
Where: Regency Ballroom 3

Study Groups

What is the Importance of Animal Models to Neuropsychiatric Disease?
Participant: Eric Nestler, MD, PhD
When: Tuesday, 8:30 – 11 am
Where: Great Hall 5

No Longer Tarred With the Same Brush? Evidence for the Therapeutic Potential of Cannabidiol: Implications for Regulatory Policy
Participant: Yasmin Hurd, PhD
When: Tuesday, 3 – 5:30 pm
Where: Atlantic Ballroom 3

Challenges and Strategies for Strengthening the Pipeline of Physician Scientists in Psychiatry and Neuroscience
Participants: René Kahn, MD, PhD, and Eric Nestler, MD, PhD
Moderator: Antonia New, MD
Co-chair: M. Mercedes Perez-Rodriguez, MD, PhD
When: Tuesday, 3 – 5:30 pm
Where: Great Hall 5

The Debate Regarding Maintenance Treatment With Antipsychotics In Schizophrenia
Participants: René Kahn, MD, PhD, and Dolores Malaspina, MD, MPH, MSc
When: Wednesday, 3 – 5:30 pm
Where: Great Hall 5

Brains in a Dish: A Promising New Tool for Studying Neurological and Psychiatric Conditions


Lotje De Witte, MD, PhD, is one of the few experts on “mini brains,” or cerebral organoids—stem cells grown into small balls of human brain tissue. This video shows a mini brain in her lab, showing the dividing cells in red. Video courtesy of Dilara Ilhan.


Until very recently, there was no way to watch human brain activity in action. Imaging, postmortem brain specimens, and animals, though useful in many respects, can only reveal so much about how a live human brain functions. Enter the “mini brain,” or cerebral organoids: stem cells grown into small balls of human brain tissue.

Aided by a biochemical cocktail of proteins and minerals, they grow and self-assemble in the lab dish, mimicking the development of fetal brains in the womb and forming regions such as the hippocampus and retina. Cerebral organoids were first used in 2013 to model microcephaly, and are now used for studying neurological and psychiatric conditions such as autism and schizophrenia. An important distinction between mini brains and real ones is their lack of vasculature and an immune system—both vital aspects.

Rapid evolution

In March of this year, researchers at the UC Davis Institute for Regenerative Cures found a way to induce vascularization. They encased the mini brains in a nutritious gel containing endothelial cells (the cells that line the insides of blood vessels) so the organoids could grow their own blood vessels. After marinating for three weeks, they were implanted into rodent brains. Over the course of their time in vitro and then for two weeks in the rodents, the endothelial cells grew into functioning blood vessels that expanded into the organoid.

The following month, researchers at the Salk Institute for Biological Studies showed in Nature that organoids implanted in mice connected to the hosts’ circulatory systems. The organoid’s neurons fired in conjunction with the mouse-host’s neurons, suggesting a level of integration that could illuminate long-elusive secrets about many brain conditions.

Dr. De Witte’s breakthrough

Lotje de Witte, MD, PhD, one of the few experts in this field, is interested in the role of microglia cells, the immune cells of the brain. Microglia are involved in both inflammation and construction of the brain (believed to be associated with schizophrenia). Incredibly, she and her team discovered that these cells can innately develop within organoids. This greatly increases the potential of mini brains to illuminate how microglia contribute to human brain development and disease. Dr. De Witte’s team published their groundbreaking findings in Nature Communications in October.

An organoid from Dr. De Witte’s lab, with the microglia shown in green. Image courtesy of Ormel PR et al via Nature Communications.

“We have known for a long time that the immune system is somehow involved in causing neurodevelopmental disorders such as schizophrenia and autism. Now, we finally have a human model to study how microglia contribute to neurodevelopment and neurodevelopmental disorders. This is very exciting because if we find a disease mechanism, these organoids can be used to screen for potential new drugs to help our patients,” said Dr. De Witte.

The ethics of mini brains

Understandably, ethical and philosophical concerns have been raised, most notably in Nature earlier this year. What are the ethics of working with these organoids? Could a mini brain feel pain, or achieve consciousness?

“I’ve read about these issues with great interest,” said Dr. De Witte. “If it’s even possible to create a fully functioning brain or fetus in a dish, it’s far, far in the future. Regardless, it’s certainly critical to think ahead and discuss where the boundaries should be drawn. Our ultimate goal is always to more effectively treat the millions of people worldwide afflicted with neurological and psychiatric conditions, and mini brains are uniquely valuable for research in service of that goal. Optimizing the protocols to use this technology should be encouraged.”

Dr. De Witte is Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, where her lab investigates the connection between the immune system and the pathogenesis of psychiatric disorders. She is also affiliated with the MIRECC at the James J. Peters VA Medical Center in the Bronx, where she is establishing a lab to culture organoids. Her PhD is in molecular biology and immunology.

Psychiatry Grand Rounds: Winter 2018-2019

The Department of Psychiatry at the Icahn School of Medicine at Mount Sinai has put together a fantastic lineup for the 2018-2019 Grand Rounds season—check out some of the highlights below.

On November 27, Raquel Gur, MD, PhD, discussed genetic and environmental effects in the emergence of psychosis. Dr. Gur is Professor of Psychiatry, Neurology, and Radiology at the University of Pennsylvania Perelman School of Medicine, where she directs the Neuropsychiatry Section and the Schizophrenia Research Center and is Vice Chair of Research Development in the Department of Psychiatry.

December 18: Eric J. Fombonne, MD, from Oregon Health and Science University School of Medicine, will discuss rates and environmental risk of autism epidemiology. Dr. Fombonne is Professor of Psychiatry and Director of Autism Research at Oregon Health and Science University.

January 22: David Glahn, PhD, Yale University School of Medicine will discuss genetics insights in psychiatry. Dr. Glahn is Professor of Psychiatry and Professor of Psychology at Yale School of Medicine.

February 5: Mark Solms, PhD, from the University of Cape Town, will discuss how and why consciousness arises. Dr. Solms is Director of Neuropsychology at the University of Cape Town, and Director of Training of the South African Psychoanalytical Association.

February 19: Maurizio Fava, MD, from Massachusetts General Hospital/Harvard Medical School, will discuss novel pharmacological approaches to treatment-resistant depression. Dr. Fava is Slater Family Professor of Psychiatry at Harvard Medical School, Executive Vice Chair of Psychiatry at Massachusetts General Hospital (MGH), Executive Director of Clinical Trials Network and Institute at MGH, and Director of the Division of Clinical Research at MGH.

March 19: Francis S. Lee, MD, PhD, from Weill Cornell Medical College, will discuss treating the developing versus the developed brain. Dr. Lee is Professor of Molecular Biology in Psychiatry, Vice Chair for Research Psychiatry, and Interim Director of the Sackler Institute for Developmental Psychobiology Psychiatry/Pharmacology at Weill Cornell Medicine. Photo credit: Jesse Winter

 

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