Rachel Yehuda, PhD
Rachel Yehuda, PhD, a world-renowned researcher whose pioneering discoveries have revolutionized the study and treatment of post-traumatic stress disorder (PTSD), has been elected to the National Academy of Medicine. Dr. Yehuda is Professor and Vice Chair for Veterans Affairs for the Department of Psychiatry, Professor of Neuroscience, and Director of the Traumatic Stress Studies Division at the Icahn School of Medicine at Mount Sinai. This Division also includes the PTSD Clinical Research Program and the Neurochemistry, Neuroendocrinology, and Molecular Biology Lab at the James J. Peters Veterans Affairs Medical Center in the Bronx.
The National Academy of Medicine is a nonprofit, nongovernmental organization that provides independent, objective analysis and advice on health issues. Its members are elected through a selective process, and election is considered one of the highest honors in health and medicine. With this election, Mount Sinai has 23 faculty members in the Academy.
Traumatic stress first interested Dr. Yehuda when she was a postdoctoral fellow in biological psychology at Yale Medical School in 1987. She and colleagues observed that Vietnam War combat veterans with PTSD had significantly lower levels of cortisol, a steroid hormone that helps regulate physiological responses to stress, compared to those without PTSD. It was a provocative discovery because elevated cortisol levels are typically associated with stress. The work led to a new understanding: In response to acute stress, ample cortisol levels are critical to mobilizing—and then containing—numerous stress-related mediators, such that those who have lower cortisol levels at the time of trauma exposure are at elevated risk for PTSD.
As Dr. Yehuda was concluding her fellowship and about to join the Icahn School of Medicine at Mount Sinai in 1991, she wondered if lower cortisol levels would also be present in other groups of trauma survivors, and initiated biological studies in Holocaust survivors. A pilot study of 100 survivors revealed that half had PTSD, and that they, too, had lower cortisol levels. To continue her work, she established a specialized treatment program for Holocaust survivors and their families at The Mount Sinai Hospital.
After years of study, Dr. Yehuda and her team of researchers had new revelations: that many Holocaust survivors and their adult offspring had epigenetic changes on the same region of a gene known as FKBP5 that is related to stress, demonstrating—for the first time in people—an epigenetic link between parental trauma and offspring effects.
Her current research interests include studying PTSD biomarkers, and other innovative PTSD prevention strategies and treatment, including the use of psychedelic medications. Today, the Icahn School of Medicine at Mount Sinai has one of the largest programs in the nation for the study of PTSD biomarkers.
In April, Dr. Yehuda was named principal investigator of a nearly $6 million grant from the United States Department of Defense through its U.S. Army Medical Research program to test whether a onetime dose of a drug—oral hydrocortisone—can prevent PTSD and related mental health disturbances in both civilians and military personnel.
Oral hydrocortisone is a synthetic glucocorticoid similar to the body’s own cortisol. The double-blind, randomized, placebo-controlled trial will be conducted on 220 recently traumatized patients presenting to the Emergency Department of The Mount Sinai Hospital and Chaim Sheba Medical Center in Israel, an academic research center.
“It has been a privilege to learn from trauma survivors and lead a first-rate research team that is devoted to developing strategies for treating PTSD,” says Dr. Yehuda. “The Icahn School of Medicine has provided the very best possible environment for fostering innovation in psychiatry research.”