Faculty Bibliography

Background/UNASSIGNED:Two decades of human neuroimaging research have associated volume reductions in the hippocampus with posttraumatic stress disorder. However, little is known about the distribution of volume loss across hippocampal subfields. Recent advances in neuroimaging methods have made it possible to accurately delineate 10 gray matter hippocampal subfields. Here, we apply a volumetric analysis of hippocampal subfields to data from a group of combat-exposed Veterans. Method/UNASSIGNED:Veterans (total, n = 68, posttraumatic stress disorder, n = 36; combat control, n = 32) completed high-resolution structural magnetic resonance imaging. Based on previously validated methods, hippocampal subfield volume measurements were conducted using FreeSurfer 6.0. The Clinician-Administered PTSD Scale assessed posttraumatic stress disorder symptom severity; Beck Depression Inventory assessed depressive symptom severity. Controlling for age and intracranial volume, partial correlation analysis examined the relationship between hippocampal subfields and symptom severity. Correction for multiple comparisons was performed using false discovery rate. Gender, intelligence, combat severity, comorbid anxiety, alcohol/substance use disorder, and medication status were investigated as potential confounds. Results/UNASSIGNED:(HATA). Beck Depression Inventory scores negatively correlated with dentate gyrus, cornu ammonis 4 (CA4), HATA, CA2/3, molecular layer, and CA1. Follow-up analysis limited to the posttraumatic stress disorder group showed a negative correlation between Clinician-Administered PTSD Scale symptom severity and each of HATA, CA2/3, molecular layer, and CA4. Conclusion/UNASSIGNED:This study provides the first evidence relating posttraumatic stress disorder and depression symptoms to abnormalities in the HATA, an anterior hippocampal region highly connected to prefrontal-amygdala circuitry. Notably, dentate gyrus abnormalities were associated with depression severity but not posttraumatic stress disorder symptoms. Future confirmatory studies should determine the extent to which dentate gyrus volume can differentiate between posttraumatic stress disorder- and depression-related pathophysiology.

BACKGROUND:F]FPEB and positron emission tomography (PET). Furthermore, we sought to determine the role glutamate plays on mGluR5 availability in MDD. METHODS:H MRS) to estimate anterior cingulate (ACC) glutamate, glutamine, and Glx (glutamate + glutamine) levels relative to creatine (Cr). RESULTS:negatively correlated with glutamate/Cr and Glx/Cr levels. CONCLUSIONS:examination, we show an inverse relationship between mGluR5 availability and glutamate levels. These data highlight the need to further investigate the role of glutamatergic system in depression.

The articles in this Special Issue are devoted to integrating the fields of disaster mental health and positive psychology. Their focus on resilience building, individual and community preparation, meaning making, and posttraumatic growth represents an important new development in disaster mental health. The overarching goal of this effort is to inform strategies to help both individuals-including children, adolescent, adult disaster survivors, and relief workers-and communities prepare for, respond to, recover from, and possibly even grow stronger in the face of adversity. To achieve this goal, this body of literature suggests that it is important for disaster mental health workers to partner with community leaders, organizations, and the population at large to understand community vulnerabilities, take advantage of existing strengths, and respect cultural factors implicated in disaster recovery. It further suggests that an effective community-based approach to disaster recovery will make psychosocial support and skill-building programs available to large numbers of survivors, which is critical for responding to future national and international disasters. Continued high-quality research that is comprehensive and considers not only relevant psychological, social, cultural, and biological factors but also interrelations between individuals, organizations and communities is needed to advance this relatively new and important direction of the disaster mental health field.

Individuals experiencing Lewy body disease (LBD) are particularly vulnerable to the adverse effects of neuroleptics. This sensitivity has been employed by some authorities as a diagnostic component for this disorder. At present, we do not have any Food and Drug Administration-approved antipsychotic for the management of psychotic symptoms in this condition. We present the first case of an LBD patient, showing favorable response in psychotic symptoms with lumateperone, a novel atypical neuroleptic. Our report revealed improvements in cognition, psychosis, and sleep following the initiation of lumateperone without concurrent emergence of extrapyramidal side effects, autonomic instability, parkinsonian features, or cognitive decline, which are typically seen when treated with available antipsychotic medications. Clinicians may wish to consider potential usefulness of lumateperone when managing patients with this disabling condition. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Neuroleptic malignant syndrome (NMS) is a life-threatening condition classically associated with the use of antipsychotic medications. NMS commonly presents with initial mental status changes, followed by muscle rigidity, fever, and eventual dysautonomia. Cocaine intoxication can present with symptoms that are very similar to those found in NMS, making differentiating the two disorders challenging. We present the case of a 28-year-old female with a history of cocaine use disorder who presented with acute cocaine intoxication. She had severe agitation associated with her intoxication, requiring the use of antipsychotic medications. Subsequently, she developed atypical NMS from abrupt dopamine withdrawal after receiving the antipsychotics. Although overlapping dopamine pathways between cocaine use and NMS could deter one from this practice and guidelines recommend against it, antipsychotics are routinely used in the emergency setting for cocaine-associated agitation. This case highlights the need for a more standardized treatment protocol, provides an explanation of why treating cocaine intoxication with antipsychotics is inappropriate, and suggests that chronic cocaine users may be more prone to NMS in this scenario. Furthermore, this is a unique case because it describes atypical NMS in the context of cocaine intoxication, chronic cocaine use, and administration of antipsychotics to an antipsychotic-naïve patient.

BACKGROUND:Antipsychotic-induced weight gain (AIWG) is a clinically relevant and concerning adverse effect of contemporary antipsychotic medications. Lumateperone is a novel antipsychotic, which became commercially available in 2020 and received Food and Drug Administration approval for schizophrenia and bipolar disorder in 2019 and 2021, respectively. To date, no comprehensive review exists on its AIWG profile. This systematic review aims to assess the association between lumateperone and AIWG. METHODS:Data Sources: A comprehensive search of published studies on "lumateperone" OR "ITI-007" OR "Caplyta" was conducted on PubMed, CINAHL Complete, APA PsychInfo, Cochrane Library, and Embase databases until January 2022.Study Selection: A total of 149 articles in English were collected. After removing duplicates, all human trials on lumateperone were screened for the inclusion criteria.Data Extraction: Two reviewers conducted an independent screening followed by full-text analysis of extracted studies adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Third reviewer resolved the conflicts as tiebreaker. RESULTS:Primary search generated 77 articles, excluding 72 duplicates, of which 51 were deemed appropriate for exclusion. Full-text analysis of the remaining 26 articles concluded with 5 studies for finalized review per inclusion criteria. Excluded studies were manually reviewed for relevant citation of studies per inclusion criteria. Three randomized, double-blinded, placebo-controlled clinical trials and 2 open-label trials were derived from this systematic review. Lumateperone showed a favorable weight profile compared with placebo and alternate antipsychotics. CONCLUSIONS:Lumateperone displays minimal to no weight gain among participants in the studies reviewed.

A growing evidence base has implicated immune dysfunction in the etiology of some cases of autism spectrum disorder. The precise relationship between immune disorders and autism spectrum disorder remains unclear. Herein we report a 14-year-old-male with agammaglobulinemia, who was diagnosed with autism spectrum disorder, and who has received exogenous immunoglobulins regularly for most of his life. This case study supports current theories implicating antibody deficiencies in some individuals with an autism spectrum disorder. Our case will add to the growing literature of understanding the connection between immune deficiencies in the pathogenesis of autism.

Objectives: Cannabis use disorder (CUD) is a common comorbidity in schizophrenia and affects the disease phenomenology. Given the heterogeneity and chronic course of schizophrenia, it is important to study the impact of CUD on healthcare utilization and outcomes in children with schizophrenia spectrum disorders. This study reports the demographic differences in a sample of inpatient children with schizophrenia and CUD, and analyzes its impact on the length of hospitalization.
Method(s): We used the nationwide inpatient sample within the Healthcare Cost and Utilization Project (HCUP) from the years 2012 to 2014. We identified patients with diagnoses of schizophrenia spectrum disorder and CUD using validated ICD-9 and Clinical Modification codes. Pearson chi² test and student's t test were used to assess categorical and continuous variables, respectively.
Result(s): We analyzed 6518 inpatient children with a diagnosis of schizophrenia spectrum disorder from 2012 to 2014. The prevalence of CUD was 1.7%. There was a relatively stable trend of CUD in children from 2012 to 2014 of 1.6%, except for a spike of 2% in the year 2013. The mean age for children with schizophrenia and CUD is 15.54 +/- 2.5 years (p < 0.00). CUD was higher in males (81.3%) than females (18.8%) (p < 0.00) with predominance in African American (37%) and White (35.9%) patients. The mean length of hospitalization was 11.5 +/- 18.54 days (p = 0.36). We further categorized this sample with comorbid suicidal ideations and found that 2.2% (n = 35) of them had CUD. The mean age for children with schizophrenia having suicidal ideation and CUD is 15.71 +/- 1.8 years (p < 0.00). CUD was higher in males (60%) than females (40%) (p = 0.16) with predominance in White (53.8%) and African American (26.9%) patients. The mean length of hospitalization was 8.5 +/- 8.9 days (p = 0.679).
Conclusion(s): Our study found almost consistent trends of CUD in children with schizophrenia between 2012 and 2014, which indicates the necessity to develop interventions and programs to target CUD and resulting healthcare expenditure. There is a need to explore the biological and psychological mechanisms behind the preponderance of cannabis use in males and to identify the gender- and race-specific risk factors to mitigate the long-term adversities. SUD, SZ, S
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Schizophrenia has a multidomain symptom cluster, including positive, negative, and cognitive symptoms. Synthetic cannabinoids (SC) commonly perpetuate the positive symptoms of schizophrenia. We present a case of predominant negative symptoms following the use of SC even though our patient had a consistent history of experiencing positive symptoms in the past. The hypoactive dopaminergic system in the prefrontal cortex can induce negative symptoms in schizophrenia. However, the modulating properties of SC on cannabinoid receptors can feed into the negative symptom progression. The psychoactive properties of SC need further research to understand its clinical characteristics.

Background: Irritable bowel syndrome (IBS) is a chronic multifactorial gastrointestinal condition that substantially affects the quality of life. Research have suggested an increasing trend in cannabis use to alleviate IBS-related psychiatric symptoms. Objectives: We aim to investigate the association of psychiatric comorbidities and cannabis use disorders (CUD) in hospitalized IBS patients. Methods: We analyzed 31,272 IBS hospitalizations in patients (aged 15-54 years) from the Nationwide Inpatient Sample (NIS). We utilized logistic regression to evaluate the adjusted odds ratio (aOR) of CUD and psychiatric comorbidities. Results: Anxiety (26.3%) and depressive (24.8%) disorders were prevalent and increased the odds for IBS-hospitalization by 2.5 and 1.8 times respectively. Tobacco use disorder was most prevalent (24.5%) followed by CUD (3.7%). After controlling for demographics, psychiatric and medical comorbidities, and other substance use disorders, CUD had higher odds for IBS hospitalizations (aOR 1.407, 95% CI 1.32-1.50). IBS hospitalizations with CUD increased by 32.8% from 2010 to 2014. CUD patients were younger (15-24 years, aOR 5.4, 95% CI 4.27-6.77), males (aOR 1.8, 95% CI 1.59-2.09) and African Americans (aOR 2.8, 95% CI 1.45-2.23) and from low-income families (aOR 1.9, 95% CI 1.58-2.39). Conclusions: We found that patients with CUD have 40.7% higher odds for IBS-hospitalizations with a rising trend of CUD and related psychiatric comorbidities which may further worsen IBS and health quality of life. With limited evidence of efficacy and safety of cannabis in IBS, larger, randomized controlled studies are required to examine its therapeutic efficacy.