Faculty Bibliography

INTRODUCTION/UNASSIGNED:The study of severe mental conditions has primarily remained under the purview of basic and clinical research. Although global epidemiological data indicate that immigrant groups are at higher risk of these conditions, U.S. data are lacking. Qualitative studies can be an important first step to bring attention to understudied phenomena. METHODS/UNASSIGNED:=4) in New York City. These strategies were synthesized from the team's internal notes of adaptations during the study design and data collection, weekly debrief meetings during data analysis, and brainstorm sessions for this manuscript. RESULTS/UNASSIGNED:The main results of the study are reported elsewhere. This section focuses on lessons learned to improve immigrant participant interest and engagement, including the strengths and limitations of the healthcare setting; recruitment by a multilingual South Asian psychiatrist; interviews by non-clinical South Asian researchers selected for a variety of ages, genders, and languages; and the interview process and content. DISCUSSION/UNASSIGNED:Overall, these strategies show the feasibility of non-clinical researchers to collect high-quality data about severe mental conditions among immigrant communities, noting that the details of specific strategies and results will be particular to each immigrant community. Public health research on severe mental conditions is essential to understand and address the experiences of severe mental conditions among immigrant communities in the U.S.

South Asians (SAs) underutilize mental health services compared to many racial and ethnic groups in the United States (US), yet there is limited research on the experiences of SAs living with severe mental illness (SMI). This study examined psychiatric healthcare experiences of SA patients with SMI diagnoses (e.g., severe depression, bipolar disorder, schizophrenia) in New York City. Data collection included semi-structured interviews with 36 participants (21 patients, 11 family members, 4 clinicians). Data was managed in NVivo. Two pairs of SA researchers conducted thematic analysis. Limited mental health knowledge led to delayed care for SAs due to a low perceived need for help. Ease of access, linguistic resources, patient-provider relationships, and family involvement influenced psychiatric healthcare experiences. Prescribed medications, self-motivation, communication, and religious practices were factors aiding symptom management and recovery. Findings highlight the need for improving psychiatric healthcare access and culturally-salient mental health education for SA communities.

PURPOSE OF REVIEW/OBJECTIVE:Patients diagnosed with HIV can now survive well into their old age. Aging with HIV is not only associated with comorbid medical illnesses but also with neuropsychiatric conditions that can range from cognitive changes to severe behavioral manifestations. This paper reviews mood, anxiety, and cognitive changes in older patients with HIV, as well as some of the treatment challenges in this population. RECENT FINDINGS/RESULTS:Most recent findings show that untreated HIV illness over a long period of time may further worsen both preexisting neuropsychiatric illness and may cause new onset behavioral and cognitive symptoms. HIV induces immune phenotypic changes that have been compared to accelerated aging Low CD 4 counts and high viral counts are indicative of poor prognosis. Evaluation for potential HIV infections may be overlooked in older adults and require screening. Older adults experience accelerated CD4 cell loss. Older adults endorsing new onset mood or cognitive changes must be screened for HIV infection. New onset neurobehavioral symptoms should be carefully screened for and treated simultaneously in patients with HIV infection.