PENN Winter 2009 Psychiatry Perspective
The Department of Psychiatry Gets A New Psychiatry Inpatient Unit at Pennsylvania Hospital In This Issue Pennsylvania Hospital has a new Psychiatry inpatient unit – and a lot more besides. COVER STORY In July 2008, the Psychiatry inpatient unit on Founders 11 at the Hospital of the University of Psychiatry Inpatient Unit-PAH . 1 Pennsylvania (HUP) was relocated to Pennsylvania Hospital (PAH). This consolidation, mutual- ly planned and implemented by the Department of Psychiatry and PENN Medicine, created two CHAIRMAN’S REPORT ...... 2 acute adult inpatient units at PAH totaling 42 beds –a new 18-bed psychiatric inpatient unit on PROGRAM HIGHLIGHTS Spruce 6 joining the existing 24-bed unit on Spruce 4. Psychosomatic Medicine-HUP . 3 Center for Community-Based . . .6 Dedicated Department clinicians and staff worked diligently to manage the inevitable disruptions Research & Health Disparities that accompanied the move, and the end result has been worth the extraordinary effort. The Penn Behavioral Health ...... 9 Spruce 4 unit continues to provide comprehensive, acute, short-term assessment and treatment for Corporate Services adult patients presenting a wide variety of psychiatric symptoms and conditions. The service collaborates closely OUR DISTINGUISHED FACULTY with many mental health and social service agencies and Awards and Honors ...... 10 private providers to meet the medical and social support News & Goings-On ...... 12 needs of patients returning to the community. Research News ...... 15 Research Grants ...... 17 The new unit on Spruce 6, already busy, expands the Faculty in the News ...... 20 scope of these clinical services by extending inpatient New Faculty ...... 22 product offerings to patients with CORNERSTONES co-morbid medical/psychiatric ill- Faculty Spotlight ...... 23 nesses, mood disorders, and to Voluntary Faculty Profile . . . . .26 geriatric patients as well. Employee Snapshot ...... 28 These clinical services will be EDUCATIONAL HIGHLIGHTS accompanied by innovative aca- Residents’ Corner ...... 30 demic programs which combine Class of 2012 ...... 31 clinical, teaching, and research components. The Department’s world-class residency program Spruce 6 Attendings has shifted its inpatient Psychiatry left to right: Scenes from Spruce 6 resident rotations from HUP to Jessica Kovach, MD top: patient room PAH, and there will be increased David Weiss, MD Up-to-date information on opportunities for medical student bottom: nurses’ station Departmental Events are rotations. Integrated academic and available on the clinical programs are already being developed and extended to PAH such as the Penn Compre- Department’s website hensive Depression Center, which includes the Women’s Mental Health and Wellness Program, (www.mail.upenn.edu/psych) collaboratively planned with the Department of Obstetrics and Gynecology, and the Psychiatric Neuromodulation Program. The Geriatric Psychiatry/Neurodegeneration Program, well-estab- lished on the HUP campus, is also being expanded to PAH. These new and expanded clinical services and academic programs join a vigorous Psychiatry presence at PAH. For a decade, PAH has been Penn’s community psychiatry hub for Center City and South Philadelphia residents needing psychiatric services. PAH’s community mental health center, Hall-Mercer Community Mental Health Center, runs approximately 30 active out- patient programs in infant, child, adult and family care. Specialty programs at PAH include Department of Psychiatry and homeless outreach, the Asian Behavioral Health Program, and the Bereavement Program, a col- Penn Behavioral Health laboration with the Joan Karnell Cancer Center. There is also a 24-hour Crisis Response Center University of Pennsylvania Continued on page 5 PAGE 2 PENN PSYCHIATRY PERSPECTIVE WINTER 2009
Chairman’s Report
central pillar of President Gutmann’s Penn Compact is the often leads to HIV infection and Acall to the University community to “engage globally…to AIDS. advance the central values of democracy and to exchange Europe – Many faculty work knowledge that improves the quality of life for all.” closely with colleagues across It’s a tall order worthy of a great University and one, I believe, Europe and lecture there fre- we are meeting as a department. In fact, I think that we are quently. Four Department facul- truly a “seven continent-plus department”, and I’d like to take ty are leaders in major on-going you for a quick trip around the world - and beyond! – to tell programs. George Woody, MD has you why. worked closely with colleagues in Russia on a number of NIH Global Leaders – For starters, Department faculty are leaders in projects related to addiction and the most prestigious international and national organizations HIV. Among other ventures, he representing Psychiatry and its sub-specialties. In the past has worked with the Medical decade, ten faculty members have served or are serving as Pres- University of Irkutsk to develop ident of thirteen of these distinguished bodies. an educational program to better North America – The Chair Report in the Fall 2007 Penn Psychi- integrate HIV and addiction treatment in Russia, and he is also atry Perspective listed some of our local community programs, working with the Post-Graduate Medical Training Institute in some with national reach. And, of course, since the Depart- Irkutsk to establish programs to screen for HIV and substance ment’s home base is the U.S., faculty programs are well-repre- use in primary care settings. sented throughout North America. Raquel Gur, MD, PhD and Ruben Gur, PhD have established a A large number of departmental programs operate in less famil- collaboration with Aachen University that includes a training iar territory, however, and a few select examples suggest our program in schizophrenia and autism funded by the German extra-continental reach. Science Foundation. Twenty-four MD and PhD students from around the world are participating. James Coyne, PhD facilitates Asia – The Department has a particularly strong presence in exchanges of doctoral students, fellows, and junior faculty Asia. Edna Foa, PhD and her colleagues in the Center for the between Penn and University of Groningen in the Netherlands. Treatment and Study of Anxiety have circled the globe to edu- cate the public and health care professionals about post-trau- South America and Australia – In recent years, Cory Newman, matic stress disorder resulting from both natural and PhD and the faculty in the Center for Cognitive Therapy have man-made events. In Asia, they have spoken to groups in Pak- given continuing education lectures in Argentina and Brazil, as istan, Thailand, Indonesia, Israel, Japan, and South Korea, as well as in the “land down under”, and Peter Bloom, MD, fea- well as to groups in Europe (Iceland, Norway, Switzerland, and tured in this issue’s Voluntary Faculty Profile, has been an Hon- Austria) and the U.S. The psychological aftermath of the tsuna- orary Member of the Australian Society of Hypnosis since 1984. mi in Southeast Asia has been a major recent focus. And now for some really out-of-the-way destinations. Since 2004, David Metzger, PhD has been the Protocol Chair of a Antarctica – You thought we couldn’t possibly be here, but large NIH-funded clinical trial investigating the efficacy of two David Dinges, PhD, as the National Space Biomedical Research medication-based approaches for the treatment of heroin injec- Institute Team Leader for neurobehavioral and psychosocial tors in Thailand and China, the first randomized trial of the function research in space, is collaborating with team members impact of drug treatment on the acquisition of HIV infection. on sleep and circadian rhythm disorders studies in the Antarctic. Dr. Metzger is also involved in other research and education projects in Thailand and Vietnam, and in the African nation of “Plus” – Nor are our faculty’s research efforts constrained by Botswana. earthly bounds. Dr. Dinges and his colleagues have a NASA- funded study on the International Space Station for the next Adrian Raine, PhD and his Center for Neurocriminology are four years, as well as studies aboard NOAA’s Aquarius under- engaged in research studies in China, Singapore, and South water laboratory, anchored 60 feet below the Gulf of Mexico off Korea, as well as in Africa and the U.S., on the etiology and the Florida Keys. treatment of antisocial and violent behavior in children and adults. Thus, a “seven-continent-plus department.” It’s a tremendous accomplishment for our world-acclaimed and world-traveled Africa – John Jemmott III, PhD and his colleagues in the Center faculty, and one in the best Penn tradition. for Health Behavior and Communication have NIH research programs to reduce risky sexual behavior among adults and youth in Botswana and the Republic of South Africa in sub- Saharan Africa, Jamaica in the Caribbean, and among African Americans and Latinos in the U.S. His work in Africa has been noteworthy. As just one example, Dr. Jemmott and his wife Loretta Sweet Jemmott, PhD have worked with sixth-grade stu- Dwight L. Evans, MD dents in South Africa’s Eastern Cape Province to design a sex Ruth Meltzer Professor and Chair education curriculum to limit unsafe sexual behavior which Professor of Psychiatry, Medicine and Neuroscience
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Program Highlights PSYCHOSOMATIC MEDICINE AT HUP – NEW INITIATIVES IN CLINICAL CARE, RESEARCH, AND TEACHING, AND A NEW NAME, TOO
he Department of Psychiatry’s Psychosomatic Continuing Emphasis on Quality Patient Care – The TMedicine section is making a new name for itself PSM section emphasizes the delivery of quality clin- at the Hospital of the University of Pennsylvania ical care, stressing a priority of Dr. Stinnett, who is (HUP), with expanded initiatives in clinical care, revered as the consummate physician. Today, the research, and teaching. PSM section offers exceptional expertise in treating psychiatric disorders presented by patients with And all of it starts with, well, a new name. neurological, dermatological, and gastrointestinal Until recently, Psychosomatic Medicine (PSM) at disorders, cancer, HIV/AIDS, and reproductive HUP had been known as the Consultation/Liaison issues, as well as patients undergoing organ trans- Psychiatry Serv- plants. PSM faculty regularly collaborate with ice, where psy- physicians from chiatrists work these specialties, with physicians and those from from other serv- other hospital serv- ices to evaluate ices, including and manage Emergency Medi- medical and sur- cine, Anesthesiolo- gical inpatients gy and Critical with psychiatric Care, and Family problems. Under Medicine and the leadership of Community James L. Stin- from left to right: Health. PSM serv- Christian Kohler, MD; Deborah Kim, MD; Henry Bleier, MD, MPH; nett, MD from ices are also Robert M. Weinrieb, MD; Lauren Kofod, MD; Jorge Rivera-Colon, MD; 1978 to 2006, the offered in HUP’s James Stinnett, MD; Reuben Kron, MD Medical-Psychiatry service earned a [Not pictured: Lisa Rosenthal, MD] stellar reputa- Outpatient Clinic, tion throughout the Hospital. run by the section’s Deborah Kim, MD. The move within the psychiatry discipline to Patients are seen throughout HUP, including those rename Consultation/Liaison Psychiatry as Psycho- coming into the Psychiatric Emergency Evaluation somatic Medicine gained momentum in 2003 when Center (PEEC). PSM clinical services are also located the American Board of Medical Specialties at Penn Presbyterian Medical Center, where Charles approved PSM as a psychiatric subspecialty. “There Dackis, MD is the director, and at Pennsylvania have been a few names for the field over the years Hospital, although neither service is formally con- and Psychosomatic Medicine is the current name,” nected with the HUP PSM section. says Robert M. Weinrieb, MD, director of the PSM Each attending psychiatrist in the PSM section has a section since 2006. “We are utilizing that name since special area of medical mastery – Dr. Weinrieb in it reflects the American Board of Psychiatry and solid organ and composite tissue transplant and Neurology board certification for added qualifica- addiction psychiatry, Dr. Kim in perinatal psychia- tions in PSM.” try with an emphasis on mood disorders, Christian While the program’s name at HUP may be different, Kohler, MD in neurology and schizophrenia, Lisa its core mission remains essentially the same, only Rosenthal, MD in somatoform disorders and strengthened. endocrine disease, and Reuben Kron, MD in emer-
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Continued from page 3 gency psychiatric evaluation. Additionally, Dr. Stin- atric complications of liver transplantation in nett, who attends the service on a weekly basis, is methadone-maintained opioid dependents. expert in psycho-cutaneous illnesses as well as the Other research projects are also underway. Dr. Kim entire PSM field. Attendings offer the very latest has initiated the only known pilot study examining treatments to patients depending on their individ- the safety and feasibility of repetitive transcranial ual needs, including supportive therapy, cognitive magnetic stimulation (rTMS) in pregnant women behavioral therapy, crisis management, motivation- with major depressive disorder. The use of rTMS, a al enhancement therapy, and drug therapy. depression treatment recently approved by the FDA, is particularly interesting in pregnant women because it has the potential to reduce exposure of Today, the PSM section offers excep- pregnant women to psychotropic medications. In tional expertise in treating psychiatric addition, Dr. Rosenthal is collaborating with faculty disorders presented by patients with in the Endocrinology, Diabetes, and Metabolism neurological, dermatological, and gas- Division in the Department of Medicine to look at trointestinal disorders, cancer, whether patients with symptoms of hypothy- HIV/AIDS, and reproductive issues, as roidism, but normal thyroid function, are manifest- well as patients undergoing organ ing a somatoform disorder, a psychiatric condition transplants. characterized by medically unexplained physical symptoms. The PSM section has also begun a sui- cide prevention study in collaboration with Centers for the Prevention of Suicide throughout the United Dr. Weinrieb acknowledges that the term "psycho- States, including the one at Penn led by Aaron T. somatic medicine" sometimes has a pejorative con- Beck, MD. notation for patients. “I personally am a bit Renewed Commitment to Teaching – The PSM sec- uncomfortable using the term ‘psychosomatic’ with tion’s solid clinical and research base nourishes its patients for that reason,” he says. “I know a lot of vigorous commitment to education and training, thought went into the decision to call it PSM, and long a priority of the program under Dr. Stinnett’s the intention was to more clearly embed the notion stewardship. Each of the attending physicians on of the mind-body connection in our medical and the PSM Service has won at least one major teaching surgical colleagues, but imagine seeing a depressed award, and they carry broad educational responsi- patient with widespread metastatic cancer and bilities. They teach Penn medical students, students introducing yourself as the doctor from Psychoso- doing electives from other medical schools from matic Medicine. I believe it will be misunderstood around the United States, and Penn Psychiatry resi- by many patients to mean ‘it's all in your head’ dents, Emergency Medicine interns, Neurology and despite our good intentions. So, for this patient, I Family Medicine and Community Health residents, would introduce myself as the consulting psychia- and Anesthesiology and Critical Care (Pain Medi- trist working with the oncology team.” cine) fellows. The section is also launching regular Increased Attention to Research – The PSM section’s case presentations with its medical and surgical col- strong clinical focus is simultaneously fostering a leagues, especially with Neurology, as well as growing focus on scientific investigation, with sev- weekly evidence-based medicine seminars. eral major studies on-going. For example, Dr. An exciting new initiative is the section’s ACGME- Weinrieb is directing the section’s participation in a accredited Psychosomatic Medicine Fellowship nine-site study of psychiatric complications for liv- Training Program. The first fellow began the pro- ing donors who donate 60 percent of their livers to gram in August 2007 and two new fellows are cur- emotionally related individuals. Published prelimi- rently enrolled. PSM fellows receive training at nary evidence shows that psychiatric problems are HUP and the Philadelphia VA Medical Center, the most common complication of this procedure. where Henry R. Bleier, MD provides programmatic Dr. Weinrieb is also heading up a re-evaluation of a leadership. Training is provided in the administra- previously published study of medical and psychi- Continued on page 5
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Continued from page 4 tive and clinical aspects of general hospital consultation and in the wide range of specialty hospital services interacting with the PSM section. Fellows interested in an academic medicine track are also offered a sec- ond year for research training. The PSM section’s Psychosomatic Interest Group provides another important teaching opportunity. This group of psychiatrists, with vast experience in Psychosomatic Medicine, meets monthly at HUP to discuss difficult PSM cases and to share insights about clinical and research developments in the field. Regular par- ticipants include the PSM fellows and 15 to 20 attending psychiatrists from the region affiliated with or working in other parts of the Health System. On the Horizon – Looking ahead, Dr. Weinrieb says that the field of Psychosomatic Medicine may be “head- ing toward more preventative treatments, such as those suggested by a recently completed randomized, controlled study showing that prophylactic olanzapine reduced the incidence of post-operative delirium in elderly patients undergoing elective hip and knee replacement.” Dr. Weinrieb also emphasizes the need to do more outcome research in the field “so we can be guided by protocols and hard data. This will require time and money, something most PSM programs don't have.” He adds, however, that few in the PSM field are trained to do research or write grants, and expressed the hope that more psychiatry residents will do PSM fellowships and learn how to conduct clinical research. Dr. Weinrieb feels the time has come to develop young faculty who can obtain independent NIH funding in this discipline. The Department’s Psychosomatic Medicine section, with outstanding clinical, research, and teaching programs, is in a superb position to train the next generation of PSM clinicians, investigators, and educators to lead the discipline in the 21st century. ______For additional information on the Psychosomatic Medicine Clinical Service or Fellowship, please contact: Robert M. Weinrieb, MD, program director (tel: 215-662-2858; e-mail: Weinrieb_B@ mail.trc.upenn.edu; PSM’s website: http://www.med.upenn.edu/ psych/psm_fellowship.html).
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(CRC), a hospital-based consultation-liaison service, and a high school for adolescents with mental health needs. PAH also has an outpatient psychology training clinic for its Clinical Psychology Training Program, a unique pro- gram for a department of psychiatry. The Department of Psychiatry and University of Pennsylvania Health System will continue to provide quality clini- cal and consultative services for patients and Health System physicians at HUP, where the Psychiatric Emergency Evaluation Center (PEEC) and Psychosomatic Medicine section (formerly the Consultation/Liaison service) contin- ue to operate and grow to meet the complex psychiatric needs of the medically ill. (Please see the article earlier in this issue on HUP’s expanded Psychosomatic Medicine section.) The strengthened relationship between the Department of Psychiatry and PAH features two historic entities, and an intriguing early connection. Pennsylvania Hospital, founded in 1751, was the first hospital in the American colonies. In turn, Penn’s Psychiatry Department, home to Benjamin Rush, the “Father of American Psychiatry”, can rightfully be called the “Birthplace of American Psychiatry.” In the late eighteenth and early nineteenth centuries, Rush treated and studied mentally ill patients at Pennsylvania Hospital, and was instrumental in establishing a sep- arate inpatient unit at the hospital to care for them. Today, that history has truly come full circle as an exciting new era in Penn Psychiatry opens at Pennsylvania Hos- pital. The Department deeply appreciates the many contributions of the faculty, nurses, and staff who made it all possible, and who will continue to serve in the future.
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CENTER FOR COMMUNITY-BASED RESEARCH AND HEALTH DISPARITIES he annual publication of the National Center for town University, because there was limited empiri- THealth Statistics (Health, United States, 2007) cal data on factors that contributed to racial differ- states the situation simply: “Significant racial and ences in African American and white women, and ethnic disparities exist across a wide range of health even less was known about how to address these measures. The gap in life expectancy between the factors to improve cancer outcomes in African black and white populations has narrowed, but per- American women.” sists. Disparities in risk The reasons for racial and factors and morbidity ethnic health disparities also exist.” A white baby are not simple. Dr. Hugh- born in 2005 can expect to es-Halbert explains that live 78.3 years; an African access to health care, the American child born the quality of care provided, same year can expect to psychological variables live 73.2 years, a seven such as the self-confi- percent differential. dence required to make Chanita Hughes-Halbert, changes and personal PhD, Associate Professor views about health, and of Psychology in Psychia- from left to right: cultural beliefs and val- try, created the Center for Benita Weathers, MPH; Brandon Mahler, BA; Aliya Collier, BA; ues all play a role. The George Moody, BA; Latifah Griffin, BA; Brenda Bryant, BA; and Community-Based Chanita Hughes-Halbert, PhD relatively low level of Research and Health Dis- trust that African Ameri- parities in 2007 to address this health gap. The Cen- cans hold for health care providers contributes as ter seeks to understand why racial and ethnic health well. disparities exist and to develop ways to improve the The Center is conducting research designed to health of medically underserved populations. understand and address many of these factors. The While interested in all aspects of health, Dr. Hugh- research is supported by grants from the National es-Halbert targets differences in cancer awareness, Cancer Institute, National Center on Minority prevention, detection, and treatment. “I decided to Health and Health Disparities, and the National focus on cancer because so many people are Human Genome Research Institute. Investigation touched by this disease,” she says. “The American converges on three lines of inquiry: 1) enhancing Cancer Society (ACS) estimates that more than one minority participation in clinical cancer prevention million people will be diagnosed with cancer this and control research; 2) developing culturally tai- year. In addition to having serious implications to lored assessments and interventions to improve individuals who are diagnosed, the entire family is health outcomes in minorities; and 3) developing a affected.” ACS statistics (Cancer Facts and Figures, sustainable infrastructure for cancer prevention and 2008) establish that African Americans are more control through community-based participatory likely to develop cancer and are more likely to die research methods. from most of the major forms of cancer (e.g., breast, One significant research effort is run through the prostate) compared to individuals from other ethnic West Philadelphia Consortium to Address Dispari- and racial groups. ties. “We are conducting research to identify the Dr. Hughes-Halbert’s interest in cancer emerged most effective methods of communicating informa- after her doctoral training at Howard University, tion about disease risk to African Americans who where she earned a PhD in Personality Psychology live in West or Southwest Philadelphia,” says Dr. in 1997. “I first became in interested in cancer dis- Hughes-Halbert. “We are also interested in under- parities as a post-doctoral fellow while at George- standing the effects of risk communication on psy-
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Continued from page 6 chological functioning and health behaviors.” The scientific findings were equally significant, Importantly, this research is based on the results of though complex. Dr. Hughes-Halbert says that the a comprehensive needs assessment of African Amer- study showed that “culturally tailored genetic coun- ican residents in West and Southwest Philadelphia seling may not significantly increase acceptance that was completed by Dr. Hughes-Halbert’s team. rates for BRCA1/2 testing. However, the majority The survey revealed that many residents are con- of African American women are satisfied with cerned about cancer and cardiovascular disease, but genetic counseling, and women who receive cultur- may not engage in healthy behaviors to address ally tailored counseling may experience greater sat- these factors. Based on these results and recommen- isfaction with some aspects of counseling.” While dations from community stakeholders, the Center counseling has benefits, particularly racially sensi- has initiated research to develop and evaluate an tive instruction, it appears to have limitations in integrated risk counseling program for African encouraging African American women to undergo American men and women who live in this commu- genetic testing. nity. This program is called the African American The Center’s work in genetic counseling and testing Risk Counseling Program and is designed to pro- for BRCA1/2 mutations has identified several vide information about risk factors for cancer and important, yet unexplored, issues in cancer risk cardiovascular disease and strategies for eating a counseling for African American women. The healthy diet and being majority of women in more physically active. the counseling pro- Dr. Hughes-Halbert While interested in all aspects of health, Dr. gram were overweight says that “our experi- Hughes-Halbert targets differences in cancer or obese, and many ence suggests that awareness, prevention, detection, and treat- underestimated their many African Ameri- ment. “I decided to focus on cancer because risk for developing cans are interested in so many people are touched by this dis- breast cancer. For this improving their health, reason, the Center but may lack sufficient ease,” she says. “The American Cancer expanded the cancer motivation to make Society (ACS) estimates that more than one risk counseling pro- changes to their behav- million people will be diagnosed with cancer gram to address diet ior to prevent and con- this year.” and physical activity trol cancer. Moreover, behaviors among since making these women who have a changes may be difficult, some individuals lack con- family history of breast cancer in a first-degree rela- fidence in their ability to change their lifestyle.” The tive. This program also sought to improve how this African American Risk Counseling Program focuses group of women understand risk. on enhancing the individual’s self-efficacy, or per- The Center’s research depends heavily upon the ceived confidence to make these changes, and pro- willingness of African Americans to participate in vides information about cancer risk factors in order clinical studies, not an easy sell given the discrimi- to motivate lifestyle changes. nation that African Americans have sometimes con- The Center also recently completed a clinical trial to fronted in experimental settings. “Fortunately, we evaluate the effects of culturally tailored versus have had positive experiences recruiting African standard genetic counseling on the decisions of Americans to participate in our research,” says Dr. African American women to have genetic testing for Hughes-Halbert. “For example, the majority of BRCA1 and BRCA2 mutations, abnormalities which African American women who were referred for have been linked to breast cancer. The study participation in a genetic counseling research study enrolled the largest number of African American enrolled in the research, and more than 50 percent women in a prospective randomized trial, and was participated in genetic counseling. Enrollment rates the first to demonstrate that the majority of African in the African American Risk Counseling Program American women identified for participation were have been comparable. However, we’ve experi- willing to enroll in a clinical genetic counseling enced some challenges recruiting sub-groups of research program. African Americans to participate in research - breast Continued on page 8
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Continued from page 7 cancer survivors, for example. For this reason, we key to success, and the Center’s community part- are now conducting research to identify barriers to ners are equally diverse, including the Philadel- African American participation in cancer genetics phia Chapter of the National Black Leadership research.” Initiative on Cancer, the Health Promotion Council of Southeastern Pennsylvania, the Southwest Com- The Center works with a multi-disciplinary group munity Action Coalition, and the Christ of Calvary of investigators from Penn, including psycholo- Community Development Corporation. gists, internists, oncologists, obesity experts, epi- demiologists, biostatisticians, communications An important strength of the Center is its empha- scientists, anthropologists, and public health pro- sis on the translation and dissemination of its fessionals. It has established important University- research findings into solutions that benefit peo- and School of Medicine-wide collaborations with ple. “That is,” says Dr. Hughes-Halbert, “we work James C. Coyne, PhD in the Department of Psychi- to enhance the translation of our findings and pro- atry; Katrina Armstrong, MD and Judy Shea, PhD grams to settings and individuals who are most in the Division of General Internal Medicine in the likely to be in need of preventive efforts to Department of Medicine; Susan Domchek, MD in improve health outcomes.” the Division of Hematology and Oncology in the The Center for Community-Based Research and Department of Medicine; Jerry C. Johnson, MD in Health Disparities is still young, but it has already the Division of Geriatric Medicine in the Depart- made an impact in the local community and has ment of Medicine; Marjorie Bowman, MD in the contributed a body of research to help begin to Department of Family Medicine and Community narrow the health disparities gap separating Health and the Center for Public Health Initia- Americans. There is much more to do, but the tives; Scarlett Bellamy, ScD, Shiriki Kumanyika, Center, under Dr. Hughes-Halbert’s leadership, is PhD, and Andrea Troxel, ScD in the Center for off to a very productive start. Clinical Epidemiology and Biostatistics; as well as with additional faculty in the Leonard Davis Insti- ______tute of Health Economics and the Institute for For further information about the Center for Com- Translational Medicine and Therapeutics. munity-Based Research and Health Disparities, Designing and implementing research protocols please contact Chanita Hughes-Halbert, PhD at that actively involve community residents is also a [email protected].
Department of Psychiatry 2008 Holiday Party December 17, 2008 Inn at Penn
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PENN BEHAVIORAL HEALTH CORPORATE SERVICES IN ACTION
enn Behavioral Health (PBH) is PBHCS’s Management and Corporate school districts who will utilize its the official name for the Depart- Assistance Programs help managers management services. P cultivate healthy and productive ment of Psychiatry’s patient care Critical incident debriefings are also working relationships to enhance and behavioral health programs. an important feature of PBHCS’ organizational and employee per- Most familiar are PBH’s patient care management and corporate assis- formance. Training modules cover programs, which cross all age tance programs. PBHCS staff have such topics as Navigating Change, groups and subspecialty areas of assisted a wide range of organiza- Dealing with Difficult People, Culti- psychiatry and behavioral health. In tions through these immediate inter- vating Resilience, Teambuilding, and recent years, these clinical programs ventions, including schools and Developing Exemplary Customer have expanded to meet the needs of surrounding communities where Service. PBHCS staff also work with the marketplace, with the introduc- violence and suicides have occurred, managers to provide resources for tion of the innovative Charles prominent organizations experienc- early intervention with troubled O’Brien Center for Addiction Treat- ing the death of a top executive, and employees, and they offer support to ment, the Albert J. Stunkard Weight police commanders, officers, and senior managers through executive Management Program, and the their families in response to the coaching, training, consultation, and Mood Disorders Comprehensive deaths of officers killed in the line of critical incident debriefings. Consultation Service. duty. During the last two years, PBHCS Penn Behavioral Health Corporate Penn Behavioral Health Corporate staff have made presentations for Services (PBHCS), a major PBH Services will continue to work with employees and managers at several component, has been equally active Philadelphia area schools, business- regional and statewide conferences in working with Philadelphia-area es, and governmental entities to for education and industry, includ- organizations to implement creative make their workplace environments ing the Pennsylvania Association of behavioral health programs aimed more congenial, productive, and School Personnel Administrators at building a productive work envi- safer, and PBHCS plans to expand and the Pennsylvania Council of ronment. PBHCS offers a wide its growing network. In January Administrators of Special Educa- range of corporate and management 2009, PBH began providing EAP tion. This summer, PBHCS provided tools, training, and educational services for the Greater Philadelphia violence-in-the-workplace preven- resources to help employers, man- Chamber of Commerce and is form- tion training for over 200 senior agers, employees, and families han- ing an affinity relationship with the management and human resources dle behavioral health issues that can Chamber to provide additional pro- staff of major industries and public impact workplace performance and grams and services to other local services attending the U.S. Equal cohesion. Several signature pro- businesses and organizations in the Employment Opportunity Commis- grams are especially noteworthy. Philadelphia region. sion regional conference in Balti- PBHCS’ Employee Assistance Program more. PBHCS staff presented two It is anticipated that this new collab- (EAP) helps managers and employ- workshops this Fall on workplace oration will help bring PBHCS’ ees resolve workplace issues and violence and substance abuse for the management tools and educational provides information to help them Mental Health Association in the resources to more Delaware Valley develop their own solutions to pro- Southwestern New Jersey EAP Con- communities and organizations to fessional and personal problems. ference titled “Mental Health Makes address the on-going behavioral The goal is to boost workplace Cents.” health needs of employees, families, morale and safety, improve employ- managers, and employers. ee retention, increase productivity, PBHCS is also providing employee and strengthen the organization’s and management assistance pro- bottom line. The EAP now serves grams for several regional school about 40,000 University and Health districts – Colonial, Wissahickon, For additional information about Penn System employees and their Upper Merion, Morrisville, and Behavioral Health Corporate Services dependents, as well as employees Bucks County Intermediate Unit. (PBHCS), please visit our website and dependents in about 50 other Beyond this, PBHCS is helping to (www.pennbehavioralhealth.org/) or call 1-888-321-4433. companies and organizations. form a consortium of Bucks County
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Our Distinguished Faculty
AWARDS & HONORS
Penn Honors (PGY-4) and Glenda Wrenn, MD (PGY-4) were the 2008 recipi- ents. The Albert Stunkard Faculty Recognition Award is given annually to faculty members who are outstanding teachers and Caryn Lerman, PhD received the 2008 Arthur K. Asbury Out- mentors. The graduating resident class selects award winners standing Faculty Mentor Award from the School of Medicine who have significantly influenced their education and training. for “foster[ing] the professional development of other faculty Named for Albert J. Stunkard, MD, Emeritus Professor of Psy- members by providing inspiring and effective counsel and chiatry and former Chair of the Department, this award recog- opportunities for achievement.” nizes Dr. Stunkard's enormous contribution to the education, Marion Lindblad-Goldberg, PhD received a Child and Ado- training, and support of Department housestaff. Sarah lescent Psychiatry Teaching Award from the Child and Adoles- DeMichele, MD, Jody Foster, MD, MBA, Alexandra McLean, cent Psychiatry Fellows (Class of 2008) at Children’s Hospital MD, John P. O'Reardon, MD, and David Weiss, MD received of Philadelphia in June 2008 in appreciation for her outstand- this honor in 2008. ing contributions as a teacher and mentor. The 2008 PGY-3 & 4 Teaching Award was awarded to Richard Karl Rickels, MD received the 2008 William F. Summers, MD and the 2008 PGY-1 & 2 Teaching Award Osler Patient-Oriented Research Award from the was awarded to Jody Foster, MD, MBA. These awards honor School of Medicine in recognition of his “achieve- those individuals whom the residents believe were the most ment in research conducted with human sub- effective teachers of the academic year and exemplary in shap- jects...for which an investigator…directly interacts ing their overall education. with human subjects.” Deborah Kim, MD was the 2008 recipient of the Earl Bond Award. Initiated by the efforts of Dr. William Peltz, this annu- al award is given to a Department member who has distin- guished himself/herself for teaching at the medical student, Regional, National & International Honors resident and/or graduate levels. Siobhan Banks, PhD is the Vice-Chair of the Sleep Depriva- J. Russell Ramsay, PhD was awarded the 2008 Martin P. tion Section of the American Academy of Sleep Medicine. Szuba Award for Excellence in Clinical Teaching and Research. This award is presented annually to a Department faculty Tami Benton, MD has been elected as Councilor at Large for member with outstanding teaching abilities, ongoing clinical the American Academy of Child and Adolescent Psychiatry to research, and a focus on translating research concepts into clin- serve a three-year term. She has also been appointed as Co- ically useful teaching, all of which Dr. Szuba embodied in his Chair of the recruitment committee for the Association of work. Directors of Psychiatric Residency Training to serve a three- year term. Peter B. Bloom, MD received the 2008 Annual Award for Clin- ical Faculty. This award, funded by a clinical faculty member, Monica E. Calkins, PhD received an Early Career Develop- is given to a volunteer clinical faculty member who has ment Award in 2008 from the American College of Neuropsy- demonstrated long-term loyalty to the Department and excel- chopharmacology. lence in teaching and/or supervising. Dr. Bloom was honored for his “clear thinking and personal warmth.” his “many con- Delane Casiano, MD began a three-year tributions to the Department,” and for having served as “a appointment in May 2008 to the American Psy- skilled clinician and a teacher of excellence...[and] as an out- chiatric Association (APA) Corresponding standing role model for a generation of students and col- Committee on Research Training, a subcommit- leagues.” tee of the Council on Research. The Correspon- ding Committee is responsible for the topic Aaron T. Beck, MD received the 2008 Chief Residents’ Award selection for the Research Colloquium for Jun- in its inaugural year. The award recognizes a teacher who has ior Investigators that is held at each annual APA meetings. expanded frontiers for residents' thinking about the role of The committee is also responsible for the selection of mentors psychiatry in medicine and society, and who also promotes the that serve as faculty for the research colloquium. In June 2008, development of leadership for such reflective thought in the she was awarded a second year of postdoctoral fellowship field of mental health. funding through the Program for Minority Research Training in Psychiatry (PMRTP). PMRTP is a fellowship funded by the The Psychodynamic Psychotherapy Award is given by the Psy- National Institute on Mental Health designed to increase the choanalytic Cluster Steering Committee to a graduating resi- number of under-represented minority men and women in the dent in recognition of his/her excellence in providing field of psychiatric research and is administered by the Ameri- Michelle Goldsmith, MD psychodynamic psychotherapy. can Psychiatric Institute for Research and Education (APIRE).
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James C. Coyne, PhD was appointed External Sci- entific Advisor to the European Commission’s pro- gram “Optimised Suicide Prevention Programs REGIONAL RECOGNITION and Their Implementation in Europe”, a 14-nation project coordinated by Leipzig University. A number of Department of Psychiatry physicans were recognized by Philadelphia Magazine as “Top David F. Dinges, PhD is a member of the Institute Doctors” in the region, as reported in the May 2008 of Medicine’s Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve issue: Patient Safety. The report of the Committee was released in December 2008. Kyle M. Kampman, MD (Addiction Psychiatry) Dwight L. Evans, MD received the Research Mentorship Award from the American Psychiatric Association at its Annual Meet- Anthony L. Rostain, MD and ing in May 2008. The award is given in recognition of a psychia- Elizabeth B. Weller, MD trist’s substantial and formative contributions to the mentoring (Child and Adolescent Psychiatry) of students and residents throughout a distinguished career in psychiatric research. Joel E. Streim, MD Ruth S. Fischer, MD was the recipient of the 2007- (Geriatric Psychiatry) 2008 National Woman Psychoanalytic Scholar Award given by the American Psychoanalytic Michael E. Thase, MD Association in recognition of her distinguished (Psychiatry) career and her contributions to advancing the understanding of female psychology. In addition, the Charles O’Brien Center for Addic- Namni Goel, PhD became President of the Society for Light tion Treatment was cited as one of the places “to Treatment and Biological Rhythms, an international organiza- tion, in June 2008. In September, she was appointed to the Edito- get the best care” for addiction treatment. rial Board of the Journal of Circadian Rhythms.
Michelle Goldsmith, MD and Glenda Wrenn, MD were recipi- Christopher Pierce, PhD received the 2008 Jacob P. Waletzky ents of the Dr. Henry P. and M. Page Durkee Laughlin Founda- Memorial Award for Innovative Research in Drug Addiction tion Award. The award is given to a resident upon and Alcoholism from the Society for Neuroscience at its Annual recommendation of the program as recognition of his/her pro- Meeting in Washington, DC in November 2008. The award fessional achievement, dedication, and scholarship throughout honors a scientist “who has conducted research or plans to con- residency training. Founded in 1964 through the generosity of duct research in the area of substance abuse and the nervous Hank and Page Laughlin, the Dr. Henry P. and M. Page Durkee system.” Laughlin Foundation is based in Frederick, Maryland. For more than thirty years, the Laughlin Foundation has honored out- Jennifer G. Plebani, PhD received a National Institute on Drug standing residents in psychiatric training programs throughout Abuse (NIDA) Women & Sex/Gender Junior Investigator Travel the United States and the United Kingdom. Award recipients Award to attend the 70th Annual Scientific Meeting of the Col- are selected by the senior faculty at their university. lege on Problems of Drug Dependence in San Juan, Puerto Rico in June 2008. John B. Jemmott III, PhD was cited in the July 25 issue of Science Magazine as one of the top 10 NIH- David B. Sarwer, PhD was named Associate Editor of the jour- funded researchers in the area of HIV/AIDS nal Surgery for Obesity and Related Diseases. research for FY2007. [http://www. sci- encemag.org/cgi/content/full/321/5888/520/F2] Robert A. Schnoll, PhD will serve as Co-Chair of the 2009 In August 2008, Dr. Jemmott received The Haven Annual Meeting of the Society for Research on Nicotine and Hero Award from the Haven Youth Center in Tobacco. Philadelphia for his “significant contribution in the fight against HIV/AIDS.” Richard F. Summers, MD was honored as the Teacher of the Year by the Psychoanalytic Center David S. Mandell, ScD was named Associate Director of the of Philadelphia in May 2008. He currently serves new Center for Autism Research (CAR). The CAR is a center of as Program Chair for the Annual Meeting of the emphasis at the Joseph Stokes Jr. Research Institute at the Chil- American Association of Directors of Psychiatry dren’s Hospital of Philadelphia and is a collaboration between Residency Training. He was appointed a Mem- CHOP and the University of Pennsylvania. ber of the Clinical Skills Assessment Curriculum Task Force of the American Board of Psychiatry and Neurology Charles P. O’Brien, MD, PhD and Thomas McLellan, PhD and a Member of the Psychotherapy Standards Committee of were recognized by ISI (Thomson Scientific) as among the “most The Psychoanalytic Consortium. highly cited psychiatrists and psychologists in America.”
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NEWS & GOINGS ON
Howard S. Baker, MD and Ethics in Behavioral Health in Philadelphia Hyperexcitability in Mouse Model of Rett Scott Jones, MDiv presented in July. Syndrome” at the June 2008 annual Inter- a paper in July at the 9th national Rett Syndrome Foundation scien- International Metanexus Judith S. Beck, MD has a new book com- tific meeting. In the Department of Conference in Madrid, Spain ing out in January 2009, The Complete Beck Psychiatry this past summer, Dr. Carlson, titled "Adding a Spiritual Diet for Life: The 5-Stage Program for Perma- Olivier Berton, PhD, and Sangwon Kim, Dimension to the Biopsy- nent Weight Loss. Oxmoor House is the PhD co-founded the Center for Neurobiol- chosocial Model: Psychoanalysis, Kohut, publisher. ogy and Behavior “Work-in-Progress Sem- Schleiermacher, Buber, and Marcel." The Wade H. Berrettini, MD, PhD was moder- inar” as a campus-wide monthly seminar paper is currently published online: ator and speaker at a NARSAD public series for post-doctoral fellows and gradu- [
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Continued from page 12 health center. Co-presenters included Sleep Restriction" (Center for Sleep and Marion Lindblad-Goldberg, PhD spoke Marna Barrett, PhD and Liz Goldstein Respiratory Neurobiology, University of on the “Use of Adherence Scales in Clini- from the Center for Psychotherapy Pennsylvania, Philadelphia); "Sex Differ- cal Supervision to Create Therapeutic Research and Patricia Green from North- ences in Objective and Subjective Sleep Focus” at the American Family Therapy western Human Services of Philadelphia. Measures in Healthy Adults" (Organiza- Academy in Philadelphia in June 2008. Paul Crits-Christoph, PhD chaired the lec- tion for the Study of Sex Differences, New ture. In November 2008, Dr. Casiano pre- Orleans); "Phenotypic Neurobehavioral James R. McKay, PhD presented a talk sented a lecture titled “Sociocultural Responses to Sleep Restriction: Relation- titled "The Treatment of Addiction: What Influences on Interpersonal Style in ship to Cognitive and Subjective Meas- Can Research Offer Practice" in Bethesda, Depressed African Americans” at the ures" (Associated Professional Sleep Maryland in May 2008 at a National Insti- Black Psychiatrists of America (BPA) Tran- Societies, Baltimore); and "Shedding Light tute on Drug Abuse (NIDA) Conference scultural Meeting held in St. Croix, Virgin on the Future by Examining the Present: on Enhancing Practice Improvement. In Islands. Highlights of the 2008 Meeting" and June, he presented results from two NIH- "Introduction and Overview: Preventative funded studies of continuing care for sub- James C. Coyne, PhD gave a workshop at Strategies for Managing Seasonal Major stance use disorders at the Research the European Health Psychology Confer- Depressive Disorder" (Society for Light Society on Alcoholism meeting in Wash- ence in Bath, England in September 2008 Treatment and Biological Rhythms, Van- ington, DC and a NIDA Blending Confer- titled “How to Write Highly Cited Papers couver, Canada). ence in Cincinnati. and What to do When Your Paper is Rejected.” He also presented a paper at Cordula T. Holzer, MD Cory F. Newman, PhD presented four that conference titled “Is Health Psycholo- and Trevor R. Hadley, half-day lectures to CEKTOS (Center for gy Ready for Meta-Analysis? Using Clini- PhD are co-directors of a Cognitive Therapy and Supervision) in cal Connoisseurship to Decide.” Also, Dr. new fellowship in public Copenhagen, Denmark in September, Coyne gave a talk in June titled “Positive psychiatry funded by the 2008. The topics were “Cognitive Therapy Psychology in Cancer Care: Is There Bene- Commonwealth of Penn- of Substance Abuse,” “Cognitive Therapy fit to be Found for Patients or Science?” at sylvania. The fellowship with Medically Ill Patients,” “The Concept the University of Groningen, the Nether- will prepare psychiatrists and Management of Resistance in Cogni- lands, and another in September at the for a career in the public tive Therapy,” and “Power Supervision: same institution titled “Exploring the sector. Also, Dr. Holzer Training the Next Generation of CBT Ther- Depression-Mortality Connection: Well was an invited speaker in apists to Deliver Effective, Memorable Worn Paths, Famous Wrong Turns, and July 2008 at the Scatter- Therapy.” Dead Ends.” good Program Summer In February 2008, Charles P. O’Brien, MD, Institute for the Applied PhD made a presentation on “The Neurobiol- Joseph DiGiacomo, MD gave a Grand Ethics of Behavioral Rounds talk at Norristown State Hospital ogy of Addiction” at the Royal Society in Lon- Health. The conference was titled "Access don. In July 2008, he chaired a symposium at in June 2008. He delivered a lecture on to Behavioral Healthcare." In May, she "Practical Guide to Managing Medico-legal the Annual Meeting of the International Con- gave a workshop on "Documenting Dis- gress of Neuropsychopharmacology, and also Risk in Psychopharmacology" in April at ability for Medical Providers" for Philadel- the 2008 Colloquium of Scholars' Annual presented research on “The Pharmacogenetics phia psychiatrists for the National Health of Alcoholism” at this meeting. Also in July, Update in Psychiatry, sponsored by the Care for the Homeless Council. Pennsylvania Medical Society and the Dr. O’Brien made a presentation to the faculty Philadelphia Psychiatric Society. In June, John B. Jemmott III, PhD testified on Sep- of the Institute of Psychiatry at the Maudsley he spoke at Cooper Health System on the tember 18, 2008 at a hearing of the U.S. Hospital in London on the treatment of alco- same topic. House of Representatives Science and holism. In August 2008, Dr. O’Brien made a Technology Subcommittee on Research presentation on “Penn Addiction Research” to David F. Dinges, PhD gave several pre- and Science Education. The hearing topic the International AIDS Conference held in sentations in the spring of 2008, including: was the “Role of Social Sciences in Public Mexico City. “Phenotypes for Differential Vulnerability Health,” and Dr. Jemmott addressed the Helen M. Pettinati, PhD, Michael P. to Sleep Deprivation (NIH Gene Work- issue of AIDS prevention. shop, Bethesda, Maryland); “Countermea- Bogenschutz, MD, and J.Scott Tonigan, sures to Neurobehavioral Deficits from Caryn Lerman, PhD joined Dr. Nora PhD presented on “Alcohol Subtypes and Cumulative Sleep Deprivation During Volkow, Director of the National Institute Differential Treatment Outcomes from the Space Flight: Dose-response Effects of on Drug Addiction (NIDA), for a Congres- COMBINE Study” at the 2008 Joint Scien- Recovery Sleep Opportunities” (79th Aero- sional Briefing in April 2008, presenting on tific Meeting of the Research Society on space Medical Association, Boston); and "Personalized Medicine for Nicotine Alcoholism and the International Society “Fatigue: Where Biology Meets Technolo- Dependence." for Biomedical Research on Alcoholism in gy” (Plenary Talk, Federal Aviation Washington, DC. The lecture was given in Administration Fatigue Symposium, Stephen E. Levick, MD led a discussion a symposium organized to honor the work Washington, DC). on the topic: "'We' and 'They' Imagine the of Dr. Jack Mendelson. Early Human Embryo: Some Psychological Namni Goel, PhD spoke at a number of Considerations in the Stem Cell 'Wars'" at Robert L. Sadoff, MD gave lectures titled local, national, and international meetings the 2008 World Stem Cell Summit in Madi- “First Do No Harm: Minimizing the Inher- on various topics, including: "Characteri- son, Wisconsin in September 2008. ent Harm in Forensic Psychiatric Practice” zation of Neurobehavioral Phenotypes to at Harvard University in September 2008 Continued on page 14
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and at the Annual Meeting of the Ameri- atric Aspects of Cosmetic Surgery" and Bethesda, Maryland in September 2008. can Academy of Psychiatry and the Law “Psychiatric Aspects of Bariatric Surgery" In October, he gave the Simon Wile semi- in Seattle in October. A short biography (Psychiatry Grand Rounds, Cooper nar on “Post-traumatic Stress Disorder of Dr. Sadoff titled “Robert L. Sadoff, Health System, Camden, New Jersey); and Non-adherence” at the Annual Meet- MD: Renaissance Man of Forensic Psychi- "The Psychology of Body Image Enhance- ing of the American Academy of Child atry,” written by Frank M. Dattilio, PhD ment" (The Aesthetic Show, Las Vegas, and Adolescent Psychiatry in Chicago, and Thomas G. Gutheil, MD, appeared in Nevada); "The Preoperative Psychologi- and was an invited speaker at the Annual the Journal of the American Academy of Psy- cal Evaluation: Issues and Controversies," Meeting in St. Louis of Studies in Pedi- chiatry and the Law (Volume 36, pages "Behavioral Modification for the Success atric Liver Transplantation (SPLIT), an 286-289, 2008). Dr. Sadoff and Dr. Dattilio of the Banding Patient," and "Psychiatric NIH-funded national registry of liver published a new book in November 2008 Preparation" (American Society of Meta- transplant outcomes, where he spoke on titled Crime and Mental Illness, published bolic and Bariatric Surgery, Washington, the “Psychosocial Assessment of Chil- by the Pennsylvania Bar Institute. In DC); and "Motivating Patient Compliance dren Who Had a Transplant.” addition, Dr. Sadoff started the new sec- Improves Obesity Management Out- tion on Medicine, Ethics and the Law at comes from Wellness to Surgery" (Case Elizabeth B. Weller, MD was an invited the College of Physicians of Philadelphia. Management Society of America, Orlan- speaker this past summer on "Treating The kickoff program on Neurolaw is do, Florida). Youth Psychiatric Disorders – Connecting scheduled in March with three speakers Clinical Knowledge and Community from Penn – Arthur Caplan, PhD, Ruben Robert A. Schnoll, PhD gave invited Application" at the 2008 National Medical C. Gur, PhD, and Stephen J. Morse, JD, talks at various forums in 2008, including Association Annual Convention and Sci- PhD. Dr. Sadoff is also the Program the 7th Annual International Conference entific Assembly in Atlanta. She lectured Director of the Department of Psychia- on Head and Neck Cancer in San Francis- about the medical and psychiatric differ- try’s newly approved Forensic Psychiatry co where he spoke on “Treating Tobacco ential diagnoses of bipolar disorder in Fellowship Training Program, which is Dependence in the Oncologic Context,” children and adolescents. In September, scheduled to begin in July 2009. and at the University of the Sciences of she gave Grand Rounds at The Reading Philadelphia where he lectured on Hospital and Medical Center in Reading, Mark S. Salzer, PhD led a session at the “Treating Nicotine Dependence.” Pennsylvania on "An Update on Bipolar National Disability Rights conference Disorder in Children and Adolescents.” held in New Orleans in June 2008 on Eyal Shemesh, MD spoke Dr. Weller also led an examination team strategies for promoting employment of on the “Psychosocial Cor- for the American Board of Psychiatry and relates of Non-adherence” individuals with psychiatric disabilities. Neurology in St. Louis in September. at a task force meeting of David B. Sarwer, PhD spoke in the the National Institute of spring and summer on a number of top- Diabetes and Digestive ics at various venues, including: "Psychi- and Kidney Diseases in
American Psychiatric Association 161st Annual Meeting May 3-8, 2008 – Washington, DC
Aaron T. Beck, MD receives 2008 Distinguished Service Award “in recognition of your extraordinary contributions as a prominent leader in the areas of cognitive therapy and depression research, and for your dedi- cated commitment and work, which has improved the care of patients and enno- bled the profession of psychiatry.”
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RESEARCH NEWS
Siobhan Banks, PhD is apeutic activity of antidepressants, cation. In addition, Dr. Dinges’ labora- Co-Investigator on two which are still largely unknown. tory received several new grants, NASA Cooperative including: “Countermeasures for Per- Agreements with the James C. Coyne, PhD received R01 formance Deficits from Sleep Loss and National Space Biomed- funding from the National Institute of Workload in Space Flight,” “Optical ical Research Institute Mental Health (NIMH) for a five-year Computer Recognition of Stress, Affect titled “Countermeasures study titled “Detection and Care for and Fatigue During Space Flight,” and for Performance Deficits from Sleep Depression During Pregnancy and the “Team Leader – Neurobehavioral and Loss and Workload in Spaceflight” and Postpartum Period.” The study will Psychosocial Factors” (NASA Cooper- “Optical Computer Recognition of examine whether women who become ative Agreements with National Space Stress, Affect and Fatigue During Per- depressed are detected in medical care Biomedical Research Institute); “Psy- formance in Spaceflight.” Both projects during pregnancy and in the postpar- chomotor Vigilance Testing on the are funded into 2011. tum period, and the kinds and quality International Space Station” (National of care for depression they receive. Space Biomedical Research Institute) – Hadas Wiseman and Jacques P. Bar- this project places cognitive testing ber, PhD, ABPP published a book Guy S. Diamond, PhD, Director of the Center for Family Intervention Science technology developed by Dr. Dinges titled Echoes of the Trauma: Relationship on the International Space Station (ISS) Themes and Emotions in the Narratives of (CFIS), is involved in youth suicide prevention research at Penn and Chil- for the study of astronaut behavioral the Children of Holocaust Survivors readiness; and “Prediction of Fatigue (Cambridge University Press, 2008). dren’s Hospital of Philadelphia. With a recent grant from the Centers for Dis- and its Effects on Vigilance and Target Wade H. Berrettini, MD, PhD ease Control and Prevention (CDC), Detection (Department of Homeland received a 4-year $3.5 million P20 cen- the CFIS completed its first trial of Security‘s Transportation Security Lab- ter grant from the National Institute on Attachment Based Family Therapy oratory). Drug Abuse (NIDA) to investigate a (ABFT) for youth suicide prevention in Kyle M. Kampman, novel function of the mu opioid recep- primary care. The results of that trial MD is directing the tor, the receptor to which morphine suggest that family treatment was Philadelphia Treatment binds in the brain to produce its more effective than community care Site as part of a “Multi- addicting and pain-relieving proper- for decreasing suicidal ideation and site Controlled Trial of ties. The grant is titled “The mu Opi- depression. The CFIS has received new Cocaine Vaccine” fund- oid Receptor in Addiction.” Dr. grants to extend this work in new ed by the National Berrettini also conducted a genetic directions. Two are from the American Institute on Drug Abuse (NIDA). study of nicotine addiction in 15,000 Foundation for Suicide Prevention and persons, establishing with high statisti- the third is a Garret Lee Smith Suicide Caryn Lerman, PhD is the Principal cal significance that variations in the Prevention grant to fund a collabora- Investigator of a new five-year Nation- alpha3-alpha5 nicotinic receptor sub- tion between CFIS and the Pennsylva- al Cancer Institute grant titled "Effects unit genes increase risk for nicotine nia Office of Mental Health and of Smoking Cues in Anti-Tobacco Pub- addiction (Berrettini WH, Yuan X, Substance Abuse Service aimed at lic Service Announcements (PSAs)," Tozzi F, Song K, Chilcoat H, Francks reducing suicide rates in three counties with Joseph N. Cappella, PhD in the C, Waterworth D, Muglia P, Mooser V: in northern Pennsylvania. Annenberg School for Communication Alpha-5/Alpha-3 Nicotinic Receptor and Andrew A. Strasser, PhD in the Subunit Alleles Increase Risk for David F. Dinges, PhD Department of Psychiatry. She is also Heavy Smoking. Molecular Psychiatry and his laboratory the Co-Principal Investigator of the 13:368-73, 2008.). team completed genet- National Cancer Institute P50 Center of ic analyses on their Excellence in Cancer Communication Olivier Berton, PhD received a 2008 database on human Research, which was competitively Young investigator Award from differential vulnerabili- renewed in September 2008 (Robert C. NARSAD, a private, not-for-profit ty to the neurobehav- Hornik, PhD, Annenberg School for organization that raises funds for sci- ioral effects of sleep deprivation. The Communication, PI). Recent key scien- entific research into the causes, cures, laboratory is supported by the Penn tific advances from Dr. Lerman's labo- treatments, and prevention of severe Genomics Institute (PGI) and Penn's ratory include the first genome-wide psychiatric brain and behavior disor- Institute for Translational Medicine association study of smoking cessation ders, such as schizophrenia and (ITMAT). Hakon Harkonarson, MD demonstrating convergent findings depression. Dr. Berton’s research is on (Children’s Hospital of Philadelphia) across multiple clinical trials. As pub- the "Neuroplasticity of Serotonin Sys- completed the genomic analyses and lished in the Archives of General Psychia- tems in a Murine Model of Affective Emmanuel Mignot, MD, PhD (Stan- try (June 2008), this study identifies Disorder: Role of HDAC6." Using a ford) analyzed the candidate genes. several novel genes including cell mouse model, the study seeks to pro- The results of these analyses are being adhesion molecules and genes vide a better understanding of the written up for publication and will be involved in memory. In addition, the basic mechanisms underlying the ther- the basis of a planned NIH grant appli- results of the first systems-based can-
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didate gene study of smoking cessation in response to changes in patients' Health Association of Southeastern by Dr. Lerman and colleagues impli- symptoms and status over time. Pennsylvania and Horizon House, both cates the nicotinic acetylcholine receptor based in Philadelphia. More informa- beta2 subunit gene in smoking cessa- In 2007, David S. Metzger, PhD and tion about the Center can be found at tion, as published in Human Molecular members of his research group were www.upennrrtc.org. Dr. Salzer is also Genetics (September 2008). Dr. Lerman active participants in the successful the lead investigator on a study examin- also published a seminal paper on per- efforts to secure a four-year award from ing the employment experiences of indi- sonalized therapy for smoking cessa- the National Institute for Child Health viduals with mental illnesses who are tion, based on a randomized and Human Development (NICHD) to newly released from jails, as part of a placebo-controlled trial of bupropion. the University of Botswana and the Uni- new Center funded by the National As published in Clinical Pharmacology versity of Pennsylvania. The goal is to Institute on Mental Health. Dr. Salzer and Therapeutics (September, 2008), these establish a collaboration to develop a also received pilot funding in July 2008 data suggest that targeted therapy research infrastructure in Botswana from the Leonard Davis Institute of based on genetic variation in nicotine capable of designing, implementing, Health Economics at Penn to examine metabolizing enzymes could improve and reporting on interventions to the recruitment and retention of the the overall effectiveness of treatment for reduce HIV transmission among adoles- entry-level behavioral health workforce nicotine dependence. cents. and the relationship between these fac- Jennifer G. Plebani, PhD started two tors and the delivery of quality services David S. Mandell, ScD is Principal and supports. Investigator on three new grants: 1) pilot studies – a "Phase II, Randomized, “Autism and Associated Neuro-Behav- Double-Blind Pilot Trial of Varenicline David B. Sarwer, PhD received an R01 ioral Functioning among Patients in a for the Treatment of Cocaine Depend- grant from the National Institute of Dia- Psychiatric Hospital” (Department of ence" and a "Phase II, Randomized, betes and Digestive and Kidney Dis- Defense) – this study seeks to determine Double-Blind Pilot Trial of Varenicline eases (NIDDK) titled “Dietary Intake the prevalence of autism among psychi- for the Treatment of Alcohol Depend- and Eating Behavior in Adolescents atric inpatients; validate a screening ence." Pfizer is generously providing who Undergo Bariatric Surgery.” The instrument for autism in an adult, psy- medication for the alcohol trial. study will focus on changes in these chiatrically impaired sample; and iden- Daniel Rodriguez, PhD domains in adolescents who undergo tify clinical and neurobehavioral received an R03 grant from bariatric surgery as part of the nation- characteristics that discriminate the National Cancer Insti- wide TeenLABS bariatric surgery con- between adults with autism and other tute titled “The Effect of sortium. Dr. Sarwer also received a psychiatric disorders; 2) “A Random- Antismoking Parenting grant from the American Society of ized Trial of the STAR Program for Practices on Adolescent Metabolic and Bariatric Surgery (along Children with Autism Spectrum Disor- Smoking.” Funding began with Kelly C. Allison, PhD) to investi- der (ASD)” (National Institute of Mental in August 2008 and will run through gate improvements in reproductive Health) – this field trial of STAR (Strate- July 2010. functioning in women who undergo gies for Teaching Based on Autism bariatric surgery for extreme obesity. Research) examines the effects of this Mark S. Salzer, PhD is the Principal classroom-based program for children Investigator and Director of a new five- Robert A. Schnoll, PhD received an with ASD on school readiness; 3) “Effi- year Rehabilitation Research and Train- R01 grant from the National Cancer cacy and Sustainability of the STAR ing Center funded by the National Institute titled “Assessment of a Teach- Program” (Department of Education) – Institute on Disability and Rehabilita- able Moment for Smoking Cessation, this study examines fidelity of imple- tion Research. The mission of the $4.25 Administrative Supplement for Eco- mentation, child outcomes, factors asso- million Center is to conduct research to nomic Studies of Interventions for Can- ciated with subgroup variation in advance theory, measures, methods, cer Survivors and Their Families.” outcomes, and sustainability of the pro- and intervention knowledge aimed at Funding will run into 2009. gram model in a group of kindergarten- promoting full community participation Andrew A. Strasser, PhD through-second grade students. (e.g., going to work, school, friendships, received the Pfizer Global parenting, self-determination, Research Award on Nico- James R. McKay, PhD leisure/recreation, citizenship) and was awarded a five-year tine Dependence independent living of adults with psy- (GRAND) Award, one of P01 grant from the Nation- chiatric disabilities and ensuring that al Institute on Alcohol six awardees worldwide. research in this area is effectively trans- The funded project will investigate the Abuse and Alcoholism lated in order to change practice and (NIAAA) in September extinction of smoking behaviors in policy at the national, state, county, and response to treatment with varenicline. 2008, which is titled "Cen- agency levels. The Center involves a ter on Adaptive Treatments for Alco- strong multidisciplinary group of col- Elizabeth B. Weller, MD is the Princi- holism." The new Center provides laborators from Penn, investigators pal Investigator of a new grant from funding to support work on the devel- from nine universities around the coun- GlaxoSmithKline titled “The Evaluation opment and evaluation of adaptive try, and significant involvement with of LAMICTAL as an Add-on Treatment algorithms, which specify when and the National Mental Health Consumers’ for Bipolar I Disorder in Children and how to modify treatment for addiction Self-Help Clearinghouse at the Mental Adolescents, 10 to 17 Years of Age.”
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RESEARCH GRANTS
The following sponsored research funding was received by the Department during the period April 1, 2008 through November 30, 2008 (*Sponsored research funding during the period 10/1/07 through 3/31/08. Awards were received after publication of last newsletter.) New NIH Awards (includes New and Competing Renewals) Name Sponsor Project Title AUDRAIN-MCGOVERN, JANET NIH THE PROTECTIVE EFFECTS OF PHYSICAL ACTIVITY ON ADOLESCENT SMOKING PRO- GRESSION
BERRETTINI, WADE NIH MU OPIOID RECEPTOR IN ADDICTION
THE CFAR SOCIAL AND BEHAVIORAL SCIENCE RESEARCH NETWORK NATIONAL SCI- BLANK, MICHAEL NIH ENTIFIC MEETING
1 of 2: REAL-TIME FMRI PATTERN TRAINING FOR TREATMENT OF CRAVING AND CHILDRESS, ANNA NIH ADDICTION
COYNE, JAMES NIH DETECTION AND CARE FOR DEPRESSION IN THE PERIPARTUM
EVANS, DWIGHT NIH DEPRESSION, ANTIDEPRESSANTS AND HIV INFECTIVITY
FAITH, MYLES NIH TREATMENT OF EARLY CHILDHOOD OVERWEIGHT IN PRIMARY CARE: PILOT STUDY FAITH, MYLES NIH BEVERAGE CHOICE AND LIFESTYLE MODIFICATION FOR CHILDHOOD
FOA, EDNA NIH TREATMENT OF SMOKING AMONG INDIVIDUALS WITH PTSD
FRANKLIN, MARTIN NIH BEHAVIOR THERAPY FOR PEDIATRIC TRICHOTILLOMANIA
GUR, RAQUEL NIH A NEUROBEHAVIORAL FAMILY STUDY OF SCHIZOPHRENIA
GUR, RAQUEL NIH 2/5 - A GENOME-WIDE METHYLATION SCAN FOR EPIGENETIC CONTRIBUTIONS TO SCHIZOPHRENIA
GUR, RUBEN NIH ADAPTING EXPERIMENTAL COGNITIVE AND AFFECTIVE TASKS FOR SCHIZOPHRENIA HAHN, CHANG-GYU NIH LITHIUM RESPONSIVENESS HUGHES-HALBERT, CHANITA NIH WEST PHILADELPHIA CONSORTIUM TO ADDRESS DISPARITIES HUGHES-HALBERT, CHANITA NIH COMMUNITY-BASED NAVIGATOR PROGRAM FOR CANCER CONTROL IN AFRICAN AMERICANS KAMPMAN, KYLE NIH MULTISITE CONTROLLED TRIAL OF COCAINE VACCINE (4 OF 6) PHILADELPHIA TREAT- MENT SITE
KIM, SANGWON NIH DEXTRAS1, BRAIN IRON HOMEOSTASIS AND MENTAL HEALTH KRAL, TANJA NIH EATING BEHAVIORS AMONG WEIGHT-DISCORDANT SIBLINGS LERMAN, CARYN NIH EFFECTS OF SMOKING CUES IN ANTI-TOBACCO PUBLIC SERVICE ANNOUNCEMENTS (PSAs) [WITH ANNENBERG SCHOOL FOR COMMUNICATION] MANDELL, DAVID NIH A RANDOMIZED TRIAL OF THE STAR PROGRAM FOR CHILDREN WITH AUTISM SPEC- TRUM DISORDER
MC KAY, JAMES NIH CENTER ON ADAPTIVE TREATMENTS FOR ALCOHOLISM O’BRIEN, CHARLES NIH TREATMENT STUDY USING DEPOT NALTREXONE (1/6) PHILADELPHIA OSLIN, DAVID NIH DEFINING AN ENDOPHENOTYPE FOR OPIOID DYSREGULATION: A PILOT STUDY OSLIN, DAVID NIH PHARMACOGENETIC RESPONSE TO NALTREXONE FOR ALCOHOL DEPENDENCE PRICE, R ARLEN NIH AN ASSOCIATION SCAN FOR HUMAN OBESITY RELATED GENES RODRIGUEZ, DANIEL NIH THE EFFECT OF ANTISMOKING PARENTING PRACTICES ON ADOLESCENT SMOKING SARWER, DAVID NIH DIETARY INTAKE AND EATING BEHAVIOR IN ADOLESCENTS WHO UNDERGO BARIATRIC SURGERY TURETSKY, BRUCE NIH TMS-EP PROBES OF NEURAL RESPONSE MECHANISMS AND CONNECTIVITY IN SCHIZ- OPHRENIA WOODY, GEORGE NIH SENIOR SCIENTIST RESEARCH AND MENTORSHIP AWARD
Continued on page 18
PENN PSYCHIATRY PERSPECTIVE WINTER 2009 PAGE 18 PENN PSYCHIATRY PERSPECTIVE WINTER 2009
Continued from page 17
Other Federal Agencies
Name Sponsor Project Title CAROFF, STANLEY DEPARTMENT OF VETERANS EFFECTIVENESS OF SWITCHING ANTIPSYCHOTIC MEDICATIONS* AFFAIRS
DINGES, DAVID NATIONAL SPACE BIOMEDICAL COUNTERMEASURES FOR PERFORMANCE DEFICITS FROM SLEEP RESEARCH INSTITUTE LOSS AND WORKLOAD IN SPACE FLIGHT
DINGES, DAVID NATIONAL SPACE BIOMEDICAL OPTICAL COMPUTER RECOGNITION OF STRESS, AFFECT AND RESEARCH INSTITUTE FATIGUE DURING PERFORMANCE IN SPACE FLIGHT
DINGES, DAVID NATIONAL SPACE BIOMEDICAL TEAM LEADER: NEUROBEHAVIORAL AND PSYCHOSOCIAL FACTORS RESEARCH INSTITUTE
DINGES, DAVID NATIONAL AERONAUTICS AND PVT SELFTEST ON ISS SPACE ADMINISTRATION
DINGES, DAVID NATIONAL SPACE BIOMEDICAL VIGILANCE, STRESS AND SLEEP/WAKE MEASURES IN NEEMO 14 - A RESEARCH INSTITUTE SIMULATED SPACE ENVIRONMENT*
FOA, EDNA DEPARTMENT OF THE ARMY MASSED VS SPACED TRIALS FOR PROLONGED EXPOSURE FOR PTSD
GEHRMAN, PHILIP DEPARTMENT OF VETERANS PT074364 CBT FOR NIGHTMARES IN OEF/OIF VETERANS AFFAIRS
MANDELL, DAVID DEPARTMENT OF EDUCATION EFFICACY AND SUSTAINABILITY OF THE STAR PROGRAM
MANDELL, DAVID DEPARTMENT OF THE ARMY AUTISM AND ASSOCIATED NEURO-BEHAVIORAL FUNCTIONING AMONG PATIENTS IN A PSYCHIATRIC HOSPITAL
SALZER, MARK DEPARTMENT OF EDUCATION THE UNIVERSITY OF PENNSYLVANIA RRTC ON PARTICIPATION AND COMMUNITY LIVING OF INDIVIDUALS WITH PSYCHIATRIC DISABILITIES
Other Agencies and Organizations
Name Sponsor Project Title ALLISON, KELLY AMERICAN SOCIETY FOR IMPROVEMENTS IN REPRODUCTIVE STATUS FOLLOWING BARIATRIC BARIATRIC SURGERY SURGERY*
BERRETTINI, WADE THE MEDICAL FOUNDATION GENOME-WIDE ASSOCIATION STUDY OF ANOREXIA NERVOSA
BERTON, OLIVIER NATIONAL ALLIANCE FOR NEUROPLASTICITY OF 5-HT SYSTEMS IN A MURINE MODEL OF AFFEC- RESEARCH ON SCHIZOPHRE- TIVE DISORDER: ROLE OF HDAC6 NIA AND DEPRESSION
BRODKIN, EDWARD CHILDREN'S HOSPITAL OF NEUROBIOLOGY AND TREATMENT OF AUTISM SPECTRUM DISOR- PHILADELPHIA DERS
FAITH, MYLES AMERICAN DIABETES ASSOCIA- LIFESTYLE MODIFICATION FOR TYPE 2 DIABETES PREVENTION IN TION YOUNG OVERWEIGHT YOUTH
HUGHES-HALBERT, ASSOCIATION FOR PREVEN- CTSA WORKSHOP CHANITA TION TEACHING AND RESEARCH
Continued on page 19
www.med.upenn.edu/psych PAGE 19 www.med.upenn.edu/psych
Continued from page 18
Other Agencies and Organizations (continued) Name Sponsor Project Title LEITMAN, DAVID NATIONAL ALLIANCE FOR FUNCTIONAL ANATOMY OF AUDIOTRY EMOTION PROCESSING IN RESEARCH ON SCHIZOPHRENIA SCHIZOPHRENIA AND DEPRESSION
RAINE, ADRIAN COMMONWEALTH OF PENNSYL- BIOSOCIAL PREDICTION AND INTERVENTION ON CHILDHOOD VANIA AGGRESSION
SARWER, DAVID PLASTIC SURGERY EDUCA- PSYCHOSOCIAL AND PHYSICAL FUNCTIONING FOLLOWING BODY TIONAL FOUNDATION CONTOURING SURGERY*
SARWER, DAVID CINCINNATI CHILDREN'S HOSPI- ADOLESCENT BARIATRICS: CONTROLLED LONGITUDINAL STUDY OF TAL MEDICAL CENTER PSYCHOSOCIAL DEVELOPMENT*
SPOKAS, MEGAN AMERICAN FOUNDATION FOR EXAMINATION OF A RELAPSE PREVENTION TASK IN PREVENTING SUICIDE PREVENTION FUTURE SUICIDE ATTEMPTERS
THASE, MICHAEL MASSACHUSETTS GENERAL LITHIUM USE FOR BIPOLAR DISORDER (LITMUS): A RANDOMIZED HOSPITAL CONTROLLED EFFECTIVENESS TRIAL*
WOLF, DANIEL AMERICAN PSYCHIATRIC ASSO- VENTRAL STRIATUM HYPOFUNCTION: RELATIONSHIP TO NEGATIVE CIATION SYMPTOMS IN SCHIZOPHRENIA PATIENTS AND FAMILY
Clinical Trials Name Sponsor Project Title ARNOLD, STEVEN ELI LILLY AND COMPA- EFFECT OF GAMMA SECRETASE INHIBITION ON THE PROGRESSION OF NY ALZHEIMER'S DISEASE: LY450139 VERSUS PLACEBO
KAMPMAN, KYLE TITAN PHARMACEUTI- PRO-809: AN OPEN-LABEL, MULTI-CENTER EXTENSION STUDY OF CALS PROBUPHINE IN PATIENTS WITH OPIOID DEPENDENCE
KOHLER, CHRISTIAN SANOFI-AVENTIS U.S. A 24-WEEK, MULTICENTER, DOUBLE-BLIND, RANDOMIZED, PARALLEL-GROUP, INC DOSE RANGING STUDY OF THE EFFICACY AND SAFETY OF ORAL DOSES OF AVE 1625 5, 10, AND 30 MG AND PLACEBO ON TOP OF AN ESTABLISHED TREATMENT REGIMEN OF EITHER OLANZAPINE, RISPERIDONE/PALIPERIDO
O’REARDON, JOHN PFIZER INC A SIX-WEEK, DOUBLE-BLIND, MULTICENTER, PLACEBO CONTROLLED STUDY EVALUATING THE EFFICACY AND SAFETY OF FLEXIBLE DOSES OR ORAL ZIPRASIDONE AS ADD ON, ADJUNCTIVE THERAPY WITH LITHIUM, VALPROATE OR LAMOTRIGINE IN BIPOLAR I DEPRESSION
O’REARDON, JOHN CERNERX BIOPHARMA A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PARALLEL GROUP ASSESSMENT OF THE EFFICACY, SAFETY, AND TOLERABILITY OFCX157 60 MG TID IN SUBJECTS WITH MDD
STREIM, JOEL EISAI INC A 12-WEEK MULTI-CENTER OPEN-LABEL STUDY TO EVALUATE THE EFFEC- TIVENESS AND SAFETY OF DONEPEZIL HYDROCHLORIDE (E2020) IN SUB- JECTS WITH MILD TO SEVERE ALZHEIMER'S DISEASE RESIDING IN AN ASSISTED LIVING FACILITY
THASE, MICHAEL ELI LILLY AND COMPA- DULOXETINE VERSUS PLACEBO IN PATIENTS WITH MAJOR DEPRESSIVE DIS- NY ORDER (MDD): ASSESSMENT OF ENERGY AND VITALITY IN MDD*
WADDEN, THOMAS VIVUS, INC A PHASE III, RANDOMIZED, DOUBLE-BLIND, PARALLEL-DESIGN, STUDY COM- PARING MULTIPLE DOSES OF VI-0521 TO PLACEBO AND THEIR SINGLE-AGENT PHENTERMINE AND TOPIRAMATE CONSTITUENTS FOR THE TREATMENT OF OBESITY IN ADULTS*
WADDEN, THOMAS NOVO NORDISK PHAR- EFFECT OF LIRAGLUTIDE ON LONG-TERM WEIGHT MAINTENANCE FOLLOW- MACEUTICALS ING WEIGHT LOSS INDUCED BY A 12-WEEK LOW CALORIE DIET IN OBESE SUBJECTS; A 52-WEEK RANDOMIZED, DOUBLE-BLIND, PLACEBO-CON- TROLLED, PARALLEL GROUP, MULTI-CENTER TRIAL WITH A 12-WEEK FOL- LOW-UP PERIOD
PENN PSYCHIATRY PERSPECTIVE WINTER 2009 PAGE 20 PENN PSYCHIATRY PERSPECTIVE WINTER 2009
FACULTY ININ THE NEWS
Judith S. Beck, MD was for an article appearing on the Live lished in the Journal of Neurology, in featured in a number of Science webpage on May 26, 2008, which researchers suggest that people published articles in "Can 'Fighters' Like Ted Kennedy Beat who are sleep-deprived alternate 2008, including: Parade Disease? [http://www.livescience.com/ between periods of near-normal brain Magazine (May 11, 2008, health/080522-positive-thinking.html]. function and dramatic lapses in atten- “Feel Better About The interview was widely quoted in tion and visual processing, making it Yourself” by Michael newspapers and blogs. In addition, clear how dangerous sleep depriva- O'Shea); Associated Maggie Koerth-Baker interviewed Dr. tion can be while driving on the high- Press (April 2008, “Weight-loss Mem- Coyne in Amsterdam, the Nether- way, when even a four-second lapse oirs, TV Shows Offer Hope to Some lands in May 2008 concerning Dutch could lead to a major accident. People Struggling with Weight, but at Olympic gold medal winner Maarten [http://uk.reuters.com/ article/UKNews1 What Cost?” by Megan Scott); Van der Weijden’s anti-positive psy- / idUKN2034716020080521?sp=true] HEALTH Magazine (May 2008, “Feel chology approach to fighting In a June 22, 2008 Baltimore Sun article Great Weight”); Publix Greenwise Mar- leukemia. The interview has been about a 3-D simulator in which sol- ket Magazine (July 2008, “Rewriting quoted in international newspapers diers see, hear and smell the rigors of Your Internal Script”); and O, The and magazines, including those in the combat to help ease war-induced Oprah Magazine (January 2008, “Can the Ukraine, Hungary, Romania, and stress, Edna B. Foa, PhD notes that You Think Yourself Fat?” by Emily China. more empirical evidence is needed to Yoffe). The research of David F. Dinges, PhD determine the efficacy and account for Wade H. Berrettini, MD was quoted on the effects of chronic sleep depriva- the cost of this type of exposure thera- in a July 28, 2008 article in the Milwau- tion was featured on CBS’s 60 Minutes py. Dr. Foa, who works with PTSD kee Journal Sentinel regarding a study in a program on “The Science of patients – including soldiers – in both which found that teenagers may start Sleep.” The program aired March 16, the U.S. and Israel, said the images in smoking because of peer pressure, but 2008, and was the sixth most watched virtual therapy might be too generic they become addicted to nicotine in show during the week of March 12-18 to effectively elicit patients' own mem- part because of their genes. among those aged 50 years and older, ories. [http://pqasb.pqarchiver.com/ balt- [http://www.jsonline.com/features/29557 with 8.8 million viewers. The large sun/access/1498721891.html?dids=1498721 579.html] He also appeared on a June viewer response resulted in the pro- 891%3A1498721891&FMT=ABS&FMTS=A 8, 2008 segment on WPIX-TV in New gram being aired again on May 25, BS%3AFT&type=current&date=Jun+22,+20 York as part of a story investigating 08&author=David+Kohn&pub=The+Sun& 2008. In a September 13, 2008 article in desc=FACING+DEMONS+IN+%27VIRTU health care insurance coverage for Science News, Dr. Dinges explained AL+IRAQ%27] people diagnosed with anorexia ner- that Dopamine may naturally increase vosa. Dr. Berrettini said that to deny when a person is sleep-deprived as a Teresa Franklin, PhD care for anorexia nervosa because it is way to counteract a revved-up drive was interviewed on Sep- ”not a biologically-based illness” is to to sleep. Sleep deprivation affects tember 10, 2008 by Tina make a grievous error that puts peo- some people profoundly, impairing Adler from MSNBC ple with a serious illness at risk. A their ability to pay attention and News on the topic of New Jersey health insurance company lengthening their reaction times. “Predicting Addiction: recently overturned its decision and [http://www.sciencenews.org/view/gene Why Some People Go provided a $250,000 settlement to a ric/id/35529/title/Dopamine_fends_off_z from Trying to Requiring.” [http:// woman with anorexia nervosa. zzzzs] Also, Dr. Dinges’ research pub- health.msn.com/health-toics/addiction [http://media.vmsnews.com/MonitoringR lished in the Journal of Neuroscience – /articlepage.aspx?cp-documentid=100 eports/060908/882804/I001432114/] Dr. reporting that being deprived of sleep, 214619] Berrettini was also quoted in a May 6, even for just one night, can it make Namni Goel, PhD was interviewed 2008 New York Times article about the the brain unstable and prone to sud- for an article by Abigail Cuffey and growing trend toward reclassifying den shutdowns – was cited by an Judy Kirkwood in the August 2008 diseases based on their genetic under- additional 15 national and local out- Ladies’ Home Journal Magazine on the pinnings. [http://www.nytimes.com/ lets, including The Osgood File, efficacy of negative air ions for major 2008/05/06/health/research/06dise.html? KCBS-TV in Los Angeles, and WBZ- depression. She was also interviewed pagewanted=2&_r=3&sq&st=nyt%22&sc AM (CBS) in Boston. Dr. Dinges was for a story by Jolene Edgar in the p=1%22university%20of%20pennsylvania] also quoted in a May 21, 2008 article October 2008 issue of Glamour on the by Reuters and posted by 30 outlets, James C. Coyne, PhD was inter- effects of olfactory stimuli on including MSNBC.com and The Aus- viewed by Senior Writer Jeanna Bryne polysomnographic sleep. tralian. He discussed a study, pub- Continued on page 21
www.med.upenn.edu/psych PAGE 21 www.med.upenn.edu/psych
Continued from page 20
Ruben C. Gur, PhD discussed the natown . [http://www.philly.com/ Anthony L. Rostain, MD, MA dis- role functional MRIs can play in philly/news/homepage/29874444.html] cussed the characteristics and scientif- examining behaviors such as decep- ic research regarding adult ADD and David S. Metzger, PhD tion with Advanced Imaging Magazine ADHD in a segment on Univision’s was quoted in an article in a September 8, 2008 article. [http: Aqui y Ahora newsmagazine televi- in the Philadelphia Inquir- //www. advancedimagingpro.com/ pub- sion show. Dr. Rostain’s patient, er on his efforts in com- lication/article.jsp?pubId=1&id=5420 Jaime Montealegve, a Penn student, bating AIDS in China. &pageNum=2] was also interviewed and spoke about Dr. Metzger will test his current treatment for ADD. John B. Jemmott III, PhD appeared "whether a drug that reduces the on NPR’s Weekend Edition on May [http://www.univision.com/content/vide craving for heroin can also reduce the o.jhtml?cid=1682879&channelName=Video 18, 2008 to discuss ways to prevent spread of HIV infection among s&_requestid=26789] HIV transmission. [http://media.vms addicts who share dirty needles.” news.com/MonitoringReports/051908/87 Robert L. Sadoff, MD 9374/J001413365/] Charles P. O'Brien, MD, PhD was testified in May 2008 quoted in a June 17, 2008 Washington that a woman charged Daniel D. Langleben, MD spoke on Post article discussing new guidelines with helping plot an St. Louis radio station KMOX's "Reali- for "Helping Patients Who Drink Too elaborate bank robbery ty Check" show and discussed new Much” proposed by the National ending with the death brain imaging technology that may be Institute on Alcohol Abuse and Alco- of a pizza deliveryman able to tell when someone is lying, holism. Dr. O’Brien said that “most "absolutely" has bipolar disorder. A although it may not be ready for use doctors don't know how to make the federal judge subsequently ruled that in uncontrolled or incomparable set- diagnosis [of alcoholism] and don't Marjorie Diehl-Armstrong was not tings (i.e., court cases). [http://www. really try to do anything about it until mentally competent to stand trial. Dr. kmox.com/topic/play_window.php?audi it is so easy to diagnose that all you oType=Episode&audioId=2951492&topic= Sadoff had known the Erie, Pennsyl- have to do is glance at the patient.” true] In a September 28, 2008 Cleveland vania woman since the 1980s and said [http://www.washingtonpost.com/wp- she has had the condition for a num- Plain Dealer article, he discussed the dyn/content/article/2008/06/13/AR2008 ber of years. [http://www.goerie.com/ potential for the utilization of fMRI 061303173.html?sid=ST2008061601500] scanners in lie detection. [http://blog. apps/pbcs.dll/article?AID=/20080522/NE cleveland.com/medical/2008/09/can_mri John P. O’Reardon, MD spoke with WS02/805220420/0/news30] The story _scanner_be_a_liedetect.html] WHYY and discussed how TMS (tran- was reported nationally by the Associated scranial magnetic stimulation) deliv- Press, The New York Times, and The Wash- Caryn Lerman, PhD was ers pulses to the brain to activate ington Post, among other outlets. on WHYY-FM on June 11, circuits that are not functioning prop- 2008 discussing her latest Mark S. Salzer, PhD was interviewed erly in people with certain mood dis- research which helps in November 2008 by Taunya English orders, including depression. Penn reveal why it is easier for of WHYY radio for a segment titled researchers are investigating this tech- some people to quit “Mental Disability and Voting nique, along with other techniques smoking than others. Dr. Lerman and Access.” Dr. Salzer spoke about the including DBS and VNS. [http://www. colleagues discovered how to identify difficulties and barriers that citizens whyy.org/news/healthsciencepages/_aud with serious mental illnesses face in several novel gene variants that pro- io_files/sci20080626depression.mp3] Dr. voting. [http://whyy.org/blogs/ health- vide clues to the basic biology under- O’Reardon also appeared on WHYY's lying nicotine dependence and the science/2008/11/04/mental-disability- “Voices in the Family” program to and-voting-access/] ability to cease smoking. [http:// discuss the standard treatments for media.vmsnews.com/MonitoringReports/ depression, as well as cutting-edge David B. Sarwer, PhD contributed to 061308/873697/K001437895/] new methods. a discussion of bariatric surgery as a Helen Luu, MSW, social worker and treatment for obesity which appeared J. Russell Ramsay, PhD was quoted team leader of the Southeast Asian in Inside Magazine in the Fall of 2008. in a Philadelphia Inquirer article dis- Mental Health Program at the Hall- On June 30, 2008, he participated in a cussing the association between elite Mercer Community Mental Health Barimd.com webcast for professionals male gymnasts and childhood hyper- Center at Pennsylvania Hospital, was who work in the area of bariatric sur- activity. Dr. Ramsay notes "there are a quoted in the Philadelphia Inquirer on gery titled “Eating Behaviors Affect- lot of parents of children with this September 29, 2008 regarding gam- ing Bariatric Surgical Outcomes.” disorder who see gymnastics, or ath- bling addiction among the Asian letics in general, as a positive way to Albert J. Stunkard, MD was inter- community, in light of the city’s plan channel their child's attention.” viewed for an oral history, which to build a casino on the edge of Chi- Continued on page 22
PENN PSYCHIATRY PERSPECTIVE WINTER 2009 PAGE 22 PENN PSYCHIATRY PERSPECTIVE WINTER 2009
Continued on page 21 included his career in psychiatry, the evolution of the ing Mirapex and Requip, experienced dramatic changes Department of Psychiatry at Penn, and his work in obe- in behavior. Some developed gambling problems, sity. [Go to http://deimos3.apple.com/WebObjects/ heightened sexual interest or compulsive spending and Core.woa/Browse/isc.upenn.edu.1461110405 to listen to the eating habits where there had previously been no sign of interview] such disorders. [http://pqasb.pqarchiver.com/ chicagotri- Thomas A. Wadden, PhD commented in a May 20, bune/access/1509722771.html?dids=1509722771%3A150972277 1&FMT=ABS&FMTS=ABS%3AFT&type=current&date=Jul+14, 2008 Washington Post article about a boarding school for +2008&author=Robert+Mitchum&pub=Chicago+Tribune&editi overweight kids. [http://www. washingtonpost.com/wp- on=&startpage=1&desc=Drugs+calm+Parkinson%27s+ dyn/content/article/ 2008/05/16/AR2008051603581.html] but+ignite+odd+actions] Dr. Weintraub also spoke with Daniel Weintraub, MD was quoted in HealthDay/Washington Post for a June 25, 2008 article the Chicago Tribune on July 14, 2008 about this new study which was presented in June at the regarding a recent study which found Movement Disorder Society's 12th International Con- that more than 13 percent of patients tak- gress of Parkinson's Disease and Movement Disorders. [http://www.washingtonpost.com/wp-dyn/content/article ing a particular class of drug called dopamine agonists to treat Parkinson’s /2008/06/25/ AR2008062501802.html] disease, sold under brand names includ-
NEW FACULTY
angwon F. Kim, PhD joined the Department faculty in April 2008 as an Assistant SProfessor in the Tenure Track. He is a member of the Center for Neurobiology and Behavior and his laboratory is located in the Translational Research Laboratories (TRL). Dr. Kim’s laboratory is interested in cellular signaling cascades in the brain – the process in which an initial stimulus or signal at the cellular level is sequentially converted into other stimuli or signals through a series of “cascading” molecular events. Working at the fundamental level of science, Dr. Kim has honed in on two areas of study that ultimately may have a clinical impact. The first is oxidative stress-mediated neurodegeneration. Dr. Kim explains that “many neurodegenera- tive diseases are associated with iron accumulation, which will lead to the oxidative stress in the brain. We hope that we can provide new strategies for the treatment of patients with various neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease by studying brain iron homeostasis.” The second area of attention concerns nutrient sensing mechanisms in the hypothalamus. “We are interested in the fundamental mechanisms of nutrient sensing and appetite control,” says Dr. Kim. “Recently, we have been investigating the molecular mechanisms of the second generation antipsychotic drugs-mediated adverse meta- bolic effects such as obesity or diabetes. Our lab utilizes molecular, cellular, and biochemical techniques in tis- sue culture, primary neuronal cell and animal models to address these issues." A native of Korea, Dr. Kim received a BSc in Biophysics from Iowa State University in 1996 and earned a PhD in Experimental Medicine from McGill University in Montreal in 2001. His thesis earned recognition as the “Best PhD Thesis of the Year” at McGill. He trained for a year as a post-doctoral fellow in Dr. Prem Ponka’s laboratory in the Department of Physiology at McGill, and followed this with three and a half years of post- doctoral training with Dr. Solomon Snyder in the Department of Neuroscience at Johns Hopkins University. In April 2006, Dr. Kim was appointed a Research Associate at Johns Hopkins, where he received an NIH K99/R00 Pathway to Independence award to study the link between NMDA-mediated iron uptake and neurotoxicity. He transferred the grant to Penn when he arrived two years later. Dr. Kim eagerly anticipates working with his new colleagues at the University. He has joined the Mahoney Institute of Neurological Sciences and the Institute for Diabetes, Obesity and Metabolism as initial steps in developing new relationships on campus, and says that he is “very much looking forward to collaborating with many other researchers in the Department and at Penn.”
www.med.upenn.edu/psych PAGE 23 www.med.upenn.edu/psych
Cornerstones Recognizing the significant achievements of our faculty and staff
never thought that I was going actually sparked my interest,” Dr. State Psychiatric Institute/Columbia “Ito be a bench scientist when I Arnold recalls. “I wasn’t sure Presbyterian Medical Center in New was training,” says Steven E. Arnold, whether I wanted to specialize in York, where he received “outstand- MD, Professor of Psychiatry and neurology or psychiatry. I had done a ing” training in psychiatric diagnosis, Neurology and a psychotherapy, member of the and psychophar- Psychiatry macology. Department for FACULTY SPOTLIGHT almost two His psychiatry decades. “I residency led always thought I him back to would be doing some Steven E. Arnold, MD earlier ques- kind of clinical research. tions. “I still But then one question felt that the led to another, and the next thing neural systems approach to thinking you know you’re using biochemistry about the mind and the brain was and molecular neuropathology.” lacking, so I ended up in neurology, too,” Dr. Arnold says. He completed It’s been that way for Dr. Arnold a neurology residency at the Univer- throughout his career, one investiga- sity of Iowa Hospitals and Clinics tive path opening to the next. It has “where they had probably the best spurred him to develop expertise program in cognitive neurology in across the full research spectrum, the country at the time.” There he from clinical to basic to translational also completed fellowship training in research and back again. And it has Behavioral Neurology/Cognitive encouraged him to adopt multiple Neuroscience and was a post-doctor- scientific disciplines and methodolog- al associate in neuroanatomy. At ical approaches to further his study Iowa, his research career began to of the biological bases of severe psy- blossom, and he received the Iowa chiatric illnesses. Midwest Neurology Association Res- idents' Day Research Award for each It’s an eclectic perspective that began of his three years there. early in his education. rotation in behavioral neurology as a medical student, and that actually Following his training in 1990, Dr. Born in Worcester, Massachusetts, seemed to be exactly what I was Arnold returned east to accept an Dr. Arnold says that he had “been interested in, as it addressed the Assistant Professor position in Penn’s interested in becoming a physician as mind-body problem. At the time, Department of Psychiatry, with a sec- long as I can remember,” a goal stem- there was a lot of talk about personal- ondary appointment in the Depart- ming from his love of science and ity changes associated with temporal ment of Neurology. He was desire to help people. He completed lobe epilepsy, and that notion just promoted to Associate Professor in an accelerated combined BA/MD entranced me.” 1999 and to Professor in 2006. “I liked program at Boston University in the people here,” he says, “and Penn 1983, graduating with dual majors in Neurology would have to wait, offered the best opportunity to grow medical science and philosophy. though. “A lot of the other neurology and do the kind of integrative science There his interest in psychiatry and I was exposed to at the time was and medicine that I wanted to do.” neurology emerged, with a specific more of the knee-tapping variety – focus on the relationship between motor functioning and sensory func- Dr. Arnold’s commitment to research brain and behavior. tioning as opposed to mental func- has always been driven by his clinical tioning,” Dr. Arnold says, “so I went work. “Treating patients is very grati- “The mind-body problem in philoso- into psychiatry.” He completed a fying on an immediate basis,” he phy is a big one, and that is what psychiatry residency at the New York says, “but when you’re fascinated by Continued on page 24
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Continued from page 23 the problems that people are experiencing, you get intel- Dr. Arnold’s laboratory is also exploring the relation- lectually curious. The only way to really satisfy that is ship of psychological distress to risk for dementia in through asking questions and seeking answers, and studies of Alzheimer’s disease, other dementias, schizo- that’s what research is.” phrenia, and healthy aging. “I’ve been very interested in aging and the cognitive and emotional changes that “I didn’t have PhD training,” Dr. Arnold notes, “but I occur with aging, and started to do more laboratory learned to define the question, and the scientific research in aging,” he says. approaches and technologies required to best answer that question. Luckily, Penn has such a depth and “I am working closely with collaborators in Chicago breadth of expertise and a remarkable degree of collabo- who direct a large longitudinal study of aging and cog- ration from scientist to scientist. There has always been nition in older people who have agreed to brain dona- the opportunity to learn new methodologies and tech- tion after they die,” Dr. Arnold says. “We have been niques from people such as John Trojanowski [MD, examining the relationships of psychological distress to PhD], Virginia Lee [PhD], James Eberwine neuropathological [PhD], and Irwin Lucki [PhD] – real pio- changes in brain tissue. neers of basic science approaches.” This is a major avenue of research for us now – to Dr. Arnold credits these and other Penn “I never thought that I was going to understand how both the faculty with major influences on his work. be a bench scientist when I was biology and phenome- “When I came to Penn as a junior faculty training. I always thought I would be nology of stress increases member,” he remembers, “I had wonderful a person’s risk for doing some kind of clinical research. mentoring from two people – Raquel Gur Alzheimer’s disease or [MD, PhD] and John Trojanowski. With But then one question led to another, their thinking difficulties Raquel, I saw the importance of integrating and the next thing you know you’re in later life.” The specific phenomenological, neuropsychological, using biochemistry and molecular focus is on how aging and diverse neuroimaging methods to and stress cause the understanding brain and behavior in com- neuropathology.” degeneration of synaps- plex psychiatric illnesses like schizophre- es, by looking at synaptic nia. With John, I developed an appreciation apoptosis in animal for the power of molecular neuroscience models, as well as in and neuropathology, and how that can be human brain tissue. applied in psychiatric illness.” Dr. Arnold also credits “And we are looking at that in patients too, using clini- former Department Chair Peter C. Whybrow, MD and cal research tools,” Dr. Arnold adds. Biomarker studies current Chair Dwight L. Evans, MD for strongly sup- are planned to look at how chronic psychological dis- porting his career at Penn. tress makes people vulnerable to cognitive decline.
Dr. Arnold’s two principal scientific mentors have been Dr. Arnold’s time with patients, about a day a week, instrumental in determining his research areas – Dr. Gur helps shape his research. “Over the last few years, I’ve in schizophrenia and Dr. Trojanowski in aging and neu- wanted to take some of the ideas that have been devel- rodegenerative dementias. His use of human post- oping in the laboratory and apply them in clinical popu- mortem tissues and mouse models of neurobehavioral lations,” he says. “That was my motivation to expand dysfunction in his studies has greatly benefited from from the laboratory to assume the Directorship of the their insights, and those of others. Geriatric Psychiatry Section and later the Directorship of the Penn Memory Center, an interdisciplinary center for Currently, Dr. Arnold is emphasizing two main lines of aging, cognition and Alzheimer’s disease research and investigation. “We have a major effort to understand clinical care.” Dr. Arnold is also Associate Director of how the gene dysbindin works in schizophrenia,” he the Institute on Aging, Associate Director of the explains. “We are looking at its protein in post-mortem Alzheimer's Disease Center (ADC), and leader of the brain tissue from people with schizophrenia who have ADC Clinical Core. While he wears these various hats, died, as well as in mice who have mutations of the dys- he continues to direct the Cellular and Molecular Neu- bindin gene. We are also looking at other candidate pro- ropathology Program in the Department of Psychiatry, teins.” Dr. Arnold’s work in the schizophrenia field has providing the basic science foundation for his work. produced a number of research contributions, including These positions have given him the opportunity and studies of neural architecture in schizophrenia and the resources to apply some of the ideas growing in the lab- discovery that dysbindin protein is abnormal in schizo- oratory to clinical populations. It’s the very epitome of phrenia. translational medicine. Continued on page 25
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Continued from page 24 Dr. Arnold also devotes time to teaching. He directed the School of Medicine’s Clinical Neuroscience Track for seven years and lectures and conducts seminars at the University, School of Medicine, and School of Nursing. “We have undergraduate students, graduate students, fellows, and residents whom we teach in the lab, as well as in the Penn Memory Center,” he says. “Why teach? I like it. It’s nice to work with people who are interested in the same things you are. It makes the job much more stimulating.”
Dr. Arnold’s work has impacted that of others at Penn. “I think it has helped guide some of the direction of Dr. Gur’s Schizophrenia Research Center and her Conte Center in Schizophrenia,” he says. “I hope it has helped to prompt and stimulate the interest of faculty in other departments and divisions such as Pathology and Laboratory Medicine, Geri- atric Medicine, and Neurology in complex mental and emotional behaviors,” he adds.
Outside of his busy work schedule, Dr. Arnold likes to spend time with his four sons and wife. “I like to cook and, hopefully, not bother my family too much with my grant writing,” he says. Does he have any culinary specialties? “No special cuisines,” he says, “but I like to do gourmet cooking and brew beer, when I have the time.”
Dr. Arnold has been honored with several research awards from NARSAD, a leading charity dedicated to mental health research. He has also received the Theodore & Vada Stanley Foundation Research Award, the New York State Psychiatric Institute Centennial Award – Alumnus of the Decade 1980-1989, and the Alzheimer’s Association T.L.L. Temple Foundation Discovery Award.
“I started off more clinically oriented,” Dr. Arnold observes, “and then I began to appreciate where my work was leading me, and I go into the lab, and then you want to start applying what you’ve learned, and you go back into clinical. So there’s now a nice mix of both clinical and basic research in my career.” It’s been a successful blend, one likely to mold his future scientific journey. If the past is any guide, we can be sure that Dr. Arnold will follow wher- ever his curiosity and imagination take him.
Department of Psychiatry Annual Family Picnic
July 12, 2008
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he brain is the source of who ment to the OB-GYN service for a medical residency helped him realize “Tand what we are,” says Peter year, he was asked to organize Sandia that suggestions given by the physi- B. Bloom, MD, Clinical Professor of Base Hospital's outpatient clinic which cian within the doctor-patient rela- Psychiatry at Penn. It is the trigger served 10,000 patients each month. tionship could be powerful. In one for the incredibly complex interactions He established two guidelines: every episode, a patient expressed to him that link mind and body. patient who called would be seen the his fear of impending death during imminent open- Focus on this intri- heart surgery, cate nexus is in fash- using the ion today, but VOLUNTARY FACULTY PROFILE metaphor of almost from the being beginning it has enclosed by occupied the core of Peter B. Bloom, MD a fence. Dr. Dr. Bloom’s intellectual Bloom coun- journey as a physician and tered that psychiatrist. the surgery would “put a gate in that Born in Philadelphia, Dr. Bloom first fence,” permitting his escape. Post- showed interest in medicine in high operatively, the patient credited the school in suburban Swarthmore, his conception of the “gate” with helping lifelong home base. “It was an evolv- him handle the surgery. “I thought,” ing sense that because I liked science says Dr. Bloom, "wow, what can and people, it was a career that would images do to create security and com- be very satisfying,” he remembers. fort in our patients and how do they His fascination was encouraged by his change one's thinking, feeling, and weekend visits to the laboratory of behavior?” It is fascinating to him Samuel Gurin, PhD, father of a high today that current fMRI studies illus- school friend and a Penn Professor of trate the physiological changes in the Biological Chemistry who later served brain's blood flow consequent to sug- as Dean of the medical school. gestions especially under hypnosis. Dr. Bloom went on to earn a BA in As a practicing psychiatrist, Dr. Bloom Chemistry from Cornell University in greatly values his medical training. 1958, and next attended medical He remembers the admonition of Chairman of Medicine James Wyn- school at Penn, where his interest in same day by a physician and patients gaarden, MD, who intersected with the brain, mind, and body first blos- were never asked to solve the admin- Dr. Bloom briefly during his medical somed. “Francis Wood, MD was my istrative problems incumbent with training at Penn. Wyngaarden Chief of Medicine and he exemplified their visits. With several changes in advised him as he began psychiatric treating the whole patient,” Dr. Bloom the infrastructure of the clinic, it training not to forget that "all thought says. “My own abilities and interest worked very smoothly and no one is laid down in lipid." “I never forgot in the psychological side of things stayed after hours. began to ripen in my senior year of his emphasis on the biological side of medical school and throughout my After his military service, he complet- who we are,” Dr. Bloom says. “It rotating internship at the Hospital of ed his medical residency and gas- complemented the psychological side the University of Pennsylvania (HUP), troenterology fellowship at HUP. “I to which I was already devoted. really liked internal medicine and which began in 1962.” Dr. Bloom began his psychiatry resi- psychiatry,” Dr. Bloom recalls, “but dency at Penn, completed it at the Before devoting full attention to nour- after my GI fellowship, which Institute of Pennsylvania Hospital in ishing that interest, however, he involved so many patients psycholog- 1971, and immediately started a pri- entered an internal medicine residen- ically presenting as medical illnesses, I vate practice at the Institute. When cy at HUP in 1963. "I loved medicine finally decided to become a psychia- the Institute closed in 1997, he contin- and didn't feel I was finished becom- trist and to emphasize what I thought ued his hospital affiliation at Pennsyl- ing a physician,” he recalls. was my best contribution to patient vania Hospital and shifted his private care.” Dr. Bloom’s medical residency was practice to his Bryn Mawr office. He interrupted by two years in the U.S. Dr. Bloom’s path to psychiatry includ- preceptored and taught at Penn Navy Medical Corps. He served in ed his hypnosis training sponsored by throughout his career earning pro- Albuquerque, New Mexico on a joint Penn's Graduate School of Medicine. gressively higher faculty positions in service military base. After assign- Several patient experiences during his Penn’s Department of Psychiatry, Continued on page 27
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Continued from page 26 becoming Clinical Professor of Psy- “collegial relationship,” even a posi- happening; I just have to trust the chiatry in 1992. tion of equality. process." Dr. Bloom’s practice of psychiatry is A dramatic example of this equality is To some extent, creativity can be broadly based. He remembers using found in Dr. Bloom’s published case enhanced through training. “You lis- lithium carbonate in clinical trials at history of a 12-year-old girl suffering ten for it very carefully [with the Institute, and currently uses med- from a conversion disorder causing trainees], and when you hear it, you ications throughout his practice. He paralysis of her entire body (1). underline it,” he emphasizes. “That’s emphasizes accurate diagnosis and Using both hypnosis and conscious so critical. I point it out. I encourage treatment planning for his patients. suggestion, Dr. Bloom helped her it, and then we spend a lot of time He has taught these principles to psy- recover completely from her paraly- talking about the context. How did chiatrists taking their certifying exam- sis. “She was creative and preco- the patient receive this? How do you inations and to Penn residents today. cious,” he recalls. “We were equal understand it? How do you bring Dr. Bloom works with patients with partners in her care, and both of us creative moments into the office? mood disorders, chronic pain, and contributed These moments can those who are stumbling in achieving the interven- “All therapy can change the way come from the desired goals in careers, families, tions that we the brain works,” Dr. Bloom says. patient. They can marriage, and their own individual used. What- “The advances in neuroscience are come from the thera- lives. He chooses his treatment ever age your clearly revolutionary in showing the pist.” For Dr. Bloom, modality based on the needs of his patient is, you brain’s plasticity and giving an idea it is important for patient at any given time and that need to find on how our psychotherapies affect each resident to learn may include elements of interpersonal out what their our very physiology. Who knows as many kinds of psychotherapy, behavioral interven- resources are when and how we will use future psychotherapy as tions, and psychodynamic psy- and find a technology in discovering how possible so that ther- chotherapy. way to res- authentic, empathic, and resonating apy does not become onate with interactions with our patients result ritualized or wedded Of special interest is his occasional them at that in growth and maturity. Won't that to one or two theo- use of medical hypnosis for which he age.” be the day!" ries. Most impor- has gained international prominence. tantly, residents Dr. Bloom comments that "hypnosis Central to the must find their own is a useful adjunct to nearly all psy- psychiatrist’s craft is creativity, a voices as therapists. Identifying their chotherapies." theme Dr. Bloom explores in his writ- own creative moments with patients ing (2). He states that "creativity is “While hypnosis is only one ‘arrow’ in is the best way to do that. the willingness of the therapist or my therapeutic quiver,” he insists, "its patient to experience something new “All therapy can change the way the attraction to me was its unique ability and unexpected in the treatment brain works,” Dr. Bloom says, from to treat the mind-body interface. process. When it happens - an idea, pharmacotherapy to various forms of Major surgery without anesthesia is an image, or humorous comment - it psychotherapy to hypnosis. “The an example of the use of surgical hyp- usually is not a part of an established advances in neuroscience are clearly nosis, which challenges our thinking theory of therapy or a technique the revolutionary in showing the brain’s on how complex the mind-body inter- therapist has used before. Most often, plasticity and giving an idea on how face can be. In addition, hypnosis it springs out of the therapeutic rela- our psychotherapies affect our very helps people get into a creative mode tionship and the interactions sur- physiology (3). Who knows when or ‘zone’ enabling them to accomplish rounding the issue for which the and how we will use future technolo- difficult goals in therapy, the arts, and patient is seeking care.” gy in discovering how authentic, sports." He believes every clinician empathic, and resonating interactions should use it more often. "Sometimes hypnosis facilitates this with our patients result in growth process,” Dr. Bloom notes, “but In describing his work, Dr. Bloom and maturity. Won't that be the day!" almost always these are mutative notes that success in healing is not up In the meantime, he observes that "the experiences in the patient's growth.” to the therapist alone. “It is clearly an art of therapy may always be the “These moments," he underscores, interaction between therapist and fusion of scientific understanding and “are not coming out of nowhere and patient,” he says. “Sometimes I have intuitive insight. Ultimately, it is a we are not 'winging it'. They originate to take charge, and sometimes the human endeavor in the setting of in the context of a full amount of patient takes charge and tells me meaningful relationships." training, a thorough understanding of what we’re going to do.” The thera- the patient's history, and acceptance Dr. Bloom enjoys teaching medical pist must be flexible and willing to by the patient. Like all art, it cannot students, residents, and fellows at learn from the patient when the situa- be forced or called upon at will." He Penn. For eighteen years, he directed tion presents itself, and to establish a says, “I don’t worry when it’s not the continuing medical education pro- Continued on page 29
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ooking back on almost twenty- nity to serve as a liaison with com- education by earning an MBA from Lfive years in nursing, Michelle E. munity agencies, landlords, local Rosemont College in May 2005. Conley, RN, BSN, MBA says that she businesses, and care providers, to Ms. Conley has forged a career of “can’t imagine doing anything else.” develop and facilitate therapeutic progressively higher levels of educa- But it wasn’t always that way. groups and health maintenance pro- tion, training, and levels of A native Philadelphi- responsibility. As with her an and now Clinical initial decision to enter Director of Women’s EMPLOYEE SNAPSHOT nursing, she didn’t design Health Servic- es and Michelle E. Conley, RN, BSN, MBA Psychi- atry at Pennsylvania Hospital, Ms. Conley her career that way. “It has certainly says that she “went to nursing school not been planned,” she says. “I right out of high school because I believe the trajectory of my career didn’t really know what I was inter- can be directly attributed to not plan- ested in.” That soon changed at the ning. If you had asked me five years Frankford Hospital School of Nurs- ago to plan where I would be now, I ing, where she became enamored couldn’t have even imagined it, let with nursing in general, and psychi- alone planned to attain it. I believe atric nursing in particular. you need to be open to all things and in doing so opportunities will present “When I was in school, I thought I themselves. It may sound foolish but wanted to be an operating room it has worked for me for the last 24 nurse,” she recalls, “but when I did years.” my psychiatry rotation my junior year, I was fascinated and hooked Initiating positive changes in her ever since.” In May 1984, she career and responding proactively to received her RN diploma, and the changes she could not control, such same month earned her Associates grams with clients, and to conduct as the closing of The Institute of Degree in Arts, Letters and Sciences psychoeducation programs with Pennsylvania Hospital and Penn’s from Pennsylvania State University. clients and families. acquisition of Pennsylvania Hospital in 1997, have been hallmarks of Ms. That summer she was hired as a Staff The position tested and strengthened Conley’s career, and make her an Nurse in Inpatient Psychiatry at her administrative and leadership ideal person to advise others. “Times Friends Hospital in Philadelphia, her abilities, but it lasted less than two of change afford us innumerable first nursing position. years because The Institute of Penn- opportunities,” she says, “and we all sylvania Hospital closed in 1997. Ms. After six years at Friends Hospital, can control how we deal with and Conley joined Pennsylvania Hospital Ms. Conley moved to The Institute of manage change. If you view change as a Staff Nurse in Acute Inpatient Pennsylvania Hospital, a psychiatric in terms of the possibilities, it feels Psychiatry immediately following. facility affiliated with Pennsylvania different.” Hospital. There she achieved a series After a year, she returned to school of positions with increasing levels of while working as the Nursing Direc- It’s an attitude that serves her well in responsibility, first as a Staff Nurse in tor of the Crisis Response Center and her current position as Clinical Direc- the Brief Intensive Treatment Pro- Inpatient Psychiatric unit to pursue a tor. Ms. Conley oversees inpatient gram, then Assistant Nursing Direc- BS in Nursing degree from Thomas psychiatry and the Crisis Response tor of the Dissociative Disorders Jefferson University, which she Center and supervises seven nurse Program as well as Assistant Nursing earned in 2000. She worked in that managers and all nurse practitioners Director of the Brief Intensive Treat- capacity until 2004 when she accept- and physician assistants at Pennsyl- ment Program. ed a position as the Nursing Director vania Hospital. She also oversees all of the Labor & Delivery/Perinatal of the operations in women’s health Ms. Conley’s last position at The Evaluation and Treatment services at Pennsylvania Hospital, Institute was as Program Director of Unit/Antepartum Unit/Birthing including the Labor & Delivery Unit, the Kirkbride Apartment Program. Suite. In April 2005 she attained her Perinatal Evaluation and Treatment In this role, she was responsible for current position as Clinical Director Unit, Antepartum Unit, Postpartum all clinical, operational, and fiscal of Women’s Health Services and Psy- Units, Intensive Care Nursery, Fami- aspects of a 12-bed community-based chiatry. Along the way, Ms. Conley ly Education, Solutions for Women program. She also had the opportu- supplemented her formal nursing Boutique, and Lactation Services. Continued on page 29 www.med.upenn.edu/psych PAGE 29 www.med.upenn.edu/psych
Continued from page 28 Recently, Ms. Conley capitalized on her ability to accept career mostly involve people. “The clinicians and patients and manage change by playing an integral role in the relo- throughout the years,” she says, “have taught me more cation of the inpatient psychiatric unit from the Hospital than any formal schooling ever could. I have been afford- of the University of Pennsylvania to Pennsylvania Hospi- ed an opportunity to work with some incredible people tal. Thinking about it, she says that “it has been a tremen- and I cannot thank them enough for all the wisdom they dous amount of work and effort, but also a tremendous have generously shared with me throughout the years.” opportunity to move inpatient psychiatry at Pennsylvania Outside of work, Ms. Conley spends time with her partner Hospital to new levels of visibility and accomplishment.” of eleven years and their two children, seven-year-old Over the course of her career, Ms. Conley cites “looking Tommy and six-year old Grace. But when she comes to for and appealing to what is best in people” as among the work at Pennsylvania Hospital, it’s all about nursing. “I traits she considers most important. “Success and a sense love nursing and I really respect and appreciate nurses,” of accomplishment is less about intellect and more about she says emphatically. “I believe nurses are the backbone diligence, humility, integrity, respect for others, and a of hospital care. It is the nurse who spends the most time willingness to fail and try again,” she emphasizes. “We with patients and has the opportunity to bring so much to are all replaceable, but that does not mean you cannot the experience of being in a hospital. Aside from the obvi- bring true meaningfulness to everything you do and every ous technical care needed, nurses are usually the care- interaction you have no matter how mundane. You can givers who are able to tap into the more subtle or have fun and still get the job done well.” humanistic needs of patients. That really appeals to me and my interests.” Not surprising, Ms. Conley’s special memories of her
VOLUNTARY FACULTY PROFILE –PETER B. BLOOM, MD Continued from page 27
gram for the Department of Psychia- President of the American Board of “Finally, my greatest achievement is try in collaboration with the Institute Medical Hypnosis, and is a member my marriage and family. In 2008, of Pennsylvania Hospital. Today, he of other boards and societies in the Marcia and I celebrated our 50th gains more satisfaction from individ- field, both here and abroad. He has anniversary with our children and ual instruction. “I think being a received many honors over the years, grandchildren." mentor is the most fun, and I am among them the 2001 ISH Pierre Summing up over a half century in deeply grateful to those who men- Janet Award for Clinical Excellence, medicine and psychiatry, Dr. Bloom tored me,” he says. “With each 2004 ISH Benjamin Franklin Gold puts it simply, “As a psychiatrist, I decade, I have more experience and Medal, and the 2007 Presidential feel I have chosen a most exciting possibly wisdom to impart. It is Award from the American Society of career and, on looking back and into enjoyable to be with so many talent- Clinical Hypnosis. In June 2008, he the future, I feel fortunate indeed.” ed and outstanding doctors in the received the Annual Award for Clin- Myriad colleagues, friends, and stu- making.” ical Faculty from the Department of dents whose lives and careers he has Psychiatry, in part for having Dr. Bloom has been affiliated with impacted over the years would no “served as an outstanding role model Penn for most of the last 50 years. doubt convey their own good for- for a generation of students and col- “Penn has provided a rich context tune at knowing him. leagues.” and a supporting environment for me to explore my interests in teach- Outside of his professional interests, ing, and in therapy,” he says. “Each Dr. Bloom says, "I love music and (1) Bloom, P. B. Treating adolescent conversion Chairman has been a good friend still sing with the twelve-man acapel- disorders: Are hypnotic techniques reusable? Clinical Forum. Int J Clin and Exp Hypnosis, 49 and has offered great encourage- la group we founded at Cornell in (3), 243-265, 2001. ment. I have traveled proudly wav- 1956." Another interest stems from ing Penn's flag around the world as I his involvement with a “woodsy” (2) Bloom, P.B. The creative process of hyp- notherapy. Chapter 13 in D.P. Brown & M.L. have lectured extensively over many camp for boys as a child and teenag- Fass (Eds.), Creative mastery: A festschrift for Erika years.” er. "It was there I learned to love Fromm. Hillsdale, N.J.: Lawrence Erlbaum Asso- camping and canoeing, heading the ciates Inc., 159-168, 1990. Outside of Penn, Dr. Bloom is a Dis- canoeing department during my col- tinguished Life Fellow of the Ameri- (3) Bloom, P.B. Recent advances in neuroscience lege summers. I still love canoeing relevant to clinical hypnosis: A clinician's per- can Psychiatric Association. He has and now enjoy teaching the skills to spective. Hypnos (Sweden). 32 (1), 17-24. 2005. served as President of the Interna- my granddaughters,” he says. tional Society of Hypnosis (ISH) and
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Educational Highlights CORNER
’ he new 2008-2009
S Tacademic year has already proven to be an T exciting year for the
N Department of Psychiatry Residency Program. We E have experienced multi-
D ple structural changes
I that presented new
S opportunities for expan- by Chief Residents (left to right):
E sion of our inpatient and Melissa Y. De Jesus, MD; Donald N. Tavakoli, MD; outpatient clinical and
R K. Ryan Connolly, MS, MD; Benjamin G. Pumphrey, MD educational experiences. The inpatient services have welcomed the new class of Mental Health Report, Individual Inpatient Psychother- 2012, who have been showing fine clinical skills and apy, Professionalism, Chief Process Group, Evidence- academic ambition in the finest tradition of the Univer- Based Psychiatry, Practical Psychopharmacology, sity of Pennsylvania. As the class of 2011 continues to Psychiatry in Context, and Inpatient Interviewing. We develop, they have welcomed two new additions to plan to add several more, including Family Assessment their already strong class, Nancy Warden, MD from didactics. the University of California, Davis, and Karla Cam- panella, MD from Penn State. David Danish, MD has This year a new chief resident role was created to fur- begun a research project with the psychosomatic medi- ther promote the educational goals within the residen- cine faculty on the management of delirium. Holly cy and medical school. Melissa De Jesus, MD, Chief Valerio, MD will be spending elective time obtaining Resident for Medical Student Education, and Benoit training in the treatment of eating disorders, and Dubé, MD, Associate Director for Medical Student Rebecca Aspden, MD will be training at Devereux Education in Psychiatry, provide clinical teaching skills Community Services to deepen her child psychiatry to residents as they are developing into better educa- experience. Christopher Tjoa, MD, Donovan Maust, tors on their inpatient psychiatry rotation through their MD, and Andrea Bowen, MD continue to devote time “Teach the Teacher” didactics. This is an exciting to independent research in the Clinical Research Schol- process as residents balance their own dual roles as ars Program. Finally, Ryan Connolly, MD is develop- teachers of junior residents and medical students and ing a new combined psychiatry-neurology conference further develop their own teaching styles. Dr. De Jesus series. also has the opportunity to work with each student from the first day of the rotation (orientation, introduc- One of the biggest changes of the year was the move of tory didactics) until the last day of the rotation (obser- our inpatient psychiatry unit from Founders 11 at HUP vation and clinical assessment of the final patient to its new home on the 6th floor of the Spruce Building interview and write-up) and strongly believes that this at Pennsylvania Hospital. In addition to having more helps to reinforce the Department’s dedication to edu- clinical space, we also now have space for didactics of cation. all kinds. 6 Spruce has already become a busy inpatient unit, serving patients with mood disorders, geriatric Outpatient rotations continue in general and special- patients, and “med/psych” patients. With the move, ized psychopharmacology clinics, and the Resident the residency program took the opportunity to greatly Psychotherapy Practice flourishes with training in cog- expand the didactics offered on the unit. Ben nitive, behavioral, psychodynamic, group, and couples Pumphrey, MD organized many new didactic pro- psychotherapy. With increased elective time, senior grams to broaden residents’ exposure to various residents also pursue their areas of interest. Examples important topics in psychiatry. These mostly resident- include Dr. Karen Berlin’s participation in the Oncolo- led didactics include: Med-Psych Report, Women’s gy Clinic at Pennsylvania Hospital and Dr. Regina
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Szucs’ pursuit of substance abuse research at the Treat- Stress Disorder (PTSD) and Exposure/Ritual Preven- ment Research Center. Dr. Connolly and Samar Jasser, tion for Obsessive Compulsive Disorder (OCD). MD participate in Comprehensive Consultation Service cases with the Mood Disorders faculty. Donald All of this has occurred before the end of the summer! Tavakoli, MD organized a specialty clinic in the We do feel a sense of momentum in the residency and Department of Dermatology providing consultation for are excited to see what the rest of the year holds. Of psychocutaneous diseases. Jenny Kim, MD is working course, none of these achievements would have been with Anthony Rostain, MD seeing patients with adult possible without the optimism and energy of everyone developmental disorders, and Sarah Mathews, MD in the Department. We (the four chiefs) would like to spends time at the college counseling service at Penn. thank everyone involved for their contributions and In addition, a number of residents will attend training support. conferences in Prolonged Exposure for Post-Traumatic
INTRODUCING THE RESIDENT CLASS OF 2012
he Department of Psychiatry welcomes the class of 2012 (pictured below) to the residency- Ttraining program. The current class of interns in psychiatry was chosen from 619 applicants of whom 74 were actually ranked. These 10 individuals are extremely talented young doctors who were at the top of their medical school classes and who demonstrated a strong commitment to the field, as well as great leadership potential. They have shown themselves to be very fine house offi- cers, eager to learn and dedicated to providing outstanding clinical care to their patients. This year's recruitment efforts began on September 1st and will continue until January 31, 2009.
Front Row, from left to right: Abraham Pachikara, MD (University of Pennsylvania) Michelle Moyer, MD (University of Pittsburgh) Laurie Gray, MD (University of Pennsylvania) Mario Cristancho, MD (Universidad Industrial de Santander)
Back Row, from left to right: John Northrop, MD, PhD (University of Pennsylvania) Rachel Bennett, MD (Drexel University) Bianca Previdi, MD (Jefferson Medical College) Mia Evertt, MD (Harvard Medical School) Adam Meadows, MD (Washington University)
Inset: Eleanor Ainslie, MD (Jefferson Medical College)
PENN PSYCHIATRY PERSPECTIVE WINTER 2009 Non-Profit Org. U.S. Postage PAID Permit No. 2563 Department of Psychiatry Phil., PA 19104 Office of the Chairman 3 Blockley Hall 423 Guardian Drive Philadelphia, PA 19104-6021 Telephone: (215) 662-2818 Fax: (215) 662-6911 URL: www.med.upenn.edu/psych
PENN PSYCHIATRY PERSPECTIVE URL: www.med.upenn.edu/psych/newsletter Editor: Rosellen Taraborrelli Telephone: (215) 662-2899 E-mail: [email protected] To make a gift to the Department of Psychiatry, please contact: Co-Editor: Paul Mischler Abigail Mason Woodworth PENN Medicine Development & Alumni Affairs Telephone: (215) 898-0602 3535 Market Street, Suite 750 Philadelphia, PA 19104-3309 E-mail: [email protected] Telephone: (215) 898-0578 Writing and Design: Email: [email protected] Williams-Campbell Administrative Services, LLC URL: www.med.upenn.edu/psych/support