Psychiatry Adult Psychiatry | Child & Adolescent Psychiatry 2017 YEAR IN REVIEW 162,955 836 99 NYU LANGONE HEALTH OUTPATIENT VISITS FACULTY RESIDENTS 550 First Avenue, New York, NY 10016 IN 2017 MEMBERS & FELLOWS NYULANGONE.ORG Contents 1 MESSAGE FROM THE CHAIRS 2 FACTS & FIGURES 4 2017 IN BRIEF 10 2017 IN DEPTH 11 Autism 13 Behavior Disorders 15 Childhood Trauma 17 Post-Traumatic Stress Disorder 19 Complex Case 21 Schizophrenia 23 Telepsychiatry 24 ACADEMIC ACTIVITIES 27 LEADERSHIP Produced by: Office of Communications and Marketing, NYU Langone Health Writer: Kenneth Miller Design: Ideas On Purpose, www.ideasonpurpose.com Primary Photographer: Karsten Moran Printing: Allied Printing Services, Inc. On the cover: Brain cells MESSAGE FROM THE CHAIRS Dear Colleagues and Friends: CHARLES R. MARMAR, MD HELEN L. EGGER, MD NYU Langone Health’s Departments of Psychiatry and Child and Adolescent Psychiatry Lucius N. Littauer Professor Arnold Simon Professor of of Psychiatry Child and Adolescent Psychiatry share a heritage of innovation Chair, Department of Chair, Department of Child and and excellence that stretches Psychiatry Adolescent Psychiatry back to the beginning of modern Director, Cohen Veterans Director, Child Study Center psychiatric medicine more than Center a century ago. Today, we continue to build on that justice system and developing models services to underserved populations. heritage with trailblazing research, for such programs nationwide. We collaborate with local and global state-of-the-art care, and residency and In 2017, our researchers published policymakers, schools, social service specialty training programs that are landmark studies on the long-term agencies, and other academic and consistently ranked among the top in the effects of antipsychotic drugs and the community partners. We are one of only United States. biochemical links between sleep two U.S. academic medical centers with Our translational research brings disorders and Alzheimer’s disease. We a department dedicated to child and neuroimaging, genetics, population discovered previously undetected neural adolescent mental health. science, and digital health approaches commonalities in children with autism Our vision is a world in which families together to advance our understanding and those with ADHD and pioneered and communities everywhere have of the causes, course, and treatment of novel therapies for adult treatment- access to the knowledge and resources mental health and developmental resistant depression and PTSD-related they need to support the mental health of disorders from infancy to late adult life. alcohol abuse. To accelerate our pursuit all children and adults. Investigators are shedding new light on of such breakthroughs, we hired an array disorders of mood, attention, cognition, of outstanding faculty. addiction, and development. We are Improving access to care has always global leaders in the study of trauma, been central to our mission. We provide spearheading a consortium of research integrated, team-based treatment to centers in the hunt for biomarkers of patients with complex medical PTSD in combat veterans. Our experts in conditions and to patients facing child and adolescent psychiatry are challenges such as poverty, substance implementing trauma-informed care abuse, or homelessness. Our tele­ throughout the New York City juvenile psychiatry programs bring mental health Psychiatry 2017 | NYU Langone Health 1 FACTS & FIGURES Adult, Child & Adolescent Psychiatry PATIENT VOLUME EDUCATION RESEARCH & FUNDING 162,955 # 3 341 OUTPATIENT VISITS IN RESEARCH CONTRIBUTIONS SCIENTIFIC PUBLICATIONS ANNUALLY* from psychiatry residency graduates (last 12 years) $24.7 M 7,852 IN FY17 NIH GRANTS CONSULTATION-LIAISON CONSULTS* # 8 IN REPUTATION FOR QUALITY $28.9 M of clinical training in 1,569 psychiatry residency IN FY17 TOTAL RESEARCH FUNDING INPATIENT DISCHARGES* 15,628 PUBLIC PROGRAMS SCHOOL-BASED VISITS ANNUALLY 12,200 + COMMUNITY MEMBERS EDUCATED through Child Study Center workshops and webinars FACULTY, RESIDENTS & FELLOWS 836 ACCOLADES FACULTY MEMBERS** Birthplace High OF AMERICAN PSYCHIATRY Performing NYU School of Medicine is home to 99 two of the largest and most respected IN U.S. NEWS & WORLD REPORT’S departments of psychiatry and child “BEST HOSPITALS” RESIDENTS and adolescent psychiatry in the country & FELLOWS and is widely considered to be the “birthplace of American psychiatry.” Numbers represent FY17 (Sept 2016–Aug 2017) unless otherwise noted *Includes NYU Langone Hospital—Brooklyn **Includes voluntary faculty 2 NYU Langone Health | Psychiatry 2017 NYU Langone Health View of NYU Langone Health’s main Manhattan campus, including renderings of the new Science Building (left) and the Helen L. and Martin S. Kimmel Pavilion (right), both set to open in 2018. (Image credit: Ennead Architects) #19 #12 Leader IN THE NATION IN THE NATION IN QUALITY CARE AND and nationally ranked in 12 specialties: BEST MEDICAL SCHOOLS PATIENT SAFETY Rehabilitation, Orthopedics, FOR RESEARCH For the past four years, NYU Langone Rheumatology, Neurology & and a leader in innovation in has received top rankings for overall Neurosurgery, Geriatrics, Urology, medical education, including patient safety and quality of care Cardiology & Heart Surgery, accelerated pathways to from Vizient, Inc., formerly the Gastroenterology & GI Surgery, the MD degree University HealthSystem Consortium. Diabetes & Endocrinology, In 2017, NYU Langone received Pulmonology, Cancer, and Nephrology two significant awards from Vizient— the Bernard A. Birnbaum, MD, Quality Leadership Award and the Ambulatory Care Quality and Accountability Award for demonstrated 5 Star Rating excellence in delivering high-quality, patient-centered outpatient care. FROM CMS HOSPITAL COMPARE NYU Langone Health is the only full-service hospital in New York State and one of 9 percent of hospitals nationwide to receive a five-star rating from the Centers for Medicare and Medicaid Services (CMS). The rating reflects overall safety, quality, and patient experience. Psychiatry 2017 | NYU Langone Health 3 2017 IN BRIEF Transforming the Future of Psychiatric Medicine John Rotrosen, MD, and Joshua D. Lee, MD, MSc Study Compares Treatments to Address a National Epidemic In 2016, more than 64,000 Americans died of drug overdoses, prescribing restrictions, and community acceptance. the vast majority involving opioids. Interventions are critical, Antagonists cannot be started until patients are fully and medications are considered the most effective opioid opioid-free for at least several days without precipitation use disorder treatments. But there is a wide gap between those of withdrawal, an “induction hurdle” that limits use. who could benefit and those who are treated, and there is no The 24-week randomized, open-label trial followed comparative research on existing office-based therapies— 570 opioid-dependent adults assigned to sublingual the partial agonist buprenorphine and the antagonist buprenorphine or injectable extended-release naltrexone. naltrexone—and hence, controversy and misconceptions As expected, fewer patients assigned to naltrexone about best practices abound. To address this problem, were successfully inducted, many of them dropping out NYU Langone Health researchers John Rotrosen, MD, of detoxification before becoming opioid-free. For the professor of psychiatry, and Joshua D. Lee, MD, MSc, associate 474 participants who were able to initiate treatment, the professor of population health and medicine, led an eight- study found that the two medications were equally safe site National Institute on Drug Abuse–supported team in a and effective in preventing relapse. major study, published in The Lancet in November 2017. “Patients, families, and providers now have compelling Opioid agonist and antagonist approaches are and consistent data, from this and a smaller, concurrent pharmacologically and conceptually distinct: Agonists Norwegian trial, to inform complex treatment choices involving activate receptors, produce opioid effects, and maintain personal preferences, risks, and long-term outcomes,” says physical dependence; antagonists block receptors, prevent Dr. Rotrosen. “Future articles from this study will describe opioid effects, and eliminate dependence. These drugs also genetic and other predictors of outcome, costs, and differ in withdrawal symptoms, abuse and diversion risks, cost-effectiveness.” 4 NYU Langone Health | Psychiatry 2017 Researchers Update Adult ADHD Autism: Identifying Biomarkers Screening Scale to Meet New and Improving Inpatient Treatment DSM-5 Standard A new study from NYU Langone’s Child Study Center To align screening for adult attention deficit hyperactivity points to possible biomarkers that could lead to more disorder (ADHD) with expanded Diagnostic and Statistical precise diagnosis and treatment of autism spectrum Manual of Mental Disorders criteria, Lenard A. Adler, MD, disorder (ASD) and its common comorbidity attention professor of psychiatry and child and adolescent psychiatry deficit hyperactivity disorder. and director of the Adult ADHD Program at NYU Langone, The study, led by Adriana Di Martino, MD, has developed an updated electronic screening tool. Dr. Adler associate professor of child and adolescent psychiatry and Ronald C. Kessler, PhD, the McNeil Family Professor of and research director of the Autism Spectrum Health Care Policy at Harvard Medical School, created the Disorder Clinical and Research Program at the Child new, six-question scale