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FALL 2015

Chairman's Message

mark rapaport  
Mark Hyman Rapaport, MD

I want to wish all of you a very happy holiday season and a wonderful New Year. This issue of our newsletter highlights the tremendous breadth of our Department. One of our articles features the innovative new models of care that Ed Craighead PhD, our Vice Chair for Child, Adolescent, and Young Adult Psychiatry, and his team have developed to help children and adolescents with mood and anxiety disorders. We are particularly proud of this integrated clinical, research, and training. This program typifies what Emory does best: it employs research-informed treatment to provide patients with the best possible care while continuing to gather data about how to refine these interventions and rigorously trains the next generation of mental health professionals in leading edge care. Our second feature article will introduce the reader to a true triple threat, Bekh Bradley PhD. Bekh is not only Chief of our Mental Health Service Line at the Atlanta VA but also a Vice Chair in our Department. He is one of the up and coming leaders in the field of research in the areas of the biology of trauma and PTSD. Yet, Bekh finds time away from his very heavy administrative and research roles to still both see veteran patients and be a wonderful and mentor to our trainees. Our VA affiliate is a large and very important component of our Department and Bekh is leading efforts to facilitate greater integration between the VA and Emory based programs such as the Emory Veteran's Program funded by the Wounded Warrior Foundation. In this issue we also introduce the reader to exciting research studying the role of social hierarchy stress on obesity and immune function being performed by Mark Wilson PhD and other faculty at the Yerkes Primate Field station. And to top off this issue we briefly describe the innovative studies that Ebrahim Haroon MD is doing looking at the brain changes that occur in older individuals with depression and inflammation.

We were excited to collaborate with the Alliance Theater in the month of September during their production of "One Flew Over's the Cuckoo's Nest". Our faculty and staff provided talk backs after most performances, consulted with the cast and provided information about our department at a table in the lobby.

I also want to publicly thank Mark and Barbara Klein for their donation that led to the first "Mark and Barbara Klein Mind-Body Conference". This consensus conference brought together international and local experts from psychiatry, neurology, education, patient care, health administration, anthropology, sociology, bioethics, patient support groups, and basic neuroscience to discuss the nosology, assessment, research and treatment for functional epilepsy and movement disorders. This groundbreaking conference will result in a series of publications and will lay the ground work for a larger international conference to be held next year.


Bradley Spearheads Mental Health Care at the VA

nadine kaslow
 

It's been about a year since Bekh Bradley, PhD, was officially named chief of the mental health service line at the Veterans Administration Medical Center (VA) in Atlanta. But the associate professor of Psychiatry and Behavioral Sciences is no newcomer to either the VA or Emory. An Atlanta native, Bradley completed his education and training in the northeast and South Carolina before returning to Atlanta in 2002. His current role includes research through the Grady Trauma Project and the VA, clinical supervision of trainees and licensed clinicians, direct clinical care, and administrative duties at the VA.

"My primary overarching goal each day at the VA is to provide good quality mental health care to veterans who need services," Bradley says. "That means making sure all of our operations are functional, including computers and facilities, and that we're all communicating if there are problems." Bradley is working to enhance the quality of veteran's care by implementing a culture of high-quality program evaluations. "It's important that our programs gather data to see if they're reducing symptoms and improving quality of life," he says.

Bradley's research collaborations include a study exploring trauma-informed yoga; another study looks at mindfulness interventions for veterans diagnosed with PTSD. Bradley and his team are also exploring connections between trauma exposure and inflammatory markers–as well as treatments.

Bradley knows the needs of veterans are complex, and says he is committed to educating the public about how trauma impacts behavior. "We need to be able to recognize that people discharging from the service may be trauma survivors," says Bradley. "Symptoms that may present as behavioral disorders are often actually understandable responses to the traumatic events they've experienced. Rather than blaming veterans for their bad behavior we need to offer them opportunities to recover and live adaptive lives."


CAMP Program at Emory University

mark rapaport  
Dr. W. Edward Craighead

Dr. W. Edward Craighead PhD., ABPP, was recruited in 2006 as the J. Rex Fuqua Chair to establish the Child and Adolescent Mood Disorders Program (CAMP). CAMP treats youth delivering evidence-based treatments including CBT (Cognitive Behavioral Therapy) , BA ( Behavioral Activation), and DBT (Dialectical Behavior Therapy) as well as providing evaluations and medications. Initially, the program focused on depression and bipolar disorders, but currently treats 500-550 active patients with a variety of clinical problems.

Led by a multi-disciplinary team of professionals and trainees, CAMP has a weekly community meeting to establish treatment and program goals. From these meetings have grown several programs within CAMP. The first expansion was a DBT program treating self-injurious behaviors (e.g. cutting) under the leadership of Dr. Cynthia Ramirez. Involved faculty includes Drs. Rickey Gillespie, Lindsay Stewart, Nori Lim, and Steve Snow.

Under the leadership of Dr. Nori Lim, CAMP expanded to treat anxiety disorders including a community education program held at Druid Hills High School. CAMP developed a program for ADHD coordinated by Dr. Nicole Almeida who is supported by Drs. Julie Pace, Rickey Gillespie, and Jennifer Holton. This clinic meets a primary need of the Emory community by treating students with ADHD. Another program meeting community needs is the treatment of eating disorders and weight concerns. Developed in collaboration with Dr. Linda Craighead, Dr. Erin Jones leads the Healthy Eating and Weight Services Program (HEWS). A formal psychoeducational assessment program directed by Dr. Julie Pace addresses the needs of the greater Atlanta community and Emory students with learning disabilities and/or ADHD. New directions include increased translational research, studying biomarkers and mechanisms of clinical change, and community outreach to Atlanta's underserved populations. By treating patients from several states, CAMP has become a premier clinical, research and educational center for youth mood and related disorders in the Southeast. CAMP is happy to acknowledge the continued support of J. Rex Fuqua, Mary and John Brock, Jay Wertheimer, and other donors who make possible CAMP's research, educational, and clinical activities.

     
 

Our General Psychiatry residency program received over 1400 applications this year. We anticipate interviewing around 125 people for 11 general psychiatry positions, with more applicants from US medical and Osteopathic schools this year. We are also interviewing for one PGY-2 position for next July . This shows that there is a lot of interest in our program with all the changes that have occurred over the last several years. Our Med-Psych residency program has received 170 applications and is interviewing 27.

Child Psychiatry Fellowship program had 60 applicants for 3 positions and are awaiting the results of their Match. The Addiction Psychiatry Fellowship has filled all 3 positions for the 2016-17 academic year with well qualified applicants.

Dr. Erika Heard (PGY-5 Med-Psych) has received the Wellborn Fellowship to support traveling alongside Dr. Martha Ward, faculty mentor, to educate Psychiatry and Internal medicine residents and faculty at Addis Ababa University in Ethiopia for one month on detection, diagnosis and treatment of mental illness. Dr. Cristina Poscablo-Stein and Dr. David Goldsmith (both PGY-4 residents) have also received support for their separate projects through this funding.

The Maqbool Hashmi Fund has enabled residents to purchase copies of relevant books and will be supporting meeting attendance for one resident this year.

Also, Dr. Yilang Tang, a current Addiction fellow received the AAAP Annual meeting Fellow Travel Award for December 2015.

We had a successful year with medical students (M-4's). We have received great feedback for both Emory and visiting students in providing them exposure to all the great options open to them in pursuing a career in psychiatry and med-psych.

   
 
norrholm

Dr. Seth Norrholm, a translational neuroscientist at Emory, explains the basis of fear and how it is processed by the brain. Read more here.


 
baer

Dr. Wendy Baer, Medical Director of psychiatric oncology at the Winship Cancer Institute of Emory University, discusses coping with the recurrence of cancer. Read more here.


 
kaslow

Dr. Nadine Kaslow educates us on how counselors help survivors of terroristic attacks and other tragedies. Read more here.



 

This section will highlight different aspects of the Department of Psychiatry and Behavioral Sciences that people may not be aware of.


Emory researchers in Dr. Claire Coles' group have developed a three part intervention program for children, ages 5 to 10, that targets impulsive and disruptive behavior that interferes with attention, learning and adaptive functioning. At the Center for Maternal Substance Abuse and Child Development, the GoFAR program uses an innovative computer game, parent training and hands-on therapy sessions to address behavior problems in alcohol and drug affected children. The 10-session, manualized treatment program is the first to demonstrate success with this population of high risk children. For more information, go here.


NIH-funded research at the Yerkes NPRC, under the direction of Dr. Mark Wilson (Research Professor, Yerkes and Professor of Psychiatry & Behavioral Sciences), in collaboration with departmental colleagues Drs. Mar Sanchez, Leonard Howell, and Vasiliki Michopoulos, is investigating how chronic exposure to social stressors in rhesus monkeys changes brain neurochemistry and functional connectivity throughout the reward system to sustain over consumption of calorically dense foods in female rhesus monkeys as a model for stress-induced emotional eating in women and girls. In addition to a focus on what accounts for this change in appetite, studies with Dr. Sanchez are also describing how the emergence of obesity promotes stress hormone and pro inflammatory cytokine signaling to impair neurobehavioral development in adolescent females as they progress through puberty.


Depression afflicts over 27 million adults in the US and is associated with decreased integrity of white matter fibers in the brain that ultimately disrupts the wiring and the communication between different brain regions and has been linked to poor response to treatments with antidepressants, increasing functional decline and cognitive impairment, especially among older individuals. Depression is also associated with increased inflammation which worsens with age and may contribute to white matter disease either directly or by increasing brain glutamate, a neurotransmitter (nerve chemical) that in excess is toxic to both white matter cells and neurons. The goal of the proposed research led by Dr. Ebrahim Haroon and his associates, is to test the hypothesis that inflammation and associated increases in brain glutamate in middle-aged depressed will be associated with increased white matter pathology leading to alterations in behavior and cognition.


Emory has a number of new clinical studies that are actively recruiting people seeking treatment as well as control participants. If you are interested in learning more, please click here.


 

Your support will help us to partner together for Atlanta and Beyond. To make a gift to the Department of Psychiatry please click here.

 
 
If you have any comments or suggestions please contact Phyllis Rosen LCSW at prosen@emory.edu