"The Times They Are A Changing"
|Mark Hyman Rapaport, MD
Our Department is undergoing an exciting transformation. We moved into two redesigned inpatient units in the Emory University Hospital at Wesley Woods. Our new senior administrative team of Frank Brown, MD, Vice Chair for Clinical Affairs, Jen Schuck, MBA, LMSW, Associate Administrator, Emory Wesley Woods Hospital, Annette Branan, MSN, RN, CNO/VP Patient Care Services Emory Wesley Woods, and Robert Cohen, PhD, MD, Chief of Inpatient Psychiatry, is developing patient-centered team-based models of care.
For the first phase of the Emory Brain Health Initiative, we have moved our outpatient adult and child clinical services, research, and most of our training programs to new offices at Executive Park 12 (N. Druid Hills Rd. at I-85). Andy Miller, MD is the Adult Director of Outpatient Services for the department and is leading the creation of an integrated clinical, research, and training environment. Ed Craighead, PhD, Vice-Chair for Child, Adolescent and Young Adult Services, is leading a similar effort for Child Psychiatry. We will have an Open House in the fall so that you can tour our new space.
We have launched Testing and Assessment, Anxiety Disorders, and Eating Disorders programs in Child Psychiatry. Our new Treatment Resistant Depression program led by Bill McDonald , MD will begin this July. It will serve as a convenient way for patients interested in our specialized clinical and research programs in psychopharmacology, deep brain stimulation, neuromodulation, and immunotherapies for mood disorders to enter our programs. We will also provide a valuable consultation service for community clinicians with difficult to treat patients.
In closing, I would be remiss not to acknowledge the retirement of a number of valuable members of our Department. I want to thank Carol Webb, PhD, Arden Dingle, MD, and Carol Levy, MN, MPH for their wonderful years of service to Emory. There are many new people joining us to introduce to you, but that will have to wait for our Fall issue!
How Stress Early in Life Changes Gene Regulation
A growing body of evidence links experiences in the womb and childhood with the development of psychiatric disorders later in life. Dr. Alicia Smith wants to know why –how do changes in gene regulation put people at risk for psychiatric disorders?
|Dr. Alicia Smith
In her Human Psychiatric Genetics Laboratory at Emory University School of Medicine, Smith looks at how risk factors such as stress, medication exposure, illness and diet effect changes within genes. She then looks at whether those changes can be used to predict the later development of a psychiatric disorder.
In one recent study, Smith focused on medication exposure, comparing four groups of pregnant women – those taking antidepressants, antiepileptics, antipsychotics or no medication. "This is an area of active debate and controversy," says Smith, an assistant professor in the Department of Psychiatry and Behavioral Sciences. "Some say that you should not take any medication while you are pregnant, but that is not always feasible. And untreated stress or depression can impact your fetus as well – stress hormones can cross the placenta. It's difficult for women and their doctors to make informed decisions because there is very little data on the effect of medications on pregnant women and their fetuses. Most drug trials ignore them."
In Smith's study, she looked for different patterns of gene regulation in the umbilical cord blood of the four groups. She found a few differences, but none that substantially influenced child development or behavior. "That's good news," says Smith. "It suggests that women who take these medications during pregnancy could worry less about the risk to their baby. But these findings need to be replicated in a larger study."
"If we can identify what causes gene regulation changes and which changes put someone at risk for developing psychiatric disorders, we can intervene early and perhaps mitigate that risk," she says.
The Fuqua Center for Late- Life Depression
|J.B., Dottie and Rex Fuqua- Longtime supporters of the Department (12/1/03)|
The Fuqua Center for Late-Life Depression was established in 1999 following a gift from Mr. J.B. Fuqua, an Atlanta businessman and philanthropist. In his memoir, Mr. Fuqua described his 50 year struggle with depression before being effectively treated with electroconvulsive therapy. Mr. Fuqua was passionate about serving older adults with mental illness.
Mr. Fuqua often lamented that the stigma associated with mental illness prevented older adults from accessing treatment. He established the Center to improve older adults' access to treatment as well as to increase public awareness and understanding of depression in this phase of life. He made this plea when he successfully testified before Congress about funding programs for older adults in early 2000.
Under the direction of William McDonald MD, the J.B. Fuqua Chair for Late-Life Depression, and Eve Byrd MSN, MPH, the executive director, the Center staff is active in both research for novel treatments of depression in the elderly and community programs addressing stigma and access to care. The Fuqua Center has received significant grant support from the National Institute of Mental Health and private foundations supporting mental health research including the Stanley Foundation and the Jesse Parker Williams Foundation. These foundations have supported treatment in community settings including care for older adults in 19 metro Atlanta affordable housing properties, peer support, and the training of aging services providers across Georgia.
Through its many services, advocacy and policy work, the Fuqua Center staff improve access to services for older adults in Georgia and nationally. Patients treated by the Fuqua Center discuss the impact of these services on their lives in a video made to commemorate the 10th anniversary of the Fuqua Center in 2009 (view video here).
For additional information regarding the Fuqua Center for Late-Life Depression, visit fuquacenter.org.