The Department of Psychiatry and Behavioral Neurobiology

2007 - 2008

GRAND ROUNDS

 Sponsored by the UAB School of Medicine, Division of CME  
 The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Archived Grand Rounds Schedules
If you need to reference past schedules or presentations, the following schedules are archived for your convenience.  
2005-2006 2006-2007

September 2007

Objectives: 
1. Understand the current status of policy regarding surrogate decision-making for research  participation.
2. Understand current clinical framework for assessment of decision-making capacity.
3. Understand effects of neuropsychiatric conditions on decision-making capacity, especially for research consent.

References:
1. Kim SYH, Appelbaum PS, Swan J, Stroup TS, McEvoy JP, Goff DC et al. Determining when impairment constitutes incapacity for informed consent in schizophrenia research. The British Journal of Psychiatry 2007; 191(1):38-43.

2. Kim SYH, Appelbaum PS, Jeste DV, Olin JT. Proxy and Surrogate Consent in Geriatric Neuropsychiatric Research: Update and Recommendations. Am J Psychiatry 2004; 161(5):797-806.

Sept. 25
11:00am

Psychotherapy Ethics in Work with Children, Adolescents, and Adults
Lee Ascherman, M.D., Professor, Director, Child Adolescent Psychiatry
Samuel Rubin, M.D., Assistant Professor, Child and Adolescent Psychiatry
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

Objectives:
Attendess will 
1. gain understanding of how ethical issues pertain to everyday practice.
2. gain understanding of the relevance of APA and AACAP Ethical Codes to ethical guildelines for the conduct of psychotherapy.
3. gain understanding of how ethical guidelines for the conduct of psychotherapy facilitate the depth of clinical work.
4. understand the legal foundation to the ethical guidelines for the conduct of psychotherapy.

References:
1.  Schetky DH.  Boundaries in Child and Adolescent Psychiatry.  Child and Adolescent Psychiatric Clinics of North America 1995;(4)4:769-778.  WB Saunders Co.

2.  Jaffe v. Redmond, 518 U.S. 1 (1996)

3.  Kassaw K, Gabbard GO.  The ethics of e-mail communication in psychiatry.  Psychiatric Clinics of North America 25 2002; 665-674.

4.  Simon RI, Williams IC.  Maintaining Treatment Boundaries in Small Communities and Rural Areas. Psychiatric Services 1999; 50(11) 1440-1446.

What Neuroscience Tells Us About How and Why Psychotherapy Works
Part 1: 
Contemporary Psychodynamic Perspectives and Neuroscience Models of the Internal Representational World
Neurobiological Underpinnings of Insecure Attachment
Psychobiological Regulatory Functions

Fred L. Griffin, M.D., Associate Professor
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine
 

What Neuroscience Tells Us About How and Why Psychotherapy Works
Part 2: 
Neural Network Models
Transference, Countertransference, and Mirror Neurons
Case Presentation

Fred L. Griffin, M.D., Associate Professor
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine
 

Primary Prevention in Schizophrenia: Using Developmental Animal Models to Inform Pharmacological Treatment Options
Neil M. Richtand, M.D., Ph.D.
Associate Professor, Department of Psychiatry
University of Cincinnati College of Medicine

Objectives: 
1) Recognize the different stages of illness in the natural history of schizophrenia.
2) Understand the relationship between clinical dose of antipsychotic medication and binding affinity to neurotransmitter receptors.
3) Recognize risks and benefits of interventions for psychosis prevention in schizophrenia.

References:
Richtand NM, Welge JA, Logue AD, Keck PE Jr, Strakowski SM, McNamara RK. Dopamine and Serotonin Receptor Binding and Antipsychotic Efficacy.  Neuropsychopharmacology, 32, 1715–1726, 2007.

Richtand, N.M. Behavioral Sensitization, Alternative Splicing, and D3 Dopamine Receptor-Mediated Inhibitory Function. Neuropsychopharmacology 31: 2368-2375, 2006.

Richtand, N.M., Taylor, B., Welge, J.A., Ahlbrand, R., Ostrander, M.M., Burr, J., Hayes, S., Coolen, L.M., Pritchard, L.M., Logue, A., Herman, J. P. and McNamara, R.K. Risperidone Pretreatment Prevents Elevated Locomotor Activity Following Neonatal Hippocampal Lesions.  Neuropsychopharmacology 31(1):77-89, 2006.

Short-Term Dynamic Psychotherapy:  Why it is Increasingly Necessary
Jorge de la Torre, MD, LFAPA 
Clinical Professor of Psychiatry,  Baylor College of Medicine
Emeritus Training & Supervising Analyst, Houston-Galveston Psychoanalytic Institute
Houston, Texas

Objectives: 
By the end of this presentation the audience will be familiar with theoretical principle, selection of patients, and application of technique to different kinds of short-term dynamic psychotherapy.

References:
de la Torre, J (1979). Chp. 26: Anxiety states and short-term psychotherapy in Phenomenology and Treatment of Anxiety. Spectrum Publications, Inc., Pgs. 377-388

de la Torre, J (1978). Brief Encounters: General and Technical Psychoanalytic Considerations." Psychiatry, Vol. 41, No. 2, May, 1978.

NO GRAND ROUNDS
UAB CNC Neuroscience Symposium
October 29-30

November 2007

Glutamate Dysfunction in Schizophrenia: Studies with Proton-MR Spectroscopy
Juan R. Bustillo, M.D.
Associate Professor of Psychiatry and Neurosciences
University of New Mexico
Health Sciences Center

Objectives:
To illustrate the presenter’s research with H-MRS in humans and animals focused on the in-vivo neurochemistry of schizophrenia

References:
Posse S, Otazo R, Caprihan A, Bustillo J, Chen H, Henry PG, Marjanska M, Gasparovic C, Zuo C, Magnotta V, Mueller B, Mullins P, Renshaw P, Ugurbil K, Lim K, Alger J. Proton Echo Planar Spectroscopic Imaging of J-Coupled Resonances in Human Brain at 3 and 4 Tesla, Magnetic Resonance in Medicine, 2007, Jul 3; [Epub ahead of print].

Bustillo J, Barrow R, Paz R, Tang J, Seraji-Bozorgzad N, Moore G, Bolognani F,  Lauriello J, Perrone-Bizzozero N, Matthew P Galloway M. Long term treatment of rats with haloperidol: lack of an effect on brain N-acetyl aspartate levels, Neuropsychopharmacology, 2006, 31:751-756. 

Abbott C, Bustillo J. What have we learned from proton magnetic resonance spectroscopy about schizophrenia? A critical update, Current Opinion Psychiatry, 2006, 19:135-139. 

Rowland L, Bustillo J, Mullins P, Jung R, Lenroot R, Landgraf E, Barrow R, Yeo R,  Lauriello J, Brooks W. The effects of ketamine on anterior cingulate glutamate metabolism in healthy humans: a 4.0T proton magnetic resonance spectroscopy study, Am J Psychiatry, 2005 162: 394-396.

 No Grand Rounds Scheduled

December 2007 

Non-Alzheimer’s Dementias
David Glenn Clark, MD
Assistant Professor of Neurology
University of Alabama School of Medicine

Objectives:
To help clinicians recognize non-Alzheimer's dementia syndromes by identifying their salient clinical features.

References:
S. Alladi, J. Xuereb, T. Bak, P. Nestor, J. Knibb, K. Patterson, and J. R. Hodges.  Focal cortical presentations of Alzheimer's disease.  Brain, October 2007; 130: 2636 - 2645.

Kertesz, Andrew MD, FRCP; Blair, Mervin BSc; McMonagle, Paul MRCPI, MD; Munoz, David G. MD, FRCP.  The Diagnosis and Course of Frontotemporal Dementia.  Alzheimer Disease & Associated Disorders. 21(2):155-163, April/June 2007.

Felix Geser, Gregor K. Wenning, Werner Poewe, Ian McKeith.  How to diagnose dementia with Lewy bodies: State of the art.  Movement Disorders, August 2005; 20, Suppl 12, S11-S20

 

Due to HIPPA policy, this Grand Rounds is closed to outside professionals.  Only UASOM Department of Psychiatry faculty, staff, residents, and medical students on rotation can attend.

Case Conference:
Management of co-morbid suicidal ideation and substance abuse in the emergency room setting

Panel: 
Andree Stoves, M.D.
Nathan Smith, M.D.
Peter Lane, M.D.
Robert McCullumsmith, M.D.
Aalok Chandora, M.D.
Andrea Dickens, M.D.

 

2007/2008 GRAND ROUNDS
"The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 1 hour in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the activity."

January 2008     February 2008     March 2008     April 2008      May 2008

January 2008

Objectives:
1) Understand paradigm shift to domains of pathology
2) Idenfity unmet treatment needs
3) Integrate pre-clinical, human and clinical models in drug evaluation
 
References:  select journal title for full text
The Cognitive and Negative Symptoms in Schizophrenia Trial (CONSIST): The Efficacy of Glutamatergic Agents
for Negative Symptoms and Cognitive Impairments.  Am J Psychiatry 164:1593-1602, October 2007 

The Schizophrenia Paradigm A Hundred-Year Challenge   J Nerv Ment Dis. 2006 Sep;194(9):639-43 

Health Awareness and Actions for Health Professionals First
Leah J. Dickstein, M.D., M.A.
Professor Emerita of Louisville School of Medicine
Department of Psychiatry and Behavioral Sciences

Dr. Dickstein is a well-known national advocate for women physicians who retired from the University of Louisville in 2003 where she was a psychiatry professor and associate dean for faculty and student advocacy.  In 2000, Dickstein received the Vestermark Education Award from the American Psychiatric Association-National Institute of Mental Health, and she served as a senior editor for "AAMC Appropriate Treatment in Medicine," a compendium on medical student mistreatment.  She has served as President of the Association of Women Psychiatrists, the American Medical Women's Association and the Association of Social Psychiatry.

Objectives:
1) To raise awareness of constructive self-care for Mind, Body, Spirit and present key steps to healthy lives. 

References:
The Handbook of Physician Health:  The Essential Guide to Understanding the Health Care Needs of Physicians.  Goldman, Larry S. (Editor), Michael Myers (Editor), Leah J. Dickstein (Editor)

Health Awareness Workshop Reference Book.  Leah J. Dickstein (Editor)

Objectives:
1) Review current treatments for Tourette syndrome
2) Review advances in behavioral treatments for Tourette syndrome 3. Review advances in somatic treatments of Tourette syndrome    

References:
Servello D, Porta M, Sassi M, Brambilla A, Robertson MM. Deep Brain Stimulation in 18 patients with severe Gilles de la Tourette Syndrome refractory to treatment: The surgery and stimulation. J Neurol Neurosurg Psychiatry. 2007 Sep 10

Himle MB, Woods DW, Piacentini JC, Walkup JT. rief review of habit reversal training for Tourette syndrome. J Child Neurol. 2006 Aug;21(8):719-25.

Mink JW, Walkup J, Frey KA, Como P, Cath D, Delong MR, Erenberg G, Jankovic J, Juncos J, Leckman JF, Swerdlow N, Visser-Vandewalle V, Vitek JL; Tourette Syndrome Association, Inc. Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome. Mov Disord. 2006 Nov;21(11):1831-8.

Select this link to view Power Point presentation

 

 February 2008

The Impact of Race on Depression Diagnosis and Treatment
Helen C. Kales, M.D.
Assistant Professor, Department of Psychiatry
Director, Geriatric Psychiatry Clinic, Veteran's Affairs Ann Arbor Healthcare System
Research Scientist, Geriatric Research Education and Clinical Center, Veteran's Affairs Ann Arbor Healthcare System
Investigator, Serious Mental Illness Treatment Research and Evaluation Center, VA

References:
Young EA and Breslau N Cortisol and Catecholamines in Posttraumatic Stress Disorder: A Community Study, Archives General Psychiatry, 61:394-401, 2004

Young EA, Abelson JL and Cameron OG. Effect of Comorbid Anxiety Disorders on the HPA Axis Response to a Social Stressor in Major Depression, Biological Psychiatry,;56:113-20, 2004.

March 2008

No Grand Rounds

Due to HIPPA policy, this Grand Rounds is closed to outside professionals.  Only UASOM Department of Psychiatry faculty, staff, residents, and medical students on rotation can attend.

Case Conference

Mar. 18
11:00am

Objectives:    
Participants will be able to
1) summarize the conventional model of schizophrenia and its pathophysiology
2) summarize two kinds of evidence that contradict this model
3) briefly summarize an alternative model supported by the evidence.

References:
Venkatasubramanian G, Chittiprol S, Neelakantachar N, Naveen MN, Thirthall J, Gangadhar BN, Shetty KT. Insulin and insulin-like growth factor-1 abnormalities in antipsychotic-naive schizophrenia. Am J Psychiatry. 2007 Oct;164(10):1557-60.

Weinberg SM, Jenkins EA, Marazita ML, Maher BS. Minor physical anomalies in schizophrenia: a meta-analysis. Schizophr Res. 2007 Jan;89(1-3):72-85. 
 
Green MF. Cognitive impairment and functional outcome in schizophrenia and bipolar disorder. J Clin Psychiatry. 2006;67 Suppl 9:3-8; discussion 36-42. 
 
Kirkpatrick B, Messias E, Harvey PD, Fernandez-Egea E, Bowie CR. Is Schizophrenia a Syndrome of Accelerated Aging? Schizophr Bull. 2007 Dec 21; [Epub ahead of print]

Objectives:
1) To provide an overview on the molecular changes in the GABAergic system, as observed in schizophrenia postmortem brain.
2) To provide an introduction and primer on histone and DNA methylation, as it pertains to epigenetic control of gene expression.
3) To understand how histone methylation relates to the 3 major factors in the neurobiology of schizophrenia – developmental mechanisms, pathological changes in diseased brain, and mechanism of antipsychotic drug action.

 April 2008

Understanding Mild Cognitive Impairment
Li Li, M.D., PG-IV Resident
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

Objectives:
1) To introduce the concept and clinical criteria of mild cognitive impairment (MCI)
2) To overview the neuropsychological perspective of MCI and the clinical approach
3) To discuss progression factors of Alzheimer’s Disease and current treatment options.

References:
Select this link to review references

Objectives:
1) To understand reasons for the high prevalence of tobacco use in people with schizophrenia and depression
2) To describe nicotinic cholinergic system abnormalities in schizophrenia and depression
3) To appreciate how this nicotinic dysregulation can be exploited therapeutically

Apr. 15
   8:30-
   12:00

Second Annual Research Symposium
Grand Rounds Series

The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 2 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

 Objectives:
1) Review current medical and fiscal statistics relevant to the obesity epidemic
2) Discuss the literature outlining a prefrontal systems hypothesis for obesity and related eating pathology
3) Introduce a link between classical addictions and binge eating disorder

References:  available upon request

Objectives:
1) To discuss the yin-yang of positive symptoms vs. negative symptoms of schizophrenia.
2) To discuss psychological and biological mechanism of delusion formation.
 

May 2008

C.J. Rosecrans Memorial Lecture
Evidence-Based Practice with Suicidal Adolescents
Cheryl A. King, Ph.D.
Chief Psychologist and Director
Youth Depression and Suicide Prevention Program
Department of Psychiatry, University of Michigan

References:
Huth-Bocks A, Kerr DCR, Ivey AZ, Kramer AC, King CA: Assessment of Psychiatrically Hospitalized Suicidal Adolescents: Self-Report Instruments as Predictors of Suicidal Thoughts and Behavior. J Am Acad Child Adolesc Psychiatry, 46:3, 387-395, 2007.
 
King CA, Kramer A, Preuss L, Kerr, DC, Weisse L, Venkataraman S: Youth-Nominated Support Team for Suicidal Adolescents (Version 1): A randomized controlled trial. Journal of Consulting and Clinical Psychology, 47(1), 199-206, 2006.

Logan DE, King CA: Parental facilitation of adolescent mental health service utilization: A conceptual and empirical review. Clinical Psychology: Science and Practice, 8: 319-333, 2001.

Select this link to view Power Point Presentation

May 20
11:00am

Objectives:
I will provide a talk that bridges basic science mechanisms with the clinical phenotypes seen in patients with metabolic syndrome. There will be two main objectives:
1)     Review the metabolic bases of obesity, insulin resistance, dyslipidemia and risks of developing type 2 diabetes and cardiovascular disease.
2)     Building on the metabolic bases in 1, I will review the mechanistic actions of selected drugs used in treatment.

References:
Wood PA. How Fat Works. Harvard University Press, 2006. 

Grundy SM, et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung and Blood Institute Scientific Statement: Executive Summary. Circulation 112: e285-e290, 2005

Grundy SM. Metabolic syndrome: A multiplex cardiovascular risk factor. J Clin Endocrinol Metab 92: 399-404, 2007

Functional Change in Mild Cognitive Impairment
Virginia G. Wadley, Ph.D.
Assistant Professor of Medicine
Director, Dementia Care Research Program
Division of Gerontology, Geriatrics, and Palliative Care
University of Alabama at Birmingham

Objectives:
1)  Review the diagnostic criteria for Mild Cognitive Impairment and controversies surrounding these criteria.
2)  Discuss recent research documenting the impact of Mild Cognitive Impairment on performance of everyday activities such as driving.
3)  Describe the evidence for novel training programs with promise for preserving function and independence in people with Mild Cognitive Impairment.

Thirteenth Annual Scholar's Bowl  
Moderated by Daniel C. Dahl, M.D.
Associate Professor, Vice Chairman for Education and Training & Clinical Affairs  
Residency Training Director 
Department of Psychiatry and Behavioral Neurobiology
University of Alabama School of Medicine

A rapid-pace, information-packed hour of questions in which a two teams of our residents and faculty will compete against each other for the title of Scholar's Bowl Champions of 2008.  Dr. Dahl will serve as moderator and will provide a series of challenging psychiatric as well as general knowledge questions.   You won't want to miss it! 

Objectives: 
To stimulate review of the Psychiatric literature and the Psychiatry Resident In-Training Examination (PRITE) material.

"The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The University of Alabama School of Medicine designates this educational activity for a maximum of 1 hour in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the activity."

Questions or  comments concerning these activities?  Write, Call, FAX, or E-mail: 

Carol Schaffhausen, B.S.
The University of Alabama at Birmingham
Eye Foundation Hospital
Psychiatry - 3rd Floor
1720 University Blvd.
Birmingham, AL 35233
PHONE 934-1307  FAX 934-4659  cschaff@uabmc.edu

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