Speaker(s):

Burgess, Doug, MD

Presentation:

Participants will gain an appreciation for the biological underpinnings of addiction and use this knowledge to identify inherent biases and barriers to care within traditional addiction treatment models.

Objectives:

1. List 3 similarities between substance use disorders and other chronic diseases.
2. Identify 3 neuroadaptations associated with transition to drug addiction.
3. Describe the general principles of a Medication First, Low Threshold model of care

Speaker(s):

Drew E. Murray, MD

Presentation:

This presentation is a side by side case comparison demonstrating the significance of a patient’s insight and includes a relevant literature review. 

Objectives:

1. Discuss two patients in forensic psychiatry with similar symptom complexes
2. Explore the role of insight in psychosis, including its definition and how we can improve upon it. 
3. Apply measures of insight to two forensic patients and compare their respective hospital courses. 

Slides and Handouts:

MURRAY_DREW_Insights on insight

Speaker(s):

Jacob Lee, MD

Presentation:

Climate change is the central crisis of the Anthropocene, a species-level threat which is part of a short list of dangers to offer true existential threat to Humans. When the Intergovernmental Panel on Climate Change released their groundbreaking Global Warming of 1.5°C Special Report in 2018 they built upon the undeniable body of evidence which had propelled 195 nations to enact the Paris Climate Accords two years earlier. Climate change threatens to become the greatest source of human misery over the next one or two human lifetimes. Natural disasters like wildfires and heatwaves, hurricanes and floods have displaced many, while desertification causes countless climate refugees. Weather-related events displace more than 20,000,000 globally each year. Disasters also cause a different kind of psychological distress than seasonal weather patterns, and cause more disruption to normal life patterns. But the implications of climate change can be more direct, with associations with the above conditions increasingly coming to light.

Rates of PTSD, depression and anxiety are found to rise sharply following flooding, another natural disaster of increasing prevalence due to anthropomorphic climate change. Heat waves have been found to directly contribute to mood disorders and anxiety, and people with mental illness are at three times increased risk to die from a heat wave than neuro-typical controls. Extreme heat’s associations with suicide attempts and heat-related violence may also be of direct interest to the psychiatrist. Thanks to an expanding body of evidence linking environmental factors to psychiatric outcomes through mechanisms including epigenetics, congenital defects, or impaired neurodevelopment, the importance of these considerations will continue to grow within psychiatry.

Objectives:

1. Briefly outline critical milestones and projections for earth’s climate
2. Identify direct and indirect associations between classical psychiatric conditions and rising temperatures, natural disasters, and other climate outcomes.
   1. PTSD
   2. Depression
   3. Suicidality
   4. Anxiety
   5. Substance use disorders
3. Discuss climate-related anxiety

Slides and Handouts:

LEE_VERSION 2_Grand Rounds Climate Change STI

Speaker(s):

Anchana Dominic, MD

Presentation:

According to the World Health Organization, an estimated 800,000 people died in 2016 due to suicide. In this era of technological advances, social media’s role in suicide and suicide prevention has often been questioned. Highly publicized media reports of celebrity suicide and TV shows romanticizing the topic may also have effects on subsequent trends in suicide rates among the general population. Data suggests that social media may have a negative impact on mental health through cyber-bullying of vulnerable individuals and by promoting comparative feelings of inadequacy. However, harnessing the unique strengths of social media can contribute to the spread and reach of suicide prevention efforts among users.

Social media platforms can encourage suicide prevention by identifying individuals who are at acute risk of suicide, reaching them anonymously and providing them with resources. It can also spread mental health awareness of appropriate prevention efforts and treatment interventions.

In this presentation, the impact of social media on mental health and recent trends in suicide rates will be teased out. The assessment of suicidal risk by identifying specific tell signs of acute suicidal ideation as expressed through social media will be discussed. How to effectively use social media as a suicide intervention tool and promotion of mental health will also be discussed.

Objectives:

1. Identify ways different social media platforms can be used to promote suicide prevention
2. Discuss the link between media reports on suicide and subsequent trends in suicide rates
3. Identify ways social media can identify, reach, or promote seeking treatment among individuals at risk of suicide

Slides and Handouts:

Speaker(s):

Timothy Dellenbaugh,MD

Presentation:

This session with provide an interactive introduction to genetics in psychiatry. We will review and define the terminology and concepts that are necessary for understanding the potential role of genetic testing in psychiatry. We will review the current status of genetic factors related to risk of developing psychiatric illness, drug response and side effects. Finally, we will discuss implications of direct-to-consumer genetic testing. This presentation will be oriented to a nonscientific audience. The only prerequisite is knowing that DNA is the genetic material in humans.

Objectives:

1. Define basic genetic terms
2. Recognize some genetic factors related to risk of developing psychiatric illness, drug response and side effects
3. Discuss implications of direct-to-consumer genetic tests

Slides and Handouts:

DELLENBAUGH_TIMOTHY_2021 Psychiatric Genetics Dellenbaugh Spring Final

Speaker(s):

Apurva Bhatt, MD

Presentation:

In 2017, Missouri ranked 4th in the nation in death by firearm (CDC). In 2017, firearm related deaths were the second leading cause of death in Missouri children ages 1-17 (CDC). According to the Gifford Law Center in 2020, Missouri received a scorecard grade F in terms of its current firearm laws. In 2017, Missouri saw a near doubling of the rates of suicide by firearms in 15-24-year-olds (the highest rate reported since data collection began in 1999). In 2015, Missouri experienced the highest firearm homicide rate in 15-24 year olds since 1999. This presentation will zoom in on changes in Missouri firearm law which occurred from 1999-2018, discuss the existing scientific literature on the effects of changes in Missouri’s firearm laws on suicide/homicide by firearms, and will elaborate on Dr. Bhatt’s work in this area.

Objectives:

1. Recall the timeline of changes in Missouri firearm policy
2. Describe the current state of affairs regarding Missouri firearm law
3. Review the scientific literature on the effects of Missouri’s firearm laws on suicide and homicide by firearms in the state
4. Learn how firearm status impacts suicide by firearms/suicide risk
5. Describe future preventive strategies to mitigate adolescent and young adult suicide by firearms in the state

Slides and Handouts:

BHATT_Spring Training Institute Bhatt slides