Abdullah Bin Mahfodh M.D. is a psychiatry resident at the University of Missouri- Kansas City. Dr. Bin Mahfodh obtained his medical degree from Jordan University of Science and Technology, soon after, he traveled to the United States and started to pursue his dream of becoming a psychiatrist. He is planning to complete a fellowship in child and adolescent psychiatry.
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Presentation: Clozapine has been widely accepted as the most effective treatment for schizophrenia, refractory to other anti-psychotic drugs, which comprise of about 25% to 30% of patient population. However, a significant portion, 45 to 70%, of Clozapine-treated patients show a partial or inadequate response to treatment. There is scarcity of established evidence to guide clozapine-resistant psychosis in patients with schizophrenia. Several augmentation strategies including addition of another antipsychotic, mood stabilizers, anxiolytics, antidepressants, and glutamatergic agents, have failed to demonstrate convincing efficacy. Some data suggested promising efficacy of adjunctive ECT, however its clinical application cannot be generalized. The treatment of this subgroup of patients remains a major challenge, with increased health care costs and poor quality of life for affected individuals. Loxapine, a mid-potency first generation anti-psychotic, which has serotonin antagonism at lower doses, could be an effective adjunctive treatment for such patients, based upon literature. This presentation cites one of such patients who showed significant clinical improvement on combination of Clozapine and Loxapine, as evident by Global Clinical Impression, BPRS scores, group attendance, and self-care.
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Umang Shah is a second-year psychiatry resident at University of Missouri Kansas City program. Shah was born and raised in Western part of India in multi-ethnic environment. Soon after graduation from medical school, Shah came to United States to purse a Master of Public Health, following a strong interest in the prevention aspect of medicine. Shah graduated from University of North Texas, Fort Worth, majoring in Epidemiology. Shah has worked at the Albert Einstein College of Medicine and New York University Advanced Dementia Research Center, which provided an opportunity to flourish and strengthen Shah’s interest in psychiatry field. During this period, Shah was fortunate to collaborate with many experts for publications and presentations.
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Presentation: This case study was of an intriguing patient treated at the Jackson County Correctional Facility that presented with a rare symptomatology of Delusional Disorder along with a co-occurring diagnosis of Malevolent Antisocial Personality Disorder. The presentation’s goal is to highlight how this particular symptom of Delusional Disorder has developed a unique internet “echo chamber” which has led to novel treatment resistance in a traditionally tough to treat sub-group. The presentation aims to reach a wide audience of practitioners in the field in how to approach this patient from a therapeutic, counseling, and pharmacologic angle. This interactive session will focus on empowerment in the face of specific challenges that can limit individuals who are in recovery from living the life of their choosing to the fullest. Recovery-oriented cognitive therapy provides a framework for understanding these challenges (low energy, aggressive behavior, self-injury, persecutory beliefs, grandiose beliefs, forensic involvement, anosognosia) along with strategies for action that enable family, peers, and providers to become the empowering collaborators.
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Haque pursued research more heavily in Psychiatry for two years in St. Louis working with psychiatrists at Saint Louis University and a private psychiatric hospital. There Haque published papers and reports using novel treatments for Treatment Resistant Depression. Haque has since joined the University of Missouri in Kansas City Psychiatry Residency program and is currently a second year resident with plans to pursue a fellowship in child and adolescent psychiatry.
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