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September 2011

Welcome

Robert O. Cotes, M.D. graduated from the Dartmouth-Hitchcock Medical Center Psychiatry Residency Training Program in June 2011.  While at Dartmouth, Dr. Cotes played a key role in the development of a night float call system, implementing a same-day didactic curriculum, and revising the existing medical student curriculum.  During his fourth year of training, he completed a 1-year fellowship in psychodynamic psychotherapy at the Boston Psychoanalytic Society and Institute.  He enjoys working with persons with chronic mental illness and has academic interests in first-break psychosis and the side effects of antipsychotic medications.  For his work on NMS and antipsychotic polypharmacy, he received a Promising New Investigator Award from the Neuroleptic Malignant Syndrome Information Service in 2010.  In August 2011, Dr. Cotes began at Grady Memorial Hospital, where he works as an inpatient attending on 13A.  He is very much looking forward to getting to know the members of the Emory community!

Farewells

David Moore came to Emory for his residency in the Department of Psychiatry and Behavioral Sciences from 1993 to 1997. He worked on the inpatient unit from 1997 to 2004 and in Student Health from 1997 to present, becoming full-time there in 2004. He has won teaching awards both from the medical students and from the residents. He has served on the Emory School of Medicine admission committee since 2004. In 2009, he won the distinguished service award in the Division of Campus Life. David was the one who developed the first psychiatric services for Oxford University, and organized this site for the child psychiatry resident electives beginning in 2010. In addition, he developed a new PGY3 outpatient site at Emory Student Health Services, beginning 2011. David will be moving to Key West and the Lower Keys Medical Center, where he  will become director of their psychiatric services, which includes inpatient, IOP/partial hospitalization, and outpatient services.

Chuck Raison came to Emory from UCLA in 1999 in hopes of transitioning from an academic clinician to a clinical researcher. Charlie Nemeroff and Steve Levy thought he had some promise, but hired him into a full-time clinical position as Director of Consultation and Liaison Serves at Grady. He had come to Emory in hopes of studying the physiological effects of advanced Tibetan Meditation techniques in collaborating with Geshe Lobsang Tenzin Negi. But Geshe-la and Chuck ran into a fairly serious roadblock: None of the advanced Tibetan monks wanted to be studied. In the midst of this impasse, his big break came when Andy Miller convinced me to shift my interests from studying the meditators to studying the systems he thought they might be affecting. This simple switch gave birth to his entire career in psychoneuroimmunology with Andy as his mentor. This work commenced with their collaborative projects using interferon (IFN)-alpha as a model system to study ways in which inflammation produces depression. First he got an EMCF award, then a K23 Award and then his first R01, all of which are now finished. Several years into the work with IFN-alpha, Geshe Lobsang and Chuck got a chance to revisit their long-term interest in the study of meditation, this time looking at the effects of compassion meditation on physiological and emotional responses to psychosocial stress. With help from then Dean of the College Bobby Paul, they launched a small study of compassion meditation in college freshmen. This study only happened because of the tremendous support they received from Daniel Adame, now retired, who then oversaw the class from which our study was run, PE101. They also relied on an army of volunteers. From these beginnings they constructed a significant program in the study of how different elements of meditation differentially affect key neurobiological and immune/autonomic/neuroendocrine activities relevant to health. Chuck secured an R01 to expand this work, then an ARRA supplement. He also served as site PI for a supplement obtained at Boston University for which they flew their meditation subjects up to that fine city before and after their training for neuroimaging. During the first years of the 21st Century Chuck and others were assembling an impressive database suggesting that inflammatory processes play important roles in the genesis of depression. A clear implication of these findings is that blocking inflammation should have antidepressant effects. They decided to put this idea to the test by conducting a randomized, placebo-controlled trial of the TNF-alpha blocker infliximab in medically healthy adults with treatment resistant depression. Chuck received an R21 grant that funded a portion of this study, but Andy was really the one who did all the heavy lifting on this project. They are not ready to release the findings yet, but they are very interesting! Amidst these more practical activities, Andy and Chuckpublished a series of conceptual pieces that were well-received and widely cited, most notably “Cytokines Sing the Blues” which is approaching the 400 mark in terms of citations. Their most recent theoretical work has focused on the role of Pathogen Host Defense (or PATHOS-D) in the evolution and persistence of depressogenic genes.

Chuck came to Emory on a clinical track, but because of all of his research, he took a risk and shifted to the tenure track. The long experience of seeking tenure—including getting deferred on his first attempt—was one of the few negative experiences he had at Emory. He didn’t know if he would have made it through the process without the expert mentoring of Nadine Kaslow. Chuck’s move to the University of Arizona in Tucson had its genesis in collaborative work he commenced with Matthias Mehl, who had invented and employed a novel real-world, daily-behavior sampling device that has allowed them to eavesdrop on the daily lives of people prior to, and following, meditation training. The University of Arizona has tremendous resources in the sophisticated analysis of human social behavior, but were in need of someone with biological expertise. Chuck has at least a modicum of this biological expertise and was in search of facilities to examine how group processes affect, and are affected by, inflammatory signaling. At the University of Arizona he will be an Associate Professor in the Department of Psychiatry and in the John & Doris Norton School of Family and Consumer Sciences. The Norton School is in the School of Agriculture, which might make him the first psychiatrist in agriculture in the U.S.

Although Chuck’s body is leaving Emory, it is his great hope that his research brain will remain to a large degree. I am already hard at work lining up large collaborative studies between the two institutions (Emory and AZ) that will expand upon the work in cytokine antagonism for depression and compassion meditation for disease prevention.

Transitions

Manisha Shroff, a former Emory resident, has been a staff psychiatrist at Emory University Student Health and Counseling Services, evaluating and treating patients, and as a department faculty member doing teaching, as well as supervision of medical students and residents. This month, she will be shifting her role to that of Staff Psychiatrist at the VA, working primarily at a community-based outpatient clinic on the south side of Atlanta evaluating and treating veterans.

Save the Date

The next faculty development workshop will be held on Wednesday February 1 from 9-10:30am and will focus on the creation of the Service Portfolio. There will be a subsequent workshop on Wednesday April 19 from 9-10:30am focused on the creation of a Personal Statement for promotion packets.

Faculty Kudos

Major Leadership Appointments, Activities and Achievements

None reported

Education

The psychology interns and postdoctoral fellows at Grady attended an intensive training at the VA on evidence based practice with PTSD, Prolonged Exposure, in late August.

The Addiction Psychiatry Group at the VA offered the Buprenorphine Half-and-half course in August for PGY-3 Psychiatry residents and Addiction Psychiatry fellows.  Ayman Fareed provided the 4 hours of face-to-face training and the American Academy of Addiction Psychiatry provided the educational materials- CD and paper for the self-study portion.  PGY-3 residents who are doing their outpatient psychiatry rotation at the Atlanta VAMC are receiving individual supervision by Aymand and Sreedevi Vayalapalli in managing patients on buprenorphine maintenance and monthly didactics.

Research

Aponte-Rivera, V and Dunlop, B.W. (in press). Public Health Consequences of State Immigration Laws. Southern Medical Journal

Bradley, B, Defife, J.A., Guarnaccia, C., Phifer, J., Fani, N., Ressler, K.J., & Westen, D. (2011). Emotion dysregulation and negative affect: association with psychiatric symptoms. Journal of Clinical Psychiatry, 72, 685-91.DOI: 10.4088/JCP.10m06409blu

Hermida, A.P., Syre, S,, Holtzheimer, P., Tudorascu, D.L., & McDonald, W.M. (2011). The use of Olanzapine for the prevention of post-ictal agitation after electroconvulsive therapy. A retrospective study. Poster presentation at the International Psychogeraitric Association meeting.  Santiago de Compostela, Spain.

Howell, B.R., Sanchez, M.M. (2011). Understanding behavioral effects of early life stress using the reactive scope and allostatic load models. Development and Psychopathology. (In press).

Juul, S.H.,& Nemeroff, C.B. (2011). Psychiatric epidemiology. In T. Schlaepfer and C.B. Nemeroff (Eds.), Handbook of Clinical Neurology: Volume on Psychiatric Disorders (in press)

Wachtel, L.E., Hermida, A, & Dhossche, D.M. (201). Maintenance electroconvulsive therapy in autistic catatonia: a case series review. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30, 581-587. DOI: 10.1016/j.pnpbp.2010.03.012 

Honors, Awards, Rankings

Both Doug Bremner and Paul Plotsky were inducted into the Emory Millipub Club, which recognizes faculty who have published individual papers that have at least 1000 citations.

Kerry Ressler received the Robert S. Laufer Award for Outstanding Scientific Achievement Award from the International Society for Traumatic Stress Studies (ISTSS) for outstanding contribution to research in the traumatic stress field.

Quality and Safety Initiatives

The HBIPS continues to be at 100% for nine weeks in a row!

Development Achievement and Capital Campaign Initiatives

None reported

Community Benefit Programs and Activities

Nadine Kaslow and her colleagues with Emory Cares 4 U, a campus-wide suicide prevention program funded by SAMHSA’s Garrett Lee Smith Grant, launched their website. http://www.emorycaresforyou.emory.edu/index.html. It provides valuable information about suicide prevention and wellness on campus. Feedback is welcome.

Resident and Psychology Training Kudos

Dennis Choi, a postdoctoral fellow in Kerry Ressler’s lab, was recognized as one of the most accomplished postdocs at Emory. This honor was bestowed upon only four postdocs at the institution.

Fani, N., Tone, E.B., Phifer, J., Norrholm, S.D., Bradley, B., Ressler, K.J., Kamkwalala, A., Jovanovic, T. (in press). Attention bias toward threat is associated with exaggerated fear expression and impaired extinction in PTSD. Psychological Medicine: DOI: 10.1017/S0033291711001565

Fani, N., Ashraf, A., Afzal, N., Jawed, F., Kitayama, N., Reed, L., & Bremner, J.D. (2011). Increased neural response to trauma scripts in posttraumatic stress disorder following paroxetine treatment: A pilot study. Neuroscience Letters, 491, 196-201.DOI: 10.1016/j.neulet.2011.01.037

Somerville, L.H., Fani, N., McClure-Tone, E.B. (2011). Behavioral and neural representation of emotional facial expressions across the lifespan. Developmental Neuropsychology, 36, 408-428. DOI: 10.1080/87565641.2010.549865

Tamela McClam was selected as a Scholar by the Geriatric Mental Health Association in conjunction with the American Association of Geriatric Psychiatrists and accepted a postdoctoral fellowship position in the Maryland Regional Interdisciplinary Geriatrics Fellowship Program for 2012 - 2013 academic sponsored by the Health Resources and Services Administration and The Johns Hopkins Department of Psychiatry working with Drs. Constantine Lyketsos and Peter Rabins.

Lauren Moffitt provided a suicide debriefing to the Cosby Spears Senior Citizen home.