CINXE.COM

<!DOCTYPE html><html lang="en"><head><meta charSet="utf-8"/><meta name="viewport" content="width=device-width"/><script src="https://cmp.osano.com/6olh2SicG0V81Mlk/1f9d883d-3834-40b9-9a96-6f89a1cda98b/osano.js"></script><title>Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases</title><meta name="description" content="A traumatic brain injury sustained earlier in adult life is likely to interact with normal aging processes. Learn more here. "/><meta property="og:url" content="https://www.psychiatrictimes.com/view/traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases "/><meta property="og:title" content="Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases"/><meta property="og:image" content="https://cdn.sanity.io/images/0vv8moc6/psychtimes/c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584.jpg?fit=crop&auto=format"/><meta property="og:site_name" content="Psychiatric Times"/><meta property="og:description" content="A traumatic brain injury sustained earlier in adult life is likely to interact with normal aging processes. Learn more here. "/><meta name="twitter:card" content="summary"/><meta name="twitter:title" content="Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases"/><meta name="twitter:image" content="https://cdn.sanity.io/images/0vv8moc6/psychtimes/c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584.jpg?fit=crop&auto=format"/><meta name="twitter:site" content="@@PsychTimes"/><meta name="twitter:description" content="A traumatic brain injury sustained earlier in adult life is likely to interact with normal aging processes. Learn more here. "/><meta name="robots" content="max-image-preview:large"/><meta name="robots" content="max-video-preview:-1"/><link rel="preconnect dns-prefetch" href="https://cmp.osano.com"/><link rel="preconnect dns-prefetch" href="https://res.lassomarketing.io"/><link rel="preconnect dns-prefetch" href="https://www.lightboxcdn.com"/><link rel="preconnect dns-prefetch" href="https://pub.doubleverify.com"/><link rel="preconnect dns-prefetch" href="https://cdn.doubleverify.com"/><link rel="preconnect dns-prefetch" href="https://cdn.segment.com"/><link rel="preconnect dns-prefetch" href="https://securepubads.g.doubleclick.net"/><link rel="preconnect dns-prefetch" href="https://pagead2.googlesyndication.com"/><link rel="preconnect dns-prefetch" href="https://cdn.sanity.io"/><link rel="preconnect dns-prefetch" href="https://www.google-analytics.com"/><link rel="preconnect dns-prefetch" href="https://www.googletagmanager.com"/><link rel="preconnect dns-prefetch" href="https://player.vimeo.com"/><link rel="preconnect dns-prefetch" href="https://youtube.com"/><link rel="preconnect dns-prefetch" href="https://connect.facebook.net"/><link rel="preconnect dns-prefetch" href="https://www.facebook.com"/><link rel="preconnect dns-prefetch" href="https://static.ads-twitter.com"/><link rel="preconnect dns-prefetch" href="https://ad.doubleclick.net"/><link rel="preload" href="https://securepubads.g.doubleclick.net/tag/js/gpt.js"/><link rel="preload" href="https://pub.doubleverify.com/signals/pub.js#ctx=20083417&cmp=DV464021"/><link rel="icon" href="/favicon.ico"/><script async="" src="https://securepubads.g.doubleclick.net/tag/js/gpt.js"></script><script src="https://pub.doubleverify.com/signals/pub.js#ctx=20083417&cmp=DV464021"></script><script src="https://one.psychiatrictimes.com/tagmanager/scripts/one.js"></script><script>window.dataLayer = window.dataLayer || []; window.dataLayer.push({ event: "page_dimensions", pageTitle: "Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases", dimension9: "topics/trauma-and-violence,topics/neuropsychiatry,topics/dementia,topics/alzheimer-disease", dimension11: "", dimension12: "", dimension13: "Articles", dimension14: "Grace S. Griesbach, PhD", dimension15: "traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases", dimension18: "2024-10-01T14:00:00.000Z", dimension19: "", dimension20: "", });</script><script type="module"> (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-5V9L5PL'); </script><script type="module"> var ALGOLIA_INSIGHTS_SRC = "https://cdn.jsdelivr.net/npm/search-insights@2.4.0"; !function(e,a,t,n,s,i,c){e.AlgoliaAnalyticsObject=s,e[s]=e[s]||function(){ (e[s].queue=e[s].queue||[]).push(arguments)},i=a.createElement(t),c=a.getElementsByTagName(t)[0], i.async=1,i.src=n,c.parentNode.insertBefore(i,c) }(window,document,"script",ALGOLIA_INSIGHTS_SRC,"aa");</script><link rel="canonical" href="https://www.psychiatrictimes.com/view/traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases"/><link rel="preload" as="image" imagesrcset="/_next/image?url=%2FPsychiatricTimesLogo%20WHT.png&w=256&q=75 1x, /_next/image?url=%2FPsychiatricTimesLogo%20WHT.png&w=640&q=75 2x"/><meta name="robots" content="max-image-preview:large"/><meta name="robots" content="max-video-preview:-1"/><meta name="next-head-count" content="13"/><link rel="preconnect" href="https://res.lassomarketing.io"/><script async="" type="text/javascript" src="https://www.lightboxcdn.com/static/lightbox_mjh.js"></script><script defer="" src="https://res.lassomarketing.io/scripts/lasso-imp-id-min.js" type="text/javascript"></script> <script defer="" type="text/javascript" src="https://www.googletagservices.com/tag/js/gpt.js"></script> <script type="module"> !function(){var analytics=window.analytics=window.analytics||[];if(!analytics.initialize)if(analytics.invoked)window.console&&console.error&&console.error("Segment snippet included twice.");else{analytics.invoked=!0;analytics.methods=["trackSubmit","trackClick","trackLink","trackForm","pageview","identify","reset","group","track","ready","alias","debug","page","once","off","on","addSourceMiddleware","addIntegrationMiddleware","setAnonymousId","addDestinationMiddleware"];analytics.factory=function(e){return function(){var t=Array.prototype.slice.call(arguments);t.unshift(e);analytics.push(t);return analytics}};for(var e=0;e<analytics.methods.length;e++){var key=analytics.methods[e];analytics[key]=analytics.factory(key)}analytics.load=function(key,e){var t=document.createElement("script");t.type="text/javascript";t.async=!0;t.src="https://cdn.segment.com/analytics.js/v1/" + key + "/analytics.min.js";var n=document.getElementsByTagName("script")[0];n.parentNode.insertBefore(t,n);analytics._loadOptions=e};analytics.SNIPPET_VERSION="4.13.1"; window.LassoImpressionID = lassoImpID(); analytics.load("BBbKMoOjmhsxPnbd2nO6osz3zq67DzuN"); analytics.page({ 'LassoImpressionID': window.LassoImpressionID }); }}(); </script> <script src="https://www.googleoptimize.com/optimize.js?id=OPT-NVFJRDN"></script><link rel="preload" href="/_next/static/css/6d291d312723e618.css" as="style"/><link rel="stylesheet" href="/_next/static/css/6d291d312723e618.css" data-n-g=""/><link rel="preload" href="/_next/static/css/1fd9d1dcb68b7a42.css" as="style"/><link rel="stylesheet" href="/_next/static/css/1fd9d1dcb68b7a42.css" data-n-p=""/><link rel="preload" href="/_next/static/css/159521ba7be98a3c.css" as="style"/><link rel="stylesheet" href="/_next/static/css/159521ba7be98a3c.css" data-n-p=""/><noscript data-n-css=""></noscript><script defer="" nomodule="" src="/_next/static/chunks/polyfills-c67a75d1b6f99dc8.js"></script><script src="/_next/static/chunks/webpack-d372a9293b426fcc.js" defer=""></script><script src="/_next/static/chunks/framework-45ce3d09104a2cae.js" defer=""></script><script src="/_next/static/chunks/main-c1ce322a402d266c.js" defer=""></script><script src="/_next/static/chunks/pages/_app-a5ed42eb6a4d2ed9.js" defer=""></script><script src="/_next/static/chunks/69bd6bf3-c7219ac9ecb38ac9.js" defer=""></script><script src="/_next/static/chunks/f36c6662-e730e1316f9aa347.js" defer=""></script><script src="/_next/static/chunks/8eec4907-bd18a9d50c17fbc1.js" defer=""></script><script src="/_next/static/chunks/065a3ddb-42216585c327b2a5.js" defer=""></script><script src="/_next/static/chunks/72585f70-0d4479e14d41a365.js" defer=""></script><script src="/_next/static/chunks/9814d858-cb162ab048445baf.js" defer=""></script><script src="/_next/static/chunks/59b4e022-7c8a205b41eac8c0.js" defer=""></script><script src="/_next/static/chunks/aeb74aa0-4e0b515016d20a9f.js" defer=""></script><script src="/_next/static/chunks/e1efa4cc-06e900eb45581c19.js" defer=""></script><script src="/_next/static/chunks/5553-adcf0734802bcf9d.js" defer=""></script><script src="/_next/static/chunks/4346-1ca981691e341246.js" defer=""></script><script src="/_next/static/chunks/7107-6cabb37a1b6db405.js" defer=""></script><script src="/_next/static/chunks/5737-bbed1e27037a005b.js" defer=""></script><script src="/_next/static/chunks/6469-c088b028345d95bf.js" defer=""></script><script src="/_next/static/chunks/7707-95432bc9099e6da4.js" defer=""></script><script src="/_next/static/chunks/1574-3911b35ef347ed70.js" defer=""></script><script src="/_next/static/chunks/4978-0ac318307a4fa3cb.js" defer=""></script><script src="/_next/static/chunks/pages/view/%5B...slug%5D-ec4d2dd06ef1142e.js" defer=""></script><script src="/_next/static/9NxASLqZOtjGmsCDs4KHX/_buildManifest.js" defer=""></script><script src="/_next/static/9NxASLqZOtjGmsCDs4KHX/_ssgManifest.js" defer=""></script><style id="__jsx-1661e6713d4eb9b5">.leaderboardAdWrapper.jsx-1661e6713d4eb9b5{min-height:90px;background:#fff}.leaderboardAdWrapper.jsx-1661e6713d4eb9b5 .AD728x90.jsx-1661e6713d4eb9b5{}@media screen and (min-width:768px){.leader-fixed.jsx-1661e6713d4eb9b5{position:fixed;margin-top:1rem;z-index:999999}}.leaderboardAdWrapper.jsx-1661e6713d4eb9b5 .AD728x90.jsx-1661e6713d4eb9b5 div[id*="google_ads_iframe"].jsx-1661e6713d4eb9b5:empty{height:0px!important}@media screen and (max-width:668px){.leaderboardAdWrapper.jsx-1661e6713d4eb9b5{min-height:0px;position:fixed;background:white;left:0;right:0;top:55px;padding-top:.5rem;padding-bottom:.25rem;z-index:9999}}</style><style id="__jsx-19ede9f0a5a45918">.jsx-19ede9f0a5a45918::-webkit-scrollbar{display:none}</style><style id="__jsx-ad50481d5ee26850">@media(min-width:980px)and (max-width:1200px){.article-detail.jsx-ad50481d5ee26850{width:47%}}@media(min-width:1201px)and (max-width:1400px){.article-detail.jsx-ad50481d5ee26850{width:55%}}</style></head><body><div id="__next" data-reactroot=""><div class="-mb-6"><div id="frame-nav" class="sticky top-0 left-0 bg-main-nav-bg text-main-nav-text z-[9948010]"><div class="container px-4 mx-auto flex justify-between items-center h-[65px] pl-4 pr-4" id="frame-mob-nav"><div class="block lg:hidden"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 20 20" aria-hidden="true" class="text-3xl" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path fill-rule="evenodd" d="M3 5a1 1 0 011-1h12a1 1 0 110 2H4a1 1 0 01-1-1zM3 10a1 1 0 011-1h12a1 1 0 110 2H4a1 1 0 01-1-1zM3 15a1 1 0 011-1h12a1 1 0 110 2H4a1 1 0 01-1-1z" clip-rule="evenodd"></path></svg></div><div class="flex-auto hidden w-auto text-sm text-left lg:flex"><div class="relative flex items-center cursor-pointer lg:px-2"><a target="_self" class="whitespace-nowrap flex items-center" href="/news">News</a></div><div class="relative flex items-center cursor-pointer lg:px-2"><div class="whitespace-nowrap flex items-center">Media<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div><div id="div_sub_menu_dropdown_desktop_1" class="absolute bg-main-nav-item-bg text-main-nav-item-text z-[9999999999] border hidden max-h-[1000px]" style="top:30px;left:0;min-width:180px"><a target="_self" href="/around-the-practice"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Around the Practice</div></a><a target="_self" href="/between-the-lines"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Between the Lines</div></a><a target="_self" href="/psych-view"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">PsychView</div></a><a target="_self" href="/expert-perspectives?page=1"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Expert Perspectives</div></a><a target="_self" href="/case-based-psych-perspectives"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Case-Based Psych Perspectives</div></a><a target="_self" href="/clinical-case-collective?page=1"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Clinical Case Collective</div></a><a target="_self" href="/dialogues"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Dialogues</div></a><a target="_self" href="/payer-provider-perspective"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Payer-Provider Perspective</div></a><a target="_self" href="/slideshows"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Slideshows</div></a><a target="_self" href="/videos"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Videos</div></a><a target="_self" href="/viewpoints"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Viewpoints</div></a></div></div><div class="relative flex items-center cursor-pointer lg:px-2"><div class="whitespace-nowrap flex items-center">Conferences<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div><div id="div_sub_menu_dropdown_desktop_2" class="absolute bg-main-nav-item-bg text-main-nav-item-text z-[9999999999] border hidden max-h-[1000px]" style="top:30px;left:0;min-width:180px"><a target="_self" href="/latest-conference"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Conference Coverage</div></a><a target="_self" href="/conferences"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Conference Listing</div></a></div></div><div class="relative flex items-center cursor-pointer lg:px-2"><div class="whitespace-nowrap flex items-center">Publication<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div><div id="div_sub_menu_dropdown_desktop_3" class="absolute bg-main-nav-item-bg text-main-nav-item-text z-[9999999999] border hidden max-h-[1000px]" style="top:30px;left:0;min-width:180px"><a target="_self" href="/journals/psychiatric-times"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Psychiatric Times</div></a></div></div><div class="relative flex items-center cursor-pointer lg:px-2"><a target="_blank" class="whitespace-nowrap flex items-center" href="http://jobs.modernmedicine.com/index.php">Job Board</a></div><div class="relative flex items-center cursor-pointer lg:px-2"><a target="_self" class="whitespace-nowrap flex items-center" href="/continuing-education">CME/CE</a></div><div class="relative flex items-center cursor-pointer lg:px-2"><a target="_self" class="whitespace-nowrap flex items-center" href="/sap-partner">Partners</a></div><div class="relative flex items-center cursor-pointer lg:px-2"><a target="_self" class="whitespace-nowrap flex items-center" href="/editorial-info">Editorial</a></div><div class="relative flex items-center cursor-pointer lg:px-2"><div class="whitespace-nowrap flex items-center">Resources<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div><div id="div_sub_menu_dropdown_desktop_8" class="absolute bg-main-nav-item-bg text-main-nav-item-text z-[9999999999] border hidden max-h-[1000px]" style="top:30px;left:0;min-width:180px"><a target="_self" href="/clinical-consult"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Clinical Consult</div></a><a target="_self" href="/resources/clinical-scales"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Clinical Scales</div></a><a target="_self" href="/interactive-tools"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Interactive Tools</div></a><a target="_self" href="/partner-perspectives"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Partner Perspectives</div></a><a target="_self" href="/resources/q-a"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Q&A</div></a><a target="_self" href="/resources/quizzes"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Quizzes</div></a><a target="_self" href="/series"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Series</div></a><a target="_self" href="/special-reports"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Special Reports</div></a><a target="_self" href="/resources/sponsored-resources"><div style="white-space:nowrap" class="w-full px-4 py-2 hover:bg-main-nav-item-hover-bg hover:text-main-nav-item-hover-text">Sponsored</div></a></div></div><div class="relative flex items-center cursor-pointer lg:px-2"><a target="_blank" class="whitespace-nowrap flex items-center" href="https://one.psychiatrictimes.com/subscribe">Subscribe</a></div></div><div class="flex flex-wrap items-center flex-none md:relative md:flex-nowrap"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" class="hidden md:block text-2xl cursor-pointer mr-[0.125rem] mt-[0.125rem] focus:border focus:border-primary" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="M505 442.7L405.3 343c-4.5-4.5-10.6-7-17-7H372c27.6-35.3 44-79.7 44-128C416 93.1 322.9 0 208 0S0 93.1 0 208s93.1 208 208 208c48.3 0 92.7-16.4 128-44v16.3c0 6.4 2.5 12.5 7 17l99.7 99.7c9.4 9.4 24.6 9.4 33.9 0l28.3-28.3c9.4-9.4 9.4-24.6.1-34zM208 336c-70.7 0-128-57.2-128-128 0-70.7 57.2-128 128-128 70.7 0 128 57.2 128 128 0 70.7-57.2 128-128 128z"></path></svg><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" class="block md:hidden text-2xl cursor-pointer mr-[0.125rem] mt-[0.125rem] focus:border focus:border-primary" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="M505 442.7L405.3 343c-4.5-4.5-10.6-7-17-7H372c27.6-35.3 44-79.7 44-128C416 93.1 322.9 0 208 0S0 93.1 0 208s93.1 208 208 208c48.3 0 92.7-16.4 128-44v16.3c0 6.4 2.5 12.5 7 17l99.7 99.7c9.4 9.4 24.6 9.4 33.9 0l28.3-28.3c9.4-9.4 9.4-24.6.1-34zM208 336c-70.7 0-128-57.2-128-128 0-70.7 57.2-128 128-128 70.7 0 128 57.2 128 128 0 70.7-57.2 128-128 128z"></path></svg><a rel="noopener" class="hidden pr-1 lg:block" target="_self" href="https://twitter.com/psychtimes/"><p> <svg xmlns='http://www.w3.org/2000/svg' version='1.1' width='25' height='25' viewBox='1.41 1.41 252.9 252.9'> <g transform='translate(1.4065934065934016 1.4065934065934016) scale(2.81 2.81)'> <polygon points='24.89,23.01 57.79,66.99 65.24,66.99 32.34,23.01' fill='#FFFFFF' transform='matrix(1 0 0 1 0 0)' /> <path d='M 45 0 L 45 0 C 20.147 0 0 20.147 0 45 v 0 c 0 24.853 20.147 45 45 45 h 0 c 24.853 0 45 -20.147 45 -45 v 0 C 90 20.147 69.853 0 45 0 z M 56.032 70.504 L 41.054 50.477 L 22.516 70.504 h -4.765 L 38.925 47.63 L 17.884 19.496 h 16.217 L 47.895 37.94 l 17.072 -18.444 h 4.765 L 50.024 40.788 l 22.225 29.716 H 56.032 z' fill='#FFFFFF' transform='matrix(1 0 0 1 0 0)' strokeLinecap='round' /> </g> </svg> </p></a><a rel="noreferrer noopener" class="hidden pr-1 lg:block" target="_blank" href="https://www.facebook.com/psychtimes/"><p> <svg width='25px' height='25px' viewBox='0 0 512 512' version='1.1' xmlns='http://www.w3.org/2000/svg'> <g id='Page-1' stroke='none' strokeWidth='1' fill='none' fillRule='evenodd'> <g id='facebook' fill='#FFFFFF' fillRule='nonzero'> <path d='M512,256 C512,114.6 397.4,0 256,0 C114.6,0 0,114.6 0,256 C0,397.4 114.6,512 256,512 C257.5,512 259,512 260.5,511.9 L260.5,312.7 L205.5,312.7 L205.5,248.6 L260.5,248.6 L260.5,201.4 C260.5,146.7 293.9,116.9 342.7,116.9 C366.1,116.9 386.2,118.6 392,119.4 L392,176.6 L358.4,176.6 C331.9,176.6 326.7,189.2 326.7,207.7 L326.7,248.5 L390.2,248.5 L381.9,312.6 L326.7,312.6 L326.7,502.1 C433.7,471.4 512,372.9 512,256 Z' id='Path' /> </g> </g> </svg> </p></a><a rel="noreferrer noopener" class="hidden pr-1 lg:block" target="_blank" href="https://www.linkedin.com/company/psychiatric-times/posts/?feedView=all"><p> <svg width='25px' height='25px' viewBox='0 0 512 512' version='1.1' xmlns='http://www.w3.org/2000/svg'> <g id='Page-1' stroke='none' strokeWidth='1' fill='none' fillRule='evenodd'> <g id='linkedin' fill='#FFFFFF' fillRule='nonzero'> <path d='M256,0 C114.636719,0 0,114.636719 0,256 C0,397.363281 114.636719,512 256,512 C397.363281,512 512,397.363281 512,256 C512,114.636719 397.363281,0 256,0 Z M181.609375,387 L119.261719,387 L119.261719,199.425781 L181.609375,199.425781 L181.609375,387 Z M150.4375,173.8125 L150.03125,173.8125 C129.109375,173.8125 115.578125,159.410156 115.578125,141.410156 C115.578125,123.003906 129.523438,109 150.851562,109 C172.179688,109 185.304688,123.003906 185.710938,141.410156 C185.710938,159.410156 172.179688,173.8125 150.4375,173.8125 Z M406.421875,387 L344.082031,387 L344.082031,286.652344 C344.082031,261.433594 335.054688,244.234375 312.496094,244.234375 C295.273438,244.234375 285.015625,255.835938 280.507812,267.035156 C278.859375,271.042969 278.457031,276.644531 278.457031,282.25 L278.457031,387 L216.113281,387 C216.113281,387 216.929688,217.023438 216.113281,199.425781 L278.457031,199.425781 L278.457031,225.984375 C286.742188,213.203125 301.566406,195.023438 334.644531,195.023438 C375.664062,195.023438 406.421875,221.832031 406.421875,279.445312 L406.421875,387 Z' id='Shape' /> </g> </g> </svg> </p></a><a rel="noreferrer noopener" class="hidden pr-1 lg:block" target="_blank" href="/rss"><p><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:svgjs="http://svgjs.com/svgjs" version="1.1" width="25px" height="25px" x="0" y="0" viewBox="0 0 512 512" style="enable-background:new 0 0 512 512" xml:space="preserve"> <g> <path xmlns="http://www.w3.org/2000/svg" d="m437.019531 74.980469c-48.351562-48.351563-112.640625-74.980469-181.019531-74.980469s-132.667969 26.628906-181.019531 74.980469c-48.351563 48.351562-74.980469 112.640625-74.980469 181.019531s26.628906 132.667969 74.980469 181.019531c48.351562 48.351563 112.640625 74.980469 181.019531 74.980469s132.667969-26.628906 181.019531-74.980469c48.351563-48.351562 74.980469-112.640625 74.980469-181.019531s-26.628906-132.667969-74.980469-181.019531zm-267.757812 292.957031c-13.730469 0-24.90625-11.171875-24.90625-24.90625s11.175781-24.90625 24.90625-24.90625c13.734375 0 24.90625 11.171875 24.90625 24.90625s-11.171875 24.90625-24.90625 24.90625zm80.277343 4.925781c-8.28125 0-15-6.714843-15-15 0-44.171875-35.9375-80.109375-80.109374-80.109375-8.285157 0-15-6.71875-15-15 0-8.285156 6.714843-15 15-15 60.714843 0 110.109374 49.394532 110.109374 110.109375 0 8.285157-6.714843 15-15 15zm67.09375 0c-8.285156 0-15-6.714843-15-15 0-81.167969-66.035156-147.203125-147.203124-147.203125-8.285157 0-15-6.714844-15-15s6.714843-15 15-15c97.710937 0 177.203124 79.492188 177.203124 177.203125 0 8.285157-6.714843 15-15 15zm66.292969 0c-8.28125 0-15-6.714843-15-15 0-117.722656-95.773437-213.496093-213.496093-213.496093-8.285157 0-15-6.714844-15-15 0-8.285157 6.714843-15 15-15 65.039062 0 126.1875 25.328124 172.179687 71.316406 45.988281 45.992187 71.316406 107.140625 71.316406 172.179687 0 8.285157-6.714843 15-15 15zm0 0" fill="#ffffff" data-original="#000000" style=""/> </g> </svg></p></a><div id="div_search_box" class="hidden flex-none md:absolute top-[50px] w-full md:w-[400px] md:left-[-400px] z-50 bg-search-box-bg p-2 rounded-xl"><form method="GET" action="/search" class="flex items-center justify-between w-full"><input type="text" name="searchTerm" placeholder="SEARCH" class="bg-white p-1 rounded-md border-0 w-[80%] text-black" required=""/><input type="submit" value="SEARCH" class="ml-2 cursor-pointer bg-search-box-button-bg text-search-box-button-text hover:bg-search-box-button-hover-bg hover:text-search-box-button-hover-text ronded rounded-md p-1 font-bold w-[20%]"/></form></div></div></div><div id="div_search_box_mobile" class="hidden flex-none md:absolute top-[50px] md:w-[400px] md:left-[-400px] z-50 bg-search-box-bg p-2 rounded-xl"><form method="GET" action="/search" class="flex items-center justify-between w-full"><input type="text" name="searchTerm" placeholder="SEARCH" class="bg-white p-1 rounded-md border-0 w-[80%] text-black" required=""/><input type="submit" value="SEARCH" class="ml-2 bg-search-box-button-bg text-search-box-button-text ronded rounded-md p-1 font-bold w-[20%]"/></form></div><div class="hidden fixed w-full top-0 modal h-[100vh] overflow-y-scroll z-[9999] max-h-screen" id="div_mobile_main_menu_0"><div class="bg-primary h-full w-[80%] "><div class="pb-10 container text-white max-h-screen overflow-auto pt-4"><div class="flex items-center py-4 px-2 relative "><div class="text-3xl w-[18%] xs:ml-8 text-left"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="M289.94 256l95-95A24 24 0 00351 127l-95 95-95-95a24 24 0 00-34 34l95 95-95 95a24 24 0 1034 34l95-95 95 95a24 24 0 0034-34z"></path></svg></div><div class="mx-auto w-[70%] text-center pt-2 absolute top-1/2 left-1/2 -translate-x-1/2 -translate-y-1/2"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27201%27%20height=%2730%27/%3e"/></span><img alt="logo" srcSet="/_next/image?url=%2FPsychiatricTimesLogo%20WHT.png&w=256&q=75 1x, /_next/image?url=%2FPsychiatricTimesLogo%20WHT.png&w=640&q=75 2x" src="/_next/image?url=%2FPsychiatricTimesLogo%20WHT.png&w=640&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/></span></div></div><div class="border-b border-[rgba(0,0,0,.20)] mx-2 pb-2"></div><div class="relative border-b border-[rgba(0,0,0,.20)] mx-2 py-2"><div class="flex items-center justify-between p-2"><div class="flex items-center w-full justify-between">Spotlight<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div></div><div class="hidden bg-nav-secondary -mx-2 " id="div_sub_menu_dropdown_mobile_0"><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/topics/major-depressive-disorder">Major Depressive Disorder</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/topics/schizophrenia">Schizophrenia/Psychosis </a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/topics/mental-health-awareness">Mental Health Awareness Month</a></div></div><div class="relative border-b border-[rgba(0,0,0,.20)] mx-2 py-2"><div class="flex items-center justify-between p-2"><div class="flex items-center w-full justify-between">Commentary<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div></div><div class="hidden bg-nav-secondary -mx-2 " id="div_sub_menu_dropdown_mobile_1"><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/commentary/couch-in-crisis">Couch In Crisis</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/commentary/early-career-psychiatry">Early Career Psychiatry</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/commentary/history-of-psychiatry">History of Psychiatry</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/commentary/residents">Residents Corner</a></div></div><div class="relative border-b border-[rgba(0,0,0,.20)] mx-2 py-2"><div class="flex items-center justify-between p-2"><div class="flex items-center w-full justify-between">Cultural Corner<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div></div><div class="hidden bg-nav-secondary -mx-2 " id="div_sub_menu_dropdown_mobile_2"><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/cultural-corner/film-and-book-reviews">Film and Book Reviews</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/cultural-corner/poetry">Poetry</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/cultural-corner/writers-contest">Writers Contest</a></div></div><div class="relative border-b border-[rgba(0,0,0,.20)] mx-2 py-2"><div class="flex items-center justify-between p-2"><div class="flex items-center w-full justify-between">Psychiatric Practice<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div></div><div class="hidden bg-nav-secondary -mx-2 " id="div_sub_menu_dropdown_mobile_3"><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/psychiatric-practice/burnout">Burnout</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/psychiatric-practice/careers">Careers</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/psychiatric-practice/coding">Coding</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/psychiatric-practice/guidelines">Guidelines</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/psychiatric-practice/risk-management">Risk Management</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/psychiatric-practice/telepsychiatry">Telepsychiatry</a></div></div><div class="relative border-b border-[rgba(0,0,0,.20)] mx-2 py-2"><div class="flex items-center justify-between p-2"><div class="flex items-center w-full justify-between">Series<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></div></div><div class="hidden bg-nav-secondary -mx-2 " id="div_sub_menu_dropdown_mobile_4"><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/series/climate-change">Climate Change</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/series/critical-conversations-in-psychiatry">Critical Conversations in Psychiatry</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/series/portraits">Portraits</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/series/psychiatric-views-on-the-daily-news">Psychiatric Views on the Daily News</a><a class="block w-full pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,0.1)]" href="/series/tales-new-asylum">Tales from the New Asylum</a></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.1)] mx-2"><div class="flex items-center p-2 " href="/news"><span class="flex items-center w-full justify-between">News</span></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.20)] mx-2"><button aria-controls="div_main_menu_dropdown_mobile_1" class="flex items-center p-2 w-full "><span class="flex items-center w-full justify-between">Media<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></span></button><div class="hidden bg-nav-secondary -mx-2" id="div_main_menu_dropdown_mobile_1"><a href="/around-the-practice"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Around the Practice</div></a><a href="/between-the-lines"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Between the Lines</div></a><a href="/psych-view"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">PsychView</div></a><a href="/expert-perspectives?page=1"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Expert Perspectives</div></a><a href="/case-based-psych-perspectives"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Case-Based Psych Perspectives</div></a><a href="/clinical-case-collective?page=1"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Clinical Case Collective</div></a><a href="/dialogues"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Dialogues</div></a><a href="/payer-provider-perspective"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Payer-Provider Perspective</div></a><a href="/slideshows"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Slideshows</div></a><a href="/videos"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Videos</div></a><a href="/viewpoints"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Viewpoints</div></a></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.20)] mx-2"><button aria-controls="div_main_menu_dropdown_mobile_2" class="flex items-center p-2 w-full "><span class="flex items-center w-full justify-between">Conferences<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></span></button><div class="hidden bg-nav-secondary -mx-2" id="div_main_menu_dropdown_mobile_2"><a href="/latest-conference"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Conference Coverage</div></a><a href="/conferences"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Conference Listing</div></a></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.20)] mx-2"><button aria-controls="div_main_menu_dropdown_mobile_3" class="flex items-center p-2 w-full "><span class="flex items-center w-full justify-between">Publication<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></span></button><div class="hidden bg-nav-secondary -mx-2" id="div_main_menu_dropdown_mobile_3"><a href="/journals/psychiatric-times"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Psychiatric Times</div></a></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.1)] mx-2"><div class="flex items-center p-2 " href="http://jobs.modernmedicine.com/index.php"><span class="flex items-center w-full justify-between">Job Board</span></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.1)] mx-2"><div class="flex items-center p-2 " href="/continuing-education"><span class="flex items-center w-full justify-between">CME/CE</span></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.1)] mx-2"><div class="flex items-center p-2 " href="/sap-partner"><span class="flex items-center w-full justify-between">Partners</span></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.1)] mx-2"><div class="flex items-center p-2 " href="/editorial-info"><span class="flex items-center w-full justify-between">Editorial</span></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.20)] mx-2"><button aria-controls="div_main_menu_dropdown_mobile_8" class="flex items-center p-2 w-full "><span class="flex items-center w-full justify-between">Resources<svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path d="m11.998 17 7-8h-14z"></path></svg></span></button><div class="hidden bg-nav-secondary -mx-2" id="div_main_menu_dropdown_mobile_8"><a href="/clinical-consult"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Clinical Consult</div></a><a href="/resources/clinical-scales"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Clinical Scales</div></a><a href="/interactive-tools"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Interactive Tools</div></a><a href="/partner-perspectives"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Partner Perspectives</div></a><a href="/resources/q-a"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Q&A</div></a><a href="/resources/quizzes"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Quizzes</div></a><a href="/series"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Series</div></a><a href="/special-reports"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Special Reports</div></a><a href="/resources/sponsored-resources"><div class=" pt-2 pb-2 pl-6 pr-6 hover:bg-secondary text-sm border-b border-[rgba(0,0,0,.20)]">Sponsored</div></a></div></div><div class="relative py-2 border-b border-[rgba(0,0,0,.1)] mx-2"><div class="flex items-center p-2 " href="https://one.psychiatrictimes.com/subscribe"><span class="flex items-center w-full justify-between">Subscribe</span></div></div></div></div></div><div class="w-full h-[2px] bg-main-nav-border-bg"></div></div><div class="container px-4 mx-auto pl-2 pr-2 sm:h-[98px] sm:w-[728px]"><div id="leaderboardWrapper" class="jsx-1661e6713d4eb9b5 leaderboardAdWrapper mx-auto mt-1 flex min-h-0 md:min-h-[90px] justify-center items-center flex-col relative z-[99999] "><div class="jsx-1661e6713d4eb9b5 bg-white md:-translate-x-4"><div class="jsx-1661e6713d4eb9b5 text-[8px] text-center text-gray-600 hidden relative">Advertisement</div><div id="div-gpt-ad-top" class="jsx-1661e6713d4eb9b5 AD728x90 mx-auto text-center x"></div></div></div></div><nav class=" relative bg-white text-gray-900 mb-6 mt-4 w-full hidden md:block" id="mega-menu"><div class="container mx-auto flex flex-col pl-4 items-center"><div class="sm:flex w-full hidden text-sm border-b border-menu-border"><div id="" class="headers w-[93%] h-5 overflow-hidden flex flex-row flex-wrap undefined my-4 ml-0 z-[9999]"><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/adhd"> ADHD </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/addiction-suds-compulsive"> | Addiction & Substance Use </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/anxiety"> | Anxiety & Stress Disorders </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/bipolar"> | Bipolar Disorder </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/covid-19"> | COVID-19 </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/cannabis"> | Cannabis </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/case-discussions"> | Case Discussions </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/child-adolescent-psychiatry"> | Child & Adolescent Psychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/climate-change"> | Climate Change </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/comorbidity"> | Comorbidity </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/compulsive-disorders"> | Compulsive Disorders </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/cultural-psychiatry"> | Cultural Psychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/digital-therapeutics"> | Digital Therapeutics </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/dei"> | Diversity, Equity, Inclusion </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/drug-watch"> | Drug Watch </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/eating-disorders"> | Eating Disorders </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/emergency-psychiatry"> | Emergency Psychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/ethics"> | Ethics </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/forensic"> | Forensic Psychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/geriatric-psychiatry"> | Geriatric Psychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/integrative-psychiatry"> | Integrative Psychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/major-depressive-disorder"> | Major Depressive Disorder </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/mental-health-awareness"> | Mental Health Awareness Month </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/mood-disorders"> | Mood Disorders </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/neuropsychiatry"> | Neuropsychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/ptsd"> | PTSD </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/personality-disorders"> | Personality Disorders </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/postpartum"> | Postpartum Depression </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/psychedelics"> | Psychedelics </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/psychopharmacology"> | Psychopharmacology </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/psychosomatics"> | Psychosomatics </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/psychotherapy"> | Psychotherapy </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/schizophrenia"> | Schizophrenia/Psychosis </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/sleep-disorders"> | Sleep Disorders </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/special-populations"> | Special Populations </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/suicide"> | Suicide </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/tardive-dyskinesia"> | Tardive Dyskinesia </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/tech-psychiatry"> | Technology & Psychiatry </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-main-nav-item-text hover:underline px-2 pb-3 hover:text-primary border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/transcranial-magnetic-stimulation"> | Transcranial Magnetic Stimulation </a><div class="mt-4 max-w-[125px]"></div></div></div><div class="group w-[10%] text-center subnav-view-all mx-auto mt-4 text-sm"><div class="cursor-pointer text-main-nav-item-text hover:opacity-80 text-right">View All >></div><div class="w-full z-[99999] h-megamenu-height overflow-x-auto right-0 p-6 mega-menu group-hover:block hidden pt-8 mb-16 sm:mb-0 shadow-xl bg-white absolute"><ul class="container w-[80%] m-auto flex flex-col flex-wrap h-full"><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/adhd">ADHD</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/addiction-suds-compulsive">Addiction & Substance Use</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/anxiety">Anxiety & Stress Disorders</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/bipolar">Bipolar Disorder</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/covid-19">COVID-19</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/cannabis">Cannabis</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/case-discussions">Case Discussions</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/child-adolescent-psychiatry">Child & Adolescent Psychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/climate-change">Climate Change</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/comorbidity">Comorbidity</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/compulsive-disorders">Compulsive Disorders</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/cultural-psychiatry">Cultural Psychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/digital-therapeutics">Digital Therapeutics</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/dei">Diversity, Equity, Inclusion</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/drug-watch">Drug Watch</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/eating-disorders">Eating Disorders</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/emergency-psychiatry">Emergency Psychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/ethics">Ethics</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/forensic">Forensic Psychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/geriatric-psychiatry">Geriatric Psychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/integrative-psychiatry">Integrative Psychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/major-depressive-disorder">Major Depressive Disorder</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/mental-health-awareness">Mental Health Awareness Month</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/mood-disorders">Mood Disorders</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/neuropsychiatry">Neuropsychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/ptsd">PTSD</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/personality-disorders">Personality Disorders</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/postpartum">Postpartum Depression</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/psychedelics">Psychedelics</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/psychopharmacology">Psychopharmacology</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/psychosomatics">Psychosomatics</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/psychotherapy">Psychotherapy</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/schizophrenia">Schizophrenia/Psychosis</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/sleep-disorders">Sleep Disorders</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/special-populations">Special Populations</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/suicide">Suicide</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/tardive-dyskinesia">Tardive Dyskinesia</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/tech-psychiatry">Technology & Psychiatry</a></li><li class=" text-left m-1 p-2 ml-8 hover:opacity-80 hover:underline hover:text-primary"><a class=" " href="/topics/transcranial-magnetic-stimulation">Transcranial Magnetic Stimulation</a></li></ul></div></div></div><div class="sm:flex w-full hidden text-sm border-menu-border"><p class="my-auto flex font-bold text-primary w-auto ">SPOTLIGHT <span class="font-normal">-</span></p><div id="" class="headers w-[90%] h-5 overflow-hidden flex flex-row flex-wrap undefined my-4 ml-0 z-[9999]"><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/major-depressive-disorder"> Major Depressive Disorder </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/schizophrenia"> | Schizophrenia/Psychosis </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/mental-health-awareness"> | Mental Health Awareness Month </a><div class="mt-4 max-w-[125px]"></div></div></div></div></div></nav><div id="traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases" class="container mx-auto flex m-1 min-h-[57vh] px-4"><div class="flex-auto w-[calc(100%-300px)] pr-0 md:pr-6 mt-16 sm:mt-0"><div class="m-2 md:my-2 md:ml-2 md:pr-12"><div class="hidden md:block fixed"><div class="md:absolute md:left-[557px] lg:left-[742px] xl:left-[942px] flex flex-col justify-center bg-white h-fit w-fit py-3 px-[.35rem] border border-[#DDDDDD] rounded-full"><button class="group mt-1"><button aria-label="linkedin" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 448 512" style="color:#818285;margin-bottom:6px;cursor:pointer" height="1.25rem" width="1.25rem" xmlns="http://www.w3.org/2000/svg"><path d="M100.28 448H7.4V148.9h92.88zM53.79 108.1C24.09 108.1 0 83.5 0 53.8a53.79 53.79 0 0 1 107.58 0c0 29.7-24.1 54.3-53.79 54.3zM447.9 448h-92.68V302.4c0-34.7-.7-79.2-48.29-79.2-48.29 0-55.69 37.7-55.69 76.7V448h-92.78V148.9h89.08v40.8h1.3c12.4-23.5 42.69-48.3 87.88-48.3 94 0 111.28 61.9 111.28 142.3V448z"></path></svg></button></button><button class="group"><button aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg stroke="currentColor" fill="currentColor" stroke-width="0" version="1.2" baseProfile="tiny" viewBox="0 0 24 24" style="color:#818285;margin-bottom:6px;cursor:pointer" height="32" width="32" xmlns="http://www.w3.org/2000/svg"><path d="M13 10h3v3h-3v7h-3v-7h-3v-3h3v-1.255c0-1.189.374-2.691 1.118-3.512.744-.823 1.673-1.233 2.786-1.233h2.096v3h-2.1c-.498 0-.9.402-.9.899v2.101z"></path></svg></button></button><button class="group"><button aria-label="twitter" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 512 512" style="color:#818285;margin-bottom:10px;cursor:pointer" height="1.25rem" width="1.25rem" xmlns="http://www.w3.org/2000/svg"><path d="M389.2 48h70.6L305.6 224.2 487 464H345L233.7 318.6 106.5 464H35.8L200.7 275.5 26.8 48H172.4L272.9 180.9 389.2 48zM364.4 421.8h39.1L151.1 88h-42L364.4 421.8z"></path></svg></button></button><button class="group"><button aria-label="email" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" style="color:#818285;margin-bottom:6px;cursor:pointer" height="1.25rem" width="1.25rem" xmlns="http://www.w3.org/2000/svg"><path fill="none" d="M0 0h24v24H0V0z"></path><path d="M22 6c0-1.1-.9-2-2-2H4c-1.1 0-2 .9-2 2v12c0 1.1.9 2 2 2h16c1.1 0 2-.9 2-2V6zm-2 0l-8 4.99L4 6h16zm0 12H4V8l8 5 8-5v10z"></path></svg></button></button><button class="group mb-4 "><a class="cursor-pointer flex justify-center"><svg stroke="currentColor" fill="none" stroke-width="2" viewBox="0 0 24 24" stroke-linecap="round" stroke-linejoin="round" style="color:#818285;margin-bottom:6px;background:white;cursor:pointer" height="1.25rem" width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2024-10-01T14:00:00.000">October 1, 2024</time></div><h1 class="text-[26px] font-medium leading-8">Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/grace-s-griesbach-phd">Grace S. Griesbach, PhD</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 c-4.1,0-6.9,2.5-6.9,7V28H24v5.3h4.6V47H34.1z" fill="white"></path></svg></button><button aria-label="twitter" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg fill="#DC7633" xmlns="http://www.w3.org/2000/svg" width="32" zoomAndPan="magnify" viewBox="0 0 375 374.9999" height="32" preserveAspectRatio="xMidYMid meet" version="1.0"><defs><path d="M 7.09375 7.09375 L 367.84375 7.09375 L 367.84375 367.84375 L 7.09375 367.84375 Z M 7.09375 7.09375 " fill="#000000"></path></defs><g><path d="M 187.46875 7.09375 C 87.851562 7.09375 7.09375 87.851562 7.09375 187.46875 C 7.09375 287.085938 87.851562 367.84375 187.46875 367.84375 C 287.085938 367.84375 367.84375 287.085938 367.84375 187.46875 C 367.84375 87.851562 287.085938 7.09375 187.46875 7.09375 " fill-opacity="1" fill-rule="nonzero" fill="#000000"></path></g><g transform="translate(85, 75)"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24" version="1.1" height="215" width="215"><path d="M18.244 2.25h3.308l-7.227 8.26 8.502 11.24H16.17l-5.214-6.817L4.99 21.75H1.68l7.73-8.835L1.254 2.25H8.08l4.713 6.231zm-1.161 17.52h1.833L7.084 4.126H5.117z" fill="#ffffff"></path></svg> </g></svg></button><button aria-label="linkedin" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#007fb1"></circle><path d="M20.4,44h5.4V26.6h-5.4V44z M23.1,18c-1.7,0-3.1,1.4-3.1,3.1c0,1.7,1.4,3.1,3.1,3.1 c1.7,0,3.1-1.4,3.1-3.1C26.2,19.4,24.8,18,23.1,18z M39.5,26.2c-2.6,0-4.4,1.4-5.1,2.8h-0.1v-2.4h-5.2V44h5.4v-8.6 c0-2.3,0.4-4.5,3.2-4.5c2.8,0,2.8,2.6,2.8,4.6V44H46v-9.5C46,29.8,45,26.2,39.5,26.2z" fill="white"></path></svg></button><button title="Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases" aria-label="pinterest" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#cb2128"></circle><path d="M32,16c-8.8,0-16,7.2-16,16c0,6.6,3.9,12.2,9.6,14.7c0-1.1,0-2.5,0.3-3.7 c0.3-1.3,2.1-8.7,2.1-8.7s-0.5-1-0.5-2.5c0-2.4,1.4-4.1,3.1-4.1c1.5,0,2.2,1.1,2.2,2.4c0,1.5-0.9,3.7-1.4,5.7 c-0.4,1.7,0.9,3.1,2.5,3.1c3,0,5.1-3.9,5.1-8.5c0-3.5-2.4-6.1-6.7-6.1c-4.9,0-7.9,3.6-7.9,7.7c0,1.4,0.4,2.4,1.1,3.1 c0.3,0.3,0.3,0.5,0.2,0.9c-0.1,0.3-0.3,1-0.3,1.3c-0.1,0.4-0.4,0.6-0.8,0.4c-2.2-0.9-3.3-3.4-3.3-6.1c0-4.5,3.8-10,11.4-10 c6.1,0,10.1,4.4,10.1,9.2c0,6.3-3.5,11-8.6,11c-1.7,0-3.4-0.9-3.9-2c0,0-0.9,3.7-1.1,4.4c-0.3,1.2-1,2.5-1.6,3.4 c1.4,0.4,3,0.7,4.5,0.7c8.8,0,16-7.2,16-16C48,23.2,40.8,16,32,16z" fill="white"></path></svg></button><button aria-label="email" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#7f7f7f"></circle><path d="M17,22v20h30V22H17z M41.1,25L32,32.1L22.9,25H41.1z M20,39V26.6l12,9.3l12-9.3V39H20z" fill="white"></path></svg></button><a class="print-wrap flex justify-center items-center cursor-pointer"><svg id="print" xmlns="http://www.w3.org/2000/svg" width="24" height="24" fill="currentColor" class="print bi bi-printer" viewBox="0 0 16 16"> <path d="M2.5 8a.5.5 0 1 0 0-1 .5.5 0 0 0 0 1z"></path> <path d="M5 1a2 2 0 0 0-2 2v2H2a2 2 0 0 0-2 2v3a2 2 0 0 0 2 2h1v1a2 2 0 0 0 2 2h6a2 2 0 0 0 2-2v-1h1a2 2 0 0 0 2-2V7a2 2 0 0 0-2-2h-1V3a2 2 0 0 0-2-2H5zM4 3a1 1 0 0 1 1-1h6a1 1 0 0 1 1 1v2H4V3zm1 5a2 2 0 0 0-2 2v1H2a1 1 0 0 1-1-1V7a1 1 0 0 1 1-1h12a1 1 0 0 1 1 1v3a1 1 0 0 1-1 1h-1v-1a2 2 0 0 0-2-2H5zm7 2v3a1 1 0 0 1-1 1H5a1 1 0 0 1-1-1v-3a1 1 0 0 1 1-1h6a1 1 0 0 1 1 1z"></path></svg></a></div><style> .print-wrap { width: 32px; height: 32px; background: #7F7F7F; border-radius: 100%; } .print { background: #7F7F7F; color: white; padding: 2px; border-radius: 100%; } </style></div></div></div></div><div class=" lg:w-full flex flex-col lg:flex-row lg:items-center lg:justify-end"></div><p class="py-2 mb-2 text-sm italic text-gray-600">A traumatic brain injury sustained earlier in adult life is likely to interact with normal aging processes. Learn more here. </p><div class="py-2"><div class="blockText_blockContent__TbCXh"><div class=""><div style="width:50%;float:left;max-width:525px;margin:0 1.5rem 1.5rem 0;clear:both;cursor:" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%275376%27%20height=%273584%27/%3e"/></span><img alt="aging brain" title="aging brain" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="aging brain" title="aging brain" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fc530ea8991dc158368cf0165173630a0e66cdf08-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fc530ea8991dc158368cf0165173630a0e66cdf08-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Ramunas/AdobeStock</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">A significant number of individuals who sustained a traumatic brain injury (TBI) during early and mid-adulthood are living with disabilities within the US. When considering the impact of TBI over the years, it becomes clear that the effects of TBI may become more evident as aging takes place. This is because a TBI sustained earlier in adult life is likely to interact with normal aging processes.</p><p class="pb-2"></p><p class="pb-2"><strong>TBI Can Exacerbate Age Related Changes</strong></p><p class="pb-2">As the brain ages, there is naturally occurring atrophy of cerebral tissue including structures such as the hippocampus, which plays a significant role in memory and cognitive processing. The hippocampus is frequently impacted by TBI, thus increasing the likelihood of developing memory impairments as one ages.<sup class="text-inherit">1</sup> Interestingly, a large hippocampal volume appears to offer protection from dementia.<sup class="text-inherit">2</sup> A decline in white matter volume is also observed during normal aging.<sup class="text-inherit">3</sup> White matter is mainly composed of myelinated axons and decreases in myelin density will hinder the capacity to transmit signals across the nervous system. Following TBI, these changes can occur at an accelerated rate compared with normal aging.<sup class="text-inherit">4</sup></p><p class="pb-2"></p><p class="pb-2">The natural process of remyelination is also altered as the brain ages.<sup class="text-inherit">3</sup> Oligodendrocyte loss arising from the original injury may predispose the brain to decreased remyelination capacity.<sup class="text-inherit">5</sup> Oligodendrocytes are critical in maintaining the myelin sheath. White matter deterioration can manifest as cognitive deficits by affecting the efficiency of connectivity.<sup class="text-inherit">6,7</sup> Studies utilizing functional imaging have shown that there is a change in network connections during normal aging that is exacerbated with brain injury.<sup class="text-inherit">8</sup> Primary pathways that were established during development may be affected by injury and replaced with redundant pathways that, while enabling function, are not as effective as the originals and will render the brain more vulnerable to the effects of aging.<sup class="text-inherit">9</sup> Given that even mild TBI can have an impact on connectivity, it is not surprising that the risk of dementia is increased with repeated injury.<sup class="text-inherit">10,11</sup></p><p class="pb-2"></p><p class="pb-2">Normal aging also has an impact on neuroendocrine and immunological systems that can contribute to age-related cognitive decline.<sup class="text-inherit">12,13</sup> Long lasting hormonal dysregulation is not uncommon in many patients after TBI and may well contribute to neurodegenerative processes across time.<sup class="text-inherit">10,11</sup> Particularly noteworthy is the impact that hormones have on emotional health and cognition.<sup class="text-inherit">14</sup> Hormones also are known to have immunomodulatory effects. Microglia, the brain’s primary immune cells, are known to be especially vulnerable to the effects of age.<sup class="text-inherit">15</sup> Age related immune changes are also likely to be exacerbated by a history of TBI. Increased microglial activity can be observed years after the initial injury.<sup class="text-inherit">16-18</sup> Persistent microglial activation can increase oxidative stress thus contribute to age- and injury-induced structural changes and long-term functional deficits.<sup class="text-inherit">18,19</sup></p><p class="pb-2"></p><p class="pb-2"><strong>TBI May Precipitate or Exacerbate Neurodegenerative Diseases</strong></p><p class="pb-2">The possibility of developing dementia increases with advancing age.<sup class="text-inherit">20</sup> When considering the interaction between TBI and neurodegenerative diseases, it is critical to distinguish between the disease per se and the pathological characteristics that are associated with these diseases.<sup class="text-inherit">21 </sup>This distinction is particularly notable in the case of Alzheimer disease (AD). Studies are suggestive of an increased incidence in AD-like pathology following TBI.<sup class="text-inherit">11,22,23</sup> In general, the association between a history of TBI and the onset of AD, has shown to be elusive.<sup class="text-inherit">24,25</sup> Nevertheless, a TBI history may influence the onset of AD given the appropriate genetic factors. APOE-4 and TBI appear to have a synergistic effect that increases the risk of AD-like symptomatology.<sup class="text-inherit">26</sup> The APOE-4 allele has been identified as a genetic predictor of AD.<sup class="text-inherit">27</sup> Associations between a history of TBI and Parkinson disease (PD), amyotrophic lateral sclerosis, and multiple sclerosis have also been observed.<sup class="text-inherit">28</sup> TBI has been associated with cerebral microinfarcts, Lewy body accumulation, and parkinsonism.<sup class="text-inherit">29</sup> Lewy bodes are intercellular protein aggregates associated with dementia and PD. The association between PD and TBI has been widely debated due to conflicting studies.<sup class="text-inherit">30,31</sup> Parkinson symptomatology may be more prevalent after repeated trauma.<sup class="text-inherit">31 </sup>Alternatively, a history of TBI may increment the likelihood of neurological illness in those patients who are at risk of PD.</p><p class="pb-2"></p><p class="pb-2"><strong>Prognosis and Treatment Strategies</strong></p><p class="pb-2">To achieve successful aging, it is important to have a lifestyle that integrates factors known to promote health and consider strategies that address changes in neuroendocrine and immune systems. These same approaches are especially important to those that have survived a TBI.Vigilance for the development of comorbidities is necessary along with proper awareness of physiological, environmental and genetic factors that may increase risk to cognitive decline.</p><p class="pb-2"></p><p class="pb-2"><strong>Dr Griesbach </strong><em>is the national director of clinical research for the Centre of Neuro Skills. She currently holds an appointment at the Neurosurgery Department, Geffen School of Medicine, UCLA, and is past president and chair for the National Neurotrauma Society.</em></p><p class="pb-2"></p><p class="pb-2"><strong>References</strong></p><p class="pb-2">1. Bigler ED, Blatter DD, Anderson CV, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/9010515/">Hippocampal volume in normal aging and traumatic brain injury.</a> <em>AJNR Am J Neuroradiol</em>. 1997;18(1):11-23.</p><p class="pb-2">2. Chetelat G, Villemagne VL, Pike KE, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/20739349/">Larger temporal volume in elderly with high versus low beta-amyloid deposition.</a> <em>Brain</em>. 2010;133(11):3349-3358.</p><p class="pb-2">3. Franklin RJ, Zhao C, Sim FJ. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/12004191/">Ageing and CNS remyelination.</a> <em>Neuroreport</em>. 2002;13(7):923-928.</p><p class="pb-2">4. Maxwell WL, MacKinnon MA, Stewart JE, Graham DI. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/19897544/">Stereology of cerebral cortex after traumatic brain injury matched to the Glasgow outcome score.</a> <em>Brain</em>. 2010;133(Pt 1):139-160.</p><p class="pb-2">5. Levin HS, Williams DH, Valastro M, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/2352026/">Corpus callosal atrophy following closed head injury: detection with magnetic resonance imaging.</a> <em>J Neurosurg</em>. 1990;73(1):77-81.</p><p class="pb-2">6. Maas AI, Menon DK. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/22172614/">Traumatic brain injury: rethinking ideas and approaches.</a> <em>Lancet Neurol</em>. 2012;11(1):12-13.</p><p class="pb-2">7. Ziegler DA, Piguet O, Salat DH, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996721/">Cognition in healthy aging is related to regional white matter integrity, but not cortical thickness.</a> <em>Neurobiol Aging</em>. 2010;31(11):1912-1926.</p><p class="pb-2">8. Filippi M, van den Heuvel MP, Fornito A, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/24120645/">Assessment of system dysfunction in the brain through MRI-based connectomics.</a> <em>Lancet Neurol</em>. 2013;12(12):1189-1199.</p><p class="pb-2">9. Blumberg M, Hardy J, Robinson S. <em>Handbook of Developmental Neuroscience.</em> Oxford; 2009.</p><p class="pb-2">10. Kreber LA, Griesnbach GS, Ashley JA. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/26414093/">Detection of growth hormone deficiency in adults with chronic traumatic brain injury.</a> <em>J Neurotrauma</em>. 2016;33(17):1607-1613.</p><p class="pb-2">11. Griesbach GS, Masel BE, Helvie RE, Ashley MJ. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/28920532/">The impact of traumatic brain injury on later life: effects on normal aging and neurodegenerative diseases.</a> <em>J Neurotrauma</em>. 2018;35(1):17-24.</p><p class="pb-2">12. Veldhuis JD, Sharma A, Roelfsema F. <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675779/">Age-dependent and gender-dependent regulation of hypothalamic-adrenocorticotropic-adrenal axis.</a> <em>Endocrinol Metab Clin North Am</em>. 2013;42(2):201-225.</p><p class="pb-2">13. McEwen B, Milner TA. <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120618/">Understanding the broad influenceof sex hormones and sex differences in the brain.</a> <em>J Neurosci Res</em>. 2017;95(1-2):24-39.</p><p class="pb-2">14. Ashman TA, Gordon WA, Cantor JB, Hibbard MR. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/17195886/">Neurobehavioral consequences of traumatic brain injury.</a> <em>Mt Sinai J Med</em>. 2006;73(7):999-1005.</p><p class="pb-2">15. Damani MR, Zhao L, Fontainhas AM, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/21108733/">Age‐related alterations in the dynamic behavior of microglia.</a> <em>Aging Cell</em>. 2011;10(2):263-276.</p><p class="pb-2">16. Rowe RK, Griesbach GS. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/35537569/">Immune-endocrine interactions in the pathophysiology of sleep-wake disturbances following traumatic brain injury: a narrative review.</a> <em>Brain Res Bull</em>. 2022;185:117-128.</p><p class="pb-2">17. Smith C, Gentleman SM, Leclercq PD, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/23231074/">The neuroinflammatory response in humans after traumatic brain injury.</a> <em>Neuropathol Appl Neurobiol</em>. 2013;39(6):654-666.</p><p class="pb-2">18. Ramlackhansingh AF, Brooks DJ, Greenwood RJ, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/21710619/">Inflammation after trauma: microglial activation and traumatic brain injury.</a> <em>Ann Neurol. </em>2011;70(3):374-383.</p><p class="pb-2">19. Brown GC, Neher JJ. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/20195798/">Inflammatory neurodegeneration and mechanisms of microglial killing of neurons.</a> <em>Mol Neurobiol</em>. 2010;41(2-3):242-247.</p><p class="pb-2">20. Katzman R. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/1259639/">The prevalence and malignancy of Alzheimer disease. A major killer.</a> <em>Arch Neurol. </em>1976;33(4):217-218.</p><p class="pb-2">21. Ashman TA, Cantor JB, Gordon WA, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/18520426/">A comparison of cognitive functioning in older adults with and without traumatic brain injury.</a> <em>J Head Trauma Rehabil.</em> 2008;23(3):139-148.</p><p class="pb-2">22. Johnson VE, Stewart W, Smith DH. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/22285252/">Axonal pathology in traumatic brain injury.</a> <em>Exp Neurol</em>. 2013;246:35-43.</p><p class="pb-2">23. Masel BE. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/26629808/">The chronic consequences of neurotrauma.</a> <em>J Neurotrauma.</em> 2015;32(23):1833.</p><p class="pb-2">24. Fleminger S, Oliver DL, Lovestone S, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738550/">Head injury as a risk factor for Alzheimer's disease: the evidence 10 years on a partial replication.</a> <em>J Neurol Neurosurg Psychiatry. </em>2003;74(7):857-862.</p><p class="pb-2">25. Dams-O'Connor K, Spielman L, Singh A, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/23924069/">The impact of previous traumatic brain injury on health and functioning: a TRACK-TBI study.</a> <em>J Neurotrauma</em>. 2013;30(24):2014-2020.</p><p class="pb-2">26. Graham DI, Horsburgh K, Nicoll JA, Teasdale GM. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/10494348/">Apolipoprotein E and the response of the brain to injury.</a> <em>Acta Neurochir Suppl.</em> 1999;73:89-92.</p><p class="pb-2">27. Guo Z, Cupples LA, Kurz A, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/10746604/">Head injury and the risk of AD in the MIRAGE study.</a> <em>Neurology</em>. 2000;54(6):1316-1323.</p><p class="pb-2">28. Perry DC, Sturm VE, Peterson MJ, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/26315003/">Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis.</a> <em>J Neurosurg.</em> 2015;124(2):511-526.</p><p class="pb-2">29. Crane PK, Gibbons LE, Dams-O’Connor K, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/27400367/">Association of traumatic brain injury with late-life neurodegenerative conditions and neuropathologic findings.</a> <em>JAMA Neurol.</em> 2017;73(9):1062-1069.</p><p class="pb-2">30. Goldman SM, Tanner CM, Oakes D, et al. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/16718702/">Head injury and Parkinson's disease risk in twins.</a> <em>Ann Neurol.</em> 2006;60(1):65-72.</p><p class="pb-2">31. Krauss JK. <a rel="nofollow noreferrer noopener" target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/25701902/">Movement disorders secondary to craniocerebral trauma.</a> <em>Handb Clin Neurol.</em> 2015;128:475-496.</p><p class="pb-2"></p><p class="pb-2"></p></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/using-brain-science-to-develop-better-safer-more-effective-treatments"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="brain" title="brain" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="brain" title="brain" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/amotivation-in-individuals-with-schizophrenia-exciting-research-ideas-at-acnp-2023"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="brain schizophrenia" title="brain schizophrenia" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="brain schizophrenia" title="brain schizophrenia" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F18558c5d86e9709750196568183fc48e4e4b34da-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/eating-disorders-and-emerging-neuroscience"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="eating disorder brain" title="eating disorder brain" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="eating disorder brain" title="eating disorder brain" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa042b8a2b459a77110e7326e322b7d36287ca733-3500x3500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/deep-dive-dementia-2023-psychiatric-times-world-cme-conference"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="dementia" title="dementia" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="dementia" title="dementia" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/nagasaki-day-the-anniversary-of-atomic-bombing"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="atomic bomb" title="atomic bomb" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="atomic bomb" title="atomic bomb" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/wrestling-with-the-fallout-from-the-atomic-bomb"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="atomic fallout" title="atomic fallout" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="atomic fallout" title="atomic fallout" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F40806405cc8452a075e6db696b82115511a6692f-5760x3840.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/we-are-still-a-traumatized-nation"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="trauma" title="trauma" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="trauma" title="trauma" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/keeping-schools-communities-safe-early-intervention-to-prevent-school-shootings"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="stop violence" title="stop violence" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="stop violence" title="stop violence" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/working-together-to-prevent-acts-of-terrorism-and-violence"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="together" title="together" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="together" title="together" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Faa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/fictional-portrayals-of-mental-illness-impact-on-stigma"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="stopping stigma" title="stopping stigma" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="stopping stigma" title="stopping stigma" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=30 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=30 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=30 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=30 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=30 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=30 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=30 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F7997ca17732af13050b2477a75d78be6d273234a-1601x1069.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a></div></div><div class="relative block sm:hidden"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="lg:grid grid-cols-2 gap-x-12"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/3baa097f1742d64c9afda10b2c6f7deda469f1dc-7280x4080.jpg?fit=crop&auto=format" alt="trauma" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 12th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Opening Pandora’s Box: The Importance of Assessing and Treating Trauma in Individuals Experiencing Psychosis</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/sripriya-chari-phd">Sripriya Chari, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/grace-eun-lee-phd">Grace Eun Lee, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/nichole-d-olson-phd">Nichole D. Olson, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kate-v-hardy-psyd">Kate V. Hardy, PsyD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/future-alzheimer-disease?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/e33780bee23eaf9f65c8d73424afe09c7790058d-480x270.jpg?fit=crop&auto=format" alt="What Will the Future of Alzheimer Disease Treatment Look Like? " width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">July 23rd 2021</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/future-alzheimer-disease?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">What Will the Future of Alzheimer Disease Treatment Look Like? </a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/helen-lavretsky-md-ms">Helen Lavretsky, MD, MS</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/future-alzheimer-disease?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/tms-for-the-treatment-of-ocd?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/6e7deea1c577db789477d44ab9518072785d31ee-6000x4000.jpg?fit=crop&auto=format" alt="brain lightbulb" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 25th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/tms-for-the-treatment-of-ocd?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">TMS for the Treatment of OCD</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/tommy-sung-md">Tommy Sung, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/coralie-eilers-md">Coralie Eilers, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/haley-schuster-md">Haley Schuster, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mark-mullen-md">Mark Mullen, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/rajesh-r-tampi-md-ms-dfapa-dfaagp">Rajesh R. Tampi, MD, MS, DFAPA, DFAAGP</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/tms-for-the-treatment-of-ocd?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/recognize-treat-traumatic-brain-injury?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/882c03d79aad20809abba7ed419641756c66f364-3000x3000.jpg?fit=crop&auto=format" alt="Recognize and Treat Traumatic Brain Injury" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 23rd 2021</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/recognize-treat-traumatic-brain-injury?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Recognize and Treat Traumatic Brain Injury</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/david-b-arciniegas-md">David B. Arciniegas, MD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/recognize-treat-traumatic-brain-injury?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/climate-change-vector-range-and-alpha-gal-in-psychiatric-practice?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/4d334999fcf64afe7e821bce3a9230aae30a5918-5998x3999.jpg?fit=crop&auto=format" alt="tick" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 22nd 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/climate-change-vector-range-and-alpha-gal-in-psychiatric-practice?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Climate Change, Vector Range, and Alpha-Gal in Psychiatric Practice</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/ryan-babineau">Ryan Babineau</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/rebecca-susan-daily-md-dlfapa-dfaacap">Rebecca Susan Daily, MD, DLFAPA, DFAACAP</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/climate-change-vector-range-and-alpha-gal-in-psychiatric-practice?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/2172f65e37645ccf10b6977cbddcfd470b116efb-4961x3508.jpg?fit=crop&auto=format" alt="dementia" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 14th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Electroconvulsive Therapy for the Treatment of Dementia Symptoms</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/t-greg-rhee-phd">T. Greg Rhee, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/samuel-t-wilkinson-md">Samuel T. Wilkinson, MD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="lg:grid grid-cols-2 gap-x-12"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/3baa097f1742d64c9afda10b2c6f7deda469f1dc-7280x4080.jpg?fit=crop&auto=format" alt="trauma" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 12th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Opening Pandora’s Box: The Importance of Assessing and Treating Trauma in Individuals Experiencing Psychosis</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/sripriya-chari-phd">Sripriya Chari, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/grace-eun-lee-phd">Grace Eun Lee, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/nichole-d-olson-phd">Nichole D. Olson, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kate-v-hardy-psyd">Kate V. Hardy, PsyD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/future-alzheimer-disease?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/e33780bee23eaf9f65c8d73424afe09c7790058d-480x270.jpg?fit=crop&auto=format" alt="What Will the Future of Alzheimer Disease Treatment Look Like? " width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">July 23rd 2021</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/future-alzheimer-disease?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">What Will the Future of Alzheimer Disease Treatment Look Like? </a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/helen-lavretsky-md-ms">Helen Lavretsky, MD, MS</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/future-alzheimer-disease?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/tms-for-the-treatment-of-ocd?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/6e7deea1c577db789477d44ab9518072785d31ee-6000x4000.jpg?fit=crop&auto=format" alt="brain lightbulb" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 25th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/tms-for-the-treatment-of-ocd?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">TMS for the Treatment of OCD</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/tommy-sung-md">Tommy Sung, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/coralie-eilers-md">Coralie Eilers, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/haley-schuster-md">Haley Schuster, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mark-mullen-md">Mark Mullen, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/rajesh-r-tampi-md-ms-dfapa-dfaagp">Rajesh R. Tampi, MD, MS, DFAPA, DFAAGP</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/tms-for-the-treatment-of-ocd?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/recognize-treat-traumatic-brain-injury?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/882c03d79aad20809abba7ed419641756c66f364-3000x3000.jpg?fit=crop&auto=format" alt="Recognize and Treat Traumatic Brain Injury" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 23rd 2021</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/recognize-treat-traumatic-brain-injury?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Recognize and Treat Traumatic Brain Injury</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/david-b-arciniegas-md">David B. Arciniegas, MD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/recognize-treat-traumatic-brain-injury?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/climate-change-vector-range-and-alpha-gal-in-psychiatric-practice?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/4d334999fcf64afe7e821bce3a9230aae30a5918-5998x3999.jpg?fit=crop&auto=format" alt="tick" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 22nd 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/climate-change-vector-range-and-alpha-gal-in-psychiatric-practice?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Climate Change, Vector Range, and Alpha-Gal in Psychiatric Practice</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/ryan-babineau">Ryan Babineau</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/rebecca-susan-daily-md-dlfapa-dfaacap">Rebecca Susan Daily, MD, DLFAPA, DFAACAP</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/climate-change-vector-range-and-alpha-gal-in-psychiatric-practice?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 gap-x-4"><a class="jsx-ad50481d5ee26850" href="/view/electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/2172f65e37645ccf10b6977cbddcfd470b116efb-4961x3508.jpg?fit=crop&auto=format" alt="dementia" width="288" class="jsx-ad50481d5ee26850 lg:w-[110px] lg:h-[100px] xl:w-[135px] xl:h-[125px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full xl:w-[70%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">October 14th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent">Electroconvulsive Therapy for the Treatment of Dementia Symptoms</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/t-greg-rhee-phd">T. Greg Rhee, PhD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/samuel-t-wilkinson-md">Samuel T. Wilkinson, MD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms?utm_source=www.psychiatrictimes.com&utm_medium=relatedContent"></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases","datePublished":"2024-10-01T14:00:00.000Z","dateModified":"2024-10-01T15:18:23Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.psychiatrictimes.com/view/traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases"},"publisher":{"@type":"Organization","name":"Psychiatric Times","logo":{"@type":"ImageObject","url":"https://www.psychiatrictimes.com/PsychiatricTimesLogo.png"}},"articleBody":"\n\nA significant number of individuals who sustained a traumatic brain injury (TBI) during early and mid-adulthood are living with disabilities within the US. When considering the impact of TBI over the years, it becomes clear that the effects of TBI may become more evident as aging takes place. This is because a TBI sustained earlier in adult life is likely to interact with normal aging processes.\n\n\n\nTBI Can Exacerbate Age Related Changes\n\nAs the brain ages, there is naturally occurring atrophy of cerebral tissue including structures such as the hippocampus, which plays a significant role in memory and cognitive processing. The hippocampus is frequently impacted by TBI, thus increasing the likelihood of developing memory impairments as one ages.1 Interestingly, a large hippocampal volume appears to offer protection from dementia.2 A decline in white matter volume is also observed during normal aging.3 White matter is mainly composed of myelinated axons and decreases in myelin density will hinder the capacity to transmit signals across the nervous system. Following TBI, these changes can occur at an accelerated rate compared with normal aging.4\n\n\n\nThe natural process of remyelination is also altered as the brain ages.3 Oligodendrocyte loss arising from the original injury may predispose the brain to decreased remyelination capacity.5 Oligodendrocytes are critical in maintaining the myelin sheath. White matter deterioration can manifest as cognitive deficits by affecting the efficiency of connectivity.6,7 Studies utilizing functional imaging have shown that there is a change in network connections during normal aging that is exacerbated with brain injury.8 Primary pathways that were established during development may be affected by injury and replaced with redundant pathways that, while enabling function, are not as effective as the originals and will render the brain more vulnerable to the effects of aging.9 Given that even mild TBI can have an impact on connectivity, it is not surprising that the risk of dementia is increased with repeated injury.10,11\n\n\n\nNormal aging also has an impact on neuroendocrine and immunological systems that can contribute to age-related cognitive decline.12,13 Long lasting hormonal dysregulation is not uncommon in many patients after TBI and may well contribute to neurodegenerative processes across time.10,11 Particularly noteworthy is the impact that hormones have on emotional health and cognition.14 Hormones also are known to have immunomodulatory effects. Microglia, the brain’s primary immune cells, are known to be especially vulnerable to the effects of age.15 Age related immune changes are also likely to be exacerbated by a history of TBI. Increased microglial activity can be observed years after the initial injury.16-18 Persistent microglial activation can increase oxidative stress thus contribute to age- and injury-induced structural changes and long-term functional deficits.18,19\n\n\n\nTBI May Precipitate or Exacerbate Neurodegenerative Diseases\n\nThe possibility of developing dementia increases with advancing age.20 When considering the interaction between TBI and neurodegenerative diseases, it is critical to distinguish between the disease per se and the pathological characteristics that are associated with these diseases.21 This distinction is particularly notable in the case of Alzheimer disease (AD). Studies are suggestive of an increased incidence in AD-like pathology following TBI.11,22,23 In general, the association between a history of TBI and the onset of AD, has shown to be elusive.24,25 Nevertheless, a TBI history may influence the onset of AD given the appropriate genetic factors. APOE-4 and TBI appear to have a synergistic effect that increases the risk of AD-like symptomatology.26 The APOE-4 allele has been identified as a genetic predictor of AD.27 Associations between a history of TBI and Parkinson disease (PD), amyotrophic lateral sclerosis, and multiple sclerosis have also been observed.28 TBI has been associated with cerebral microinfarcts, Lewy body accumulation, and parkinsonism.29 Lewy bodes are intercellular protein aggregates associated with dementia and PD. The association between PD and TBI has been widely debated due to conflicting studies.30,31 Parkinson symptomatology may be more prevalent after repeated trauma.31 Alternatively, a history of TBI may increment the likelihood of neurological illness in those patients who are at risk of PD.\n\n\n\nPrognosis and Treatment Strategies\n\nTo achieve successful aging, it is important to have a lifestyle that integrates factors known to promote health and consider strategies that address changes in neuroendocrine and immune systems. These same approaches are especially important to those that have survived a TBI.Vigilance for the development of comorbidities is necessary along with proper awareness of physiological, environmental and genetic factors that may increase risk to cognitive decline.\n\n\n\nDr Griesbach is the national director of clinical research for the Centre of Neuro Skills. She currently holds an appointment at the Neurosurgery Department, Geffen School of Medicine, UCLA, and is past president and chair for the National Neurotrauma Society.\n\n\n\nReferences\n\n1. Bigler ED, Blatter DD, Anderson CV, et al. Hippocampal volume in normal aging and traumatic brain injury. AJNR Am J Neuroradiol. 1997;18(1):11-23.\n\n2. Chetelat G, Villemagne VL, Pike KE, et al. Larger temporal volume in elderly with high versus low beta-amyloid deposition. Brain. 2010;133(11):3349-3358.\n\n3. Franklin RJ, Zhao C, Sim FJ. Ageing and CNS remyelination. Neuroreport. 2002;13(7):923-928.\n\n4. Maxwell WL, MacKinnon MA, Stewart JE, Graham DI. Stereology of cerebral cortex after traumatic brain injury matched to the Glasgow outcome score. Brain. 2010;133(Pt 1):139-160.\n\n5. Levin HS, Williams DH, Valastro M, et al. Corpus callosal atrophy following closed head injury: detection with magnetic resonance imaging. J Neurosurg. 1990;73(1):77-81.\n\n6. Maas AI, Menon DK. Traumatic brain injury: rethinking ideas and approaches. Lancet Neurol. 2012;11(1):12-13.\n\n7. Ziegler DA, Piguet O, Salat DH, et al. Cognition in healthy aging is related to regional white matter integrity, but not cortical thickness. Neurobiol Aging. 2010;31(11):1912-1926.\n\n8. Filippi M, van den Heuvel MP, Fornito A, et al. Assessment of system dysfunction in the brain through MRI-based connectomics. Lancet Neurol. 2013;12(12):1189-1199.\n\n9. Blumberg M, Hardy J, Robinson S. Handbook of Developmental Neuroscience. Oxford; 2009.\n\n10. Kreber LA, Griesnbach GS, Ashley JA. Detection of growth hormone deficiency in adults with chronic traumatic brain injury. J Neurotrauma. 2016;33(17):1607-1613.\n\n11. Griesbach GS, Masel BE, Helvie RE, Ashley MJ. The impact of traumatic brain injury on later life: effects on normal aging and neurodegenerative diseases. J Neurotrauma. 2018;35(1):17-24.\n\n12. Veldhuis JD, Sharma A, Roelfsema F. Age-dependent and gender-dependent regulation of hypothalamic-adrenocorticotropic-adrenal axis. Endocrinol Metab Clin North Am. 2013;42(2):201-225.\n\n13. McEwen B, Milner TA. Understanding the broad influenceof sex hormones and sex differences in the brain. J Neurosci Res. 2017;95(1-2):24-39.\n\n14. Ashman TA, Gordon WA, Cantor JB, Hibbard MR. Neurobehavioral consequences of traumatic brain injury. Mt Sinai J Med. 2006;73(7):999-1005.\n\n15. Damani MR, Zhao L, Fontainhas AM, et al. Age‐related alterations in the dynamic behavior of microglia. Aging Cell. 2011;10(2):263-276.\n\n16. Rowe RK, Griesbach GS. Immune-endocrine interactions in the pathophysiology of sleep-wake disturbances following traumatic brain injury: a narrative review. Brain Res Bull. 2022;185:117-128.\n\n17. Smith C, Gentleman SM, Leclercq PD, et al. The neuroinflammatory response in humans after traumatic brain injury. Neuropathol Appl Neurobiol. 2013;39(6):654-666.\n\n18. Ramlackhansingh AF, Brooks DJ, Greenwood RJ, et al. Inflammation after trauma: microglial activation and traumatic brain injury. Ann Neurol. 2011;70(3):374-383.\n\n19. Brown GC, Neher JJ. Inflammatory neurodegeneration and mechanisms of microglial killing of neurons. Mol Neurobiol. 2010;41(2-3):242-247.\n\n20. Katzman R. The prevalence and malignancy of Alzheimer disease. A major killer. Arch Neurol. 1976;33(4):217-218.\n\n21. Ashman TA, Cantor JB, Gordon WA, et al. A comparison of cognitive functioning in older adults with and without traumatic brain injury. J Head Trauma Rehabil. 2008;23(3):139-148.\n\n22. Johnson VE, Stewart W, Smith DH. Axonal pathology in traumatic brain injury. Exp Neurol. 2013;246:35-43.\n\n23. Masel BE. The chronic consequences of neurotrauma. J Neurotrauma. 2015;32(23):1833.\n\n24. Fleminger S, Oliver DL, Lovestone S, et al. Head injury as a risk factor for Alzheimer's disease: the evidence 10 years on a partial replication. J Neurol Neurosurg Psychiatry. 2003;74(7):857-862.\n\n25. Dams-O'Connor K, Spielman L, Singh A, et al. The impact of previous traumatic brain injury on health and functioning: a TRACK-TBI study. J Neurotrauma. 2013;30(24):2014-2020.\n\n26. Graham DI, Horsburgh K, Nicoll JA, Teasdale GM. Apolipoprotein E and the response of the brain to injury. Acta Neurochir Suppl. 1999;73:89-92.\n\n27. Guo Z, Cupples LA, Kurz A, et al. Head injury and the risk of AD in the MIRAGE study. Neurology. 2000;54(6):1316-1323.\n\n28. Perry DC, Sturm VE, Peterson MJ, et al. Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis. J Neurosurg. 2015;124(2):511-526.\n\n29. Crane PK, Gibbons LE, Dams-O’Connor K, et al. Association of traumatic brain injury with late-life neurodegenerative conditions and neuropathologic findings. JAMA Neurol. 2017;73(9):1062-1069.\n\n30. Goldman SM, Tanner CM, Oakes D, et al. Head injury and Parkinson's disease risk in twins. Ann Neurol. 2006;60(1):65-72.\n\n31. Krauss JK. Movement disorders secondary to craniocerebral trauma. Handb Clin Neurol. 2015;128:475-496.\n\n\n\n","description":"A traumatic brain injury sustained earlier in adult life is likely to interact with normal aging processes. Learn more here. ","author":[{"@type":"Person","name":"Grace S. Griesbach, PhD"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-5V9L5PL" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class="w-full bg-primary flex flex-col items-center justify-center"><div class="container w-[1340px]"><div id="footerInnerWrap" class="bg-primary w-full py-12"><div class="py-4 pl-4 flex flex-row items-center"><div class="flex flex-row flex-wrap w-[55%] h-full"><div class="w-[33%] p-1 my-0 cursor-pointer text-footer-text-color hover:text-footer-text-color/80 hover:underline"><a class="text-md" target="_self" href="/about">About</a></div><div class="w-[33%] p-1 my-0 cursor-pointer text-footer-text-color hover:text-footer-text-color/80 hover:underline"><a class="text-md" target="_self" href="/advertise">Advertise</a></div><div class="w-[33%] p-1 my-0 cursor-pointer text-footer-text-color hover:text-footer-text-color/80 hover:underline"><a class="text-md" target="_blank" href="https://www.mjhlifesciences.com/contact">Contact Us</a></div><div class="w-[33%] p-1 my-0 cursor-pointer text-footer-text-color hover:text-footer-text-color/80 hover:underline"><a class="text-md" target="_self" href="/editorial-info">Editorial</a></div><div class="w-[33%] p-1 my-0 cursor-pointer text-footer-text-color hover:text-footer-text-color/80 hover:underline"><a class="text-md" target="_self" href="/terms">Terms and Conditions</a></div><div class="w-[33%] p-1 my-0 cursor-pointer text-footer-text-color hover:text-footer-text-color/80 hover:underline"><a class="text-md" target="_self" href="/privacy">Privacy Policy</a></div><div class="w-[33%] p-1 my-0 cursor-pointer text-footer-text-color hover:text-footer-text-color/80 hover:underline"><a class="text-md" target="_blank" href="https://www.mjhlifesciences.com/ccpa?domain=www.psychiatrictimes.com">Do Not Sell My Personal Information</a></div></div><div class="w-[45%] flex flex-row"><div class="w-[1px] bg-footer-vertical-rule"></div><div class="text-center flex w-[50%] flex-col gap-4 px-8 text-footer-text-color"><div class="py-2 text-xl">Contact Info</div><div class="mx-auto"><div class="flex flex-row gap-4 mb-4"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24" class="text-footer-icon-color" font-size="30" style="margin-top:0.2rem" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path fill="none" d="M0 0h24v24H0z"></path><path d="M12 2C8.13 2 5 5.13 5 9c0 1.74.5 3.37 1.41 4.84.95 1.54 2.2 2.86 3.16 4.4.47.75.81 1.45 1.17 2.26.26.55.47 1.5 1.26 1.5s1-.95 1.25-1.5c.37-.81.7-1.51 1.17-2.26.96-1.53 2.21-2.85 3.16-4.4C18.5 12.37 19 10.74 19 9c0-3.87-3.13-7-7-7zm0 9.75a2.5 2.5 0 010-5 2.5 2.5 0 010 5z"></path></svg><p class="text-left text-sm">2 Commerce Drive <br/>Cranbury, NJ 08512</p></div><div class="flex flex-row gap-4 mb-4"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 16 16" class="text-footer-icon-color ml-2" font-size="25" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg"><path fill-rule="evenodd" d="M1.885.511a1.745 1.745 0 0 1 2.61.163L6.29 2.98c.329.423.445.974.315 1.494l-.547 2.19a.678.678 0 0 0 .178.643l2.457 2.457a.678.678 0 0 0 .644.178l2.189-.547a1.745 1.745 0 0 1 1.494.315l2.306 1.794c.829.645.905 1.87.163 2.611l-1.034 1.034c-.74.74-1.846 1.065-2.877.702a18.634 18.634 0 0 1-7.01-4.42 18.634 18.634 0 0 1-4.42-7.009c-.362-1.03-.037-2.137.703-2.877L1.885.511z"></path></svg><p class="text-sm"><a href="tel:609-716-7777">609-716-7777</a></p></div></div></div><div class="w-[1px] bg-footer-vertical-rule"></div><div class="flex flex-col gap-8 items-center justify-center" style="margin:0 auto"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27200%27%20height=%2733%27/%3e"/></span><img alt="" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="" srcSet="/_next/image?url=%2Fan_mjhls_brand_ko.png&w=256&q=75 1x, /_next/image?url=%2Fan_mjhls_brand_ko.png&w=640&q=75 2x" src="/_next/image?url=%2Fan_mjhls_brand_ko.png&w=640&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" loading="lazy"/></noscript></span><div class="flex flex-wrap self-start pt-6 pl-2"><a href="https://twitter.com/psychtimes/" class="social-icon mx-0.5 mb-1" target="_self" rel="noopener noreferrer" style="display:inline-block;width:30px;height:30px;position:relative;overflow:hidden;vertical-align:middle" aria-label="x"><span class="social-container" style="position:absolute;top:0;left:0;width:100%;height:100%"><svg role="img" aria-label="x social icon" class="social-svg" viewBox="0 0 64 64" style="position:absolute;top:0;left:0;width:100%;height:100%;border-radius:50%;fill-rule:evenodd"><g class="social-svg-icon" style="transition:fill 170ms ease-in-out;fill:white"><path d="M0,0H64V64H0ZM0 0v64h64V0zm16 17.537h10.125l6.992 9.242 8.084-9.242h4.908L35.39 29.79 48 46.463h-9.875l-7.734-10.111-8.85 10.11h-4.908l11.465-13.105zm5.73 2.783 17.75 23.205h2.72L24.647 20.32z"></path></g><g class="social-svg-mask" style="transition:fill 170ms ease-in-out;fill:#000000"><path d="M0 0v64h64V0zm16 17.537h10.125l6.992 9.242 8.084-9.242h4.908L35.39 29.79 48 46.463h-9.875l-7.734-10.111-8.85 10.11h-4.908l11.465-13.105zm5.73 2.783 17.75 23.205h2.72L24.647 20.32z"></path></g></svg></span></a><a href="https://www.facebook.com/psychtimes/" class="social-icon mx-0.5 mb-1" target="_blank" rel="noopener noreferrer" style="display:inline-block;width:30px;height:30px;position:relative;overflow:hidden;vertical-align:middle" aria-label="facebook"><span class="social-container" style="position:absolute;top:0;left:0;width:100%;height:100%"><svg role="img" aria-label="facebook social icon" class="social-svg" viewBox="0 0 64 64" style="position:absolute;top:0;left:0;width:100%;height:100%;border-radius:50%;fill-rule:evenodd"><g class="social-svg-icon" style="transition:fill 170ms ease-in-out;fill:white"><path d="M0,0H64V64H0ZM0 0v64h64V0zm39.6 22h-2.8c-2.2 0-2.6 1.1-2.6 2.6V28h5.3l-.7 5.3h-4.6V47h-5.5V33.3H24V28h4.6v-4c0-4.6 2.8-7 6.9-7 2 0 3.6.1 4.1.2z"></path></g><g class="social-svg-mask" style="transition:fill 170ms ease-in-out;fill:#3b5998"><path d="M0 0v64h64V0zm39.6 22h-2.8c-2.2 0-2.6 1.1-2.6 2.6V28h5.3l-.7 5.3h-4.6V47h-5.5V33.3H24V28h4.6v-4c0-4.6 2.8-7 6.9-7 2 0 3.6.1 4.1.2z"></path></g></svg></span></a><a href="https://www.linkedin.com/company/psychiatric-times/posts/?feedView=all" class="social-icon mx-0.5 mb-1" target="_blank" rel="noopener noreferrer" style="display:inline-block;width:30px;height:30px;position:relative;overflow:hidden;vertical-align:middle" aria-label="linkedin"><span class="social-container" style="position:absolute;top:0;left:0;width:100%;height:100%"><svg role="img" aria-label="linkedin social icon" class="social-svg" viewBox="0 0 64 64" style="position:absolute;top:0;left:0;width:100%;height:100%;border-radius:50%;fill-rule:evenodd"><g class="social-svg-icon" style="transition:fill 170ms ease-in-out;fill:white"><path d="M0,0H64V64H0ZM0 0v64h64V0zm25.8 44h-5.4V26.6h5.4zm-2.7-19.7c-1.7 0-3.1-1.4-3.1-3.1s1.4-3.1 3.1-3.1 3.1 1.4 3.1 3.1-1.4 3.1-3.1 3.1M46 44h-5.4v-8.4c0-2 0-4.6-2.8-4.6s-3.2 2.2-3.2 4.5V44h-5.4V26.6h5.2V29h.1c.7-1.4 2.5-2.8 5.1-2.8 5.5 0 6.5 3.6 6.5 8.3V44z"></path></g><g class="social-svg-mask" style="transition:fill 170ms ease-in-out;fill:#007fb1"><path d="M0 0v64h64V0zm25.8 44h-5.4V26.6h5.4zm-2.7-19.7c-1.7 0-3.1-1.4-3.1-3.1s1.4-3.1 3.1-3.1 3.1 1.4 3.1 3.1-1.4 3.1-3.1 3.1M46 44h-5.4v-8.4c0-2 0-4.6-2.8-4.6s-3.2 2.2-3.2 4.5V44h-5.4V26.6h5.2V29h.1c.7-1.4 2.5-2.8 5.1-2.8 5.5 0 6.5 3.6 6.5 8.3V44z"></path></g></svg></span></a><a href="/rss" class="social-icon mx-0.5 mb-1" target="_blank" rel="noopener noreferrer" style="display:inline-block;width:30px;height:30px;position:relative;overflow:hidden;vertical-align:middle" aria-label="rss"><span class="social-container" style="position:absolute;top:0;left:0;width:100%;height:100%"><svg role="img" aria-label="rss social icon" class="social-svg" viewBox="0 0 64 64" style="position:absolute;top:0;left:0;width:100%;height:100%;border-radius:50%;fill-rule:evenodd"><g class="social-svg-icon" style="transition:fill 170ms ease-in-out;fill:white"><path d="M0,0H64V64H0ZM0 0v64h64V0zm24 44c-2.2 0-4-1.8-4-4s1.8-4 4-4 4 1.8 4 4-1.8 4-4 4m11-1c-1.1 0-2-.9-2-2 0-5.5-4.5-10-10-10-1.1 0-2-.9-2-2s.9-2 2-2c7.7 0 14 6.3 14 14 0 1.1-.9 2-2 2m9 0c-1.1 0-2-.9-2-2 0-10.5-8.5-19-19-19-1.1 0-2-.9-2-2s.9-2 2-2c12.7 0 23 10.3 23 23 0 1.1-.9 2-2 2"></path></g><g class="social-svg-mask" style="transition:fill 170ms ease-in-out;fill:#EF8733"><path d="M0 0v64h64V0zm24 44c-2.2 0-4-1.8-4-4s1.8-4 4-4 4 1.8 4 4-1.8 4-4 4m11-1c-1.1 0-2-.9-2-2 0-5.5-4.5-10-10-10-1.1 0-2-.9-2-2s.9-2 2-2c7.7 0 14 6.3 14 14 0 1.1-.9 2-2 2m9 0c-1.1 0-2-.9-2-2 0-10.5-8.5-19-19-19-1.1 0-2-.9-2-2s.9-2 2-2c12.7 0 23 10.3 23 23 0 1.1-.9 2-2 2"></path></g></svg></span></a></div></div></div></div></div></div><div class="w-full bg-secondary flex justify-center"><div class="bg-secondary w-[85%] text-subfooter-text-color text-sm font-bold"><div class="flex flex-col gap-8 md:flex-row justify-between p-4 md:py-4 md:px-12"><div>© 2024 MJH Life Sciences <br/> <br/> All rights reserved.</div><div class="flex flex-column" style="gap:2rem;align-items:center"></div></div></div></div></div></div></div><script id="__NEXT_DATA__" type="application/json">{"props":{"pageProps":{"pageProps":{},"cache":{"main_menu":[{"is_active":true,"_rev":"c0yE3Bu5KElxUwrEaznFHf","_updatedAt":"2023-01-12T21:37:12Z","navParent":null,"subQuery":[],"url":"/news","name":"News","_id":"1843e321-488e-4669-93ca-cab2440aed6d","_createdAt":"2023-01-12T21:37:12Z","sortOrder":0,"_type":"mainNavigation"},{"sortOrder":2,"is_active":true,"navParent":null,"subQuery":[{"url":"/around-the-practice","_createdAt":"2021-09-21T13:28:00Z","_type":"mainNavigation","_updatedAt":"2021-12-22T16:26:33Z","_rev":"ChnBnF2xw1R5u2UJAWSuuF","_id":"de72718f-4e22-471c-abe0-8b043ef92406","name":"Around the Practice","is_active":true,"navParent":{"_type":"reference","_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147"},"sortOrder":1,"children":[]},{"url":"/between-the-lines","name":"Between the Lines","_id":"c5a4d211-1b2f-40fe-ae07-abfb539fc598","_type":"mainNavigation","_rev":"36kaxChiThYqCLNeM3hhVp","children":[],"_updatedAt":"2021-12-22T16:49:00Z","is_active":true,"navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_createdAt":"2021-12-22T16:26:36Z","sortOrder":2},{"navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_createdAt":"2021-05-27T15:56:49Z","_updatedAt":"2021-05-27T15:57:03Z","children":[],"_type":"mainNavigation","name":"PsychView","is_active":true,"_id":"979bbc49-d8e6-43ac-a127-9e69bd520019","_rev":"fHJeXuT6UrG2EzoqzYEGVy","url":"/psych-view","sortOrder":3},{"is_active":true,"_rev":"9AI7T3W4gDT22gBLmTo0As","_id":"105f3bcc-920b-4ff7-a249-06f884e59f75","url":"/expert-perspectives?page=1","children":[],"navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_type":"mainNavigation","name":"Expert Perspectives","sortOrder":5,"_updatedAt":"2023-05-25T18:01:08Z","_createdAt":"2023-05-25T18:00:26Z"},{"blank":false,"is_active":true,"_type":"mainNavigation","url":"/case-based-psych-perspectives","children":[],"_createdAt":"2020-12-02T22:08:30Z","_rev":"rJWQJ3YdV4iXBwE4Cgb60n","name":"Case-Based Psych Perspectives","_id":"84644adf-8708-4065-9312-ba1e741adfbb","_updatedAt":"2021-02-02T13:28:39Z","navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"}},{"is_active":true,"_rev":"AO7SV74IIejg0KBxJQrVAT","_id":"9c1882bf-8a3a-43d6-9238-e73c41eaeeff","_updatedAt":"2024-09-24T12:59:50Z","_createdAt":"2024-09-24T12:59:29Z","url":"/clinical-case-collective?page=1","navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_type":"mainNavigation","name":"Clinical Case Collective","children":[]},{"children":[],"_rev":"MqLNOsFfWNrEK75cxC5vlV","_type":"mainNavigation","_updatedAt":"2023-11-07T16:21:56Z","url":"/dialogues","is_active":true,"navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_createdAt":"2023-11-07T16:21:45Z","name":"Dialogues","_id":"721c996b-f6c8-46f7-becc-ca1a61c6aa05"},{"children":[],"_rev":"ssa5UxKU775yMCmhdm7Dli","_type":"mainNavigation","name":"Payer-Provider Perspective","_createdAt":"2022-08-11T20:44:23Z","_id":"ed6715e2-25b1-45f3-a8eb-b9a1fafee934","url":"/payer-provider-perspective","is_active":true,"_updatedAt":"2022-08-11T20:44:23Z","navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"}},{"_createdAt":"2020-05-20T08:15:17Z","url":"/slideshows","_rev":"fSrtE9SUG7ytm1P8Db4nKr","_type":"mainNavigation","children":[],"navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_id":"0302b195-9741-4a3f-8c23-a8fd8df8dcdb","_updatedAt":"2023-01-11T20:45:02Z","is_active":true,"name":"Slideshows"},{"navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_type":"mainNavigation","_updatedAt":"2020-06-10T19:43:38Z","is_active":true,"_createdAt":"2020-03-19T16:02:22Z","_id":"418d0610-56dc-4f7f-90ba-7fe942ae1135","_rev":"IlP9l41tH9jB20SbSpvPeM","name":"Videos","url":"/videos","children":[]},{"_createdAt":"2020-12-01T21:40:10Z","name":"Viewpoints","_rev":"kv47vbxDVlS4qhKkRLYuFx","_updatedAt":"2020-12-01T21:40:56Z","is_active":true,"_id":"6a9888b6-102a-4ede-bc6b-a7068ffa1f4a","navParent":{"_ref":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147","_type":"reference"},"_type":"mainNavigation","children":[],"url":"/viewpoints"}],"_updatedAt":"2020-05-29T13:44:24Z","_createdAt":"2020-03-19T16:02:04Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"mainNavigation","name":"Media","_id":"d8e0ba32-9f66-4c8e-b6eb-e4c285b62147"},{"subQuery":[{"_updatedAt":"2024-03-14T17:30:06Z","navParent":{"_ref":"395dfdb3-82e2-44c9-a54d-183ecbb75220","_type":"reference"},"_rev":"GE1zs3WNkZAi8NNFHbliyX","_createdAt":"2020-08-28T15:15:10Z","_type":"mainNavigation","name":"Conference Coverage","children":[],"_id":"e2672269-cacc-43a5-8977-3a14ffd1384e","url":"/latest-conference","is_active":true},{"_updatedAt":"2024-03-14T17:30:23Z","_createdAt":"2020-08-28T15:14:51Z","url":"/conferences","_rev":"GE1zs3WNkZAi8NNFHblpwL","_type":"mainNavigation","name":"Conference Listing","_id":"f2d6a179-8a80-4257-b8e2-d66f19e1fc57","is_active":true,"navParent":{"_ref":"395dfdb3-82e2-44c9-a54d-183ecbb75220","_type":"reference"},"children":[]}],"_type":"mainNavigation","name":"Conferences","_updatedAt":"2024-03-14T17:28:34Z","is_active":true,"navParent":null,"_createdAt":"2024-03-14T17:28:12Z","sortOrder":3,"_rev":"GE1zs3WNkZAi8NNFHblOnd","_id":"395dfdb3-82e2-44c9-a54d-183ecbb75220"},{"_rev":"GE1zs3WNkZAi8NNFHblv2P","_id":"6da3da6b-2f68-4b25-8a15-149c821f807a","_updatedAt":"2024-03-14T17:30:34Z","subQuery":[{"sortOrder":1,"_type":"mainNavigation","_updatedAt":"2020-06-10T19:43:38Z","children":[],"_createdAt":"2020-03-26T11:50:06Z","url":"/journals/psychiatric-times","is_active":true,"navParent":{"_ref":"6da3da6b-2f68-4b25-8a15-149c821f807a","_type":"reference"},"_rev":"IlP9l41tH9jB20SbSpvPnI","_id":"9e6ca761-b435-40b5-96b5-9aa62d02379c","name":"Psychiatric Times"}],"name":"Publication","navParent":null,"url":"/journals","is_active":true,"_createdAt":"2020-03-24T08:13:09Z","sortOrder":4,"_type":"mainNavigation"},{"name":"Job Board","_id":"65c10b12-2c79-434e-8f72-8bf7a190a789","_updatedAt":"2024-03-14T17:31:13Z","blank":true,"is_active":true,"_rev":"GE1zs3WNkZAi8NNFHbm6xN","_type":"mainNavigation","_createdAt":"2020-06-05T12:39:51Z","sortOrder":5,"navParent":null,"subQuery":[],"url":"http://jobs.modernmedicine.com/index.php"},{"_id":"387a9885-df6d-429a-a5b5-7c1a0c00a1d9","_createdAt":"2020-03-19T16:19:20Z","sortOrder":6,"_rev":"GE1zs3WNkZAi8NNFHbm7tF","_type":"mainNavigation","name":"CME/CE","url":"/continuing-education","navParent":null,"subQuery":[],"_updatedAt":"2024-03-14T17:31:20Z","is_active":true},{"name":"Partners","_updatedAt":"2024-03-14T17:31:36Z","_createdAt":"2021-10-14T20:21:59Z","sortOrder":7,"_id":"458a06a9-a0a8-4ba9-b0c1-14e3107be838","url":"/sap-partner","navParent":null,"subQuery":[],"is_active":true,"_rev":"GE1zs3WNkZAi8NNFHbmCur","_type":"mainNavigation"},{"_type":"mainNavigation","_id":"4b098fae-43cf-4a67-9400-e0fc1b55195a","_rev":"u8GFRcAIyRJ3mDD0auyX3j","sortOrder":8,"navParent":null,"is_active":true,"name":"Editorial","_updatedAt":"2024-03-14T17:32:05Z","url":"/editorial-info","_createdAt":"2024-03-14T17:31:47Z","subQuery":[]},{"name":"Resources","_id":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","is_active":true,"sortOrder":8,"_createdAt":"2020-03-19T16:26:53Z","_type":"mainNavigation","_rev":"GE1zs3WNkZAi8NNFHbmDhp","_updatedAt":"2024-03-14T17:31:42Z","url":"/resources","navParent":null,"subQuery":[{"navParent":{"_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","_type":"reference"},"_createdAt":"2024-05-31T17:01:59Z","_id":"6bdc0dbb-645f-4eac-a8c1-567d9dd72d76","children":[],"_rev":"YnHcRrfS97TenynEl03ID1","_type":"mainNavigation","is_active":true,"blank":false,"name":"Clinical Consult","_updatedAt":"2024-05-31T17:02:16Z","url":"/clinical-consult"},{"navParent":{"_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","_type":"reference"},"_createdAt":"2020-03-24T08:07:34Z","_type":"mainNavigation","url":"/resources/clinical-scales","children":[],"_rev":"IlP9l41tH9jB20SbSpvPeM","name":"Clinical Scales","_id":"27d4f862-fad0-4e4c-921d-e9b5f1ca0aa9","is_active":true,"_updatedAt":"2020-06-10T19:43:38Z"},{"navParent":{"_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","_type":"reference"},"_rev":"m02m7wCFelmJf04sT3Dcyu","blank":false,"children":[],"is_active":true,"_id":"22784626-75df-4699-9c39-cadec66c00a1","url":"/interactive-tools","_type":"mainNavigation","name":"Interactive Tools","_updatedAt":"2021-03-10T19:42:37Z","_createdAt":"2021-03-10T19:42:37Z"},{"_rev":"KzS6kYoWzDJY07Cgj1zNlS","_type":"mainNavigation","_id":"b938bf02-028f-489d-9725-79982289ad00","_createdAt":"2024-09-06T17:10:36Z","children":[],"is_active":true,"name":"Partner Perspectives","_updatedAt":"2024-09-06T17:10:51Z","blank":false,"navParent":{"_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","_type":"reference"},"url":"/partner-perspectives"},{"is_active":true,"name":"Q\u0026A","navParent":{"_type":"reference","_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8"},"_rev":"IlP9l41tH9jB20SbSpvPeM","_type":"mainNavigation","_createdAt":"2020-03-24T08:08:55Z","_id":"22e9b11e-a818-4534-9f69-eb4690e7000a","_updatedAt":"2020-06-10T19:43:38Z","url":"/resources/q-a","children":[]},{"_rev":"snQqhhB4O8T5bi1viUShjg","_createdAt":"2020-03-24T08:09:11Z","_id":"fdc93267-d2f7-4a70-a0cc-8553106902bb","url":"/resources/quizzes","children":[],"is_active":true,"name":"Quizzes","_updatedAt":"2020-06-10T19:43:38Z","navParent":{"_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","_type":"reference"},"_type":"mainNavigation"},{"_rev":"6v9gXhKVIkpZE4xQ8o8RSp","url":"/series","_updatedAt":"2023-01-16T14:57:17Z","is_active":true,"navParent":{"_type":"reference","_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8"},"children":[],"_type":"mainNavigation","name":"Series","_id":"c647a9af-83e7-441e-b3f8-01f3ce388f97","_createdAt":"2023-01-16T14:55:47Z"},{"is_active":true,"_updatedAt":"2020-06-10T19:43:38Z","children":[],"_createdAt":"2020-03-24T08:09:30Z","_rev":"IlP9l41tH9jB20SbSpvPeM","_type":"mainNavigation","name":"Special Reports","_id":"31beecbb-9280-47c1-80c6-b3aedfe52542","url":"/special-reports","navParent":{"_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","_type":"reference"}},{"_id":"dbab3601-30b7-4ff8-b9ad-cd563cf0d149","url":"/resources/sponsored-resources","children":[],"_updatedAt":"2021-02-08T18:04:22Z","navParent":{"_ref":"9d1d3280-79c1-4f3c-86dd-fe8d9dcfcdd8","_type":"reference"},"_createdAt":"2020-03-24T08:09:55Z","_rev":"xbchpXbFe07Cgtkdynd1WF","name":"Sponsored","is_active":true,"_type":"mainNavigation"}]},{"url":"https://one.psychiatrictimes.com/subscribe","_id":"bbf146ea-82b5-4669-9bfa-336d093ee93e","_updatedAt":"2024-04-08T16:08:41Z","navParent":null,"subQuery":[],"sortOrder":9,"_type":"mainNavigation","_rev":"Ar19jrAZ1MlIiaihL3HN64","is_active":true,"name":"Subscribe","blank":true,"_createdAt":"2020-05-29T13:43:21Z"}],"sub_menu":[{"_rev":"dsDuJ8RgDkZe5YdVQL0T1F","_type":"subNavigation","is_active":true,"_createdAt":"2020-04-09T16:05:12Z","_updatedAt":"2020-07-02T14:18:45Z","navParent":null,"subQuery":[{"_updatedAt":"2024-06-18T12:59:46Z","_createdAt":"2022-12-22T20:49:42Z","_rev":"w3c4fqW02PkQg1BodQbQeG","is_active":true,"_id":"0586180c-22ee-475e-a116-6e033e13e3ad","navParent":{"_ref":"c0b83ec2-95cb-4420-afbd-fcc8b5b34c32","_type":"reference"},"sortOrder":1,"_type":"subNavigation","name":"Major Depressive Disorder","url":"/topics/major-depressive-disorder","children":[]},{"_rev":"n7oekD5bZ5TrEiyxt4RqrO","name":"Mental Health Awareness Month","_id":"57e01bb0-872d-4eea-9d2f-02c00088d1c3","_updatedAt":"2024-05-01T17:52:53Z","children":[],"navParent":{"_type":"reference","_ref":"c0b83ec2-95cb-4420-afbd-fcc8b5b34c32"},"sortOrder":3,"_type":"subNavigation","url":"/topics/mental-health-awareness","is_active":true,"_createdAt":"2024-05-01T17:51:49Z"},{"children":[],"sortOrder":2,"_updatedAt":"2024-04-23T14:47:29Z","navParent":{"_ref":"c0b83ec2-95cb-4420-afbd-fcc8b5b34c32","_type":"reference"},"_type":"subNavigation","_createdAt":"2024-04-23T14:47:05Z","name":"Schizophrenia/Psychosis ","_id":"10bddb17-c39b-453e-b1ba-33771ee28934","url":"/topics/schizophrenia","is_active":true,"_rev":"q0dkrmgYP2pOzEVrwNHVJ3"}],"_id":"c0b83ec2-95cb-4420-afbd-fcc8b5b34c32","url":"/topics","sortOrder":1,"name":"Spotlight"},{"_type":"subNavigation","subQuery":[{"name":"Couch In Crisis","is_active":true,"_id":"10e59262-5310-4126-9220-ec546ba4d151","_updatedAt":"2020-06-10T19:43:38Z","url":"/commentary/couch-in-crisis","_rev":"IlP9l41tH9jB20SbSpvPeM","_createdAt":"2020-04-01T21:50:43Z","navParent":{"_ref":"d525cee2-75c5-4b12-858b-d17aab33821f","_type":"reference"},"_type":"subNavigation","children":[]},{"_rev":"IlP9l41tH9jB20SbSpvPeM","url":"/commentary/early-career-psychiatry","children":[],"_updatedAt":"2020-06-10T19:43:38Z","_id":"8c04af33-26cd-4fb3-8bf3-07ea17fd2880","is_active":true,"navParent":{"_type":"reference","_ref":"d525cee2-75c5-4b12-858b-d17aab33821f"},"_createdAt":"2020-04-01T21:51:01Z","_type":"subNavigation","name":"Early Career Psychiatry"},{"navParent":{"_ref":"d525cee2-75c5-4b12-858b-d17aab33821f","_type":"reference"},"_createdAt":"2020-04-01T21:51:19Z","children":[],"is_active":true,"_type":"subNavigation","_id":"59b44890-e52e-444b-b9cc-258f4a7a0a98","_rev":"IlP9l41tH9jB20SbSpvPeM","name":"History of Psychiatry","_updatedAt":"2020-06-10T19:43:38Z","url":"/commentary/history-of-psychiatry"},{"_type":"subNavigation","name":"Residents Corner","_updatedAt":"2020-06-10T19:43:38Z","is_active":true,"navParent":{"_ref":"d525cee2-75c5-4b12-858b-d17aab33821f","_type":"reference"},"children":[],"url":"/commentary/residents","_id":"4991b8d9-e319-48b7-b441-5c30bb2ee29e","_rev":"IlP9l41tH9jB20SbSpvPeM","_createdAt":"2020-04-01T21:51:34Z"}],"_createdAt":"2020-03-24T14:31:58Z","_updatedAt":"2020-05-19T17:17:01Z","sortOrder":2,"name":"Commentary","_id":"d525cee2-75c5-4b12-858b-d17aab33821f","navParent":null,"is_active":true,"_rev":"snQqhhB4O8T5bi1viURsgs","url":"/commentary"},{"_type":"subNavigation","name":"Cultural Corner","_createdAt":"2020-03-24T14:29:12Z","_rev":"snQqhhB4O8T5bi1viURsgs","_id":"6d311f61-f270-4a24-b269-705bcb5d7ba0","url":"/cultural-corner","navParent":null,"subQuery":[{"name":"Film and Book Reviews","_id":"d8402029-d770-4704-913e-ea45d3779a7c","_rev":"IlP9l41tH9jB20SbSpvPnI","children":[],"_createdAt":"2020-03-24T14:29:26Z","_updatedAt":"2020-06-10T19:43:38Z","sortOrder":1,"_type":"subNavigation","url":"/cultural-corner/film-and-book-reviews","is_active":true,"navParent":{"_ref":"6d311f61-f270-4a24-b269-705bcb5d7ba0","_type":"reference"}},{"children":[],"blank":false,"_createdAt":"2020-03-24T14:29:49Z","sortOrder":2,"_id":"cd5112ce-340b-4cd7-a63e-5db49067c729","_rev":"IlP9l41tH9jB20SbSpvPnI","_updatedAt":"2020-06-10T19:43:38Z","url":"/cultural-corner/poetry","navParent":{"_type":"reference","_ref":"6d311f61-f270-4a24-b269-705bcb5d7ba0"},"is_active":true,"_type":"subNavigation","name":"Poetry"},{"_type":"subNavigation","children":[],"name":"Writers Contest","_updatedAt":"2020-06-10T19:43:38Z","_id":"2555f011-792e-4edd-a3a2-9b8275a55043","is_active":true,"_createdAt":"2020-03-24T14:30:58Z","_rev":"IlP9l41tH9jB20SbSpvPeM","url":"/cultural-corner/writers-contest","navParent":{"_ref":"6d311f61-f270-4a24-b269-705bcb5d7ba0","_type":"reference"},"sortOrder":3}],"sortOrder":3,"_updatedAt":"2020-05-19T17:17:13Z","is_active":true},{"url":"/psychiatric-practice","sortOrder":4,"_type":"subNavigation","_id":"1bea9f4b-4597-4c81-a1ab-8d4afea5ddc9","_updatedAt":"2020-05-19T17:16:51Z","is_active":true,"_createdAt":"2020-04-01T21:39:49Z","_rev":"snQqhhB4O8T5bi1viURsgs","navParent":null,"name":"Psychiatric Practice","subQuery":[{"_updatedAt":"2020-06-10T19:43:38Z","url":"/psychiatric-practice/burnout","_createdAt":"2020-04-01T21:40:05Z","_rev":"IlP9l41tH9jB20SbSpvPeM","_type":"subNavigation","name":"Burnout","is_active":true,"navParent":{"_ref":"1bea9f4b-4597-4c81-a1ab-8d4afea5ddc9","_type":"reference"},"children":[],"_id":"3390661b-0619-4f29-939e-eace8faae992"},{"url":"/psychiatric-practice/careers","name":"Careers","navParent":{"_ref":"1bea9f4b-4597-4c81-a1ab-8d4afea5ddc9","_type":"reference"},"_createdAt":"2020-04-01T21:40:23Z","_updatedAt":"2020-06-10T19:43:38Z","is_active":true,"_rev":"IlP9l41tH9jB20SbSpvPeM","_id":"4ceccc05-3c24-4261-bebe-cad9ee5530df","_type":"subNavigation","children":[]},{"_id":"d71f55d5-a867-426e-ba4b-c28c798cb245","children":[],"navParent":{"_ref":"1bea9f4b-4597-4c81-a1ab-8d4afea5ddc9","_type":"reference"},"url":"/psychiatric-practice/coding","is_active":true,"_createdAt":"2020-05-19T14:36:43Z","_rev":"IlP9l41tH9jB20SbSpvPnI","name":"Coding","_updatedAt":"2020-06-10T19:43:38Z","_type":"subNavigation"},{"_createdAt":"2020-05-19T14:36:26Z","_type":"subNavigation","_id":"8ccdfe96-24f0-4daa-9011-6e4d8ceb4a93","url":"/psychiatric-practice/guidelines","is_active":true,"_rev":"IlP9l41tH9jB20SbSpvPeM","name":"Guidelines","_updatedAt":"2020-06-10T19:43:38Z","navParent":{"_ref":"1bea9f4b-4597-4c81-a1ab-8d4afea5ddc9","_type":"reference"},"children":[]},{"is_active":true,"navParent":{"_ref":"1bea9f4b-4597-4c81-a1ab-8d4afea5ddc9","_type":"reference"},"_type":"subNavigation","_id":"b9e2c00e-9cf8-41a1-81c8-9c9ae622cd10","_createdAt":"2020-05-19T14:36:09Z","name":"Risk Management","_updatedAt":"2020-06-14T14:20:02Z","url":"/psychiatric-practice/risk-management","children":[],"_rev":"ZMYcYT2CLb3vZFFgs0psbG"},{"is_active":true,"navParent":{"_ref":"1bea9f4b-4597-4c81-a1ab-8d4afea5ddc9","_type":"reference"},"_createdAt":"2020-05-19T14:35:50Z","_id":"7a80afad-0ac8-48ab-b711-b6602380b38a","children":[],"url":"/psychiatric-practice/telepsychiatry","_rev":"IlP9l41tH9jB20SbSpvPeM","name":"Telepsychiatry","_updatedAt":"2020-06-10T19:43:38Z","_type":"subNavigation"}]},{"_id":"790fcafc-0d49-4d10-927a-c003531095c0","_updatedAt":"2020-05-19T17:14:56Z","navParent":null,"subQuery":[{"children":[],"_type":"subNavigation","_updatedAt":"2020-06-10T19:43:38Z","_id":"56d70f3b-0dbb-4a76-b93d-32a15c60459b","url":"/series/climate-change","is_active":true,"_rev":"IlP9l41tH9jB20SbSpvPeM","navParent":{"_ref":"790fcafc-0d49-4d10-927a-c003531095c0","_type":"reference"},"_createdAt":"2020-05-19T17:15:22Z","name":"Climate Change"},{"_rev":"IlP9l41tH9jB20SbSpvPeM","_type":"subNavigation","name":"Critical Conversations in Psychiatry","url":"/series/critical-conversations-in-psychiatry","navParent":{"_ref":"790fcafc-0d49-4d10-927a-c003531095c0","_type":"reference"},"children":[],"_createdAt":"2020-05-19T17:15:44Z","_id":"14f817fa-5837-4aa4-82e4-7d32ae19149b","is_active":true,"_updatedAt":"2020-06-10T19:43:38Z"},{"children":[],"_type":"subNavigation","_id":"aaf583e3-d77e-4b92-9272-0fd976813d1b","url":"/series/portraits","is_active":true,"_rev":"IlP9l41tH9jB20SbSpvPnI","name":"Portraits","navParent":{"_ref":"790fcafc-0d49-4d10-927a-c003531095c0","_type":"reference"},"_createdAt":"2020-05-19T17:15:53Z","_updatedAt":"2020-06-10T19:43:38Z"},{"_createdAt":"2021-10-28T16:35:03Z","_updatedAt":"2021-10-28T16:35:03Z","navParent":{"_ref":"790fcafc-0d49-4d10-927a-c003531095c0","_type":"reference"},"_rev":"BXHEdz19TlV0w95nuSkK0S","children":[],"is_active":true,"name":"Psychiatric Views on the Daily News","_id":"4d8c2e30-6795-4853-8a3e-6effc976f071","url":"/series/psychiatric-views-on-the-daily-news","_type":"subNavigation"},{"_updatedAt":"2020-06-10T19:43:38Z","_createdAt":"2020-05-19T17:16:20Z","url":"/series/tales-new-asylum","is_active":true,"_id":"28f3773f-8f99-4b53-933b-d5c569416077","_rev":"IlP9l41tH9jB20SbSpvPeM","_type":"subNavigation","name":"Tales from the New Asylum","navParent":{"_ref":"790fcafc-0d49-4d10-927a-c003531095c0","_type":"reference"},"children":[]}],"_type":"subNavigation","_rev":"snQqhhB4O8T5bi1viURsgs","name":"Series","url":"/series","is_active":true,"_createdAt":"2020-05-19T17:14:56Z","sortOrder":5}],"site_setting":{"socialLinks":[{"title":"X","url":"https://twitter.com/psychtimes/","blank":false,"_type":"urlArray","_key":"8d7532457054"},{"_type":"urlArray","_key":"a573173a4c8a","title":"Facebook","url":"https://www.facebook.com/psychtimes/","blank":true},{"_key":"fd1668a909ff","title":"LinkedIn","url":"https://www.linkedin.com/company/psychiatric-times/posts/?feedView=all","blank":true,"_type":"urlArray"},{"blank":true,"_type":"urlArray","_key":"23a37f7661a2","title":"RSS","url":"/rss"}],"redisConfig":{"cachePurgeDomain":"https://www2.psychiatrictimes.com","redisURL":"https://global-current-seahorse-30408.upstash.io","redisPWD":"AXbIASQgOGM4NDU0ZWMtMjA2YS00NDM4LTg5ZmQtMTBkNDc5ZTY1NWVlMTk3MjMxN2JmNTRkNGRkODhjY2U0NzY3NjRmNzRhYWI="},"salesforceDMPId":"uvi8wzngz","creativeLayoutLatestNews":null,"enableSanity2":true,"footerLinks":[{"_type":"urlArray","_key":"2087aaeb2ba19093221f839004d60d38","title":"About","url":"/about"},{"url":"/advertise","_type":"urlArray","_key":"bdbfed9283cd","title":"Advertise"},{"_type":"urlArray","_key":"15464e4eca0f","title":"Contact Us","url":"https://www.mjhlifesciences.com/contact","blank":true},{"_type":"urlArray","_key":"b9910177c702","title":"Editorial","url":"/editorial-info"},{"_type":"urlArray","_key":"21f996ea3e94","title":"Terms and Conditions","url":"/terms"},{"_type":"urlArray","_key":"04fd2bebcf00","title":"Privacy Policy","url":"/privacy"},{"_type":"urlArray","_key":"fe4a3b0871aa","title":"Do Not Sell My Personal Information","url":"https://www.mjhlifesciences.com/ccpa?domain=www.psychiatrictimes.com","blank":true}],"creativeLayout":null,"siteURL":"www.psychiatrictimes.com","_createdAt":"2020-02-21T05:35:48Z","_updatedAt":"2024-10-09T17:37:16Z","name":"Psychiatric Times","gaID":"UA-155582410-43,UA-630614-1","_rev":"iwIk0EhdBdoIVjJwZ7tUIw","_type":"siteSettings","_id":"siteSettings"},"clinicalData":[{"name":"ADHD","identifier":"topics/adhd","sortOrder":9999,"children":[],"_id":"pst_taxonomy_8_adhd"},{"_id":"pst_taxonomy_254_addictionsubstanceuse","name":"Addiction \u0026 Substance Use","identifier":"topics/addiction-suds-compulsive","sortOrder":9999,"children":[{"_id":"pst_taxonomy_175_gambling","name":"Gambling","identifier":"topics/gambling","sortOrder":null},{"_id":"pst_taxonomy_288_opioidrelateddisorders","name":"Opioid Related Disorders","identifier":"topics/opioid","sortOrder":null},{"_id":"pst_taxonomy_29_alcoholabuse","name":"Alcohol Abuse","identifier":"topics/alcohol-abuse","sortOrder":null},{"_id":"pst_taxonomy_34_amphetaminerelateddisorders","name":"Amphetamine Related Disorders","identifier":"topics/amphetamine-related-disorders","sortOrder":null},{"_id":"pst_taxonomy_394_substanceusedisorder","name":"Substance Use Disorder","identifier":"topics/substance-use-disorder","sortOrder":null}]},{"_id":"pst_taxonomy_119_anxietystressdisorders","name":"Anxiety \u0026 Stress Disorders","identifier":"topics/anxiety","sortOrder":9999,"children":[{"_id":"pst_taxonomy_143_disasterpsychiatry","name":"Disaster Psychiatry","identifier":"topics/disaster-psychiatry","sortOrder":null},{"_id":"pst_taxonomy_296_panicdisorder","name":"Panic Disorder","identifier":"topics/panic","sortOrder":null},{"_id":"pst_taxonomy_415_traumaandviolence","name":"Trauma And Violence","identifier":"topics/trauma-and-violence","sortOrder":null},{"_id":"pst_taxonomy_416_traumaticstressdisorders","name":"Traumatic Stress Disorders","identifier":"topics/traumatic-stress-disorders","sortOrder":null}]},{"sortOrder":9999,"children":[{"_id":"pst_taxonomy_241_mania","name":"Mania","identifier":"topics/mania","sortOrder":null}],"_id":"pst_taxonomy_52_bipolardisorder","name":"Bipolar Disorder","identifier":"topics/bipolar"},{"_id":"f159c13f-564a-44fe-a9ef-9bb704b05b1d","name":"COVID-19","identifier":"topics/covid-19","sortOrder":9999,"children":[]},{"_id":"634d24b6-a345-4f1a-9f9f-dbf3abd45d8a","name":"Cannabis","identifier":"topics/cannabis","sortOrder":9999,"children":[]},{"_id":"pst_taxonomy_767_casediscussions","name":"Case Discussions","identifier":"topics/case-discussions","sortOrder":9999,"children":[]},{"name":"Child \u0026 Adolescent Psychiatry","identifier":"topics/child-adolescent-psychiatry","sortOrder":9999,"children":[],"_id":"pst_taxonomy_89_childadolescentpsychiatry"},{"children":[],"_id":"a2be30ac-7b19-4ec4-92e2-27e180b2455e","name":"Climate Change","identifier":"topics/climate-change","sortOrder":9999},{"children":[],"_id":"pst_taxonomy_120_comorbidity","name":"Comorbidity","identifier":"topics/comorbidity","sortOrder":9999},{"_id":"pst_taxonomy_280_compulsivedisorders","name":"Compulsive Disorders","identifier":"topics/compulsive-disorders","sortOrder":9999,"children":[]},{"name":"Cultural Psychiatry","identifier":"topics/cultural-psychiatry","sortOrder":9999,"children":[],"_id":"pst_taxonomy_128_culturalpsychiatry"},{"children":[],"_id":"150ff356-9cf5-4634-86ca-acbaeaa9a998","name":"Digital Therapeutics","identifier":"topics/digital-therapeutics","sortOrder":9999},{"_id":"3015942b-5d84-4549-a34c-c5d4cd50d946","name":"Diversity, Equity, Inclusion","identifier":"topics/dei","sortOrder":9999,"children":[]},{"_id":"01583c5c-f3f9-433a-a948-ce2d3bbdc164","name":"Drug Watch","identifier":"topics/drug-watch","sortOrder":9999,"children":[]},{"_id":"pst_taxonomy_150_eatingdisorders","name":"Eating Disorders","identifier":"topics/eating-disorders","sortOrder":9999,"children":[]},{"_id":"pst_taxonomy_334_psychiatricemergencies","name":"Emergency Psychiatry","identifier":"topics/emergency-psychiatry","sortOrder":9999,"children":[]},{"name":"Ethics","identifier":"topics/ethics","sortOrder":9999,"children":[],"_id":"3f005629-ac29-46f4-b4f1-49ffa396908b"},{"_id":"pst_taxonomy_173_forensicpsychiatry","name":"Forensic Psychiatry","identifier":"topics/forensic","sortOrder":9999,"children":[{"_id":"pst_taxonomy_261_munchausensyndrome","name":"Munchausen Syndrome","identifier":"topics/munchausen-syndrome","sortOrder":null},{"_id":"pst_taxonomy_371_sexualoffenses","name":"Sexual Offenses","identifier":"topics/sexual-offenses","sortOrder":null}]},{"children":[],"_id":"pst_taxonomy_184_geriatricpsychiatry","name":"Geriatric Psychiatry","identifier":"topics/geriatric-psychiatry","sortOrder":9999},{"name":"Integrative Psychiatry","identifier":"topics/integrative-psychiatry","sortOrder":9999,"children":[],"_id":"pst_taxonomy_214_integrativepsychiatry"},{"_id":"pst_taxonomy_238_majordepressivedisorder","name":"Major Depressive Disorder","identifier":"topics/major-depressive-disorder","sortOrder":9999,"children":[]},{"children":[],"_id":"33300c16-1d5e-48d8-bf27-16706480c6c5","name":"Mental Health Awareness Month","identifier":"topics/mental-health-awareness","sortOrder":9999},{"_id":"pst_taxonomy_253_mooddisorders","name":"Mood Disorders","identifier":"topics/mood-disorders","sortOrder":9999,"children":[]},{"_id":"pst_taxonomy_35_neuropsychiatry","name":"Neuropsychiatry","identifier":"topics/neuropsychiatry","sortOrder":9999,"children":[{"_id":"pst_taxonomy_115_cognitivedisorders","name":"Cognitive Disorders","identifier":"topics/cognitive-disorders","sortOrder":null},{"_id":"pst_taxonomy_132_dementia","name":"Dementia","identifier":"topics/dementia","sortOrder":null},{"_id":"pst_taxonomy_149_alzheimerdisease","name":"Alzheimer Disease","identifier":"topics/alzheimer-disease","sortOrder":null},{"_id":"pst_taxonomy_45_autism","name":"Autism","identifier":"topics/autism","sortOrder":null}]},{"_id":"pst_taxonomy_339_ptsd","name":"PTSD","identifier":"topics/ptsd","sortOrder":9999,"children":[]},{"identifier":"topics/personality-disorders","sortOrder":9999,"children":[{"_id":"pst_taxonomy_122_compulsivepersonalitydisorder","name":"Compulsive Personality Disorder","identifier":"topics/compulsive-personality-disorder","sortOrder":null},{"_id":"pst_taxonomy_134_dependentpersonalitydisorder","name":"Dependent Personality Disorder","identifier":"topics/dependent-personality-disorder","sortOrder":null},{"_id":"pst_taxonomy_145_dissociativeidentitydisorder","name":"Dissociative Identity Disorder","identifier":"topics/dissociative-identity-disorder","sortOrder":null},{"_id":"pst_taxonomy_198_histrionicpersonalitydisorder","name":"Histrionic Personality Disorder","identifier":"topics/histrionic-personality-disorder","sortOrder":null},{"_id":"pst_taxonomy_361_schizoidpersonalitydisorder","name":"Schizoid Personality Disorder","identifier":"topics/schizoid-personality-disorder","sortOrder":null},{"_id":"pst_taxonomy_36_antisocialpersonalitydisorder","name":"Antisocial Personality Disorder","identifier":"topics/antisocial-personality-disorder","sortOrder":null},{"_id":"pst_taxonomy_65_borderlinepersonality","name":"Borderline Personality","identifier":"topics/borderline-personality","sortOrder":null}],"_id":"pst_taxonomy_310_personalitydisorders","name":"Personality Disorders"},{"name":"Postpartum Depression","identifier":"topics/postpartum","sortOrder":9999,"children":[],"_id":"1880d7c4-6501-4ce5-a0bf-866838092a1f"},{"sortOrder":9999,"children":[],"_id":"ac6c86f4-3fb2-4bb9-b7e5-3ed6f20ac45a","name":"Psychedelics","identifier":"topics/psychedelics"},{"sortOrder":9999,"children":[],"_id":"pst_taxonomy_336_psychopharmacology","name":"Psychopharmacology","identifier":"topics/psychopharmacology"},{"_id":"pst_taxonomy_351_psychosomatics","name":"Psychosomatics","identifier":"topics/psychosomatics","sortOrder":9999,"children":[{"_id":"pst_taxonomy_129_delirium","name":"Delirium","identifier":"topics/delirium","sortOrder":null},{"_id":"pst_taxonomy_247_metabolicdisorders","name":"Metabolic Disorders","identifier":"topics/metabolic-disorders","sortOrder":null},{"_id":"pst_taxonomy_384_somatoformdisorder","name":"Somatoform Disorder","identifier":"topics/somatoform-disorder","sortOrder":null}]},{"_id":"pst_taxonomy_337_psychotherapy","name":"Psychotherapy","identifier":"topics/psychotherapy","sortOrder":9999,"children":[{"_id":"pst_taxonomy_114_cognitivebehavioraltherapy","name":"Cognitive Behavioral Therapy","identifier":"topics/cognitive-behavioral-therapy","sortOrder":null}]},{"sortOrder":9999,"children":[{"_id":"pst_taxonomy_299_paranoidschizophrenia","name":"Paranoid Schizophrenia","identifier":"topics/paranoid-schizophrenia","sortOrder":null},{"_id":"pst_taxonomy_338_psychoticaffectivedisorders","name":"Psychotic Affective Disorders","identifier":"topics/psychotic-affective-disorders","sortOrder":null},{"_id":"pst_taxonomy_360_schizoaffective","name":"Schizoaffective","identifier":"topics/schizoaffective","sortOrder":null},{"_id":"pst_taxonomy_363_schizophreniapsychoticfeatures","name":"Schizophrenia Psychotic Features","identifier":"topics/schizophrenia","sortOrder":null},{"_id":"pst_taxonomy_364_schizotypalpersonalitydisorder","name":"Schizotypal Personality Disorder","identifier":"topics/schizotypal-personality-disorder","sortOrder":null},{"_id":"pst_taxonomy_85_catatonicschizophrenia","name":"Catatonic Schizophrenia","identifier":"topics/catatonic-schizophrenia","sortOrder":null}],"_id":"pst_taxonomy_362_schizophreniapsychosis","name":"Schizophrenia/Psychosis","identifier":"topics/schizophrenia"},{"_id":"pst_taxonomy_694_sleepdisorders","name":"Sleep Disorders","identifier":"topics/sleep-disorders","sortOrder":9999,"children":[{"_id":"pst_taxonomy_272_nocturnalparoxysmaldystonia","name":"Nocturnal Paroxysmal Dystonia","identifier":"topics/nocturnal-paroxysmal-dystonia","sortOrder":null},{"_id":"pst_taxonomy_379_sleepdeprivation","name":"Sleep Deprivation","identifier":"topics/sleep-deprivation","sortOrder":null},{"_id":"pst_taxonomy_380_sleepwaketransition","name":"Sleep Wake Transition","identifier":"topics/sleep-wake-transition","sortOrder":null},{"_id":"pst_taxonomy_95_circadianrhythmsleepdisorders","name":"Circadian Rhythm Sleep Disorders","identifier":"topics/circadian-rhythm-sleep-disorders","sortOrder":null}]},{"_id":"pst_taxonomy_53201_specialpopulations","name":"Special Populations","identifier":"topics/special-populations","sortOrder":9999,"children":[{"_id":"43325cb4-0ee9-4642-bdda-e378111c2bf0","name":"Pervasive Developmental Disorder","identifier":"topics/pervasive-developmental-disorder","sortOrder":null},{"_id":"pst_taxonomy_180_genderissues","name":"Gender Issues","identifier":"topics/gender","sortOrder":null},{"_id":"pst_taxonomy_249_militarymentalhealth","name":"Military Mental Health","identifier":"topics/military","sortOrder":null}]},{"_id":"pst_taxonomy_395_suicide","name":"Suicide","identifier":"topics/suicide","sortOrder":9999,"children":[]},{"sortOrder":9999,"children":[],"_id":"pst_taxonomy_49771_tardivedyskinesia","name":"Tardive Dyskinesia","identifier":"topics/tardive-dyskinesia"},{"_id":"pst_taxonomy_407_digitalpsychiatry","name":"Technology \u0026 Psychiatry","identifier":"topics/tech-psychiatry","sortOrder":9999,"children":[]},{"name":"Transcranial Magnetic Stimulation","identifier":"topics/transcranial-magnetic-stimulation","sortOrder":9999,"children":[],"_id":"b160eca8-057d-49f5-a06e-962599380ee9"}],"seo_data":[],"recent_news":[{"thumbnail":{"asset":{"_ref":"image-75e054327354fd399f1c1b0d16066577da5800d1-5000x3500-jpg","_type":"reference"},"_type":"mainImage","alt":"eating disorders","caption":"Wanlee/AdobeStock"},"url":{"current":"multidisciplinary-inpatient-care-for-medically-compromised-youth-and-young-adults-with-eating-disorders","_type":"slug"},"published":"2024-11-22T17:00:00.488Z","authorMapping":{"_rev":"CD9JqQ0bQG227zfp2cIPTv","_updatedAt":"2024-11-22T14:13:08Z","url":{"current":"jessica-m-pierce-md-msc","_type":"slug"},"authorType":"author","displayName":"Jessica M. Pierce, MD, MSc","_createdAt":"2024-11-22T14:13:08Z","_type":"author","_id":"3fa09261-2624-4db8-beda-31f80992ff4b","biography":[{"style":"normal","_key":"977b8bc0d21e","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Pierce ","_key":"262f7acc2f3f0"},{"_type":"span","marks":["em"],"text":"is the medical director of the Pediatric Consultation-Liaison Psychiatry Service and the child and adolescent psychiatry hospital education lead at the C.S. Mott Children’s Hospital, University of Michigan Hospital Systems. She is also a clinical assistant professor in the Department of Psychiatry, Division of Child and Adolescent Psychiatry.","_key":"dc0d9ad6962f"}],"_type":"block"}]},"factCheckAuthorMapping":null,"_id":"c96f9125-3add-4679-b518-ea8d76d3e29b","title":"Multidisciplinary Inpatient Care for Medically Compromised Youth and Young Adults With Eating Disorders","summary":"In this CME article, learn more about a protocolized approach to the hospital management of pediatric patients with severe malnutrition related to eating disorders, including the utilization of a multidisciplinary care team and structured psychoeducation materials for families.","contentCategory":{"_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","_updatedAt":"2020-02-25T09:35:56Z","_createdAt":"2020-02-06T09:15:47Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Articles"}},{"url":{"current":"palliative-psychiatry-and-assisted-suicide-compassion-abandonment-or-something-far-worse","_type":"slug"},"authorMapping":{"_type":"author","_updatedAt":"2024-11-18T17:24:48Z","authorType":"author","displayName":"Karandeep Sonu Gaind, MD","_id":"6f4f3c8d-2957-4993-93ae-1a0a52abfa2e","biography":[{"_key":"5e6d3d345730","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Gaind","_key":"a0ec3a53c9600"},{"text":" is a professor and governor at the University of Toronto, Chief of Psychiatry at Sunnybrook Health Sciences Centre, Honorary Member of the World Psychiatric Association and former president (but no longer member) of the Canadian Psychiatric Association. He is not a “conscientious objector” to PAD and previously was physician chair of his former hospital’s assisted dying team. Views expressed are his own and not meant to represent any group he works with.","_key":"a0ec3a53c9601","_type":"span","marks":["em"]}],"_type":"block","style":"normal"}],"url":{"current":"karandeep-sonu-gaind-md","_type":"slug"},"_createdAt":"2024-11-18T17:24:48Z","_rev":"5AevX4rXJx5kciLHgHczig"},"factCheckAuthorMapping":null,"_id":"d4539d56-8c75-4ea6-a4d3-3ed1acb6535a","title":"“Palliative Psychiatry” and Assisted Suicide: Compassion? Abandonment? Or Something Far Worse?","summary":"Palliative psychiatry takes a dangerous turn when discussions lead to advocacy for assisted suicide policies for mental illness.","thumbnail":{"_type":"mainImage","alt":"death","caption":"Sergey/AdobeStock","asset":{"_ref":"image-235edfaaffbb2e5338f877ce4d82405056490460-5205x3655-jpg","_type":"reference"}},"published":"2024-11-22T16:00:00.000Z","contentCategory":{"_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","_updatedAt":"2020-02-25T09:35:56Z","_createdAt":"2020-02-06T09:15:47Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Articles"}},{"factCheckAuthorMapping":null,"contentCategory":{"_createdAt":"2020-02-06T09:15:47Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Articles","_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","_updatedAt":"2020-02-25T09:35:56Z"},"_id":"261a46e8-f089-4c26-b5f3-c98a57fcbce9","summary":"\"The headlines said Well-Loved American Foods Resisted Arrest, Failed to Comply, and Were Delicious While Black.\"\n","url":{"current":"mrs-butterworth-uncle-ben-aunt-jemima","_type":"slug"},"published":"2024-11-22T15:00:00.000Z","authorMapping":{"_rev":"lqwyDMFYHH51hbHPPpJSq6","_type":"author","_id":"pst_author_330909","_updatedAt":"2022-01-13T19:09:39Z","url":{"_type":"slug","current":"richard-m-berlin-md"},"displayName":"Richard M. Berlin, MD","_createdAt":"2020-02-21T11:23:21Z"},"title":"Mrs. Butterworth, Uncle Ben \u0026 Aunt Jemima","thumbnail":{"_type":"mainImage","alt":"pancakes","caption":"jobi_pro/AdobeStock","asset":{"_ref":"image-3ed6ed0e603c50cecd341c8574a13634688ead88-5058x3358-jpg","_type":"reference"}}},{"contentCategory":{"_createdAt":"2020-02-06T09:15:47Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Articles","_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","_updatedAt":"2020-02-25T09:35:56Z"},"_id":"3166139c-fb47-45ca-bf06-c67f6440fec8","title":"Last Rights – Ode to C7","summary":"“We’ll soon become the land, Of death on demand…”","thumbnail":{"_type":"mainImage","alt":"dying","caption":"Photographee.eu/AdobeStock","asset":{"_ref":"image-78c7e7c0979b3affdb11b56b14662604c7c9cfb2-5760x1782-jpg","_type":"reference"}},"url":{"current":"last-rights-ode-to-c7","_type":"slug"},"factCheckAuthorMapping":null,"published":"2024-11-22T14:00:00.000Z","authorMapping":{"_rev":"5AevX4rXJx5kciLHgHczig","_id":"6f4f3c8d-2957-4993-93ae-1a0a52abfa2e","biography":[{"style":"normal","_key":"5e6d3d345730","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Gaind","_key":"a0ec3a53c9600"},{"text":" is a professor and governor at the University of Toronto, Chief of Psychiatry at Sunnybrook Health Sciences Centre, Honorary Member of the World Psychiatric Association and former president (but no longer member) of the Canadian Psychiatric Association. He is not a “conscientious objector” to PAD and previously was physician chair of his former hospital’s assisted dying team. Views expressed are his own and not meant to represent any group he works with.","_key":"a0ec3a53c9601","_type":"span","marks":["em"]}],"_type":"block"}],"url":{"current":"karandeep-sonu-gaind-md","_type":"slug"},"_createdAt":"2024-11-18T17:24:48Z","displayName":"Karandeep Sonu Gaind, MD","_type":"author","_updatedAt":"2024-11-18T17:24:48Z","authorType":"author"}}],"isLiveSite":true,"host":"www.psychiatrictimes.com","settings":{"title":"Psychiatric Times","networkID":"4688","adUnit":"cmpm.psychiatrictimes","liveDomain":"www.psychiatrictimes.com","publicationName":"Psychiatric Times","logo":"/PsychiatricTimesLogo.png","mobile_logo":"/PsychiatricTimesLogo WHT.png","white_logo":"/PsychiatricTimesLogo WHT.png","enableEdgeCache":false,"sMaxAge":300,"staleWhileRevalidate":359,"logoWidth":"391px","mobileLogoWidth":"201px","logoHeight":"55px","mobileLogoHeight":"30px","logoBannerHeight":"80","logoPadding":"2","megaMenuTaxName":"topics","sharingImageUrl":"https://www.psychiatrictimes.com/PT_share_logo.png","twitterHandle":"@PsychTimes","publicationMapping":"journals","marginRightFromLogo":"3rem","gateEnabled":"modal","redesignDetail":true}},"targeting":{"content_placement":["topics/trauma-and-violence","topics/neuropsychiatry","topics/dementia","topics/alzheimer-disease"],"document_url":["traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases"],"document_group":[],"content_group":[],"rootDocumentGroup":[],"issue_url":[],"publication_url":[],"tags":[],"hostname":"www.psychiatrictimes.com"},"statusCode":200,"data":{"page":{"searchConfig":{"baseUrl":"/view/"},"isDsoGated":null,"pages":null,"pageSliders":null,"useV3":null,"contentCategories":null,"parent":null,"cmeConfig":null,"identifier":null,"intro":null,"hasSubCategory":false,"theme":"default","fixIdentifier":null,"url":{"current":"/view","_type":"slug"},"filterRequired":false,"disableEpisode":null,"docGroup":null,"taxonomy":null,"linkedPage":null,"labelRequired":false,"label":null,"externalLinks":null,"relatedMegaMenu":false,"creativeLayoutLatestNews":null,"gateCode":null,"featureContent":null,"content":null,"contentCategory":null,"archived":false,"articleDetailConfig":{"drupalleadBaseURL":"https://drupalleads.mjh.group/injectablewebform/output/","issueMapping":"/journals","enableSegmentRecommend":false,"brightcoveAccountID":"10203567001","downloadCitation":false,"shareOptions":{"siteName":"psychiatrictimes","hideFacebook":false,"SocialIconSize":32,"twitterSiteName":"psychtimes","hidePinterest":false,"shareSubject":"Check out this article!","twitterHandle":"@psychtimes","thumbnail":{"alt":"aging brain","caption":"Ramunas/AdobeStock","asset":{"_ref":"image-c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584-jpg","_type":"reference"},"_type":"mainImage"}},"brightcovePlayerID":"cv3eRkzu9"},"styling":{"border":{"borderRadius":{"topLeft":"0rem","topRight":"0rem","bottomLeft":"0rem","bottomRight":"0rem"},"_type":"border","borderSize":0},"contentControl":{"showSummary":false,"_type":"contentControl","showPublished":true,"readMore":false,"showAuthor":true},"imageControl":{"_type":"imageControl","showImage":true,"thumbnailRadius":{"bottomLeft":"0rem","bottomRight":"0rem","topLeft":"0rem","topRight":"0rem"}},"divider":{"_type":"divider","dividerSize":1},"columns":"2","titleOptions":{"_type":"titleOptions","titleSize":"1rem"}},"excludeFromSitemap":false,"title":"View","pageType":"Article Detail","creativeLayout":null,"creativeLayoutDetail":null,"filters":null,"franchise":null,"videoPlayerConfig":null,"orderDesc":null},"pageData":{"article":{"contentCategory":{"_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","name":"Articles"},"contentGroup":null,"filter":null,"taxonomyMapping":[{"pixelTrackingCode":null,"_rev":"BmvClBuXMtNlljYu6nhdr9","_id":"pst_taxonomy_415_traumaandviolence","_createdAt":"2020-03-26T06:11:21Z","identifier":"topics/trauma-and-violence","parent":{"cmeType":"per","_createdAt":"2020-03-26T06:11:21Z","name":"Anxiety \u0026 Stress Disorders","_id":"pst_taxonomy_119_anxietystressdisorders","_updatedAt":"2023-03-31T19:07:26Z","parent":{"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","isMainTopic":true},"identifier":"topics/anxiety","_type":"taxonomy","_rev":"37333Uv1mHMuPikcnyAiz0","perKeywordMapping":["Psychiatry","Neurology"]},"_type":"taxonomy","name":"Trauma And Violence","_updatedAt":"2020-06-10T19:45:36Z"},{"parent":{"_id":"pst_taxonomy_53202_clinical","identifier":"topics","isMainTopic":true,"_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","parent":null,"_updatedAt":"2023-03-31T19:15:59Z","_createdAt":"2020-03-26T06:11:21Z"},"_type":"taxonomy","name":"Neuropsychiatry","perKeywordMapping":["Psychiatry","Neurology"],"_createdAt":"2020-03-26T06:11:21Z","_updatedAt":"2023-03-31T19:19:55Z","identifier":"topics/neuropsychiatry","cmeType":"per","_rev":"77mZ7PORfofI3dBGfWcsCF","_id":"pst_taxonomy_35_neuropsychiatry","pixelTrackingCode":null},{"pixelTrackingCode":null,"parent":{"perKeywordMapping":["Psychiatry","Neurology"],"identifier":"topics/neuropsychiatry","_id":"pst_taxonomy_35_neuropsychiatry","cmeType":"per","_rev":"77mZ7PORfofI3dBGfWcsCF","_type":"taxonomy","_createdAt":"2020-03-26T06:11:21Z","name":"Neuropsychiatry","_updatedAt":"2023-03-31T19:19:55Z","parent":{"_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z"}},"_createdAt":"2020-03-26T06:11:21Z","_rev":"snQqhhB4O8T5bi1viUSkda","_type":"taxonomy","name":"Dementia","_id":"pst_taxonomy_132_dementia","_updatedAt":"2020-06-10T19:45:36Z","identifier":"topics/dementia"},{"pixelTrackingCode":null,"_type":"taxonomy","name":"Alzheimer Disease","_id":"pst_taxonomy_149_alzheimerdisease","_rev":"snQqhhB4O8T5bi1viUSkda","_updatedAt":"2020-06-10T19:45:36Z","identifier":"topics/alzheimer-disease","parent":{"cmeType":"per","perKeywordMapping":["Psychiatry","Neurology"],"_createdAt":"2020-03-26T06:11:21Z","name":"Neuropsychiatry","_id":"pst_taxonomy_35_neuropsychiatry","identifier":"topics/neuropsychiatry","parent":{"isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics"},"_rev":"77mZ7PORfofI3dBGfWcsCF","_type":"taxonomy","_updatedAt":"2023-03-31T19:19:55Z"},"_createdAt":"2020-03-26T06:11:21Z"}],"_updatedAt":"2024-10-01T15:18:23Z","summary":"A traumatic brain injury sustained earlier in adult life is likely to interact with normal aging processes. Learn more here. ","_createdAt":"2024-09-30T13:43:32Z","_rev":"gY6HNa1AWMhOBvzVtjEFkq","url":{"current":"traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases","_type":"slug"},"articleType":"News","is_visible":true,"factCheckAuthorMapping":null,"pdfUrl":null,"_type":"article","published":"2024-10-01T14:00:00.000Z","ExcludeFromPubMedXML":false,"body":[{"widthP":50,"asset":{"_ref":"image-c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584-jpg","_type":"reference"},"disableLightBox":true,"upload_doc":null,"uploadAudio":null,"imgcaption":[{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Ramunas/AdobeStock","_key":"be62b1d476270"}],"_type":"block","style":"normal","_key":"e03465c8d151"}],"_type":"figure","_key":"f3b1412f25ec","medias":null,"disableTextWrap":false,"alt":"aging brain","alignment":"left"},{"markDefs":[],"children":[{"_key":"0fc0b62dbe490","_type":"span","marks":[],"text":"A significant number of individuals who sustained a traumatic brain injury (TBI) during early and mid-adulthood are living with disabilities within the US. When considering the impact of TBI over the years, it becomes clear that the effects of TBI may become more evident as aging takes place. This is because a TBI sustained earlier in adult life is likely to interact with normal aging processes."}],"_type":"block","style":"normal","_key":"2e80073ac3f4","upload_doc":null,"uploadAudio":null,"medias":null},{"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"","_key":"208ea6c9429e0"}],"_type":"block","style":"normal","_key":"c0941f5acc99","markDefs":[],"upload_doc":null},{"style":"normal","upload_doc":null,"uploadAudio":null,"medias":null,"_key":"39596641a051","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"TBI Can Exacerbate Age Related Changes","_key":"46275b42154b0"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"As the brain ages, there is naturally occurring atrophy of cerebral tissue including structures such as the hippocampus, which plays a significant role in memory and cognitive processing. The hippocampus is frequently impacted by TBI, thus increasing the likelihood of developing memory impairments as one ages.","_key":"219b6164bb5a0"},{"text":"1","_key":"16fa957a1345","_type":"span","marks":["superscript"]},{"_type":"span","marks":[],"text":" Interestingly, a large hippocampal volume appears to offer protection from dementia.","_key":"dbe187f848e0"},{"marks":["superscript"],"text":"2","_key":"9ff1fabf1a98","_type":"span"},{"_type":"span","marks":[],"text":" A decline in white matter volume is also observed during normal aging.","_key":"ef6014575e3e"},{"_type":"span","marks":["superscript"],"text":"3","_key":"5ec622ae380e"},{"text":" White matter is mainly composed of myelinated axons and decreases in myelin density will hinder the capacity to transmit signals across the nervous system. Following TBI, these changes can occur at an accelerated rate compared with normal aging.","_key":"a4a51262d38d","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"4","_key":"15aea21bacec"}],"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block","style":"normal","_key":"c6132477b2d5"},{"uploadAudio":null,"medias":null,"_key":"8bfb59bf72ab","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"899f708c19890"}],"_type":"block","style":"normal","upload_doc":null},{"markDefs":[],"children":[{"text":"The natural process of remyelination is also altered as the brain ages.","_key":"a3885508d4da0","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"3","_key":"1491cc52497e"},{"marks":[],"text":" Oligodendrocyte loss arising from the original injury may predispose the brain to decreased remyelination capacity.","_key":"657a3512df87","_type":"span"},{"_key":"8abba1cec22d","_type":"span","marks":["superscript"],"text":"5"},{"_type":"span","marks":[],"text":" Oligodendrocytes are critical in maintaining the myelin sheath. White matter deterioration can manifest as cognitive deficits by affecting the efficiency of connectivity.","_key":"b0e511e2c13a"},{"_type":"span","marks":["superscript"],"text":"6,7","_key":"1393cfbf5891"},{"_type":"span","marks":[],"text":" Studies utilizing functional imaging have shown that there is a change in network connections during normal aging that is exacerbated with brain injury.","_key":"65775570bcee"},{"_type":"span","marks":["superscript"],"text":"8","_key":"423e002c187e"},{"text":" Primary pathways that were established during development may be affected by injury and replaced with redundant pathways that, while enabling function, are not as effective as the originals and will render the brain more vulnerable to the effects of aging.","_key":"fe0801d97674","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"9","_key":"cc554d91844e"},{"marks":[],"text":" Given that even mild TBI can have an impact on connectivity, it is not surprising that the risk of dementia is increased with repeated injury.","_key":"d25c855f9fb8","_type":"span"},{"_type":"span","marks":["superscript"],"text":"10,11","_key":"08377f772894"}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null,"medias":null,"_key":"06958899648b"},{"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"","_key":"97b5a7e0c4910"}],"_type":"block","style":"normal","_key":"a738f94ae387","markDefs":[],"upload_doc":null},{"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal","_key":"4afced5422b0","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Normal aging also has an impact on neuroendocrine and immunological systems that can contribute to age-related cognitive decline.","_key":"35a42050c2a30"},{"_type":"span","marks":["superscript"],"text":"12,13","_key":"dce4290814f2"},{"_type":"span","marks":[],"text":" Long lasting hormonal dysregulation is not uncommon in many patients after TBI and may well contribute to neurodegenerative processes across time.","_key":"b584ffd6f37b"},{"marks":["superscript"],"text":"10,11","_key":"d371f203cffc","_type":"span"},{"marks":[],"text":" Particularly noteworthy is the impact that hormones have on emotional health and cognition.","_key":"3a1ddb847c6f","_type":"span"},{"_key":"09fff016ad79","_type":"span","marks":["superscript"],"text":"14"},{"_type":"span","marks":[],"text":" Hormones also are known to have immunomodulatory effects. Microglia, the brain’s primary immune cells, are known to be especially vulnerable to the effects of age.","_key":"8ca2211fb141"},{"_type":"span","marks":["superscript"],"text":"15","_key":"e164d068f7cc"},{"_key":"360fe8b78645","_type":"span","marks":[],"text":" Age related immune changes are also likely to be exacerbated by a history of TBI. Increased microglial activity can be observed years after the initial injury."},{"_type":"span","marks":["superscript"],"text":"16-18","_key":"9a87119298d1"},{"_type":"span","marks":[],"text":" Persistent microglial activation can increase oxidative stress thus contribute to age- and injury-induced structural changes and long-term functional deficits.","_key":"4815038bdbab"},{"_type":"span","marks":["superscript"],"text":"18,19","_key":"b5bfb3fc5600"}]},{"uploadAudio":null,"medias":null,"_key":"a2ec67b15a11","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"f39956183a410"}],"_type":"block","style":"normal","upload_doc":null},{"medias":null,"markDefs":[],"children":[{"_key":"3ff3a01ce4e00","_type":"span","marks":["strong"],"text":"TBI May Precipitate or Exacerbate Neurodegenerative Diseases"}],"_type":"block","style":"normal","_key":"de5fae730b98","upload_doc":null,"uploadAudio":null},{"_type":"block","style":"normal","_key":"3e43a15a2bb2","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The possibility of developing dementia increases with advancing age.","_key":"3f7facbe5c100"},{"marks":["superscript"],"text":"20","_key":"d06e22615196","_type":"span"},{"_key":"006d26fb6e08","_type":"span","marks":[],"text":" When considering the interaction between TBI and neurodegenerative diseases, it is critical to distinguish between the disease per se and the pathological characteristics that are associated with these diseases."},{"_type":"span","marks":["superscript"],"text":"21 ","_key":"ca52344ec3db"},{"text":"This distinction is particularly notable in the case of Alzheimer disease (AD). Studies are suggestive of an increased incidence in AD-like pathology following TBI.","_key":"f789ca9c0b22","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"11,22,23","_key":"5bed8cfaea4e"},{"_type":"span","marks":[],"text":" In general, the association between a history of TBI and the onset of AD, has shown to be elusive.","_key":"23a991e4532b"},{"_type":"span","marks":["superscript"],"text":"24,25","_key":"3de8c16a3446"},{"_type":"span","marks":[],"text":" Nevertheless, a TBI history may influence the onset of AD given the appropriate genetic factors. APOE-4 and TBI appear to have a synergistic effect that increases the risk of AD-like symptomatology.","_key":"0afb5e64419b"},{"_type":"span","marks":["superscript"],"text":"26","_key":"e58392a0c37c"},{"marks":[],"text":" The APOE-4 allele has been identified as a genetic predictor of AD.","_key":"08d6e37cc28a","_type":"span"},{"_key":"166343d118d6","_type":"span","marks":["superscript"],"text":"27"},{"marks":[],"text":" Associations between a history of TBI and Parkinson disease (PD), amyotrophic lateral sclerosis, and multiple sclerosis have also been observed.","_key":"c5ba5321add7","_type":"span"},{"_type":"span","marks":["superscript"],"text":"28","_key":"9707a04d38b4"},{"marks":[],"text":" TBI has been associated with cerebral microinfarcts, Lewy body accumulation, and parkinsonism.","_key":"8c23fb39d5a1","_type":"span"},{"text":"29","_key":"a8e63300d2a6","_type":"span","marks":["superscript"]},{"_type":"span","marks":[],"text":" Lewy bodes are intercellular protein aggregates associated with dementia and PD. The association between PD and TBI has been widely debated due to conflicting studies.","_key":"151e610c527a"},{"_type":"span","marks":["superscript"],"text":"30,31","_key":"2decf79bddaf"},{"_type":"span","marks":[],"text":" Parkinson symptomatology may be more prevalent after repeated trauma.","_key":"2070c000f0bc"},{"_key":"02b4de10d6d9","_type":"span","marks":["superscript"],"text":"31 "},{"_type":"span","marks":[],"text":"Alternatively, a history of TBI may increment the likelihood of neurological illness in those patients who are at risk of PD.","_key":"da9cce5a3fe3"}]},{"style":"normal","_key":"05feb71f9e49","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"","_key":"b66752fc338e0"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Prognosis and Treatment Strategies","_key":"0bcbaf7da5380"}],"_type":"block","style":"normal","_key":"e00a5dac072b","upload_doc":null,"uploadAudio":null,"medias":null},{"style":"normal","_key":"ca5d564f49a6","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"To achieve successful aging, it is important to have a lifestyle that integrates factors known to promote health and consider strategies that address changes in neuroendocrine and immune systems. These same approaches are especially important to those that have survived a TBI.Vigilance for the development of comorbidities is necessary along with proper awareness of physiological, environmental and genetic factors that may increase risk to cognitive decline.","_key":"87d975d393030"}],"_type":"block"},{"upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_key":"f844be8d8de40","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"0346488ceb09"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Griesbach ","_key":"590f7f78d38e0"},{"_type":"span","marks":["em"],"text":"is the national director of clinical research for the Centre of Neuro Skills. She currently holds an appointment at the Neurosurgery Department, Geffen School of Medicine, UCLA, and is past president and chair for the National Neurotrauma Society.","_key":"590f7f78d38e1"}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null,"medias":null,"_key":"2d16e9945d56"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"efea041653310"}],"_type":"block","style":"normal","_key":"a9facfecc4de","upload_doc":null,"uploadAudio":null,"medias":null},{"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"References","_key":"6ae7112a83260"}],"_type":"block","style":"normal","_key":"383c20de3d39","upload_doc":null},{"medias":null,"markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/9010515/","_key":"c8dd871fcd7c","blank":true}],"children":[{"marks":[],"text":"1. Bigler ED, Blatter DD, Anderson CV, et al. ","_key":"04d26b2c87d00","_type":"span"},{"text":"Hippocampal volume in normal aging and traumatic brain injury.","_key":"04d26b2c87d01","_type":"span","marks":["c8dd871fcd7c"]},{"text":" ","_key":"984500e8855a","_type":"span","marks":[]},{"text":"AJNR Am J Neuroradiol","_key":"04d26b2c87d02","_type":"span","marks":["em"]},{"text":". 1997;18(1):11-23.","_key":"04d26b2c87d03","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"52d99993dedc","upload_doc":null,"uploadAudio":null},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/20739349/","_key":"cfe9089a272f"}],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_key":"310ee3ea660d0","_type":"span","marks":[],"text":"2. Chetelat G, Villemagne VL, Pike KE, et al. "},{"_type":"span","marks":["cfe9089a272f"],"text":"Larger temporal volume in elderly with high versus low beta-amyloid deposition.","_key":"310ee3ea660d1"},{"_type":"span","marks":[],"text":" ","_key":"cb86a1feb338"},{"_key":"310ee3ea660d2","_type":"span","marks":["em"],"text":"Brain"},{"text":". 2010;133(11):3349-3358.","_key":"310ee3ea660d3","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"50c67d74d232"},{"children":[{"marks":[],"text":"3. Franklin RJ, Zhao C, Sim FJ. ","_key":"b3beda8d92e30","_type":"span"},{"text":"Ageing and CNS remyelination.","_key":"b3beda8d92e31","_type":"span","marks":["3b5e2a1a265a"]},{"marks":[],"text":" ","_key":"bd480b5488f6","_type":"span"},{"text":"Neuroreport","_key":"b3beda8d92e32","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". 2002;13(7):923-928.","_key":"b3beda8d92e33"}],"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block","style":"normal","_key":"f235ac31eaf8","markDefs":[{"_key":"3b5e2a1a265a","blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/12004191/"}]},{"_key":"668f86271ba1","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/19897544/","_key":"6e5bb04d6d4b"}],"children":[{"_type":"span","marks":[],"text":"4. Maxwell WL, MacKinnon MA, Stewart JE, Graham DI. ","_key":"ab10e6f9a3dc0"},{"text":"Stereology of cerebral cortex after traumatic brain injury matched to the Glasgow outcome score.","_key":"ab10e6f9a3dc1","_type":"span","marks":["6e5bb04d6d4b"]},{"_type":"span","marks":[],"text":" ","_key":"447ca61ffda1"},{"marks":["em"],"text":"Brain","_key":"ab10e6f9a3dc2","_type":"span"},{"text":". 2010;133(Pt 1):139-160.","_key":"ab10e6f9a3dc3","_type":"span","marks":[]}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal"},{"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_key":"abafdc6c03fe0","_type":"span","marks":[],"text":"5. Levin HS, Williams DH, Valastro M, et al. "},{"marks":["71383cd93b0b"],"text":"Corpus callosal atrophy following closed head injury: detection with magnetic resonance imaging.","_key":"abafdc6c03fe1","_type":"span"},{"_type":"span","marks":[],"text":" ","_key":"88486171963a"},{"marks":["em"],"text":"J Neurosurg","_key":"abafdc6c03fe2","_type":"span"},{"_type":"span","marks":[],"text":". 1990;73(1):77-81.","_key":"abafdc6c03fe3"}],"_type":"block","style":"normal","_key":"34725ee3ad67","markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/2352026/","_key":"71383cd93b0b","blank":true,"_type":"link"}]},{"_key":"b873cf602ee5","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/22172614/","_key":"e64083bf7b85"}],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"6. Maas AI, Menon DK. ","_key":"f9f21f068e6c0"},{"_type":"span","marks":["e64083bf7b85"],"text":"Traumatic brain injury: rethinking ideas and approaches.","_key":"f9f21f068e6c1"},{"_key":"29105f14beb3","_type":"span","marks":[],"text":" "},{"_key":"f9f21f068e6c2","_type":"span","marks":["em"],"text":"Lancet Neurol"},{"text":". 2012;11(1):12-13.","_key":"f9f21f068e6c3","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"style":"normal","_key":"c7e6b2e648c8","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"blank":true,"_type":"link","href":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996721/","_key":"5be9bddd16ac"}],"children":[{"text":"7. Ziegler DA, Piguet O, Salat DH, et al. ","_key":"ba15ef8c66b20","_type":"span","marks":[]},{"_type":"span","marks":["5be9bddd16ac"],"text":"Cognition in healthy aging is related to regional white matter integrity, but not cortical thickness.","_key":"ba15ef8c66b21"},{"text":" ","_key":"d728faaa9fa8","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"Neurobiol Aging","_key":"ba15ef8c66b22"},{"marks":[],"text":". 2010;31(11):1912-1926.","_key":"ba15ef8c66b23","_type":"span"}],"_type":"block"},{"upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/24120645/","_key":"43db18831b12","blank":true}],"children":[{"_type":"span","marks":[],"text":"8. Filippi M, van den Heuvel MP, Fornito A, et al. ","_key":"8c37a9460acd0"},{"_key":"8c37a9460acd1","_type":"span","marks":["43db18831b12"],"text":"Assessment of system dysfunction in the brain through MRI-based connectomics."},{"_type":"span","marks":[],"text":" ","_key":"3a0b8bd7b491"},{"_type":"span","marks":["em"],"text":"Lancet Neurol","_key":"8c37a9460acd2"},{"text":". 2013;12(12):1189-1199.","_key":"8c37a9460acd3","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"ba515d6a1039"},{"medias":null,"_type":"block","style":"normal","_key":"e4c7dc82539d","markDefs":[],"children":[{"marks":[],"text":"9. Blumberg M, Hardy J, Robinson S. ","_key":"41ee7e4992270","_type":"span"},{"text":"Handbook of Developmental Neuroscience.","_key":"41ee7e4992271","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":" Oxford; 2009.","_key":"41ee7e4992272"}],"upload_doc":null,"uploadAudio":null},{"_key":"c17197bf6825","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/26414093/","_key":"7391a49ef024"}],"children":[{"_type":"span","marks":[],"text":"10. Kreber LA, Griesnbach GS, Ashley JA. ","_key":"78f1dfe6f5d60"},{"_type":"span","marks":["7391a49ef024"],"text":"Detection of growth hormone deficiency in adults with chronic traumatic brain injury.","_key":"78f1dfe6f5d61"},{"_type":"span","marks":[],"text":" ","_key":"e9d85cd8d18e"},{"text":"J Neurotrauma","_key":"78f1dfe6f5d62","_type":"span","marks":["em"]},{"_key":"78f1dfe6f5d63","_type":"span","marks":[],"text":". 2016;33(17):1607-1613."}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"2595ddebabab","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/28920532/","_key":"b69cd647468e"}],"children":[{"_key":"000cca7d37ad0","_type":"span","marks":[],"text":"11. Griesbach GS, Masel BE, Helvie RE, Ashley MJ. "},{"text":"The impact of traumatic brain injury on later life: effects on normal aging and neurodegenerative diseases.","_key":"000cca7d37ad1","_type":"span","marks":["b69cd647468e"]},{"_type":"span","marks":[],"text":" ","_key":"3784c3d4c14f"},{"_type":"span","marks":["em"],"text":"J Neurotrauma","_key":"000cca7d37ad2"},{"_type":"span","marks":[],"text":". 2018;35(1):17-24.","_key":"000cca7d37ad3"}]},{"_key":"5c61c3754430","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"blank":true,"_type":"link","href":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675779/","_key":"b188999156d5"}],"children":[{"marks":[],"text":"12. Veldhuis JD, Sharma A, Roelfsema F. ","_key":"36de8f75ba6e0","_type":"span"},{"_type":"span","marks":["b188999156d5"],"text":"Age-dependent and gender-dependent regulation of hypothalamic-adrenocorticotropic-adrenal axis.","_key":"36de8f75ba6e1"},{"_type":"span","marks":[],"text":" ","_key":"d7ba407510a9"},{"marks":["em"],"text":"Endocrinol Metab Clin North Am","_key":"36de8f75ba6e2","_type":"span"},{"text":". 2013;42(2):201-225.","_key":"36de8f75ba6e3","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"_key":"89b7ed59c7c5","markDefs":[{"blank":true,"_type":"link","href":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120618/","_key":"07571f1c9312"}],"children":[{"_type":"span","marks":[],"text":"13. McEwen B, Milner TA. ","_key":"03bdda1f30a50"},{"text":"Understanding the broad influenceof sex hormones and sex differences in the brain.","_key":"03bdda1f30a51","_type":"span","marks":["07571f1c9312"]},{"_type":"span","marks":[],"text":" ","_key":"47be0680fbe0"},{"_type":"span","marks":["em"],"text":"J Neurosci Res","_key":"03bdda1f30a52"},{"marks":[],"text":". 2017;95(1-2):24-39.","_key":"03bdda1f30a53","_type":"span"}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal"},{"medias":null,"_key":"9f66b1d36123","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/17195886/","_key":"47f0ca1ac1d6"}],"children":[{"_type":"span","marks":[],"text":"14. Ashman TA, Gordon WA, Cantor JB, Hibbard MR. ","_key":"7f924003cbb10"},{"_type":"span","marks":["47f0ca1ac1d6"],"text":"Neurobehavioral consequences of traumatic brain injury.","_key":"7f924003cbb11"},{"marks":[],"text":" ","_key":"1aef5349c414","_type":"span"},{"_type":"span","marks":["em"],"text":"Mt Sinai J Med","_key":"7f924003cbb12"},{"_type":"span","marks":[],"text":". 2006;73(7):999-1005.","_key":"7f924003cbb13"}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null},{"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"15. Damani MR, Zhao L, Fontainhas AM, et al. ","_key":"224ae2571c030"},{"marks":["fc6c832b6485"],"text":"Age‐related alterations in the dynamic behavior of microglia.","_key":"224ae2571c031","_type":"span"},{"_key":"6cc7e4cbd3eb","_type":"span","marks":[],"text":" "},{"_type":"span","marks":["em"],"text":"Aging Cell","_key":"224ae2571c032"},{"_type":"span","marks":[],"text":". 2011;10(2):263-276.","_key":"224ae2571c033"}],"_type":"block","style":"normal","_key":"ca28d6fd0179","markDefs":[{"_key":"fc6c832b6485","blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/21108733/"}],"upload_doc":null},{"uploadAudio":null,"medias":null,"_key":"d50fa9cb856e","markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/35537569/","_key":"6cb882a92c32","blank":true}],"children":[{"text":"16. Rowe RK, Griesbach GS. ","_key":"0a73f324a9390","_type":"span","marks":[]},{"_type":"span","marks":["6cb882a92c32"],"text":"Immune-endocrine interactions in the pathophysiology of sleep-wake disturbances following traumatic brain injury: a narrative review.","_key":"0a73f324a9391"},{"_type":"span","marks":[],"text":" ","_key":"6a60dafabd7a"},{"_type":"span","marks":["em"],"text":"Brain Res Bull","_key":"0a73f324a9392"},{"_type":"span","marks":[],"text":". 2022;185:117-128.","_key":"0a73f324a9393"}],"_type":"block","style":"normal","upload_doc":null},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/23231074/","_key":"5aa2ece6cb5b"}],"children":[{"marks":[],"text":"17. Smith C, Gentleman SM, Leclercq PD, et al. ","_key":"1905aa046d3e0","_type":"span"},{"_type":"span","marks":["5aa2ece6cb5b"],"text":"The neuroinflammatory response in humans after traumatic brain injury.","_key":"1905aa046d3e1"},{"marks":[],"text":" ","_key":"9c02feddcc5f","_type":"span"},{"_key":"1905aa046d3e2","_type":"span","marks":["em"],"text":"Neuropathol Appl Neurobiol"},{"_type":"span","marks":[],"text":". 2013;39(6):654-666.","_key":"1905aa046d3e3"}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null,"medias":null,"_key":"32712847b2cf"},{"_key":"82c060700f12","markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/21710619/","_key":"fedf72ef883e","blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"18. Ramlackhansingh AF, Brooks DJ, Greenwood RJ, et al. ","_key":"ef34b767086e0"},{"marks":["fedf72ef883e"],"text":"Inflammation after trauma: microglial activation and traumatic brain injury.","_key":"ef34b767086e1","_type":"span"},{"_type":"span","marks":[],"text":" ","_key":"282aea2022e2"},{"_type":"span","marks":["em"],"text":"Ann Neurol. ","_key":"ef34b767086e2"},{"_type":"span","marks":[],"text":"2011;70(3):374-383.","_key":"ef34b767086e3"}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal"},{"_key":"aa1a0f5f8599","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"_key":"7799b4c3995f","blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/20195798/"}],"children":[{"_type":"span","marks":[],"text":"19. Brown GC, Neher JJ. ","_key":"cbe95b7332130"},{"_type":"span","marks":["7799b4c3995f"],"text":"Inflammatory neurodegeneration and mechanisms of microglial killing of neurons.","_key":"cbe95b7332131"},{"_type":"span","marks":[],"text":" ","_key":"ecad07e241ec"},{"_type":"span","marks":["em"],"text":"Mol Neurobiol","_key":"cbe95b7332132"},{"_type":"span","marks":[],"text":". 2010;41(2-3):242-247.","_key":"cbe95b7332133"}],"_type":"block","style":"normal"},{"uploadAudio":null,"medias":null,"style":"normal","_key":"e27ce5b29ff0","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/1259639/","_key":"f20f8a4bba17"}],"children":[{"_type":"span","marks":[],"text":"20. Katzman R. ","_key":"113d68a4bb620"},{"_type":"span","marks":["f20f8a4bba17"],"text":"The prevalence and malignancy of Alzheimer disease. A major killer.","_key":"113d68a4bb621"},{"_type":"span","marks":[],"text":" ","_key":"9bcf0b3073da"},{"text":"Arch Neurol. ","_key":"113d68a4bb622","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":"1976;33(4):217-218.","_key":"113d68a4bb623"}],"_type":"block","upload_doc":null},{"medias":null,"children":[{"marks":[],"text":"21. Ashman TA, Cantor JB, Gordon WA, et al. ","_key":"2b551cdaa71b0","_type":"span"},{"_type":"span","marks":["6a2da23c94e3"],"text":"A comparison of cognitive functioning in older adults with and without traumatic brain injury.","_key":"2b551cdaa71b1"},{"_type":"span","marks":[],"text":" ","_key":"167f3e416f56"},{"_type":"span","marks":["em"],"text":"J Head Trauma Rehabil.","_key":"2b551cdaa71b2"},{"_key":"2b551cdaa71b3","_type":"span","marks":[],"text":" 2008;23(3):139-148."}],"_type":"block","style":"normal","_key":"9563cc996a3e","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/18520426/","_key":"6a2da23c94e3"}],"upload_doc":null,"uploadAudio":null},{"_key":"9620b13a6bcc","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/22285252/","_key":"540f5cdbffa2"}],"children":[{"text":"22. Johnson VE, Stewart W, Smith DH. ","_key":"bcaf1cc46dde0","_type":"span","marks":[]},{"_type":"span","marks":["540f5cdbffa2"],"text":"Axonal pathology in traumatic brain injury.","_key":"bcaf1cc46dde1"},{"_type":"span","marks":[],"text":" ","_key":"1bff56246114"},{"_type":"span","marks":["em"],"text":"Exp Neurol","_key":"bcaf1cc46dde2"},{"_type":"span","marks":[],"text":". 2013;246:35-43.","_key":"bcaf1cc46dde3"}],"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block","style":"normal"},{"children":[{"text":"23. Masel BE. ","_key":"759c1fb23a990","_type":"span","marks":[]},{"_type":"span","marks":["c29b82d8ecda"],"text":"The chronic consequences of neurotrauma.","_key":"759c1fb23a991"},{"_type":"span","marks":[],"text":" ","_key":"077ce0d5fcbc"},{"_type":"span","marks":["em"],"text":"J Neurotrauma.","_key":"759c1fb23a992"},{"_type":"span","marks":[],"text":" 2015;32(23):1833.","_key":"759c1fb23a993"}],"_type":"block","style":"normal","_key":"854567206ac3","markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/26629808/","_key":"c29b82d8ecda","blank":true,"_type":"link"}],"upload_doc":null,"uploadAudio":null,"medias":null},{"_key":"6da7fc483dee","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"blank":true,"_type":"link","href":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738550/","_key":"8d9043526c36"}],"children":[{"_key":"d9130682a1290","_type":"span","marks":[],"text":"24. Fleminger S, Oliver DL, Lovestone S, et al. "},{"_type":"span","marks":["8d9043526c36"],"text":"Head injury as a risk factor for Alzheimer's disease: the evidence 10 years on a partial replication.","_key":"d9130682a1291"},{"text":" ","_key":"d718a5299d6a","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"J Neurol Neurosurg Psychiatry. ","_key":"d9130682a1292"},{"marks":[],"text":"2003;74(7):857-862.","_key":"d9130682a1293","_type":"span"}],"_type":"block","style":"normal"},{"uploadAudio":null,"medias":null,"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/23924069/","_key":"bbb292454548"}],"children":[{"marks":[],"text":"25. Dams-O'Connor K, Spielman L, Singh A, et al. ","_key":"2d9db466fec80","_type":"span"},{"_type":"span","marks":["bbb292454548"],"text":"The impact of previous traumatic brain injury on health and functioning: a TRACK-TBI study.","_key":"2d9db466fec81"},{"_type":"span","marks":[],"text":" ","_key":"de1c07481592"},{"_type":"span","marks":["em"],"text":"J Neurotrauma","_key":"2d9db466fec82"},{"_type":"span","marks":[],"text":". 2013;30(24):2014-2020.","_key":"2d9db466fec83"}],"_type":"block","style":"normal","_key":"2b54fc9fe98d","upload_doc":null},{"uploadAudio":null,"medias":null,"markDefs":[{"_key":"bd1d24b77ae6","blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/10494348/"}],"children":[{"_type":"span","marks":[],"text":"26. Graham DI, Horsburgh K, Nicoll JA, Teasdale GM. ","_key":"bbe6d34cc3970"},{"_type":"span","marks":["bd1d24b77ae6"],"text":"Apolipoprotein E and the response of the brain to injury.","_key":"bbe6d34cc3971"},{"_type":"span","marks":[],"text":" ","_key":"c015ee0be715"},{"_type":"span","marks":["em"],"text":"Acta Neurochir Suppl.","_key":"bbe6d34cc3972"},{"marks":[],"text":" 1999;73:89-92.","_key":"bbe6d34cc3973","_type":"span"}],"_type":"block","style":"normal","_key":"05872ed0c627","upload_doc":null},{"style":"normal","_key":"5842a37fff8e","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/10746604/","_key":"44a2f81ae5bd"}],"children":[{"_type":"span","marks":[],"text":"27. Guo Z, Cupples LA, Kurz A, et al. ","_key":"0ea8591e515f0"},{"_type":"span","marks":["44a2f81ae5bd"],"text":"Head injury and the risk of AD in the MIRAGE study.","_key":"0ea8591e515f1"},{"_type":"span","marks":[],"text":" ","_key":"26acaa9a3de5"},{"_type":"span","marks":["em"],"text":"Neurology","_key":"0ea8591e515f2"},{"_type":"span","marks":[],"text":". 2000;54(6):1316-1323.","_key":"0ea8591e515f3"}],"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block"},{"_type":"block","style":"normal","_key":"4a21e87f9f96","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/26315003/","_key":"fa33459f12f9"}],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_key":"5bf2572005e50","_type":"span","marks":[],"text":"28. Perry DC, Sturm VE, Peterson MJ, et al. "},{"_type":"span","marks":["fa33459f12f9"],"text":"Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis.","_key":"5bf2572005e51"},{"text":" ","_key":"ebea12bb89d6","_type":"span","marks":[]},{"text":"J Neurosurg.","_key":"5bf2572005e52","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":" 2015;124(2):511-526.","_key":"5bf2572005e53"}]},{"_key":"7bb84f50dad2","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/27400367/","_key":"c6db55792d0c"}],"children":[{"_type":"span","marks":[],"text":"29. Crane PK, Gibbons LE, Dams-O’Connor K, et al. ","_key":"c38e24d3b1660"},{"_key":"c38e24d3b1661","_type":"span","marks":["c6db55792d0c"],"text":"Association of traumatic brain injury with late-life neurodegenerative conditions and neuropathologic findings."},{"_type":"span","marks":[],"text":" ","_key":"2d75140e2c0f"},{"_key":"c38e24d3b1662","_type":"span","marks":["em"],"text":"JAMA Neurol."},{"_type":"span","marks":[],"text":" 2017;73(9):1062-1069.","_key":"c38e24d3b1663"}],"_type":"block","style":"normal"},{"children":[{"text":"30. Goldman SM, Tanner CM, Oakes D, et al. ","_key":"30d3ea06d8f10","_type":"span","marks":[]},{"_type":"span","marks":["04d4c1bbaec3"],"text":"Head injury and Parkinson's disease risk in twins.","_key":"30d3ea06d8f11"},{"_type":"span","marks":[],"text":" ","_key":"d750df5851e0"},{"_key":"30d3ea06d8f12","_type":"span","marks":["em"],"text":"Ann Neurol."},{"marks":[],"text":" 2006;60(1):65-72.","_key":"30d3ea06d8f13","_type":"span"}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal","_key":"23af75cb6e06","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/16718702/","_key":"04d4c1bbaec3"}]},{"upload_doc":null,"uploadAudio":null,"medias":null,"_type":"block","style":"normal","_key":"173d9f98cdd8","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/25701902/","_key":"c76da4f38589"}],"children":[{"_type":"span","marks":[],"text":"31. Krauss JK. ","_key":"4a7b39f8aefe0"},{"_key":"4a7b39f8aefe1","_type":"span","marks":["c76da4f38589"],"text":"Movement disorders secondary to craniocerebral trauma."},{"text":" ","_key":"151fa187ef66","_type":"span","marks":[]},{"_key":"4a7b39f8aefe2","_type":"span","marks":["em"],"text":"Handb Clin Neurol."},{"_key":"4a7b39f8aefe3","_type":"span","marks":[],"text":" 2015;128:475-496."}]},{"uploadAudio":null,"medias":null,"style":"normal","_key":"aa71d701d607","markDefs":[],"children":[{"text":"","_key":"3f5a50becfd00","_type":"span","marks":[]}],"_type":"block","upload_doc":null},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"95bf88dad4fe0"}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal","_key":"017c9075a044"}],"thumbnail":{"alt":"aging brain","caption":"Ramunas/AdobeStock","asset":{"_ref":"image-c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584-jpg","_type":"reference"},"_type":"mainImage"},"issueGroup":null,"issueSection":null,"_id":"abd80119-fed6-4089-bf72-0a1a7be185e1","authorMapping":[{"_rev":"CHUkpLRK3ESqW5j2unhLxY","_type":"author","_id":"d81c7c60-6652-4668-9313-0fc1d283462b","biography":[{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Griesbach ","_key":"5f9021a02a160"},{"_key":"5f9021a02a161","_type":"span","marks":["em"],"text":"is the national director of clinical research for the Centre of Neuro Skills. She currently holds an appointment at the Neurosurgery Department, Geffen School of Medicine, UCLA, and is past president and chair for the National Neurotrauma Society."}],"_type":"block","style":"normal","_key":"df5c4eefa0b2"}],"_updatedAt":"2024-09-30T13:44:12Z","url":{"current":"grace-s-griesbach-phd","_type":"slug"},"displayName":"Grace S. Griesbach, PhD","_createdAt":"2024-09-30T13:44:12Z"}],"title":"Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases","documentGroup":null,"documentGroupMapping":null,"disableAds":false,"disableRelatedContent":false,"relatedArticles":[{"url":"opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis","documentGroup":null,"summary":"Traumatic life events are common among individuals who experience psychosis. Here's how best to assess and treat. ","_type":"article","issueGroup":{"_ref":"7d283d85-869a-4578-b7e0-00266f149eb6","_type":"reference"},"thumbnail":{"asset":{"_ref":"image-3baa097f1742d64c9afda10b2c6f7deda469f1dc-7280x4080-jpg","_type":"reference"},"_type":"mainImage","alt":"trauma","caption":"necropos12/AdobeStock"},"drugMentions":"{\"drug_mentions\": [\"antipsychotic medication\"]}","factCheckAuthorMapping":null,"documentGroupMapping":null,"authorMapping":[{"displayName":"Sripriya Chari, PhD","_createdAt":"2024-11-11T21:05:25Z","_rev":"bcxmLYb4HqB4YfW9fqgeea","_type":"author","_id":"7a2dbbd2-fbd1-4c92-8edb-65e6653f8d85","biography":[{"style":"normal","_key":"663779a4e16c","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Chari ","_key":"30c7cfdf43610"},{"marks":["em"],"text":"is the assistant psychosocial director and didactic lead of the INSPIRE Clinic and a clinical associate professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine in California.","_key":"3d04c53f7248","_type":"span"}],"_type":"block"}],"_updatedAt":"2024-11-11T21:05:55Z","authorType":"author","url":{"current":"sripriya-chari-phd","_type":"slug"}},{"displayName":"Grace Eun Lee, PhD","biography":[{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Lee","_key":"a8ea80de7bfd0"},{"_type":"span","marks":[],"text":" ","_key":"4ff69dceb752"},{"_key":"70e90c1e1ed5","_type":"span","marks":["em"],"text":"is a clinical assistant professor and a California-licensed clinical psychologist in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine."}],"_type":"block","style":"normal","_key":"8bf2fa8feeab"}],"authorType":"author","_rev":"c2YzzhLhcB98QKtLpbqvd1","_type":"author","_id":"7e9121ae-e03b-44db-9735-079f6f94354e","_updatedAt":"2024-11-11T21:06:31Z","url":{"current":"grace-eun-lee-phd","_type":"slug"},"_createdAt":"2024-11-11T21:06:31Z"},{"url":{"current":"nichole-d-olson-phd","_type":"slug"},"authorType":"author","displayName":"Nichole D. Olson, PhD","_type":"author","_id":"53770cf0-6158-412d-959c-28823b7ac823","_createdAt":"2024-11-11T21:07:15Z","_rev":"bcxmLYb4HqB4YfW9fqgqYo","biography":[{"children":[{"_type":"span","marks":["strong"],"text":"Dr Olson","_key":"77c1edc636ef0"},{"_type":"span","marks":[],"text":" ","_key":"85e92925f8ba"},{"text":"is a clinical associate professor and licensed psychologist in the INSPIRE Clinic and dialectical behavior therapy program at Stanford University.","_key":"5005fc9eea8e","_type":"span","marks":["em"]}],"_type":"block","style":"normal","_key":"cb63384533ad","markDefs":[]}],"_updatedAt":"2024-11-11T21:07:38Z"},{"displayName":"Kate V. Hardy, PsyD","_type":"author","_id":"81b94746-54aa-488a-b0ac-98cfbe85d8ab","biography":[{"style":"normal","_key":"63f723cd2219","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Hardy","_key":"36792f8aea220"},{"text":" is the codirector of the INSPIRE Clinic, the co–section chief of INSPIRE Section, and a clinical professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine.","_key":"4a8e080cb949","_type":"span","marks":["em"]}],"_type":"block"},{"children":[{"marks":[],"text":"\n","_key":"bcf77501ed800","_type":"span"}],"_type":"block","style":"normal","_key":"03fe34e53770","markDefs":[]}],"authorType":"author","_rev":"bcxmLYb4HqB4YfW9fqgsXE","_updatedAt":"2024-11-11T21:08:13Z","url":{"current":"kate-v-hardy-psyd","_type":"slug"},"_createdAt":"2024-11-11T21:08:13Z"}],"gptTakeaways":"• Trauma and psychosis frequently co-occur, necessitating comprehensive assessments to identify trauma in individuals presenting with psychosis symptoms.\n\n• Trauma-informed care, incorporating safety, trust, and collaboration, is crucial for effective treatment and recovery in individuals with psychosis.\n\n• Evidence-based PTSD treatments, including trauma-focused CBTp, can be safely and effectively used in individuals with comorbid psychosis and PTSD.\n\n• Clinicians should adapt trauma interventions to address both trauma and psychosis symptoms, ensuring adequate coping skills and minimizing retraumatization.","_rev":"fS416cKfEI6INbS7bhIg66","body":[{"disableLightBox":true,"widthP":52,"alignment":"left","asset":{"_ref":"image-3baa097f1742d64c9afda10b2c6f7deda469f1dc-7280x4080-jpg","_type":"reference"},"alt":"trauma","_key":"ea3d94bb02c1","disableTextWrap":false,"_type":"figure","imgcaption":[{"children":[{"_key":"01fe0f8049d20","_type":"span","marks":[],"text":"necropos12/AdobeStock"}],"_type":"block","style":"normal","_key":"c7587d8ba6a0","markDefs":[]}]},{"_type":"block","style":"normal","_key":"9cfae10a87c3","markDefs":[],"children":[{"_key":"3923afc8f8ae","_type":"span","marks":["strong"],"text":"Case Vignette "}]},{"_type":"block","style":"normal","_key":"6f0a120a970f","markDefs":[],"children":[{"marks":[],"text":"“Sasha” is a 23-year-old nonbinary Asian American individual. Sasha is a survivor of childhood emotional and physical abuse by their parents. In addition, Sasha was physically assaulted when they were a freshman in college as they were walking back to their dorm late at night. Soon after this experience, they started having nightmares and flashbacks about the assault. They became easily startled and hypervigilant and no longer felt safe in lecture halls and on campus, which led them to drop out of college. Sasha also believes that strangers on the street intend to harm them physically, and they let Sasha know this by making eye contact with Sasha or by touching their faces. Sasha also reports seeing shadowy figures that seem threatening and hearing voices—both of their abusers from the past and strangers. These voices say degrading things about Sasha, which they interpret as a sign that there is a larger plot against them. Sasha no longer feels safe leaving the house or socializing, is disengaged from loved ones, is unable to return to college or work, and is currently on a leave of absence from their job at a daycare center. In the context of reduced sleep, concerns about financial stressors, and worsening voices, Sasha presents to the emergency department, where they disclose their voices, the shadowy figures, and fears that others in their neighborhood are threatening them. They are commenced on antipsychotic medication and are connected with their local early psychosis service for follow-up. ","_key":"ae86b87ed1ba","_type":"span"}]},{"_type":"block","style":"normal","_key":"19df16d351eb","markDefs":[],"children":[{"text":"Trauma and Psychosis","_key":"2d2c4984cef80","_type":"span","marks":["strong"]}]},{"_type":"block","style":"normal","_key":"68f22e6675d4","markDefs":[{"blank":true,"_type":"link","href":"https://www.psychiatrictimes.com/topics/ptsd","_key":"478472b25997","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"Per the Substance Abuse and Mental Health Services Administration (SAMHSA), “Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” ","_key":"f449939cd7920"},{"_key":"f67cd3fc6889","_type":"span","marks":["478472b25997"],"text":"Posttraumatic stress disorder"},{"_type":"span","marks":[],"text":" (PTSD) refers to a cluster of symptoms often experienced by individuals who have experienced trauma. Whether a person who has experienced a traumatic event will go on to qualify for a diagnosis of PTSD depends on the event, the person’s experience of the event, and the long-lasting adverse effects of the event.","_key":"a3b6e2739dbe"},{"text":"1","_key":"92582eb60ccd","_type":"span","marks":["superscript"]}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Sasha’s presentation with comorbid symptoms of psychosis and PTSD is not unusual. Individuals experiencing psychosis often have also been exposed to traumatic life events,","_key":"ee6a2b1559200"},{"_type":"span","marks":["superscript"],"text":"2,3","_key":"a27c7b8ee84a"},{"text":" with some estimates suggesting that all individuals with a psychotic disorder have experienced at least 1 traumatic event.","_key":"dcb93fc61fa0","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"2","_key":"99c0afb0ecfe"},{"marks":[],"text":" In addition, the experience of psychosis, as well as some aspects of mental health treatment including police involvement in admission, seclusion, and restraint, can also be traumatic.","_key":"dd679da3dd71","_type":"span"},{"_type":"span","marks":["superscript"],"text":"4","_key":"65573a220790"},{"_type":"span","marks":[],"text":" The rates of PTSD in those experiencing psychosis range from 10% to 30%, and approximately 40% of individuals with PTSD experience psychosis.","_key":"212019e0ea47"},{"_key":"5097ee08e0cc","_type":"span","marks":["superscript"],"text":"3,5-8"},{"text":" Psychosis-related PTSD, or PTSD directly related to having a psychotic episode, varies from 14% to 47%.","_key":"360632143304","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"9","_key":"3ffe271492c2"},{"text":" Comorbid PTSD/psychosis is associated with increased health care use and worse clinical outcomes.","_key":"e02108a5ca10","_type":"span","marks":[]},{"marks":["superscript"],"text":"8,10","_key":"797dc58322e8","_type":"span"},{"text":" Hence, when planning for effective care, it is important to assess for trauma and PTSD in anyone presenting with symptoms of psychosis.","_key":"69351212f915","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"863374d0a5fa"},{"_key":"ecb3ce78093d","markDefs":[],"children":[{"_key":"56654ffc90760","_type":"span","marks":["strong","em"],"text":"Clinical Pearl:"},{"text":" ","_key":"8c35cc633a2d","_type":"span","marks":["strong"]},{"_type":"span","marks":[],"text":"Traumatic experiences are very common for those who report symptoms of psychosis. Trauma may be a result of early childhood experiences or later traumatic experiences linked to psychosis symptoms or treatment for psychosis. Psychosis symptoms can also occur in the context of PTSD and posttraumatic stress. ","_key":"12f9523c581a"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"","_key":"2a2bedb339b7"}],"_type":"block","style":"normal","_key":"31d6921130a7","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Assessment of Trauma in Individuals Experiencing Psychosis","_key":"d92720c7ab3b0"}],"_type":"block","style":"normal","_key":"68cd91cd5237"},{"style":"normal","_key":"10d1823d4bc6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Trauma is often overlooked in individuals with psychosis, resulting in an inadequate assessment of traumatic or adverse life events and, therefore, limited access to gold standard, evidence-based trauma treatments. Assessing for trauma should occur routinely, and access to these treatments should be made available for all individuals as needed. If Sasha is asked specific questions assessing past traumas, they will likely report childhood abuse and the more recent physical assault. Structured assessments commonly used to assess PTSD symptoms include the PTSD Checklist for DSM-5 (PCL-5),","_key":"85ece899cd910"},{"_type":"span","marks":["superscript"],"text":"11 ","_key":"9741bccf172c"},{"_type":"span","marks":[],"text":"PTSD Symptom Scale – Interview for DSM-5 (PSS-I-5),","_key":"719f8a0d30ef"},{"_key":"a8dfabe13e7d","_type":"span","marks":["superscript"],"text":"12"},{"_type":"span","marks":[],"text":" and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5).","_key":"e2d96d86b540"},{"marks":["superscript"],"text":"13","_key":"1fc5c376246c","_type":"span"},{"_type":"span","marks":[],"text":" During an initial assessment, it is vital for clinicians assessing potential traumatic experiences to gather only the information necessary to determine whether a trauma history is present and whether trauma interventions are appropriate, which does not require a full account of traumatic experiences. Requiring individuals to disclose a detailed account of their trauma history during the initial assessment poses a risk for retraumatization and may limit what the individual feels comfortable sharing. PTSD assessments only ask clients to, at most, share a brief description of the traumatic event and PTSD symptoms.","_key":"942804615eb4"}],"_type":"block"},{"_key":"a6b8aeb9f68e","markDefs":[{"_type":"link","href":"https://www.psychiatrictimes.com/topics/schizophrenia","_key":"d8214a5a9350","nofollow":true,"blank":true}],"children":[{"_type":"span","marks":[],"text":"Assessment is an essential component of understanding, and addressing, trauma as part of a psychosis presentation. In our clinical example, if Sasha is only assessed for psychosis and not asked questions about past traumas, they will likely receive a diagnosis of a psychotic disorder (such as ","_key":"a3c19acd92eb0"},{"_type":"span","marks":["d8214a5a9350"],"text":"schizophrenia","_key":"77604a39a007"},{"_key":"3559fd194365","_type":"span","marks":[],"text":") and be prescribed antipsychotic medications to reduce the occurrence of the voices and shadowy figures. Sasha may also be offered supportive psychotherapy and case management. If the clinic has trained staff, Sasha may be offered an evidence-based psychotherapeutic intervention such as cognitive behavioral therapy for psychosis (CBTp). However, the traumatic experiences would go untreated, thus limiting the potential for recovery."}],"_type":"block","style":"normal"},{"_key":"21cd01287ce4","markDefs":[],"children":[{"_type":"span","marks":["strong","em"],"text":"Clinical Pearl: ","_key":"fd9eb8545e9c0"},{"_type":"span","marks":[],"text":"As clients do not often report trauma experiences unless asked about them explicitly, assessment of trauma in individuals presenting with psychosis symptoms is essential. Assessing for the types of trauma experienced and PTSD symptoms, as opposed to a full account of traumatic events, is sufficient at this stage of care.","_key":"ecfb99764e01"}],"_type":"block","style":"normal"},{"_key":"9c9613896724","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"33f834148e7a"}],"_type":"block","style":"normal"},{"style":"normal","_key":"d1e421b5bec3","markDefs":[],"children":[{"_key":"9765ab1dd28b0","_type":"span","marks":["strong"],"text":"Trauma-Informed Care"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"SAMHSA recommends that all treatment programs take a trauma-informed approach.","_key":"b67d570f20860"},{"_type":"span","marks":["superscript"],"text":"1","_key":"8d86306d3ac6"},{"_type":"span","marks":[],"text":" This incorporates key principles into the organizational culture of the program. These include acknowledging the widespread impact of trauma and the path to recovery, recognizing the signs of trauma in individuals, and responding by making sure policies and practices are geared toward not retraumatizing the individual. A trauma-informed approach may or may not include trauma-specific treatments. Some fundamental principles in a trauma-informed approach are ensuring a sense of physical and psychological safety for all served; building and maintaining individuals’ trust in the program by those accessing services and their families; welcoming mutual self-help from those with lived experience of trauma and recovery from trauma; adopting a nonhierarchical, collaborative stance where the expertise of individuals accessing services is understood and respected; keeping individuals accessing services front and center, and believing in their resilience and ability to recover from trauma; and providing care that actively moves away from stereotypes and biases.","_key":"ba8723c5431d"}],"_type":"block","style":"normal","_key":"7e446c9a1681"},{"_type":"block","style":"normal","_key":"d6b894b68ec2","markDefs":[],"children":[{"_type":"span","marks":["strong","em"],"text":"Clinical Pearl: ","_key":"22aeea7450c00"},{"_key":"4cb2122c8799","_type":"span","marks":[],"text":"Programs should consider how to implement trauma-informed care and ensure staff are trained in this approach to best meet the needs of individuals accessing services."}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"6ad611286096"}],"_type":"block","style":"normal","_key":"a1504d8d40cc","markDefs":[]},{"_type":"block","style":"normal","_key":"e9c37a269cc3","markDefs":[],"children":[{"_key":"88f3e6fa02c30","_type":"span","marks":["strong"],"text":"Addressing Trauma"}]},{"style":"normal","_key":"bf19bb1c869d","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Clinicians are often concerned about the increased sensitivity to stress in those experiencing psychosis and can be hesitant to use evidence-based treatments for PTSD.","_key":"f20c8abcc6470"},{"_key":"d2744bce97f2","_type":"span","marks":["superscript"],"text":"14,15"},{"_type":"span","marks":[],"text":" As a result, evidence-based trauma treatments are not offered routinely to individuals seeking treatment for psychosis in the United States.","_key":"3701106caee7"},{"_type":"span","marks":["superscript"],"text":"16","_key":"35b05d027c71"},{"text":" However, Grubaugh et al, in a meta-analysis of PTSD treatments for individuals diagnosed with PTSD and a “severe and persistent comorbid mental illness,” which included psychotic spectrum disorders or mood disorders, found that PTSD treatment can be used safely in this population.","_key":"1444440872d4","_type":"span","marks":[]},{"text":"5","_key":"2fd90c84cf85","_type":"span","marks":["superscript"]}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"In addition, a growing evidence base suggests that standard protocols for trauma treatments in psychosis are effective.","_key":"af52c57198d70"},{"marks":["superscript"],"text":"17","_key":"844c511b2b18","_type":"span"},{"_type":"span","marks":[],"text":" These treatment protocols include trauma-focused CBTp,","_key":"b806af46327e"},{"_type":"span","marks":["superscript"],"text":"18","_key":"961c7f1dc092"},{"_type":"span","marks":[],"text":" prolonged exposure,","_key":"761eaf8e1bed"},{"_key":"533e62e1f515","_type":"span","marks":["superscript"],"text":"19"},{"marks":[],"text":" and eye movement desensitization reprocessing.","_key":"bd1e88d694b7","_type":"span"},{"_type":"span","marks":["superscript"],"text":"20","_key":"a40fb0106e08"},{"_type":"span","marks":[],"text":" However, adapting these protocols may be necessary to ensure the needs of an individual experiencing psychosis symptoms are thoroughly addressed; for example, ensuring the individual has sufficient coping skills in place to tolerate the trauma intervention while not prolonging access to exposure-based therapies (“as much as needed, but as little as necessary”) and supporting the individual around psychosis symptoms if these are intrusive and may impact the trauma treatment. Developing an initial formulation to understand the trauma timeline, subsequent symptoms (both trauma and psychosis focused), and impact of these on core beliefs will aid the clinician in determining where to focus psychosocial interventions.","_key":"b559930bfda4"}],"_type":"block","style":"normal","_key":"87c3e1c1e9d9"},{"markDefs":[],"children":[{"text":"Clinical Pearl:","_key":"b5b3e14824a50","_type":"span","marks":["strong","em"]},{"_type":"span","marks":[],"text":" Treatment options and pacing are guided by the immediate needs of the individual and should support the reduction of distress and movement toward meaningful goals.","_key":"09df86fc96fc"}],"_type":"block","style":"normal","_key":"3d54d81ab544"},{"children":[{"_type":"span","marks":[],"text":"","_key":"ceadb6aed9cd"}],"_type":"block","style":"normal","_key":"c6ba35812f68","markDefs":[]},{"_type":"block","style":"normal","_key":"04c89206a160","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Concluding Thoughts","_key":"6c96206f90d20"}]},{"markDefs":[],"children":[{"_key":"a5ecb30f9ece0","_type":"span","marks":[],"text":"Traumatic life events are common among individuals who experience psychosis. Often, when an individual presents with psychosis, past traumas are not assessed. This could be due to the individual’s hesitancy to talk about these events or the clinician’s fear that asking about trauma will exacerbate symptoms. We now know that trauma-informed care leads to better outcomes. This systemwide approach begins with creating safe spaces for individuals to speak about past experiences in a way that is not retraumatizing and incorporates the impact of these experiences into a formulation that guides treatment. Evidence-based trauma interventions have been shown to be effective in addressing trauma in individuals experiencing psychosis and should be made routinely available. Further research on effective trauma intervention adaptations for individuals with psychosis would be meaningful. We encourage all clinicians who support individuals experiencing psychosis to provide trauma- informed care across treatment settings."}],"_type":"block","style":"normal","_key":"54ee64fccb50"},{"style":"normal","_key":"5e4006ea3d7d","markDefs":[],"children":[{"_key":"2f2dc6a7b49d","_type":"span","marks":[],"text":""}],"_type":"block"},{"_key":"6d6dd3a97886","markDefs":[],"children":[{"marks":["strong"],"text":"Dr Chari","_key":"58e1667f91790","_type":"span"},{"_type":"span","marks":[],"text":" ","_key":"5cf65405f242"},{"_type":"span","marks":["em"],"text":"is the assistant psychosocial director and didactic lead of the INSPIRE Clinic and a clinical associate professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine in California. ","_key":"e866b43f1ed2"},{"marks":["strong"],"text":"Dr Lee","_key":"ccb4f0afd429","_type":"span"},{"marks":[],"text":" ","_key":"2f0e11fb3a7f","_type":"span"},{"_type":"span","marks":["em"],"text":"is a clinical assistant professor and a California-licensed clinical psychologist in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine.","_key":"7b4d350db1c9"},{"_type":"span","marks":["em","strong"],"text":" ","_key":"354ee8181f6a"},{"_type":"span","marks":["strong"],"text":"Dr Olson","_key":"00a55572510f"},{"_type":"span","marks":["em"],"text":" is a clinical associate professor and licensed psychologist in the INSPIRE Clinic and dialectical behavior therapy program at Stanford University.","_key":"064317cd6de7"},{"marks":[],"text":" ","_key":"e5ddf42511aa","_type":"span"},{"text":"Dr Hardy","_key":"361261b71957","_type":"span","marks":["strong"]},{"_type":"span","marks":["em"],"text":" is the codirector of the INSPIRE Clinic, the co–section chief of INSPIRE Section, and a clinical professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine.","_key":"2ae2be231aa1"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"005a3e2c28bd","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"","_key":"571f1168fb33"}]},{"style":"normal","_key":"8d33c20439ca","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"References","_key":"78ff24c7b93a0"}],"_type":"block"},{"markDefs":[{"blank":true,"_type":"link","href":"https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf","_key":"0ce96c8b2d16"}],"children":[{"text":"1. Substance Abuse and Mental Health Services Administration. ","_key":"4cd7d88fbc060","_type":"span","marks":[]},{"marks":["em"],"text":"SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach","_key":"4cd7d88fbc061","_type":"span"},{"_type":"span","marks":[],"text":". Substance Abuse and Mental Health Services Administration; 2014. HHS Publication No. (SMA) 14-4884. Accessed September 25, 2024. ","_key":"4cd7d88fbc062"},{"_type":"span","marks":["0ce96c8b2d16"],"text":"https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf","_key":"4cd7d88fbc063"}],"_type":"block","style":"normal","_key":"65064370f438"},{"style":"normal","_key":"fd9a524350bb","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/16023620/","_key":"1fe6fbca1660"}],"children":[{"_type":"span","marks":[],"text":"2. Kessler RC, Birnbaum H, Demler O, et al. ","_key":"024ba5700fc90"},{"_type":"span","marks":["1fe6fbca1660"],"text":"The prevalence and correlates of nonaffective psychosis in the National Comorbidity Survey Replication (NCS-R).","_key":"024ba5700fc91"},{"marks":[],"text":" ","_key":"7c5b46a5e614","_type":"span"},{"_type":"span","marks":["em"],"text":"Biol Psychiatry","_key":"024ba5700fc92"},{"_type":"span","marks":[],"text":". 2005;58(8)668-676.","_key":"024ba5700fc93"}],"_type":"block"},{"markDefs":[{"_key":"2f4dd8eb6b96","blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/19959704/"}],"children":[{"_key":"7d61c21346920","_type":"span","marks":[],"text":"3. Achim AM, Maziade M, Raymond E, et al. "},{"text":"How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association.","_key":"7d61c21346921","_type":"span","marks":["2f4dd8eb6b96"]},{"_type":"span","marks":[],"text":" ","_key":"7d61c21346922"},{"_type":"span","marks":["em"],"text":"Schizophr Bull","_key":"7d61c21346923"},{"_type":"span","marks":[],"text":". 2011;37(4):811-821.","_key":"7d61c21346924"}],"_type":"block","style":"normal","_key":"a7cdf1dd1c8d"},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/29163239/","_key":"3e2bbe429683"}],"children":[{"marks":[],"text":"4. Hardy KV, Mueser KT. Editorial: ","_key":"382ce079fc510","_type":"span"},{"_key":"382ce079fc511","_type":"span","marks":["3e2bbe429683"],"text":"trauma, psychosis and posttraumatic stress disorder."},{"_key":"382ce079fc512","_type":"span","marks":[],"text":" "},{"_key":"382ce079fc513","_type":"span","marks":["em"],"text":"Front Psychiatry"},{"_key":"382ce079fc514","_type":"span","marks":[],"text":". 2017;8:220."}],"_type":"block","style":"normal","_key":"16fc36532644"},{"markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/34033709/","_key":"100f436f7a08","blank":true}],"children":[{"_key":"71d6e96019f20","_type":"span","marks":[],"text":"5. Grubaugh AL, Brown WJ, Wojtalik JA, et al. "},{"_type":"span","marks":["100f436f7a08"],"text":"Meta-analysis of the treatment of posttraumatic stress disorder in adults with comorbid severe mental illness.","_key":"71d6e96019f21"},{"_type":"span","marks":[],"text":" ","_key":"9e662b34ae06"},{"_type":"span","marks":["em"],"text":"J Clin Psychiatry","_key":"71d6e96019f22"},{"marks":[],"text":". 2021;82(3):20r13584.","_key":"71d6e96019f23","_type":"span"}],"_type":"block","style":"normal","_key":"687bdce9942f"},{"_type":"block","style":"normal","_key":"854f54831f43","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/25792693/","_key":"710a5f067805"}],"children":[{"_key":"b4f37a2c6ff80","_type":"span","marks":[],"text":"6. de Bont PAJM, van den Berg DPG, van der Vleugel BM, et al. "},{"text":"Predictive validity of the Trauma Screening Questionnaire in detecting post-traumatic stress disorder in patients with psychotic disorders. ","_key":"b4f37a2c6ff81","_type":"span","marks":["710a5f067805"]},{"_type":"span","marks":["em"],"text":"Br J Psychiatry","_key":"b4f37a2c6ff82"},{"_type":"span","marks":[],"text":". 2015;206(5):408-416.","_key":"b4f37a2c6ff83"}]},{"children":[{"_type":"span","marks":[],"text":"7. Mueser KT, Goodman LB, Trumbetta SL, et al. ","_key":"3ebab5da0fbc0"},{"_type":"span","marks":["30eb8c3dff4a"],"text":"Trauma and posttraumatic stress disorder in severe mental illness.","_key":"3ebab5da0fbc1"},{"_type":"span","marks":[],"text":" ","_key":"3ebab5da0fbc2"},{"_type":"span","marks":["em"],"text":"J Consult Clin Psychol","_key":"3ebab5da0fbc3"},{"_type":"span","marks":[],"text":". 1998;66(3):493-499.","_key":"3ebab5da0fbc4"}],"_type":"block","style":"normal","_key":"9b2e4010f051","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/9642887/","_key":"30eb8c3dff4a"}]},{"style":"normal","_key":"e439204545a2","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/27230289/","_key":"8066cca62e09"}],"children":[{"_type":"span","marks":[],"text":"8. Seow LSE, Ong C, Mahesh MV, et al. ","_key":"ff48c15be2d30"},{"_type":"span","marks":["8066cca62e09"],"text":"A systematic review on comorbid post-traumatic stress disorder in schizophrenia.","_key":"ff48c15be2d31"},{"_key":"ff48c15be2d32","_type":"span","marks":[],"text":" "},{"_type":"span","marks":["em"],"text":"Schizophr Res","_key":"ff48c15be2d33"},{"marks":[],"text":". 2016;176(2-3):441-451.","_key":"ff48c15be2d34","_type":"span"}],"_type":"block"},{"_type":"block","style":"normal","_key":"8dc45834b718","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/33413179/","_key":"540cc82357ec"}],"children":[{"_type":"span","marks":[],"text":"9. Buswell G, Haime Z, Lloyd-Evans, B, Billings J. ","_key":"b5f945a882dc0"},{"marks":["540cc82357ec"],"text":"A systematic review of PTSD to the experience of psychosis: prevalence and associated factors.","_key":"b5f945a882dc1","_type":"span"},{"_type":"span","marks":[],"text":" ","_key":"b5f945a882dc2"},{"text":"BMC Psychiatry","_key":"b5f945a882dc3","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". 2021;21(1):9.","_key":"b5f945a882dc4"}]},{"style":"normal","_key":"460abbbeb4ab","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/25468176/","_key":"ec0887bd9e68"}],"children":[{"_key":"642c17a5970e0","_type":"span","marks":[],"text":"10. Hassan AN, De Luca V. "},{"_type":"span","marks":["ec0887bd9e68"],"text":"The effect of lifetime adversities on resistance to antipsychotic treatment in schizophrenia patients.","_key":"642c17a5970e1"},{"marks":["em"],"text":" Schizophr Res.","_key":"642c17a5970e2","_type":"span"},{"marks":[],"text":" 2015;161(2-3):496-500.","_key":"642c17a5970e3","_type":"span"}],"_type":"block"},{"style":"normal","_key":"9689fd7c1dd3","markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/26606250/","_key":"02b13d2554f0","blank":true}],"children":[{"_key":"10bd4feadaf40","_type":"span","marks":[],"text":"11. Blevins CA, Weathers FW, Davis MT, et al. "},{"_key":"10bd4feadaf41","_type":"span","marks":["02b13d2554f0"],"text":"The posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): development and initial psychometric evaluation."},{"_key":"10bd4feadaf42","_type":"span","marks":[],"text":" "},{"marks":["em"],"text":"J Trauma Stress","_key":"10bd4feadaf43","_type":"span"},{"_type":"span","marks":[],"text":". 2015;28(6):489-498.","_key":"10bd4feadaf44"}],"_type":"block"},{"_type":"block","style":"normal","_key":"9c8439a4f403","markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/26691507/","_key":"92e862af4fa4","blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"12. Foa EB, McLean CP, Zang Y, et al. ","_key":"cd7c5782451d0"},{"_type":"span","marks":["92e862af4fa4"],"text":"Psychometric properties of the Posttraumatic Stress Disorder Symptom Scale Interview for DSM–5 (PSSI–5). ","_key":"cd7c5782451d1"},{"_type":"span","marks":["em"],"text":"Psychol Assess","_key":"cd7c5782451d2"},{"_type":"span","marks":[],"text":". 2016;28(10):1159-1165.","_key":"cd7c5782451d3"}]},{"_type":"block","style":"normal","_key":"7ac1801c3108","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/28493729/","_key":"2939d0321406"}],"children":[{"marks":[],"text":"13. Weathers FW, Bovin MJ, Lee DJ, et al. ","_key":"8f77b78d83850","_type":"span"},{"_type":"span","marks":["2939d0321406"],"text":"The Clinician-Administered PTSD Scale for DSM–5 (CAPS-5): development and initial psychometric evaluation in military veterans.","_key":"8f77b78d83851"},{"_key":"8f77b78d83852","_type":"span","marks":[],"text":" "},{"_type":"span","marks":["em"],"text":"Psychol Assess","_key":"8f77b78d83853"},{"_type":"span","marks":[],"text":". 2018;30(3):383-395.","_key":"8f77b78d83854"}]},{"_type":"block","style":"normal","_key":"b433caef6e5b","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/23111055/","_key":"f5a903d62e18"}],"children":[{"marks":[],"text":"14. Lataster T, Valmaggia L, Lardinois M, et al. ","_key":"536d6c14f3eb0","_type":"span"},{"_type":"span","marks":["f5a903d62e18"],"text":"Increased stress reactivity: a mechanism specifically associated with the positive symptoms of psychotic disorder.","_key":"536d6c14f3eb1"},{"marks":[],"text":" ","_key":"536d6c14f3eb2","_type":"span"},{"text":"Psychol Med","_key":"536d6c14f3eb3","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". 2013;43(7):1389-1400.","_key":"536d6c14f3eb4"}]},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/24530499/","_key":"c63fb91a88b0"}],"children":[{"_type":"span","marks":[],"text":"15. Meyer JM, Farrell NR, Kemp JJ, et al. ","_key":"96be82f048170"},{"_type":"span","marks":["c63fb91a88b0"],"text":"Why do clinicians exclude anxious clients from exposure therapy?","_key":"96be82f048171"},{"_type":"span","marks":[],"text":" ","_key":"96be82f048172"},{"_type":"span","marks":["em"],"text":"Behav Res Ther","_key":"96be82f048173"},{"_type":"span","marks":[],"text":". 2014;54:49-53.","_key":"96be82f048174"}],"_type":"block","style":"normal","_key":"beeed05c8bbf"},{"_key":"b2b72c87a4d0","markDefs":[{"blank":true,"_type":"link","href":"https://www.researchgate.net/publication/224856492_Emotional_expression_perceptions_of_therapy_and_help-seeking_intentions_in_men_attending_therapy_services","_key":"b0163f07bbd8"}],"children":[{"_type":"span","marks":[],"text":"16. Cusack J, Deane FP, Wilson CJ, Ciarrochi J. ","_key":"12472d1f9d2d0"},{"_type":"span","marks":["b0163f07bbd8"],"text":"Emotional expression, perceptions of therapy, and help-seeking intentions in men attending therapy services.","_key":"12472d1f9d2d1"},{"_type":"span","marks":[],"text":" ","_key":"12472d1f9d2d2"},{"text":"Psychol Men Masc","_key":"12472d1f9d2d3","_type":"span","marks":["em"]},{"text":". 2006;7(2):1-14.","_key":"12472d1f9d2d4","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"_key":"2bb7b1a3336d","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/28352239/","_key":"0caadd16bb26"}],"children":[{"_type":"span","marks":[],"text":"17. Swan S, Keen N, Reynolds N, Onwumere J. ","_key":"26f050a9e16c0"},{"_type":"span","marks":["0caadd16bb26"],"text":"Psychological interventions for post-traumatic stress symptoms in psychosis: a systematic review of outcomes.","_key":"26f050a9e16c1"},{"_key":"0e842dc56ce3","_type":"span","marks":[],"text":" "},{"_type":"span","marks":["em"],"text":"Front Psychol","_key":"26f050a9e16c2"},{"_type":"span","marks":[],"text":". 2017;8:341.","_key":"26f050a9e16c3"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"13894984ae5a","markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/35606886/","_key":"48194721ef70","nofollow":true,"blank":true}],"children":[{"marks":[],"text":"18. Peters E, Hardy A, Dudley R, et al. ","_key":"82daf0b1b2010","_type":"span"},{"text":"Multisite randomised controlled trial of trauma-focused cognitive behaviour therapy for psychosis to reduce post-traumatic stress symptoms in people with co-morbid post-traumatic stress disorder and psychosis, compared to treatment as usual: study protocol for the STAR (Study of Trauma And Recovery) trial.","_key":"73d52aeb1290","_type":"span","marks":["48194721ef70"]},{"marks":[],"text":" ","_key":"781132ef9973","_type":"span"},{"_type":"span","marks":["em"],"text":"Trials","_key":"82daf0b1b2012"},{"text":". 2022;23(1):429.","_key":"82daf0b1b2013","_type":"span","marks":[]}]},{"children":[{"_type":"span","marks":[],"text":"19. Foa EB, Hembree EA, Rothbaum BO. ","_key":"505914104e9f0"},{"_type":"span","marks":["em"],"text":"Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences, Therapist Guide.","_key":"505914104e9f1"},{"_type":"span","marks":[],"text":" 1st ed. Oxford University Press; 2007.","_key":"505914104e9f2"}],"_type":"block","style":"normal","_key":"3568880b6296","markDefs":[]},{"_key":"ee3c292864e2","markDefs":[],"children":[{"_key":"cbc915caac500","_type":"span","marks":[],"text":"20. Shapiro F, Forrest MS. "},{"_key":"cbc915caac501","_type":"span","marks":["em"],"text":"EMDR: The Breakthrough “Eye Movement” Therapy for Overcoming Anxiety, Stress, and Trauma."},{"marks":[],"text":" Basic Books; 1998.","_key":"cbc915caac502","_type":"span"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"b7ab06f92913","markDefs":[],"children":[{"_type":"span","marks":[],"text":" ","_key":"9187682643530"}]}],"taxonomyMapping":[{"perKeywordMapping":["Psychiatry","Neurology"],"cmeType":"per","identifier":"topics/schizophrenia","_createdAt":"2020-03-26T06:11:21Z","_rev":"77mZ7PORfofI3dBGfWfij5","_type":"taxonomy","pixelTrackingCode":null,"parent":{"_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","parent":null,"isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","identifier":"topics"},"name":"Schizophrenia/Psychosis","_id":"pst_taxonomy_362_schizophreniapsychosis","_updatedAt":"2023-03-31T19:32:05Z"},{"_id":"pst_taxonomy_415_traumaandviolence","_updatedAt":"2020-06-10T19:45:36Z","parent":{"identifier":"topics/anxiety","parent":{"_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics"},"_type":"taxonomy","perKeywordMapping":["Psychiatry","Neurology"],"cmeType":"per","_rev":"37333Uv1mHMuPikcnyAiz0","name":"Anxiety \u0026 Stress Disorders","_createdAt":"2020-03-26T06:11:21Z","_id":"pst_taxonomy_119_anxietystressdisorders","_updatedAt":"2023-03-31T19:07:26Z"},"_rev":"BmvClBuXMtNlljYu6nhdr9","pixelTrackingCode":null,"_type":"taxonomy","name":"Trauma And Violence","identifier":"topics/trauma-and-violence","_createdAt":"2020-03-26T06:11:21Z"},{"parent":{"parent":{"_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m"},"_rev":"37333Uv1mHMuPikcnyAiz0","_id":"pst_taxonomy_119_anxietystressdisorders","identifier":"topics/anxiety","name":"Anxiety \u0026 Stress Disorders","perKeywordMapping":["Psychiatry","Neurology"],"cmeType":"per","_createdAt":"2020-03-26T06:11:21Z","_updatedAt":"2023-03-31T19:07:26Z","_type":"taxonomy"},"_rev":"BmvClBuXMtNlljYu6nhdr9","pixelTrackingCode":null,"_updatedAt":"2020-06-10T19:45:36Z","identifier":"topics/traumatic-stress-disorders","_createdAt":"2020-03-26T06:11:21Z","_type":"taxonomy","name":"Traumatic Stress Disorders","_id":"pst_taxonomy_416_traumaticstressdisorders"},{"name":"PTSD","_id":"pst_taxonomy_339_ptsd","identifier":"topics/ptsd","parent":{"identifier":"topics","isMainTopic":true,"_type":"taxonomy","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","parent":null,"_rev":"uvXJooXtzvjNOyx50HTt8m","name":"Topics","_createdAt":"2020-03-26T06:11:21Z"},"_createdAt":"2020-03-26T06:11:21Z","pixelTrackingCode":null,"_rev":"IakUcQKwj7kr3xQjaaTSXO","_type":"taxonomy","_updatedAt":"2024-02-21T20:35:27Z"}],"_id":"27edffd5-7239-4709-aabd-de1c4da243df","_updatedAt":"2024-11-11T21:23:40Z","title":"Opening Pandora’s Box: The Importance of Assessing and Treating Trauma in Individuals Experiencing Psychosis","ExcludeFromPubMedXML":false,"articleType":"Publication","authors":[{"displayName":"Sripriya Chari, PhD","url":"sripriya-chari-phd"},{"displayName":"Grace Eun Lee, PhD","url":"grace-eun-lee-phd"},{"displayName":"Nichole D. Olson, PhD","url":"nichole-d-olson-phd"},{"displayName":"Kate V. Hardy, PsyD","url":"kate-v-hardy-psyd"}],"factCheckAuthors":null,"published":"2024-11-12T16:00:00.000Z","gptSummary":"Sasha, a 23-year-old nonbinary individual, experiences comorbid symptoms of PTSD and psychosis following childhood abuse and a college assault. This case highlights the frequent overlap of trauma and psychosis, emphasizing the need for trauma-informed care. Trauma is often overlooked in psychosis assessments, leading to inadequate treatment. Implementing trauma-informed approaches and evidence-based PTSD treatments, such as trauma-focused CBTp, can improve outcomes. Clinicians should routinely assess trauma in psychosis patients and adapt interventions to address both trauma and psychosis symptoms effectively, supporting recovery and reducing distress.","is_visible":true,"_createdAt":"2024-11-11T21:23:30Z","contentCategory":{"_type":"contentCategory","name":"Articles","_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","_updatedAt":"2020-02-25T09:35:56Z","_createdAt":"2020-02-06T09:15:47Z","_rev":"snQqhhB4O8T5bi1viURsgs"},"audioUrl":"https://s3.us-east-1.amazonaws.com/ai-generated-audios/www.psychiatrictimes.com/27edffd5-7239-4709-aabd-de1c4da243df_1731360212633.399e5f32-8658-484c-a952-433eac9f8a1a.mp3","targeting":{"content_placement":["topics/schizophrenia","topics/trauma-and-violence","topics/traumatic-stress-disorders","topics/ptsd"],"document_url":["opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"FDA Committees Vote to Dismiss Clozapine REMS","url":{"_type":"slug","current":"fda-committees-vote-to-dismiss-clozapine-rems"},"thumbnail":{"_type":"mainImage","asset":{"_ref":"image-3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304-jpg","_type":"reference"}},"published":"2024-11-20T23:59:05.227Z"},{"title":"Beyond Dopamine: Muscarinic Solutions Bring New Hope for Schizophrenia","url":{"current":"beyond-dopamine-muscarinic-solutions-bring-new-hope-for-schizophrenia","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"schizophrenia brain","caption":"ArtistryAlchemy/AdobeStock","asset":{"_ref":"image-15620d5296df4215dfbf6a510820b123d360e256-4630x2595-jpg","_type":"reference"}},"published":"2024-11-20T15:00:00.000Z"},{"title":"4 Ways to Cope With Bipolar Uncertainty","url":{"current":"4-ways-to-cope-with-bipolar-uncertainty","_type":"slug"},"thumbnail":{"alt":"bipolar","caption":"Vector Tradition/AdobeStock","asset":{"_ref":"image-404e1c0468b1b692448c95b34c56c94c7d55a7bd-462x451-jpg","_type":"reference"},"_type":"mainImage"},"published":"2024-11-19T15:00:00.000Z"},{"title":"Long-Acting Injectables and a Team-Driven Approach for Schizophrenia Treatment ","url":{"_type":"slug","current":"long-acting-injectables-and-a-team-driven-approach-for-schizophrenia-treatment"},"thumbnail":{"_type":"mainImage","alt":"schizophrenia","caption":"tashatuvango/AdobeStock","asset":{"_ref":"image-4d0666c33abcebc4983e7f4b879ee0fc1eff754f-5733x3780-jpg","_type":"reference"}},"published":"2024-11-18T15:00:00.000Z"},{"title":"Opening Pandora’s Box: The Importance of Assessing and Treating Trauma in Individuals Experiencing Psychosis","url":{"_type":"slug","current":"opening-pandoras-box-the-importance-of-assessing-and-treating-trauma-in-individuals-experiencing-psychosis"},"thumbnail":{"_type":"mainImage","alt":"trauma","caption":"necropos12/AdobeStock","asset":{"_ref":"image-3baa097f1742d64c9afda10b2c6f7deda469f1dc-7280x4080-jpg","_type":"reference"}},"published":"2024-11-12T16:00:00.000Z"},{"title":"Differential Diagnosis of Mixed States is Nearly Impossible. Here’s How to Cope. ","url":{"current":"differential-diagnosis-of-mixed-states-is-nearly-impossible-heres-how-to-cope","_type":"slug"},"thumbnail":{"alt":"questions","caption":"sergign/AdobeStock","asset":{"_ref":"image-0ed42755e5073b545ec9cabf17e17101c1af23d2-4000x2667-jpg","_type":"reference"},"_type":"mainImage"},"published":"2024-11-12T15:00:00.000Z"}]},{"documentGroupMapping":null,"thumbnail":{"asset":{"_ref":"image-e33780bee23eaf9f65c8d73424afe09c7790058d-480x270-jpg","_type":"reference"},"_type":"mainImage"},"_id":"a99b0208-5577-42c2-87e6-f3da323c7104","taxonomyMapping":[{"_rev":"snQqhhB4O8T5bi1viUSkda","_type":"taxonomy","name":"Alzheimer Disease","_id":"pst_taxonomy_149_alzheimerdisease","pixelTrackingCode":null,"_createdAt":"2020-03-26T06:11:21Z","parent":{"_id":"pst_taxonomy_35_neuropsychiatry","parent":{"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","isMainTopic":true},"perKeywordMapping":["Psychiatry","Neurology"],"cmeType":"per","_rev":"77mZ7PORfofI3dBGfWcsCF","_type":"taxonomy","name":"Neuropsychiatry","identifier":"topics/neuropsychiatry","_updatedAt":"2023-03-31T19:19:55Z","_createdAt":"2020-03-26T06:11:21Z"},"_updatedAt":"2020-06-10T19:45:36Z","identifier":"topics/alzheimer-disease"},{"identifier":"topics/neuropsychiatry","cmeType":"per","name":"Neuropsychiatry","_createdAt":"2020-03-26T06:11:21Z","_updatedAt":"2023-03-31T19:19:55Z","pixelTrackingCode":null,"perKeywordMapping":["Psychiatry","Neurology"],"_type":"taxonomy","parent":{"parent":null,"_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","_id":"pst_taxonomy_53202_clinical","isMainTopic":true,"name":"Topics"},"_rev":"77mZ7PORfofI3dBGfWcsCF","_id":"pst_taxonomy_35_neuropsychiatry"},{"_id":"pst_taxonomy_351_psychosomatics","_createdAt":"2020-03-26T06:11:21Z","pixelTrackingCode":null,"identifier":"topics/psychosomatics","parent":{"_updatedAt":"2023-03-31T19:15:59Z","_createdAt":"2020-03-26T06:11:21Z","_id":"pst_taxonomy_53202_clinical","isMainTopic":true,"_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","parent":null,"identifier":"topics"},"perKeywordMapping":["Psychiatry","Neurology"],"cmeType":"per","_rev":"37333Uv1mHMuPikcnyBIO2","_updatedAt":"2023-03-31T19:23:55Z","_type":"taxonomy","name":"Psychosomatics"},{"_type":"taxonomy","perKeywordMapping":["Psychiatry","Neurology","New Drugs"],"_id":"pst_taxonomy_336_psychopharmacology","parent":{"name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","isMainTopic":true,"_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","identifier":"topics","_createdAt":"2020-03-26T06:11:21Z","parent":null},"cmeType":"per","_createdAt":"2020-03-26T06:11:21Z","_rev":"4roekEga8ZReQAdH6zkAp9","identifier":"topics/psychopharmacology","name":"Psychopharmacology","_updatedAt":"2023-03-31T19:23:25Z","pixelTrackingCode":null}],"documentGroup":null,"summary":"Although the new drug aducanumab has grabbed all the headlines, the future of Alzheimer treatment may be just as much about public health campaigns as it is about psychopharmacology. In this episode of Psych Pearls, we find out why. ","_type":"article","contentCategory":{"_updatedAt":"2020-02-25T09:31:48Z","_createdAt":"2020-02-25T09:31:48Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Podcasts","_id":"93d57b69-2d72-45fe-8b8a-d18e7e7e5f20"},"factCheckAuthors":null,"body":[{"_key":"f887654c659e","url":"https://embeds.audioboom.com/posts/7910130/embed/v4","_type":"iframe"},{"style":"normal","_key":"b1115e593b05","markDefs":[],"children":[{"marks":["strong"],"text":"PSYCHPEARLS PODCAST","_key":"f4dc40d13ddd","_type":"span"}],"_type":"block"},{"markDefs":[{"blank":true,"_type":"link","href":"https://pharmanewsintel.com/news/3-fda-committee-members-resign-over-alzheimers-drug-approval#:~:text=June%2014%2C%202021%20%2D%20Three%20experts,the%20beginning%20of%20last%20week.","_key":"3bdc8d0565b0"},{"blank":true,"_type":"link","href":"https://www.psychiatrictimes.com/view/narrower-label-for-alzheimer-disease-treatment-aducanumab","_key":"5c1ada65bd7a"},{"blank":true,"_type":"link","href":"https://www.wsj.com/articles/cleveland-clinic-mount-sinai-wont-give-biogens-new-alzheimers-drug-11626366968","_key":"9916fdca8f23"}],"children":[{"text":"Alzheimer disease (AD) remains one of the most dreaded diagnoses a patient can get. The US Food and Drug Administration (FDA) raised hopes when it approved aducanumab, which promised to be the first disease-modifying drug for AD. But the approval immediately proved controversial. Three FDA board members ","_key":"7fc9718eeec40","_type":"span","marks":[]},{"marks":["3bdc8d0565b0"],"text":"resigned","_key":"7fc9718eeec41","_type":"span"},{"_type":"span","marks":[],"text":", the FDA then ","_key":"7fc9718eeec42"},{"_key":"7fc9718eeec43","_type":"span","marks":["5c1ada65bd7a"],"text":"narrowed"},{"_type":"span","marks":[],"text":" its patient label, and in mid-July, major hospitals announced that they would not administer the ","_key":"7fc9718eeec44"},{"_type":"span","marks":["9916fdca8f23"],"text":"drug","_key":"7fc9718eeec45"},{"_key":"7fc9718eeec46","_type":"span","marks":[],"text":"."}],"_type":"block","style":"normal","_key":"38ba56943bcf"},{"style":"normal","_key":"1367acceeacf","markDefs":[],"children":[{"_type":"span","marks":[],"text":"In this edition of ","_key":"3bc874e5c4fc0"},{"_type":"span","marks":["em"],"text":"Psych Pearls","_key":"3bc874e5c4fc1"},{"_type":"span","marks":[],"text":", Helen Lavretsky, MD, MS clarifies the issues in the aducanumab debate and offers guidance for clinicians whose patients may ask about it. Going beyond pharmacology, she points out that other treatment options, including mind-body interventions and diet changes, have been shown to slow AD’s progression.","_key":"3bc874e5c4fc2"}],"_type":"block"},{"_key":"265b04f05e57","markDefs":[],"children":[{"_type":"span","marks":[],"text":"In this conversation, ","_key":"1447bc2ec6a00"},{"marks":["em"],"text":"Psychiatric Times","_key":"1447bc2ec6a01","_type":"span"},{"marks":["superscript"],"text":"TM ","_key":"1447bc2ec6a02","_type":"span"},{"text":"and Lavretsky cover:","_key":"01f00d0f8348","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"style":"normal","_key":"6911ac39e83a","listItem":"bullet","markDefs":[],"children":[{"marks":[],"text":"The aducanumab controversy","_key":"cdab4099e4d60","_type":"span"}],"level":1,"_type":"block"},{"level":1,"_type":"block","style":"normal","_key":"a7b81e55a02c","listItem":"bullet","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Advice for talking to patients and caregivers about aducanumab and other novel pharmacological options","_key":"43e0b549198c0"}]},{"_type":"block","style":"normal","_key":"d6d40282fa21","listItem":"bullet","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Mind-body and lifestyle interventions for AD","_key":"1874c9bfecba0"}],"level":1},{"children":[{"_type":"span","marks":[],"text":"AD prevention programs, including nutrition, exercise, and stress reduction","_key":"8abde66614610"}],"level":1,"_type":"block","style":"normal","_key":"c367123d9cd9","listItem":"bullet","markDefs":[]},{"level":1,"_type":"block","style":"normal","_key":"100d606d19f9","listItem":"bullet","markDefs":[],"children":[{"_key":"346324a657c80","_type":"span","marks":[],"text":"Taking care of caregivers, including psychiatrists and other medical professionals"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"How to prescribe joy","_key":"5386380f5d250"}],"level":1,"_type":"block","style":"normal","_key":"79bc513db3fd","listItem":"bullet"},{"children":[{"_type":"span","marks":["strong"],"text":"Dr Lavretsky ","_key":"e28f8c0eed700"},{"_type":"span","marks":["em"],"text":"is a professor in-residence in the Department of Psychiatry at the University of California, Los Angeles. Her work on geriatric depression and integrative mental health using mind-body interventions has received national attention, and she has won numerous grants supporting that work. A distinguished fellow of the American Psychiatric Association and a fellow of the American College of Neuropsychopharmacology, she is also on the board of ","_key":"e28f8c0eed701"},{"_type":"span","marks":[],"text":"Psychiatric Times","_key":"e28f8c0eed702"},{"text":"TM","_key":"e28f8c0eed703","_type":"span","marks":["em","superscript"]},{"_key":"9b716257b994","_type":"span","marks":["em"],"text":"."}],"_type":"block","style":"normal","_key":"442eadddd301","markDefs":[]}],"title":"What Will the Future of Alzheimer Disease Treatment Look Like? ","_rev":"0qItlCDE0t7k0fmkkc9rw1","url":"future-alzheimer-disease","seoTag":["alzheimer disease","aducanumab","mind-body interventions","public health","dementia"],"is_visible":true,"authors":[{"displayName":"Helen Lavretsky, MD, MS","url":"helen-lavretsky-md-ms"}],"factCheckAuthorMapping":null,"_updatedAt":"2021-07-23T14:56:04Z","published":"2021-07-23T14:39:00.000Z","_createdAt":"2021-07-22T22:43:14Z","authorMapping":[{"address1":"300 HANOVER ST STE 1E","displayName":"Helen Lavretsky, MD, MS","_createdAt":"2020-02-21T11:23:21Z","_rev":"pI9SawGKsTP14Lioy52fLS","_type":"author","_id":"pst_author_322822","_updatedAt":"2020-08-21T07:23:47Z","url":{"current":"helen-lavretsky-md-ms","_type":"slug"}}],"targeting":{"content_placement":["topics/alzheimer-disease","topics/neuropsychiatry","topics/psychosomatics","topics/psychopharmacology"],"document_url":["future-alzheimer-disease"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"FDA Committees Vote to Dismiss Clozapine REMS","url":{"current":"fda-committees-vote-to-dismiss-clozapine-rems","_type":"slug"},"thumbnail":{"_type":"mainImage","asset":{"_type":"reference","_ref":"image-3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304-jpg"}},"published":"2024-11-20T23:59:05.227Z"},{"title":"“Happy Accidents”: Repurposing Metformin","url":{"current":"happy-accidents-repurposing-metformin","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"metformin","asset":{"_ref":"image-e043699441b7cb5a79c8ffaaeb75a30836c12c9d-2048x2048-jpg","_type":"reference"}},"published":"2024-11-11T18:00:18.436Z"},{"title":"Time to Think of Aggression as a Treatment Target Symptom, Independent of Diagnosis ","url":{"current":"time-to-think-of-aggression-as-a-treatment-target-symptom-independent-of-diagnosis","_type":"slug"},"thumbnail":{"caption":"Stranger ManAdobeStock","asset":{"_ref":"image-986628c7bb80dae06a08a56503356ed45edbefbb-4017x3734-jpg","_type":"reference"},"_type":"mainImage","alt":"aggression"},"published":"2024-11-08T16:00:00.000Z"},{"title":"Positive Phase 3 Results Evaluating Lumateperone for the Prevention of Relapse in Schizophrenia","url":{"current":"positive-phase-3-results-evaluating-lumateperone-for-the-prevention-of-relapse-in-schizophrenia","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"schizophrenia","caption":"Adin/AdobeStock","asset":{"_ref":"image-aa32b9c9311ae9016ca84e15914daf1d3645a569-6272x3584-jpg","_type":"reference"}},"published":"2024-11-06T17:04:30.308Z"},{"title":"What Is Cardio-Metabolic Depression?","url":{"current":"what-is-cardio-metabolic-depression","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"obesity","caption":"Maya Kruchancova/AdobeStock","asset":{"_ref":"image-e882a13d16535d0b0e44349e93b673ddb43e2268-5472x2047-jpg","_type":"reference"}},"published":"2024-11-05T20:00:18.665Z"},{"title":"Challenging Prevalent “Benzophobia”","url":{"current":"challenging-prevalent-benzophobia","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"benzodiazepine","caption":"luchschenF/AdobeStock","asset":{"_ref":"image-cd4410b4be572f54210c9ba800bf4ae1095e875d-7405x4939-jpg","_type":"reference"}},"published":"2024-10-30T14:00:00.000Z"}]},{"is_visible":true,"title":"TMS for the Treatment of OCD","url":"tms-for-the-treatment-of-ocd","_rev":"VUkuE34wajTefC0u4VjgIa","published":"2024-10-25T15:00:00.000Z","thumbnail":{"alt":"brain lightbulb","caption":"Dilok/AdobeStock","asset":{"_ref":"image-6e7deea1c577db789477d44ab9518072785d31ee-6000x4000-jpg","_type":"reference"},"_type":"mainImage"},"authors":[{"displayName":"Tommy Sung, MD","url":"tommy-sung-md"},{"displayName":"Coralie Eilers, MD","url":"coralie-eilers-md"},{"displayName":"Haley Schuster, MD","url":"haley-schuster-md"},{"displayName":"Mark Mullen, MD","url":"mark-mullen-md"},{"displayName":"Rajesh R. Tampi, MD, MS, DFAPA, DFAAGP","url":"rajesh-r-tampi-md-ms-dfapa-dfaagp"}],"factCheckAuthorMapping":null,"_id":"7d0e87c6-e5f7-465a-9533-d3ca7df2d4f6","contentCategory":{"_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Articles","_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","_updatedAt":"2020-02-25T09:35:56Z","_createdAt":"2020-02-06T09:15:47Z"},"authorMapping":[{"_id":"345d23d6-dc09-43a7-bd44-521a39d8f16f","biography":[{"style":"normal","_key":"8770ec168795","markDefs":[],"children":[{"_key":"bb9b303fd9dd0","_type":"span","marks":["strong"],"text":"Dr Sung "},{"_type":"span","marks":["em"],"text":"is a psychiatry second year resident at Creighton University in Omaha, Nebraska.","_key":"bb9b303fd9dd1"}],"_type":"block"}],"_updatedAt":"2024-10-24T20:37:33Z","url":{"current":"tommy-sung-md","_type":"slug"},"displayName":"Tommy Sung, MD","_createdAt":"2024-10-24T20:37:33Z","_rev":"VUkuE34wajTefC0u4ViuSh","_type":"author"},{"_updatedAt":"2024-10-24T20:39:06Z","url":{"current":"coralie-eilers-md","_type":"slug"},"displayName":"Coralie Eilers, MD","_createdAt":"2024-10-24T20:38:43Z","_rev":"JplNnnoVjWzg3lpd7EJhql","_type":"author","_id":"7e55142c-23d6-409c-978d-2b6d3421adf4","biography":[{"_type":"block","style":"normal","_key":"afb32e12d68f","markDefs":[],"children":[{"_key":"c5e24e59c5860","_type":"span","marks":["strong"],"text":"Dr Eilers "},{"_type":"span","marks":["em"],"text":"is a fourth-year psychiatry resident at Creighton University in Omaha, Nebraska. ","_key":"c5e24e59c5861"}]}]},{"displayName":"Haley Schuster, MD","_createdAt":"2024-05-24T15:49:30Z","_rev":"ifjrlh8MYXGMNmzEfgbRYB","_type":"author","_id":"3ff7746c-e133-452b-bb1f-d5cd8ce981c6","_updatedAt":"2024-05-24T15:49:30Z","url":{"current":"haley-schuster-md","_type":"slug"}},{"firstName":"Mark","lastName":"Mullen","_updatedAt":"2024-07-10T19:31:55Z","url":{"current":"mark-mullen-md","_type":"slug"},"displayName":"Mark Mullen, MD","_createdAt":"2024-01-16T16:49:20Z","_rev":"doviSoj42X0En17wa2vZGW","_type":"author","_id":"5e396760-2c2c-494c-95b0-ed8aca2a9d8f","biography":[{"style":"normal","_key":"581caf2a8491","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Mullen","_key":"aacf5594af1c"},{"marks":[],"text":" ","_key":"48f9d3a9aeb5","_type":"span"},{"_type":"span","marks":["em"],"text":"is a fourth-year psychiatry resident at Creighton University. ","_key":"7a65cd847455"}],"_type":"block"}]},{"_createdAt":"2022-01-06T20:32:28Z","_rev":"jvOgZ3KZdbRHfWlt9chxeg","_type":"author","_updatedAt":"2022-01-06T20:32:28Z","firstName":"Rajesh","lastName":"Tampi","displayName":"Rajesh R. Tampi, MD, MS, DFAPA, DFAAGP","_id":"ff656093-70f8-433b-85d2-28c0b91d0eea","url":{"current":"rajesh-r-tampi-md-ms-dfapa-dfaagp","_type":"slug"}}],"ExcludeFromPubMedXML":false,"_type":"article","body":[{"_type":"figure","asset":{"_ref":"image-6e7deea1c577db789477d44ab9518072785d31ee-6000x4000-jpg","_type":"reference"},"imgcaption":[{"_key":"6f2c50fcaa64","markDefs":[],"children":[{"text":"Dilok/AdobeStock","_key":"f2875fad65510","_type":"span","marks":[]}],"_type":"block","style":"normal"}],"alignment":"left","disableTextWrap":false,"_key":"dc800c144276","disableLightBox":true,"alt":"brain lightbulb","widthP":50},{"_key":"fa7aea7a215d","markDefs":[],"children":[{"text":"TRANSLATING RESEARCH INTO PRACTICE","_key":"ef5ee58847f40","_type":"span","marks":["strong"]}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"397f3d3c077b","markDefs":[],"children":[{"_type":"span","marks":["em"],"text":"Rajesh R. Tampi MD, MS, DFAPA, DFAAGP, Editor","_key":"12ca9eb5e6e9"}]},{"_key":"5b6f70c151c2","markDefs":[],"children":[{"marks":[],"text":"While pharmacological and therapy-based treatments have shown therapeutic efficacy in obsessive-compulsive disorder (OCD), there are many patients who have inadequate responses to these treatment modalities. Repetitive transcranial magnetic stimulation (rTMS) has shown promise for treatment-refractory affective disorders. This meta-analysis included 25 randomized controlled trials (RCTs) with 860 participants. The aim was to assess the therapeutic benefit of rTMS in patients with OCD and explored the moderators of its treatment effect.","_key":"c346786b0d6c","_type":"span"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"78dccbe6cd640"}],"_type":"block","style":"normal","_key":"68f7e9a1c953"},{"_type":"block","style":"normal","_key":"2baa14ba8e48","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"The Study","_key":"7537ff2823690"}]},{"markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/37343662/","_key":"753cd38161b3","blank":true}],"children":[{"_type":"span","marks":[],"text":"Steuber ER, McGuire JF. ","_key":"5b88e5b38c3b0"},{"_type":"span","marks":["753cd38161b3"],"text":"A meta-analysis of transcranial magnetic stimulation in obsessive-compulsive disorder.","_key":"5b88e5b38c3b1"},{"_type":"span","marks":[],"text":" ","_key":"6b5e6ac7c8c1"},{"_type":"span","marks":["em"],"text":"Biol Psychiatry Cogn Neurosci Neuroimaging.","_key":"5b88e5b38c3b2"},{"_type":"span","marks":[],"text":" 2023;8(11):1145-1155.","_key":"5b88e5b38c3b3"}],"_type":"block","style":"normal","_key":"bf2f93fcf4fd"},{"_type":"block","style":"normal","_key":"599b822bb622","markDefs":[],"children":[{"_key":"4109d8010fb60","_type":"span","marks":[],"text":""}]},{"markDefs":[],"children":[{"marks":["strong"],"text":"Study Funding","_key":"8c4dc714c0360","_type":"span"}],"_type":"block","style":"normal","_key":"a966d8581890"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"None listed.","_key":"1c42973325cd0"}],"_type":"block","style":"normal","_key":"1a6d36a6cb4e"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"75bac16673840"}],"_type":"block","style":"normal","_key":"473ae48048cd"},{"children":[{"_key":"b80c64b098950","_type":"span","marks":["strong"],"text":"Study Objectives"}],"_type":"block","style":"normal","_key":"a85c95f3d82d","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"To examine the therapeutic benefit of rTMS in patients with OCD and to explore the moderators of its treatment effect.","_key":"20a59adb68bb0"}],"_type":"block","style":"normal","_key":"edb1e4dee75a"},{"markDefs":[],"children":[{"_key":"723d2e388aa50","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"1f8104e21d01"},{"markDefs":[],"children":[{"_key":"9611349f138d0","_type":"span","marks":["strong"],"text":"Methodology"}],"_type":"block","style":"normal","_key":"31e57b156fb2"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"This meta-analysis adhered to PRISMA guidelines and included studies from 1997 to December 31, 2022. Pubmed, SCOPUS, and PsycINFO databases were searched using keywords: “obsessive-compulsive disorder,” “transcranial magnetic stimulation,” and “randomized controlled trial.” Inclusion criteria were that the study had to be an RCT that compares rTMS treatment with sham condition. In addition, the participants had to meet diagnostic criteria for OCD, and there had to be sufficient data to calculate treatment effects using psychometrically supported rating scales. The authors screened a total of 159 records for eligibility. After applying inclusion criteria, 25 studies were included with 3 trials having multiple rTMS conditions. This provided a total of 28 treatment comparisons for inclusion. The Yale-Brown Obsessive-Compulsive Scale (YBOCS) was utilized to extract effect sizes for OCD severity. If multiple depression scales were reported in the RCT, the Montgomery-Asberg Depression Scale (MADRS) was favored over the Hamilton Depression Scale (HDS) and Beck Depression Inventory (BDI). To quantify treatment effects, Hedge’s ","_key":"f7ec0b9cc5110"},{"_key":"f7ec0b9cc5111","_type":"span","marks":["em"],"text":"g "},{"_key":"f7ec0b9cc5112","_type":"span","marks":[],"text":"was selected. Effective sizes were calculated using change scores. Relative risk ratios were used to calculate the treatment response and effective size."}],"_type":"block","style":"normal","_key":"51714d2703a9"},{"children":[{"marks":[],"text":"","_key":"58a4ced104110","_type":"span"}],"_type":"block","style":"normal","_key":"a54173961ed0","markDefs":[]},{"_key":"a4ddfb4a2a02","markDefs":[],"children":[{"marks":["strong"],"text":"Study Results","_key":"44f414d47f190","_type":"span"}],"_type":"block","style":"normal"},{"style":"normal","_key":"2d53a2bb77b2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The random effects model found that rTMS had a moderate therapeutic effect on OCD severity when compared with sham conditions. (","_key":"46e75fb8096c0"},{"_type":"span","marks":["em"],"text":"g","_key":"46e75fb8096c1"},{"_type":"span","marks":[],"text":"=0.65, ","_key":"46e75fb8096c2"},{"_key":"46e75fb8096c3","_type":"span","marks":["em"],"text":"P"},{"_type":"span","marks":[],"text":"\u003c0.001). Significant heterogeneity was identified (","_key":"46e75fb8096c4"},{"_type":"span","marks":["em"],"text":"P","_key":"46e75fb8096c5"},{"_type":"span","marks":[],"text":"\u003c0.003) and Egger’s test indicated that publication bias was significant (","_key":"46e75fb8096c6"},{"_type":"span","marks":["em"],"text":"P","_key":"46e75fb8096c7"},{"_type":"span","marks":[],"text":"=0.04). Further testing using the Duval and Tweedie’s trim and fill method indicated that no studies needed to be trimmed and that a moderate therapeutic effect remained (","_key":"46e75fb8096c8"},{"text":"g","_key":"46e75fb8096c9","_type":"span","marks":["em"]},{"_key":"46e75fb8096c10","_type":"span","marks":[],"text":"=0.65)."}],"_type":"block"},{"markDefs":[],"children":[{"marks":[],"text":"For treatment response, the average rate across trials was 39.5% for rTMS and 8.8% for sham conditions. A large treatment effect of rTMS when compared with sham conditions was found using the random effects model (Relative Risk [RR] =3.15, ","_key":"c3f01fb62ca70","_type":"span"},{"_type":"span","marks":["em"],"text":"P","_key":"c3f01fb62ca71"},{"_type":"span","marks":[],"text":"\u003c0.001). There was little heterogeneity across trials (","_key":"c3f01fb62ca72"},{"text":"P","_key":"c3f01fb62ca73","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":"=0.61), but publication bias was present (","_key":"c3f01fb62ca74"},{"marks":["em"],"text":"P","_key":"c3f01fb62ca75","_type":"span"},{"_type":"span","marks":[],"text":"=0.03). When Duval and Tweedie’s trim-and-fill method was used, rTMS continued to show a moderate effect (RR=2.67), although 4 studies had to be trimmed. There were no significant differences between trials that used \u003e 25% improvement on the YBOCS scale compared with \u003e30%, \u003e35%, or \u003e40% improvement (","_key":"c3f01fb62ca76"},{"_type":"span","marks":["em"],"text":"P","_key":"c3f01fb62ca77"},{"_type":"span","marks":[],"text":"=0.86).","_key":"c3f01fb62ca78"}],"_type":"block","style":"normal","_key":"7b8acc57fb95"},{"style":"normal","_key":"118e864d818c","markDefs":[],"children":[{"marks":[],"text":"Three treatment moderators were found to be statistically significant when analyzing heterogeneity. First, when patients had a greater improvement in depression severity, this was found to produce a larger treatment effect of rTMS on OCD (","_key":"88b9ac5f555d0","_type":"span"},{"_type":"span","marks":["em"],"text":"P","_key":"88b9ac5f555d1"},{"_key":"88b9ac5f555d2","_type":"span","marks":[],"text":"=0.02). Second, longer TMS sessions were associated with greater improvement in OCD ("},{"_type":"span","marks":["em"],"text":"P","_key":"88b9ac5f555d3"},{"_type":"span","marks":[],"text":"=0.05). And lastly, a lower number of TMS sessions were associated with greater improvement in OCD severity (","_key":"88b9ac5f555d4"},{"_type":"span","marks":["em"],"text":"P","_key":"88b9ac5f555d5"},{"text":"=0.02).","_key":"88b9ac5f555d6","_type":"span","marks":[]}],"_type":"block"},{"children":[{"_key":"45af34743b360","_type":"span","marks":[],"text":"It is important to note that patient average age, sex, duration of OCD illness, concurrent use of serotonin reuptake inhibitor pharmacotherapy or antipsychotic pharmacotherapy, baseline OCD symptom severity, and/or use of medication free status were not statistically significant regarding the treatment effect of rTMS on OCD severity. Other intervention characteristics that were not found to be statistically significant included rTMS motor thresholds, rTMS frequencies, coils used for rTMS, total number of pulses used, and the location of rTMS treatment including the dorsolateral prefrontal cortex, orbitofrontal cortex, and supplementary motor area."}],"_type":"block","style":"normal","_key":"629094e89acc","markDefs":[]},{"children":[{"marks":[],"text":"When looking through trial design characteristics as moderators of rTMS treatment effects, sample size, trial attrition, and year of publications were not found to be statistically significant. There was no difference between studies that used full sham conditions vs those that did not (","_key":"3b3148c602600","_type":"span"},{"_type":"span","marks":["em"],"text":"P","_key":"3b3148c602601"},{"_type":"span","marks":[],"text":"=0.75). Finally, there was no statistical significance between trials that used treatment refractory patients, vs nontreatment refractory patients (","_key":"3b3148c602602"},{"_key":"3b3148c602603","_type":"span","marks":["em"],"text":"P"},{"text":"=0.81).","_key":"3b3148c602604","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"340d2b25eb91","markDefs":[]},{"_key":"cba7ec021871","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"eb2d1768b6a90"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"ee7f97e230ef","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Study Strengths","_key":"e7b92274f3770"}]},{"style":"normal","_key":"e3989420e3a1","markDefs":[],"children":[{"marks":[],"text":"1. This review included 25 studies and 860 participants.","_key":"41f586fa31b50","_type":"span"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"2. Only RCTs were included.","_key":"5d8d43efed160"}],"_type":"block","style":"normal","_key":"7f0626127b21","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"3. Trials included different rTMS coils, frequencies, motor thresholds, and anatomical locations.","_key":"439258ced4970"}],"_type":"block","style":"normal","_key":"18eac58de530","markDefs":[]},{"style":"normal","_key":"dbc8a43454d7","markDefs":[],"children":[{"_type":"span","marks":[],"text":"4. There were no conflicts of interest for the authors.","_key":"eb9bd3d137fe0"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"143bc959b9290"}],"_type":"block","style":"normal","_key":"a9ab2d713138"},{"markDefs":[],"children":[{"marks":["strong"],"text":"Study Limitations","_key":"591cc0828a2f0","_type":"span"}],"_type":"block","style":"normal","_key":"bdb9dfe50669"},{"_type":"block","style":"normal","_key":"a3456ec4324c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"1. The studies included only focused on acute treatment outcomes.","_key":"68cab9fcd22b0"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"2. Statistical analysis did not correct for multiple comparisons.","_key":"a69ecb269a0c0"}],"_type":"block","style":"normal","_key":"5564852255f8"},{"markDefs":[],"children":[{"text":"3. Limited patient characteristics were available for extraction across trials, such as whether exposure and response therapy had been trialed.","_key":"174b455c00800","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"ca95428eb679"},{"_type":"block","style":"normal","_key":"aeab51476381","markDefs":[],"children":[{"_type":"span","marks":[],"text":"4. Publication bias was present.","_key":"d71b26b10e6f0"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"2de6d4bf21ed0"}],"_type":"block","style":"normal","_key":"b4436e517e61"},{"children":[{"text":"Conclusions","_key":"5deba80fdece0","_type":"span","marks":["strong"]}],"_type":"block","style":"normal","_key":"0bba84d479aa","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"This meta-analysis found that rTMS had a moderate therapeutic effect for the treatment of OCD. In addition, greater improvement in depression severity, longer TMS sessions, and fewer number of TMS sessions were moderators associated with greater improvement in OCD severity.","_key":"1c6b83747fc30"}],"_type":"block","style":"normal","_key":"ecf65d121661","markDefs":[]},{"_type":"block","style":"normal","_key":"657e07e93cda","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"80b3132b67790"}]},{"_key":"4357b9c51e84","markDefs":[],"children":[{"_key":"89ad068c44b50","_type":"span","marks":["strong"],"text":"Practical Applications"}],"_type":"block","style":"normal"},{"children":[{"_key":"04289f1555c50","_type":"span","marks":[],"text":"OCD is a heterogenous disorder that can be debilitating for patients. This study shows that rTMS has moderate therapeutic effects on OCD severity."}],"_type":"block","style":"normal","_key":"7da82891fb7e","markDefs":[]},{"_type":"block","style":"normal","_key":"f891977db9a1","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"a94404cf2fe70"}]},{"_key":"755657fc7115","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bottom Line","_key":"aee38074d46b0"}],"_type":"block","style":"normal"},{"children":[{"marks":[],"text":"Clinicians should consider rTMS as an intervention to alleviate OCD symptoms, especially in those who have failed other treatments or those with comorbid depression.","_key":"e51f954da3c20","_type":"span"}],"_type":"block","style":"normal","_key":"bbc8eb2cb3b2","markDefs":[]},{"_key":"110fca7774c2","markDefs":[],"children":[{"marks":[],"text":"","_key":"86267235b37a0","_type":"span"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"0ae7eff1ec6c","markDefs":[],"children":[{"marks":["strong"],"text":"Dr Sung ","_key":"82fc7e49d63c0","_type":"span"},{"text":"is a psychiatry second year resident at Creighton University in Omaha, Nebraska.","_key":"82fc7e49d63c1","_type":"span","marks":["em"]},{"_type":"span","marks":["strong"],"text":" Dr Eilers ","_key":"82fc7e49d63c2"},{"_type":"span","marks":["em"],"text":"is a fourth-year psychiatry resident at Creighton University in Omaha, Nebraska.","_key":"82fc7e49d63c3"},{"_type":"span","marks":[],"text":" ","_key":"82fc7e49d63c4"},{"_type":"span","marks":["strong"],"text":"Dr Schuster","_key":"82fc7e49d63c5"},{"text":" ","_key":"82fc7e49d63c6","_type":"span","marks":[]},{"text":"is a fourth-year psychiatry resident at Creighton University in Omaha, Nebraska.","_key":"82fc7e49d63c7","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":" ","_key":"82fc7e49d63c8"},{"_type":"span","marks":["strong"],"text":"Dr Mullen","_key":"82fc7e49d63c9"},{"text":" ","_key":"82fc7e49d63c10","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"is an assistant professor of Psychiatry at Saint Louis University School of Medicine.","_key":"82fc7e49d63c11"},{"_type":"span","marks":[],"text":" ","_key":"82fc7e49d63c12"},{"_type":"span","marks":["strong"],"text":"Dr Tampi ","_key":"82fc7e49d63c13"},{"text":"is professor and Chairman of the Department of Psychiatry at Creighton University School of Medicine and Catholic Health Initiatives (CHI) Health Behavioral Health Services. He is also an adjunct professor of psychiatry at Yale School of Medicine, and he is a member of the ","_key":"82fc7e49d63c14","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":"Psychiatric Times","_key":"82fc7e49d63c15"},{"_type":"span","marks":["em"],"text":" editorial board.","_key":"82fc7e49d63c16"}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"4652944bb81c0"}],"_type":"block","style":"normal","_key":"6eed3777cc73","markDefs":[]},{"_type":"block","style":"normal","_key":"467e81c21c13","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Reference","_key":"0af0a16f6ad00"}]},{"markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/37343662/","_key":"9857ad5b6708","blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"Steuber ER, McGuire JF. ","_key":"619280fbea2f0"},{"_key":"619280fbea2f1","_type":"span","marks":["9857ad5b6708"],"text":"A meta-analysis of transcranial magnetic stimulation in obsessive-compulsive disorder."},{"text":" ","_key":"aa02b71ba4f4","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"Biol Psychiatry Cogn Neurosci Neuroimaging.","_key":"619280fbea2f2"},{"_key":"619280fbea2f3","_type":"span","marks":[],"text":" 2023;8(11):1145-1155."}],"_type":"block","style":"normal","_key":"c13bbf66b4f1"}],"articleType":"News","drugMentions":"{\"drug_mentions\": [\"serotonin reuptake inhibitor pharmacotherapy\", \"antipsychotic pharmacotherapy\"]}","gptSummary":"Repetitive transcranial magnetic stimulation (rTMS) shows moderate efficacy in treating obsessive-compulsive disorder (OCD), particularly in treatment-refractory cases. A meta-analysis of 25 randomized controlled trials with 860 participants revealed a moderate therapeutic effect of rTMS on OCD severity, with a significant treatment response rate compared to sham conditions. Key moderators of treatment effect include improvement in depression severity, session duration, and session frequency. Patient demographics and other intervention characteristics did not significantly influence outcomes. Despite publication bias, rTMS remains a viable option for OCD management.","gptTakeaways":"• rTMS demonstrated a moderate therapeutic effect on OCD severity, with a significant treatment response rate compared to sham conditions.\n\n• Improvement in depression severity, longer TMS sessions, and fewer sessions were significant moderators of rTMS treatment effect.\n\n• Patient demographics and intervention characteristics like rTMS frequencies and anatomical locations did not significantly impact treatment outcomes.\n\n• Despite publication bias, rTMS remains a promising intervention for treatment-refractory OCD, especially in patients with comorbid depression.","audioUrl":"https://s3.us-east-1.amazonaws.com/ai-generated-audios/www.psychiatrictimes.com/7d0e87c6-e5f7-465a-9533-d3ca7df2d4f6_1729802687448.d842a76a-241a-465e-8c0b-f5c9168a7e6e.mp3","documentGroup":null,"documentGroupMapping":null,"summary":"A new study shows that rTMS has moderate therapeutic effects on OCD severity. ","factCheckAuthors":null,"_updatedAt":"2024-10-24T20:44:47Z","taxonomyMapping":[{"pixelTrackingCode":null,"perKeywordMapping":["Psychiatry","Neurology"],"name":"Transcranial Magnetic Stimulation","parent":{"_updatedAt":"2023-03-31T19:15:59Z","parent":null,"identifier":"topics","isMainTopic":true,"_rev":"uvXJooXtzvjNOyx50HTt8m","name":"Topics","_createdAt":"2020-03-26T06:11:21Z","_type":"taxonomy","_id":"pst_taxonomy_53202_clinical"},"cmeType":"per","_rev":"77mZ7PORfofI3dBGfWgBUq","_type":"taxonomy","identifier":"topics/transcranial-magnetic-stimulation","_createdAt":"2023-02-16T20:20:33Z","usedForRecommendations":false,"_id":"b160eca8-057d-49f5-a06e-962599380ee9","_updatedAt":"2023-03-31T19:34:56Z"},{"_updatedAt":"2023-03-31T19:07:26Z","perKeywordMapping":["Psychiatry","Neurology"],"_createdAt":"2020-03-26T06:11:21Z","_id":"pst_taxonomy_119_anxietystressdisorders","identifier":"topics/anxiety","parent":{"_rev":"uvXJooXtzvjNOyx50HTt8m","identifier":"topics","isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_id":"pst_taxonomy_53202_clinical","parent":null,"_updatedAt":"2023-03-31T19:15:59Z","_type":"taxonomy","name":"Topics"},"pixelTrackingCode":null,"_type":"taxonomy","cmeType":"per","_rev":"37333Uv1mHMuPikcnyAiz0","name":"Anxiety \u0026 Stress Disorders"},{"_updatedAt":"2023-03-31T19:19:55Z","_type":"taxonomy","parent":{"name":"Topics","_id":"pst_taxonomy_53202_clinical","identifier":"topics","isMainTopic":true,"_rev":"uvXJooXtzvjNOyx50HTt8m","parent":null,"_updatedAt":"2023-03-31T19:15:59Z","_createdAt":"2020-03-26T06:11:21Z","_type":"taxonomy"},"_id":"pst_taxonomy_35_neuropsychiatry","_createdAt":"2020-03-26T06:11:21Z","_rev":"77mZ7PORfofI3dBGfWcsCF","identifier":"topics/neuropsychiatry","pixelTrackingCode":null,"cmeType":"per","name":"Neuropsychiatry","perKeywordMapping":["Psychiatry","Neurology"]}],"_createdAt":"2024-10-24T20:34:25Z","targeting":{"content_placement":["topics/transcranial-magnetic-stimulation","topics/anxiety","topics/neuropsychiatry"],"document_url":["tms-for-the-treatment-of-ocd"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"4 Ways to Cope With Bipolar Uncertainty","url":{"current":"4-ways-to-cope-with-bipolar-uncertainty","_type":"slug"},"thumbnail":{"asset":{"_ref":"image-404e1c0468b1b692448c95b34c56c94c7d55a7bd-462x451-jpg","_type":"reference"},"_type":"mainImage","alt":"bipolar","caption":"Vector Tradition/AdobeStock"},"published":"2024-11-19T15:00:00.000Z"},{"title":"NeuroStar TMS for Adolescents With Major Depressive Disorder: A Look at the New Data","url":{"current":"neurostar-tms-for-adolescents-with-major-depressive-disorder-a-look-at-the-new-data","_type":"slug"},"thumbnail":{"asset":{"_ref":"image-60a8a242efef4dcca3c2e74f18eefed5676af69d-320x400-png","_type":"reference"},"_type":"mainImage","alt":"Melissa Fickey"},"published":"2024-11-14T17:30:56.510Z"},{"title":"Newly FDA-Cleared TMS for Major Depressive Disorder, Obsessive-Compulsive Disorder, and Anxious Depression","url":{"_type":"slug","current":"newly-fda-cleared-tms-for-major-depressive-disorder-obsessive-compulsive-disorder-and-anxious-depression"},"thumbnail":{"_type":"mainImage","alt":"brain electric","caption":"LuckyStep/AdobeStock","asset":{"_ref":"image-fe4aecdda8576865763573dc3fea3f22023851dc-600x375-jpg","_type":"reference"}},"published":"2024-11-12T19:37:30.544Z"},{"title":"Differential Diagnosis of Mixed States is Nearly Impossible. Here’s How to Cope. ","url":{"current":"differential-diagnosis-of-mixed-states-is-nearly-impossible-heres-how-to-cope","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"questions","caption":"sergign/AdobeStock","asset":{"_ref":"image-0ed42755e5073b545ec9cabf17e17101c1af23d2-4000x2667-jpg","_type":"reference"}},"published":"2024-11-12T15:00:00.000Z"},{"title":"SAINT iTBS Protocol Shows Promise for Bipolar I Depression","url":{"current":"saint-itbs-protocol-shows-promise-for-bipolar-i-depression","_type":"slug"},"thumbnail":{"hotspot":{"_type":"sanity.imageHotspot","width":1,"x":0.5,"y":0.48739624023437506,"height":0.7238275146484376},"_type":"mainImage","alt":"bipolar","caption":"Dariia/AdobeStock","asset":{"_ref":"image-738ebb291ae9b226a64c2958546f0756b62b47fc-2000x2000-jpg","_type":"reference"},"crop":{"bottom":0.15069000244140618,"_type":"sanity.imageCrop","right":0,"top":0.12548248291015623,"left":0}},"published":"2024-11-04T15:00:00.000Z"},{"title":"ADHD: Overlooked Cause of Persistent Anxiety and Depression in Adults","url":{"_type":"slug","current":"adhd-overlooked-cause-of-persistent-anxiety-and-depression-in-adults"},"thumbnail":{"caption":"1STunningART/AdobeStock","asset":{"_ref":"image-480b7b29f69d9743ec4d45ba543c1fc8e7aa932f-6000x3375-jpg","_type":"reference"},"_type":"mainImage","alt":"ADHD"},"published":"2024-10-29T15:00:00.000Z"}]},{"_type":"article","published":"2021-02-23T22:27:51.516Z","thumbnail":{"_type":"mainImage","asset":{"_ref":"image-882c03d79aad20809abba7ed419641756c66f364-3000x3000-jpg","_type":"reference"}},"summary":"Millions of Americans will suffer brain injuries this year, and many of them will need a psychiatrist’s help. ","factCheckAuthors":null,"url":"recognize-treat-traumatic-brain-injury","documentGroupMapping":null,"_rev":"lcksSrK6MQ8IAMSXDurZd6","_id":"df456d96-2873-469e-aadc-99175b205c87","seoTag":["traumatic brain injury","depression","psychosis","suicide"],"is_visible":true,"taxonomyMapping":[{"_type":"taxonomy","parent":{"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","name":"Topics","_id":"pst_taxonomy_53202_clinical","identifier":"topics","isMainTopic":true,"_type":"taxonomy","_updatedAt":"2023-03-31T19:15:59Z","parent":null},"perKeywordMapping":["Psychiatry","Neurology"],"_rev":"37333Uv1mHMuPikcnyBIO2","_updatedAt":"2023-03-31T19:23:55Z","cmeType":"per","_createdAt":"2020-03-26T06:11:21Z","name":"Psychosomatics","_id":"pst_taxonomy_351_psychosomatics","identifier":"topics/psychosomatics","pixelTrackingCode":null},{"_type":"taxonomy","cmeType":"per","identifier":"topics/depression","_id":"pst_taxonomy_641_depression","parent":null,"pixelTrackingCode":null,"_updatedAt":"2024-02-28T20:45:13Z","perKeywordMapping":["Psychiatry","Neurology"],"_createdAt":"2020-03-26T06:11:21Z","_rev":"eEqAv6Sbdk37RM523WcvVR","name":"Depression"},{"pixelTrackingCode":null,"_id":"pst_taxonomy_362_schizophreniapsychosis","_updatedAt":"2023-03-31T19:32:05Z","perKeywordMapping":["Psychiatry","Neurology"],"_type":"taxonomy","identifier":"topics/schizophrenia","_createdAt":"2020-03-26T06:11:21Z","_rev":"77mZ7PORfofI3dBGfWfij5","parent":{"isMainTopic":true,"_type":"taxonomy","name":"Topics","parent":null,"_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m"},"cmeType":"per","name":"Schizophrenia/Psychosis"},{"perKeywordMapping":["Psychiatry","Neurology"],"name":"Neuropsychiatry","_createdAt":"2020-03-26T06:11:21Z","_rev":"77mZ7PORfofI3dBGfWcsCF","_updatedAt":"2023-03-31T19:19:55Z","identifier":"topics/neuropsychiatry","cmeType":"per","_type":"taxonomy","parent":{"_rev":"uvXJooXtzvjNOyx50HTt8m","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z","parent":null,"isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_type":"taxonomy","identifier":"topics"},"_id":"pst_taxonomy_35_neuropsychiatry","pixelTrackingCode":null}],"body":[{"children":[{"marks":[],"text":"","_key":"c61811477d4e","_type":"span"}],"_type":"block","style":"normal","_key":"d244bf263a86","markDefs":[]},{"_type":"iframe","_key":"a12836b39ec5","url":"https://embeds.audioboom.com/posts/7808025/embed/v4"},{"style":"normal","_key":"f8ad89658019","markDefs":[],"children":[{"_key":"bbcc43bd52420","_type":"span","marks":["strong"],"text":"PSYCHPEARLS PODCAST"}],"_type":"block"},{"markDefs":[{"blank":true,"_type":"link","href":"https://www.psychiatrictimes.com/view/pharmacological-management-psychiatric-aspects-traumatic-brain-injury","_key":"d9d669c0713e"}],"children":[{"_type":"span","marks":[],"text":"March is brain injury awareness month. According to a study by the Centers for Disease Control, nearly 3 million individuals a year suffer a traumatic brain injury (TBI), and psychiatric disturbances are the most-common ","_key":"ccc580f571c20"},{"_type":"span","marks":["d9d669c0713e"],"text":"long-term effects of these injuries","_key":"ccc580f571c21"},{"_key":"ccc580f571c22","_type":"span","marks":[],"text":"."}],"_type":"block","style":"normal","_key":"75d2e345d84a"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"In this edition of ","_key":"da09fe455c830"},{"text":"Psych Pearls","_key":"da09fe455c831","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":", we speak to David Arciniegas, MD, about how to spot TBI and its psychiatric sequalae—and how to give effective treatment.","_key":"da09fe455c832"}],"_type":"block","style":"normal","_key":"3e40a478d77f"},{"markDefs":[],"children":[{"_key":"bb0f4b4c04720","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"03da52bb0c8e"},{"children":[{"marks":["strong"],"text":"Dr Arciniegas ","_key":"fcaf8ad96b870","_type":"span"},{"_type":"span","marks":["em"],"text":"is professor and senior research neuropsychiatrist in the Department of Psychiatry and Behavioral Sciences at the University of New Mexico School of Medicine. He is director of research at the Marcus Institute for Brain health and editor of the ","_key":"fcaf8ad96b871"},{"_type":"span","marks":[],"text":"Journal of Neuropsychiatry and Clinical Neurosciences.","_key":"fcaf8ad96b872"}],"_type":"block","style":"normal","_key":"b0ce2d244426","markDefs":[]},{"_type":"block","style":"normal","_key":"6b230f00ac54","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"9295895cde530"}]}],"_updatedAt":"2021-02-23T22:29:32Z","_createdAt":"2021-02-23T22:29:32Z","authorMapping":[{"_id":"pst_author_625280","_updatedAt":"2020-08-21T07:23:58Z","url":{"current":"david-b-arciniegas-md","_type":"slug"},"displayName":"David B. Arciniegas, MD","_createdAt":"2020-02-21T11:23:21Z","_rev":"5NSo4DlKj6Rwd777Axd62t","_type":"author"}],"documentGroup":null,"title":"Recognize and Treat Traumatic Brain Injury","contentCategory":{"_id":"93d57b69-2d72-45fe-8b8a-d18e7e7e5f20","_updatedAt":"2020-02-25T09:31:48Z","_createdAt":"2020-02-25T09:31:48Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Podcasts"},"authors":[{"displayName":"David B. Arciniegas, MD","url":"david-b-arciniegas-md"}],"factCheckAuthorMapping":null,"targeting":{"content_placement":["topics/psychosomatics","topics/depression","topics/schizophrenia","topics/neuropsychiatry"],"document_url":["recognize-treat-traumatic-brain-injury"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"FDA Committees Vote to Dismiss Clozapine REMS","url":{"current":"fda-committees-vote-to-dismiss-clozapine-rems","_type":"slug"},"thumbnail":{"_type":"mainImage","asset":{"_ref":"image-3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304-jpg","_type":"reference"}},"published":"2024-11-20T23:59:05.227Z"},{"title":"Beyond Dopamine: Muscarinic Solutions Bring New Hope for Schizophrenia","url":{"current":"beyond-dopamine-muscarinic-solutions-bring-new-hope-for-schizophrenia","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"schizophrenia brain","caption":"ArtistryAlchemy/AdobeStock","asset":{"_ref":"image-15620d5296df4215dfbf6a510820b123d360e256-4630x2595-jpg","_type":"reference"}},"published":"2024-11-20T15:00:00.000Z"},{"title":"4 Ways to Cope With Bipolar Uncertainty","url":{"current":"4-ways-to-cope-with-bipolar-uncertainty","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"bipolar","caption":"Vector Tradition/AdobeStock","asset":{"_ref":"image-404e1c0468b1b692448c95b34c56c94c7d55a7bd-462x451-jpg","_type":"reference"}},"published":"2024-11-19T15:00:00.000Z"},{"title":"Long-Acting Injectables and a Team-Driven Approach for Schizophrenia Treatment ","url":{"current":"long-acting-injectables-and-a-team-driven-approach-for-schizophrenia-treatment","_type":"slug"},"thumbnail":{"caption":"tashatuvango/AdobeStock","asset":{"_ref":"image-4d0666c33abcebc4983e7f4b879ee0fc1eff754f-5733x3780-jpg","_type":"reference"},"_type":"mainImage","alt":"schizophrenia"},"published":"2024-11-18T15:00:00.000Z"},{"title":"NeuroStar TMS for Adolescents With Major Depressive Disorder: A Look at the New Data","url":{"current":"neurostar-tms-for-adolescents-with-major-depressive-disorder-a-look-at-the-new-data","_type":"slug"},"thumbnail":{"asset":{"_ref":"image-60a8a242efef4dcca3c2e74f18eefed5676af69d-320x400-png","_type":"reference"},"_type":"mainImage","alt":"Melissa Fickey"},"published":"2024-11-14T17:30:56.510Z"},{"title":"Newly FDA-Cleared TMS for Major Depressive Disorder, Obsessive-Compulsive Disorder, and Anxious Depression","url":{"current":"newly-fda-cleared-tms-for-major-depressive-disorder-obsessive-compulsive-disorder-and-anxious-depression","_type":"slug"},"thumbnail":{"alt":"brain electric","caption":"LuckyStep/AdobeStock","asset":{"_ref":"image-fe4aecdda8576865763573dc3fea3f22023851dc-600x375-jpg","_type":"reference"},"_type":"mainImage"},"published":"2024-11-12T19:37:30.544Z"}]},{"_id":"8f14bcad-bf99-4751-b19b-d4d5f852b397","audioUrl":"https://s3.us-east-1.amazonaws.com/ai-generated-audios/www.psychiatrictimes.com/8f14bcad-bf99-4751-b19b-d4d5f852b397_1729534446021.f4d757d9-b087-425a-84bc-75cba7dd507b.mp3","_updatedAt":"2024-10-21T18:16:24Z","_type":"article","summary":"It is important to raise awareness about alpha-gal syndrome and the risks of tick exposure, and to provide resources to medical providers treating patients with this condition.","published":"2024-10-22T16:00:00.000Z","factCheckAuthors":null,"documentGroupMapping":null,"gptSummary":"Alpha-gal syndrome (AGS) is a delayed allergic reaction to the oligosaccharide alpha-gal, commonly triggered by lone star tick bites. Symptoms vary and can include urticaria, gastrointestinal distress, and anaphylaxis. AGS poses significant diagnostic challenges due to its rarity and the lack of standardized testing. The syndrome's impact extends to mental health, as patients face dietary restrictions and potential social isolation. Climate change may expand AGS prevalence. Effective management requires interdisciplinary care, including allergists, psychiatrists, and pharmacists, to address both physical and psychological aspects of the condition.","contentCategory":{"_updatedAt":"2020-02-25T09:35:56Z","_createdAt":"2020-02-06T09:15:47Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Articles","_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb"},"title":"Climate Change, Vector Range, and Alpha-Gal in Psychiatric Practice","factCheckAuthorMapping":null,"_rev":"yfV8wp4eUDtgm1JJ6avfWu","gptTakeaways":"• AGS is triggered by lone star tick bites, causing delayed allergic reactions to mammalian products. Symptoms include urticaria, gastrointestinal distress, and anaphylaxis.\n\n• Diagnosis is challenging due to the lack of standardized testing and the rarity of the condition, often leading to delayed identification.\n\n• AGS impacts mental health, causing dietary restrictions, social isolation, and financial stress, necessitating interdisciplinary care.\n\n• Climate change may increase AGS prevalence by expanding the range of lone star ticks, complicating management and diagnosis.\n\n• Effective management involves allergists, psychiatrists, and pharmacists to address both physical and psychological aspects of AGS.","drugMentions":"{\"drug_mentions\": [\"cetuximab\", \"EpiPens\", \"selective serotonin reuptake inhibitors\", \"serotonin–norepinephrine reuptake inhibitors\", \"tricyclic antidepressants\", \"1st and 2nd generation antipsychotics\", \"mood stabilizers\", \"lithium\", \"anticonvulsants\", \"anxiolytic\", \"benzodiazepine\", \"nonbenzodiazepine\", \"heparin\", \"oxycodone\"]}","authorMapping":[{"_id":"27ff1210-98f8-4719-bf79-c5ee2239de87","profileImage":{"_type":"mainImage","asset":{"_ref":"image-455fd5a645f878d7500074d4c822bbc3004f08ef-800x800-jpg","_type":"reference"}},"url":{"current":"ryan-babineau","_type":"slug"},"displayName":"Ryan Babineau","_rev":"iwIk0EhdBdoIVjJwZZF7My","_type":"author","_createdAt":"2024-10-21T17:41:43Z","biography":[{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Mr Babineau","_key":"87a4ad98326e0"},{"_type":"span","marks":["em"],"text":" is a medical student at Virginia Commonwealth University School of Medicine.","_key":"87a4ad98326e1"}],"_type":"block","style":"normal","_key":"22f2fb64f850"}],"_updatedAt":"2024-10-21T17:52:22Z"},{"biography":[{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Daily ","_key":"957e5e844f480"},{"_type":"span","marks":["em"],"text":"is adjunct faculty at the Oklahoma State University School of Osteopathic Medicine at The Cherokee Nation.","_key":"957e5e844f481"}],"_type":"block","style":"normal","_key":"5b2dc5e7f88e"}],"profileImage":{"_type":"mainImage","asset":{"_ref":"image-28565033521595bbe60fa20c0624e2c2778153cd-320x320-jpg","_type":"reference"}},"_updatedAt":"2024-10-21T17:52:48Z","_createdAt":"2024-10-21T17:43:17Z","_id":"597e3e31-4eac-4cf6-b9a2-3b53e6878ea0","_type":"author","url":{"current":"rebecca-susan-daily-md-dlfapa-dfaacap","_type":"slug"},"displayName":"Rebecca Susan Daily, MD, DLFAPA, DFAACAP","_rev":"piyJAhpB4yoL7s3CRcqGYa"}],"authors":[{"displayName":"Ryan Babineau","url":"ryan-babineau"},{"displayName":"Rebecca Susan Daily, MD, DLFAPA, DFAACAP","url":"rebecca-susan-daily-md-dlfapa-dfaacap"}],"_createdAt":"2024-10-21T18:14:05Z","thumbnail":{"alt":"tick","caption":"ondreicka/AdobeStock","asset":{"_ref":"image-4d334999fcf64afe7e821bce3a9230aae30a5918-5998x3999-jpg","_type":"reference"},"_type":"mainImage"},"taxonomyMapping":[{"parent":{"identifier":"topics","parent":null,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","_updatedAt":"2023-03-31T19:15:59Z","isMainTopic":true,"name":"Topics","_id":"pst_taxonomy_53202_clinical"},"_type":"taxonomy","name":"Neuropsychiatry","_updatedAt":"2023-03-31T19:19:55Z","_createdAt":"2020-03-26T06:11:21Z","pixelTrackingCode":null,"cmeType":"per","_id":"pst_taxonomy_35_neuropsychiatry","identifier":"topics/neuropsychiatry","perKeywordMapping":["Psychiatry","Neurology"],"_rev":"77mZ7PORfofI3dBGfWcsCF"}],"body":[{"widthP":50,"disableTextWrap":false,"disableLightBox":true,"alt":"tick","imgcaption":[{"markDefs":[],"children":[{"marks":[],"text":"ondreicka/AdobeStock","_key":"bf8c44d2eaf30","_type":"span"}],"_type":"block","style":"normal","_key":"d790799c6b8b"}],"_type":"figure","_key":"d4c284b59b6e","alignment":"left","asset":{"_ref":"image-4d334999fcf64afe7e821bce3a9230aae30a5918-5998x3999-jpg","_type":"reference"}},{"style":"normal","_key":"4afef286faa0","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Alpha-gal syndrome (AGS) arises via delayed allergic (IgE) reaction to galactose-alpha-1,3–galactose (alpha-gal), which is an oligosaccharide molecule found in mammalian products such as meat, milk, and mammalian byproducts, including medications and medical devices.","_key":"e2fc311168c00"},{"_key":"77e8581c52bc","_type":"span","marks":["superscript"],"text":"1"},{"marks":[],"text":" Bites from the lone star tick are the most common cause of AGS, sensitizing individuals to the alpha-gal molecule on subsequent exposure to mammalian products; however, globally there may be other explanatory vectors. Symptoms present hours to days after exposure and include urticaria, gastrointestinal distress, angioedema, and possibly anaphylaxis, with significant variability among individuals. The psychological impacts of AGS are broad, and this vector-borne disease may cause patients to seek or be referred to psychiatric care.","_key":"e53d8b434bb7","_type":"span"}],"_type":"block"},{"markDefs":[],"children":[{"text":"","_key":"f9e481c308a60","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"d99a297fa557"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Case Example","_key":"ca1de9a3248c0"}],"_type":"block","style":"normal","_key":"5a890d1283b4"},{"_type":"block","style":"normal","_key":"42d89574bc61","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“Ben” is an 11-year-old boy referred to the psychiatric clinic by his pediatrician after experiencing years of gastrointestinal symptoms, including nausea, diarrhea, and episodic stomach pains. Workup including upper gastrointestinal endoscopy and colonoscopy was unrevealing and conservative management has failed. He has been missing school due to his symptoms and the school district is concerned about truancy. He lives in rural Missouri with his family who manages a tight budget, saving money by purchasing half of a steer or a whole hog at a time to feed the family. Ben is a picky eater, preferring meat with most meals.","_key":"3c8316ddd4660"}]},{"children":[{"text":"","_key":"a581f0ed38490","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"d3e46cfaea56","markDefs":[]},{"markDefs":[],"children":[{"_key":"7c557dad5d8d0","_type":"span","marks":["strong"],"text":"Psychiatric Concerns"}],"_type":"block","style":"normal","_key":"874a0dcb082d"},{"children":[{"_type":"span","marks":[],"text":"AGS lies at the intersection of physical and mental health. This case emphasizes some of the principal psychiatric concerns originating from AGS. This syndrome, which can arrive unannounced, may be triggered by foods and medications the patient has consumed their entire life. Suddenly, individuals with AGS may be limited in the types of food they eat, which can ostracize them from their family and culture, as well as place undue financial and administrative stressors on the individual and family. Of the top 20 pharmaceutical companies, only 60% were able to accurately provide information on whether there were animal products in their formulation. Of those respondents, many required repeated calls and prompting to coax out this information.","_key":"9551113830620"},{"_type":"span","marks":["superscript"],"text":"2 ","_key":"744a36f9d3bf"},{"_type":"span","marks":[],"text":"Climate change applies additional pressure onto mental health concerns, from increased AGS range to changes in food choice/availability, and even potential disruptions to supply chains for medication.","_key":"842be518b3f7"}],"_type":"block","style":"normal","_key":"8ee4e996549e","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"","_key":"8639a3e38abb0"}],"_type":"block","style":"normal","_key":"034688161565","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"The prevalence of AGS is greatest in the United States, where the link between tick bites and AGS was initially identified by an Australian group in 2009. Subsequently, an American group discovered that cetuximab reactions overlapped with Rocky Mountain Spotted fever, a Rickettsial infection transmitted by the lone star tick (Amblyomma americanum).","_key":"c0483753cd1b0"},{"_type":"span","marks":["superscript"],"text":"1","_key":"33261792e545"},{"_type":"span","marks":[],"text":" Recent data showed 18,885 positive tests in the United States in 2021, rising from 13,371 in 2017 with geographic preference for the Midwest, Southern, and Mid-Atlantic regions, which not so coincidentally mirrors the distribution of the lone star tick.","_key":"e31024bb0d6c"},{"_type":"span","marks":["superscript"],"text":"3","_key":"85bca20fcb02"},{"marks":[],"text":" Without established surveillance for AGS, its exact prevalence is largely unknown. A survey from the same Centers for Disease Control and Prevention (CDC) weekly morbidity and mortality report highlights the lack of provider knowledge on AGS and its underdiagnosis.","_key":"8599def10961","_type":"span"},{"text":"4","_key":"8211256330fe","_type":"span","marks":["superscript"]}],"_type":"block","style":"normal","_key":"25ab86fab149","markDefs":[]},{"_key":"e6e3f871d64f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"52468ef0c6650"}],"_type":"block","style":"normal"},{"_key":"db781f6bde69","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Changing climates alter regions suitable for ticks, and the range of AGS will likely follow such migrations.1 The northward expansion of lone star ticks and AGS is amplified by the acceleration of the tick life cycle from climate impacts. One study identified that milder northeastern winters facilitated increased survival of the lone star tick, where patients with AGS may appear in the clinic of unsuspecting clinicians.5","_key":"534a792fb45f0"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"4e67beec185a0","_type":"span"}],"_type":"block","style":"normal","_key":"2d00dc4ae40b"},{"children":[{"_type":"span","marks":["strong"],"text":"Diagnosis","_key":"6fe0c939ad000"}],"_type":"block","style":"normal","_key":"5599e8c0e152","markDefs":[]},{"style":"normal","_key":"0a66578f3872","markDefs":[],"children":[{"_type":"span","marks":[],"text":"This condition poses a challenge for many physicians. There is no consensus diagnostic threshold of IgE to alpha-gal molecules, as testing itself is relatively new. Likewise, there are no curative treatments for this condition, which can be life-threatening.","_key":"69786a7dfcc90"},{"marks":["superscript"],"text":"1,4","_key":"17d88e251d9b","_type":"span"},{"_type":"span","marks":[],"text":" A 28-person survey from 2016 found an average time to diagnosis of 7 years, requiring repeat visits, workups, and independent research, with roughly 3 out of 4 patients self-diagnosing their unique presentation of this presently rare condition.","_key":"0a16e27e0c01"},{"_type":"span","marks":["superscript"],"text":"6","_key":"954d0fa84ca6"},{"_type":"span","marks":[],"text":" This increased time to diagnosis for a chronic condition with a risk of repeated symptom flares can have an immense psychological impact. Core aspects of people’s lives now have the potential to induce a reaction, making you think twice about pets, eating out, apparel choices (leather), and personal care products. Unlabeled food and drug products pose a hazard to patients seeking to manage their condition chronically. Products containing alpha-gal moieties are ubiquitous—even when excluding red meat. Currently, the US Food and Drug Administration does not require labeling products this way, which is an added daily stressor for patients, seeding doubt, anxiety, and isolation even after a drawn-out diagnosis. The costs for health care, prescriptions including EpiPens, social impacts, and ambiguity when seeking information about the syndrome compound. The distress felt by patients and families navigating AGS can be immense. Supportive communities and resources with appropriate therapy can help manage this condition.","_key":"b203efbb8dd5"}],"_type":"block"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"b163c44ff9100","_type":"span"}],"_type":"block","style":"normal","_key":"f16bc9bd24bd"},{"children":[{"_type":"span","marks":[],"text":"For the practicing psychiatrist, there are obstacles to medical management for many psychiatric conditions. Gelatin capsules and animal-derived stabilizers, including lactose and other mammalian products, frequently occupy selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, tricyclic antidepressants, 1st and 2nd generation antipsychotics, mood stabilizers (lithium, anticonvulsants), and anxiolytic (benzodiazepine and nonbenzodiazepine) medications. These were found just from a cursory glance online, because not even the CDC has a comprehensive list, deferring to the patient’s provider.","_key":"6a2663c2fd720"},{"text":"7-10","_key":"7209baa560a0","_type":"span","marks":["superscript"]},{"text":" A column from the American Academy of Allergy, Asthma, and Immunology takes a similar stance to the CDC, where a blanket response defers patient risk, treatment consent, and care decisions to the institution, as there is no standardized reporting of product ingredients.","_key":"d4a4ee5a1493","_type":"span","marks":[]},{"_key":"75e818277f9e","_type":"span","marks":["superscript"],"text":"11"},{"marks":[],"text":" This significantly impinges on the therapeutic latitude available for patients with AGS and psychiatric concerns, with elevated risks in acute management. Pharmacies themselves may only receive information from the manufacturer, who may be rather lax in their reporting. A case report on initiating psychotropic treatment in the setting of AGS emphasized the necessity of interdisciplinary care for initiating appropriate treatment, and that generic manufacturers may use different ingredients, so generalizing alpha-gal content from one formulation to another is not possible.","_key":"007f48955e0a","_type":"span"},{"_type":"span","marks":["superscript"],"text":"7","_key":"7795510a69ce"},{"text":" For some patients, multiple trials of medication may be needed for effective treatment. Chronic illness is related to psychiatric comorbidities such as depression and anxiety.","_key":"182dcc36152f","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"12","_key":"c0ebe67ada21"},{"_key":"e27e31cc1a3d","_type":"span","marks":[],"text":" Addressing mental health alongside organic disease should be pursued in patients with AGS if applicable, as this diagnosis can be life-altering."}],"_type":"block","style":"normal","_key":"26ee1d09128c","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"2a0ff53db8eb0"}],"_type":"block","style":"normal","_key":"4ced177c21f4"},{"style":"normal","_key":"2b69ccd692c6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Challenges in managing patients with AGS have been documented across many specialties. In the emergency department, AGS should be on the differential for anaphylaxis of unknown origin, as well as an adverse drug reaction in an unknown patient.","_key":"c507bf5a8bcf0"},{"_key":"ecf7dead1967","_type":"span","marks":["superscript"],"text":"13"},{"_type":"span","marks":[],"text":" In the operative setting, porcine valves, certain types of sutures, and common drugs including heparin and oxycodone are off-limits.","_key":"fb9e68fc8dd5"},{"text":"14","_key":"1b81a57dddaa","_type":"span","marks":["superscript"]},{"_type":"span","marks":[],"text":" Once outpatient, compounding pharmacies with custom medication formulations can provide an answer to the uncertainty of living with AGS, but these are often more expensive than traditional pharmacies. Rural patients may not have access to this, or other options if there are no pharmacies in their area with the available prescriptions to turn to when first-line meds contain the alpha-gal epitope. Prescription medications are something individuals living with AGS become hyperaware of, as common entities can cause flares in symptoms. In a recent survey, half of patients with AGS have had an anaphylactic reaction to a health product.","_key":"f55985f62d27"},{"_key":"90455d642d80","_type":"span","marks":["superscript"],"text":"8"},{"text":" ","_key":"ecdea9ab7859","_type":"span","marks":[]}],"_type":"block"},{"style":"normal","_key":"a663545e9b82","markDefs":[],"children":[{"_key":"a7d632936f750","_type":"span","marks":[],"text":""}],"_type":"block"},{"markDefs":[],"children":[{"marks":[],"text":"Treatment of AGS involves avoiding allergens and having rescue medications available if a reaction occurs.","_key":"4ce16a225e570","_type":"span"},{"_type":"span","marks":["superscript"],"text":"15","_key":"80728d891b61"},{"_type":"span","marks":[],"text":" On first presentation, if suspicious for AGS physicians should encourage mammalian meat and product avoidance, provide an EpiPen and antihistamine prescription, and refer the patient to an allergist.","_key":"b7c2ce9ed69c"},{"_type":"span","marks":["superscript"],"text":"13","_key":"69f543f4065b"},{"_type":"span","marks":[],"text":" Once diagnosed, significant patient education surrounding lifestyle changes is needed to help avoid reactions, though complete avoidance is next to impossible. After reviewing the broad swath of everyday products where we encounter alpha-gal, education on label reading can help mitigate encountering the antigen. Advocating for more information about medical treatments like vaccines and prescriptions is key to reducing iatrogenic risks, and tick avoidance remains essential in preventing disease onset or worsening. Psychiatrists have an important role in the interdisciplinary treatment of patients with AGS to address psychological sequelae. Collaboration with pharmacists and registered dietitians helps in providing comprehensive care to people with AGS, too.","_key":"e0f5f446d26b"},{"_type":"span","marks":["superscript"],"text":"15","_key":"c3f493b30d0a"},{"_type":"span","marks":[],"text":" As with many of the rarer chronic diseases receiving insufficient attention from research, there seems to be a robust, supportive online community for those living with AGS. With accelerating climate change, the reality of AGS becoming more prevalent and significant for practicing physicians including psychiatrists, provides another incentive to allocate more energy towards the diagnosis and management of AGS. Through gene editing, an alpha-gal free porcine products are on the horizon, but increasing awareness on the part of physicians to identify and adequately treat people with AGS would yield substantial benefit to those unfortunate enough to be sensitized to the oligosaccharide.","_key":"65860d1ace65"}],"_type":"block","style":"normal","_key":"105c6a841ee2"},{"_type":"block","style":"normal","_key":"0d43acdc779f","markDefs":[],"children":[{"marks":[],"text":"","_key":"4b6841a22e5a0","_type":"span"}]},{"style":"normal","_key":"fa6443acdb2f","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Concluding Thoughts","_key":"15986115b0660"}],"_type":"block"},{"markDefs":[],"children":[{"_key":"5fe5b1a69d430","_type":"span","marks":[],"text":"AGS is a chronic disease affecting an increasing number of Americans and is difficult for physicians to identify. Its physical and psychological impact on patients is significant, and providers should have a plan in place in their practice for addressing the needs of these patients. Mandated reporting of all drug ingredients would go a long way in managing their care and alleviating stress for both patients and their providers. Future efforts to evaluate the burden of this disease, clear guidelines for AGS diagnosis, and improved labeling would have substantial benefits to those learning to live with alpha-gal."}],"_type":"block","style":"normal","_key":"84421899e092"},{"markDefs":[],"children":[{"text":"","_key":"6d2cb61f3f640","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"6b9904a7c1c9"},{"children":[{"_type":"span","marks":["strong"],"text":"List of Resources for Patients and Providers","_key":"4428d062ea5b0"}],"_type":"block","style":"normal","_key":"563785eb05e8","markDefs":[]},{"level":1,"_type":"block","style":"normal","_key":"fe058bcf379d","listItem":"bullet","markDefs":[{"blank":true,"_type":"link","href":"https://alphagalinformation.org/","_key":"29424b7fc5c6"}],"children":[{"_type":"span","marks":["29424b7fc5c6"],"text":"https://alphagalinformation.org/","_key":"b3f1c558d7670"}]},{"listItem":"bullet","markDefs":[{"_type":"link","href":"https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2023/alpha-gal","_key":"c8950079b449","nofollow":true,"blank":true}],"children":[{"_key":"9611b5be5b470","_type":"span","marks":["c8950079b449"],"text":"https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2023/alpha-gal"}],"level":1,"_type":"block","style":"normal","_key":"47aee12221bd"},{"_key":"9acc93d5bc0f","listItem":"bullet","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://www.twoalphagals.com/blog/psychological-impacts","_key":"c63ffdef68fc"}],"children":[{"_type":"span","marks":["c63ffdef68fc"],"text":"https://www.twoalphagals.com/blog/psychological-impacts","_key":"5211e11b9a2d0"}],"level":1,"_type":"block","style":"normal"},{"listItem":"bullet","markDefs":[{"_type":"link","href":"https://tickedoffmastcells.org/?p=181","_key":"9fe0589279f1","blank":true}],"children":[{"_type":"span","marks":["9fe0589279f1"],"text":"https://tickedoffmastcells.org/?p=181","_key":"adcc8fc5a32a0"}],"level":1,"_type":"block","style":"normal","_key":"5fce3ec7828e"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"6db5fd9260740"}],"_type":"block","style":"normal","_key":"2df59ce2f29a"},{"children":[{"text":"Mr Babineau","_key":"5137e130d91e0","_type":"span","marks":["strong"]},{"_key":"5137e130d91e1","_type":"span","marks":["em"],"text":" is a medical student at Virginia Commonwealth University School of Medicine."},{"text":" Dr Daily ","_key":"5137e130d91e2","_type":"span","marks":["strong"]},{"_type":"span","marks":["em"],"text":"is adjunct faculty at the Oklahoma State University School of Osteopathic Medicine at The Cherokee Nation.","_key":"5137e130d91e3"}],"_type":"block","style":"normal","_key":"34afbb545661","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"62e571d0e3e40"}],"_type":"block","style":"normal","_key":"03fec2e8aee6"},{"style":"normal","_key":"698ff2433a57","markDefs":[],"children":[{"text":"References","_key":"3cd8d9a429b30","_type":"span","marks":["strong"]}],"_type":"block"},{"markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/33529984/","_key":"193b3b722a33","blank":true,"_type":"link"}],"children":[{"text":"1. Young I, Prematunge C, Pussegoda K, et al. ","_key":"a2cb27ccf39a0","_type":"span","marks":[]},{"_type":"span","marks":["193b3b722a33"],"text":"Tick exposures and alpha-gal syndrome: a systematic review of the evidence. ","_key":"a2cb27ccf39a1"},{"text":"Ticks Tick Borne Dis","_key":"a2cb27ccf39a2","_type":"span","marks":["em"]},{"_key":"a2cb27ccf39a3","_type":"span","marks":[],"text":". 2021;12(3):101674."}],"_type":"block","style":"normal","_key":"193c96aa1af9"},{"_key":"8315a6cfa29b","markDefs":[{"_type":"link","href":"https://meridian.allenpress.com/jcphp/article/70/2a/8/493818/Patient-Experience-With-Pharmaceutical-Medical","_key":"e11920380e75","blank":true}],"children":[{"_type":"span","marks":[],"text":"2. Son FS, Wolfe A, Nguyen YT, Uchi J. ","_key":"67652bd44db90"},{"_type":"span","marks":["e11920380e75"],"text":"Patient experience with pharmaceutical medical information centers to identify animal-free medications. ","_key":"67652bd44db91"},{"_type":"span","marks":["em"],"text":"J Contemp Pharm Prac.","_key":"67652bd44db92"},{"_type":"span","marks":[],"text":" 2023;70(2a):8-11.","_key":"67652bd44db93"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"991ae18be404","markDefs":[{"_type":"link","href":"https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm","_key":"ebf377e342a3","blank":true}],"children":[{"_type":"span","marks":[],"text":"3. Thompson JM, Carpenter A, Kersh GJ, et al. ","_key":"4b8362756b790"},{"_type":"span","marks":["ebf377e342a3"],"text":"Geographic distribution of suspected alpha-gal syndrome cases - United States, January 2017-December 2022. ","_key":"4b8362756b791"},{"_type":"span","marks":["em"],"text":"MMWR Morb Mortal Wkly Rep","_key":"4b8362756b792"},{"_type":"span","marks":[],"text":". 2023;72(30):815-820.","_key":"4b8362756b793"}]},{"style":"normal","_key":"235a5469b343","markDefs":[{"_key":"f7b6ca3bceb7","blank":true,"_type":"link","href":"https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a1.htm"}],"children":[{"marks":[],"text":"4. Carpenter A, Drexler NA, McCormick DW, et al. ","_key":"71abcd9baece0","_type":"span"},{"_type":"span","marks":["f7b6ca3bceb7"],"text":"Health care provider knowledge regarding alpha-gal syndrome - United States, March-May 2022. ","_key":"71abcd9baece1"},{"marks":["em"],"text":"MMWR Morb Mortal Wkly Rep","_key":"71abcd9baece2","_type":"span"},{"marks":[],"text":". 2023;72(30):809-814.","_key":"71abcd9baece3","_type":"span"}],"_type":"block"},{"style":"normal","_key":"82cfb8255ce2","markDefs":[{"blank":true,"_type":"link","href":"https://www.mdpi.com/2075-4450/11/1/13","_key":"1c85ba9c9b30"}],"children":[{"_type":"span","marks":[],"text":"5. Linske MA, Williams SC, Stafford KC 3rd, et al. ","_key":"0280da0b4af10"},{"_type":"span","marks":["1c85ba9c9b30"],"text":"Determining effects of winter weather conditions on adult ","_key":"0280da0b4af11"},{"_key":"0280da0b4af12","_type":"span","marks":["1c85ba9c9b30","em"],"text":"Amblyomma americanum"},{"marks":["1c85ba9c9b30"],"text":" (Acari: Ixodidae) survival in Connecticut and Maine, USA. ","_key":"0280da0b4af13","_type":"span"},{"_type":"span","marks":["em"],"text":"Insects","_key":"0280da0b4af14"},{"_type":"span","marks":[],"text":". 2019;11(1):13.","_key":"0280da0b4af15"}],"_type":"block"},{"markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/28447914/","_key":"1a65756f8ac1","blank":true,"_type":"link"}],"children":[{"_key":"a16f84c912390","_type":"span","marks":[],"text":"6. Flaherty MG, Kaplan SJ, Jerath MR. "},{"text":"Diagnosis of life-threatening alpha-gal food allergy appears to be patient driven.","_key":"a16f84c912391","_type":"span","marks":["1a65756f8ac1"]},{"_type":"span","marks":[],"text":" ","_key":"6292175303ac"},{"marks":["em"],"text":"J Prim Care Community Health","_key":"a16f84c912392","_type":"span"},{"_type":"span","marks":[],"text":". 2017;8(4):345-348.","_key":"a16f84c912393"}],"_type":"block","style":"normal","_key":"e8b49167fa56"},{"markDefs":[{"blank":true,"_type":"link","href":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512307/","_key":"cfb6af3a3f7e"}],"children":[{"_type":"span","marks":[],"text":"7. Narlesky MR, Palting A, Sukpraprut-Braaten S, et al. ","_key":"33550e8344e10"},{"_type":"span","marks":["cfb6af3a3f7e"],"text":"Initiating psychotropic treatment in a patient with alpha-gal syndrome. ","_key":"33550e8344e11"},{"_key":"33550e8344e12","_type":"span","marks":["em"],"text":"Cureus"},{"_type":"span","marks":[],"text":". 2022;14(8):e28443.","_key":"33550e8344e13"}],"_type":"block","style":"normal","_key":"1bd092ced1cf"},{"markDefs":[{"blank":true,"_type":"link","href":"https://optiorx.com/wp-content/uploads/2023/11/POSTER_Understanding-Health-Related-Challenges-in-Patients-with-Alpha-Gal-Syndrome-Jasmine-Uchi.pdf","_key":"24a6a79041e6"}],"children":[{"_type":"span","marks":[],"text":"8. Uchi J. Understanding health-related challenges in patients with alpha-gal syndrome. Poster presented at the DIA Global Annual Meeting 2023 in Boston, MA. Accessed October 4, 2024. ","_key":"1d53ba0c74150"},{"_type":"span","marks":["24a6a79041e6"],"text":"https://optiorx.com/wp-content/uploads/2023/11/POSTER_Understanding-Health-Related-Challenges-in-Patients-with-Alpha-Gal-Syndrome-Jasmine-Uchi.pdf","_key":"1d53ba0c74151"}],"_type":"block","style":"normal","_key":"f58174bd73d0"},{"_key":"8b2a6f7d15b1","markDefs":[{"blank":true,"_type":"link","href":"https://www.researchgate.net/publication/238339520_Remember_the_depressed_vegetarian","_key":"12d714cc2832"}],"children":[{"_type":"span","marks":[],"text":"9. Singsit S, Naik PC. ","_key":"93896808993c0"},{"marks":["12d714cc2832"],"text":"Remember the depressed vegetarian. ","_key":"93896808993c1","_type":"span"},{"_type":"span","marks":["em"],"text":"Br J Psychiatry","_key":"93896808993c2"},{"marks":[],"text":". 2001;178(2):184-184.","_key":"93896808993c3","_type":"span"}],"_type":"block","style":"normal"},{"_key":"d50ac0cde3aa","markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/12091220/","_key":"33377b91a01a","blank":true,"_type":"link"}],"children":[{"marks":[],"text":"10. Sauer J, Howard R. ","_key":"006d29637a350","_type":"span"},{"marks":["33377b91a01a"],"text":"The beef with atypical antipsychotics. ","_key":"006d29637a351","_type":"span"},{"text":"Am J Psychiatry","_key":"006d29637a352","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". 2002;159(7):1249.","_key":"006d29637a353"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"4c0b70a3360d","markDefs":[{"href":"https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2023/alpha-gal","_key":"0301e2c052a3","blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"11. Alpha-gal and medications. American Academy of Allergy, Asthma, and Immunology. January 10, 2023. Accessed October 4, 2024. ","_key":"75f4f9a7770d0"},{"_type":"span","marks":["0301e2c052a3"],"text":"https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2023/alpha-gal","_key":"75f4f9a7770d1"}]},{"style":"normal","_key":"674e60061f6b","markDefs":[{"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/28628766/","_key":"21b106f720a4","blank":true}],"children":[{"_key":"9fec0a80158d0","_type":"span","marks":[],"text":"12. Read JR, Sharpe L, Modini M, Dear BF. "},{"text":"Multimorbidity and depression: a systematic review and meta-analysis. ","_key":"9fec0a80158d1","_type":"span","marks":["21b106f720a4"]},{"text":"J Affect Disord","_key":"9fec0a80158d2","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". 2017;221:36-46.","_key":"9fec0a80158d3"}],"_type":"block"},{"style":"normal","_key":"413f052db4a4","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/37831041/","_key":"295acb1fc770"}],"children":[{"_type":"span","marks":[],"text":"13. Edlow JA. ","_key":"4108666330b30"},{"_type":"span","marks":["295acb1fc770"],"text":"Alpha-gal syndrome: a novel and increasingly common cause of anaphylaxis. ","_key":"4108666330b31"},{"_type":"span","marks":["em"],"text":"Ann Emerg Med","_key":"4108666330b32"},{"_type":"span","marks":[],"text":". 2024;83(4):380-384.","_key":"4108666330b33"}],"_type":"block"},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/29847378/","_key":"c5434eabef0f"}],"children":[{"_type":"span","marks":[],"text":"14. Dunkman WJ, Rycek W, Manning MW. ","_key":"815b583e89880"},{"_type":"span","marks":["c5434eabef0f"],"text":"What does a red meat allergy have to do with anesthesia? Perioperative management of alpha-gal syndrome. ","_key":"815b583e89881"},{"_type":"span","marks":["em"],"text":"Anesth Analg","_key":"815b583e89882"},{"text":". 2019;129(5):1242-1248.","_key":"815b583e89883","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"17b9a0cef267"},{"_key":"f5643f78caf6","markDefs":[{"_type":"link","href":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344025/","_key":"ce8955dd4985","blank":true}],"children":[{"_type":"span","marks":[],"text":"15. Commins SP. ","_key":"70135ab7aefd0"},{"_type":"span","marks":["ce8955dd4985"],"text":"Diagnosis \u0026 management of alpha-gal syndrome: lessons from 2,500 patients. ","_key":"70135ab7aefd1"},{"marks":["em"],"text":"Expert Rev Clin Immunol","_key":"70135ab7aefd2","_type":"span"},{"_type":"span","marks":[],"text":". 2020;16(7):667-677.","_key":"70135ab7aefd3"}],"_type":"block","style":"normal"},{"style":"normal","_key":"2c02fb2f233e","markDefs":[{"blank":true,"_type":"link","href":"https://www.revivicor.com/technologies","_key":"bbd5801a3222"}],"children":[{"_type":"span","marks":[],"text":"16. Technologies. Revivicor. Accessed October 4, 2024. ","_key":"778b5b8419dc0"},{"_key":"778b5b8419dc1","_type":"span","marks":["bbd5801a3222"],"text":"https://www.revivicor.com/technologies"}],"_type":"block"}],"ExcludeFromPubMedXML":false,"url":"climate-change-vector-range-and-alpha-gal-in-psychiatric-practice","articleType":"News","is_visible":true,"documentGroup":null,"targeting":{"content_placement":["topics/neuropsychiatry"],"document_url":["climate-change-vector-range-and-alpha-gal-in-psychiatric-practice"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"TMS for the Treatment of OCD","url":{"current":"tms-for-the-treatment-of-ocd","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"brain lightbulb","caption":"Dilok/AdobeStock","asset":{"_ref":"image-6e7deea1c577db789477d44ab9518072785d31ee-6000x4000-jpg","_type":"reference"}},"published":"2024-10-25T15:00:00.000Z"},{"title":"Evaluating Brexpiprazole for the Management of Behavioral and Psychological Symptoms of Dementia","url":{"current":"evaluating-brexpiprazole-for-the-management-of-behavioral-and-psychological-symptoms-of-dementia","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"dementia","caption":"GordonGrand/AdobeStock","asset":{"_ref":"image-32cef1d30b31a8a9054644b3895cd6d7285bd198-4256x2832-jpg","_type":"reference"}},"published":"2024-10-23T16:00:00.000Z"},{"title":"Climate Change, Vector Range, and Alpha-Gal in Psychiatric Practice","url":{"current":"climate-change-vector-range-and-alpha-gal-in-psychiatric-practice","_type":"slug"},"thumbnail":{"caption":"ondreicka/AdobeStock","asset":{"_ref":"image-4d334999fcf64afe7e821bce3a9230aae30a5918-5998x3999-jpg","_type":"reference"},"_type":"mainImage","alt":"tick"},"published":"2024-10-22T16:00:00.000Z"},{"title":"Electroconvulsive Therapy for the Treatment of Dementia Symptoms","url":{"current":"electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"dementia","caption":"SJM Photos/AdobeStock","asset":{"_ref":"image-2172f65e37645ccf10b6977cbddcfd470b116efb-4961x3508-jpg","_type":"reference"}},"published":"2024-10-14T15:00:06.211Z"},{"title":"Traumatic Brain Injury’s Impact on Normal Aging and Neurodegenerative Diseases","url":{"current":"traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"aging brain","caption":"Ramunas/AdobeStock","asset":{"_ref":"image-c530ea8991dc158368cf0165173630a0e66cdf08-5376x3584-jpg","_type":"reference"}},"published":"2024-10-01T14:00:00.000Z"},{"title":"Neurosyphilis: When an Antipsychotic Is Not Enough ","url":{"_type":"slug","current":"neurosyphilis-when-an-antipsychotic-is-not-enough"},"thumbnail":{"_type":"mainImage","alt":"brain","caption":"Alex Alex/AdobeStock","asset":{"_ref":"image-bd9f138da69aadd1781819ac9441411821ed3966-5824x3264-jpg","_type":"reference"}},"published":"2024-09-09T16:00:00.000Z"}]},{"issueGroup":{"_ref":"5a9163da-f212-4c01-a207-8ab23dbd2246","_type":"reference"},"body":[{"alt":"dementia","alignment":"left","asset":{"_ref":"image-2172f65e37645ccf10b6977cbddcfd470b116efb-4961x3508-jpg","_type":"reference"},"disableLightBox":true,"imgcaption":[{"markDefs":[],"children":[{"text":"SJM Photos/AdobeStock","_key":"0d11ea729b9a0","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"e665fe85327b"}],"_type":"figure","disableTextWrap":false,"_key":"2478269859f7","widthP":50},{"_key":"cb2bc9eab9ac","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://www.psychiatrictimes.com/view/treatment-options-for-the-management-of-behavioral-and-psychological-symptoms-of-dementia","_key":"f3abfe08b086"},{"nofollow":true,"blank":true,"_type":"link","href":"https://www.psychiatrictimes.com/topics/major-depressive-disorder","_key":"cd777310ed17"}],"children":[{"text":"Dementia is among the most debilitating neurodegenerative disorders related to aging. More than 6 million adults in the United States have dementia, and both the prevalence and the incidence rates of ","_key":"1c7b6dc601660","_type":"span","marks":[]},{"_type":"span","marks":["f3abfe08b086"],"text":"dementia","_key":"ac16148487b4"},{"_type":"span","marks":[],"text":" are expected to rise quickly because of aging trends.","_key":"b046b6b0375d"},{"text":"1","_key":"6b6eed965e42","_type":"span","marks":["superscript"]},{"_type":"span","marks":[],"text":" The risk of dementia doubles every 5 years after the age of 65 years, and this increases to almost 50% in adults 90 years or older.","_key":"e99b29217a56"},{"_type":"span","marks":["superscript"],"text":"2","_key":"c95b45d5ecd4"},{"_type":"span","marks":[],"text":" Individuals with dementia often experience both psychological and behavioral symptoms, including ","_key":"3931ecd9969b"},{"text":"depression","_key":"788f501fbb58","_type":"span","marks":["cd777310ed17"]},{"_type":"span","marks":[],"text":", agitation, irritability, apathy, hallucinations, and delusions.","_key":"f0709a3c0519"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"There are currently no treatments approved by the US Food and Drug Administration (FDA) to manage behavioral and psychological symptoms of dementia. Nonpharmacological behavioral interventions are often recommended, but these can be difficult to implement in a standardized way and require substantial resources. Electroconvulsive therapy (ECT) has been shown to be very effective as a treatment for severe depression (without dementia).","_key":"66bbdd2c59280"},{"_type":"span","marks":["superscript"],"text":"3","_key":"643fb5860af2"},{"_type":"span","marks":[],"text":" Some clinicians have used ECT as a therapy in severe cases to manage behavioral and psychological symptoms of dementia. Here we review the evidence for the use of ECT to manage those symptoms.","_key":"46825e5670b4"}],"_type":"block","style":"normal","_key":"ce51d0249a9d"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Randomized Trials","_key":"2a39a51548010"}],"_type":"block","style":"normal","_key":"755bb4fbe3b5"},{"children":[{"_type":"span","marks":[],"text":"For any proposed therapy or intervention, the gold-standard level of evidence comes from randomized, controlled trials. As of October 23, 2023, there were no completed randomized trials of ECT in patients with dementia. A list of clinical trials of ECT use in patients with comorbid depression and dementia is in the ","_key":"7caa98862c000"},{"_type":"span","marks":["strong"],"text":"Table","_key":"62cdba9d79d4"},{"_type":"span","marks":[],"text":".","_key":"459a0caf505c"},{"_type":"span","marks":["superscript"],"text":"4","_key":"7ba244338dbb"},{"_type":"span","marks":[],"text":" An ongoing, multisite trial (NCT03926520) in which patients with dementia are treated with ECT and usual care proposes to enroll 50 patients and aims to be completed in 2024.","_key":"c64a24b37575"}],"_type":"block","style":"normal","_key":"ce5d6740b866","markDefs":[]},{"widthP":50,"disableLightBox":true,"alt":"Table. Clinical Trials of ECT Use in Patients With Comorbid Depression and Dementia","imgcaption":[{"_type":"block","style":"normal","_key":"7d5a5f6f6970","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Table. ","_key":"3492ba9f6d290"},{"marks":[],"text":"Clinical Trials of ECT Use in Patients With Comorbid Depression and Dementia","_key":"3e2af0809a46","_type":"span"},{"_type":"span","marks":["superscript"],"text":"4","_key":"40f1a6984f5e"}]}],"blank":true,"_key":"b82f362c2d79","alignment":"right","asset":{"_type":"reference","_ref":"image-518c574ccf7edf310b0b3a2f02f69ac551386eba-1102x426-png"},"disableTextWrap":false,"_type":"figure"},{"children":[{"marks":[],"text":"There have been 2 prospective, nonrandomized (single group) trials of ECT in dementia that have been completed. In one of these studies, patients were enrolled prospectively and were all treated with ECT. This study (NCT01856010) enrolled inpatients with dementia complicated by severe agitation and aggression who did not benefit from either pharmacological or nonpharmacological interventions. Most of these patients (78.3%) exhibited significantly reduced agitation from baseline to discharge as measured by the Cohen-Mansfield Agitation Inventory,","_key":"049a953713eb0","_type":"span"},{"_type":"span","marks":["superscript"],"text":"5-7","_key":"3fa644576f63"},{"_type":"span","marks":[],"text":" a common assessment of agitation in dementia.","_key":"4df9bf7caba7"}],"_type":"block","style":"normal","_key":"0fa8ce04d401","markDefs":[]},{"children":[{"marks":[],"text":"The neuropsychiatric inventory","_key":"347b568f17e00","_type":"span"},{"_type":"span","marks":["superscript"],"text":"8,9","_key":"f266943ff9c3"},{"marks":[],"text":" scores also significantly decreased from baseline to discharge, indicating an improvement in memory (","_key":"a55269c18db4","_type":"span"},{"text":"P","_key":"50d9c0d590d4","_type":"span","marks":["em"]},{"text":" \u003c .001). Further, the Clinical Global Impressions Scale","_key":"209d5eeb1c2d","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"10,11","_key":"49333b4291db"},{"_type":"span","marks":[],"text":" scores changed from a rating of “markedly agitated/aggressive” at baseline to a rating of “borderline agitated/aggressive” at discharge. There was no change in functioning (daily living) before or after ECT. Five of 23 patients discontinued treatment, with 3 patients stopping due to adverse events (2 for confusion/delirium, 1 for atrial fibrillation) and 2 patients stopping due to poor clinical response.","_key":"c166c3b758da"},{"_type":"span","marks":["superscript"],"text":"4","_key":"4df0c3c7b851"}],"_type":"block","style":"normal","_key":"e287b0ee6a25","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Another study (NCT02969499) recruited 33 individuals with dementia who were treated with ECT. In this study, patients exhibited improvement in neuropsychiatric functioning a week following a course of ECT and an improvement in agitation 8 weeks following ECT. There was no discernible worsening in cognitive functioning or dementia symptoms.","_key":"c3af668ddff70"},{"_type":"span","marks":["superscript"],"text":"12","_key":"67e9f1f39245"}],"_type":"block","style":"normal","_key":"7f32a98d4c1c"},{"style":"normal","_key":"2e26a82d0e7a","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Retrospective Analyses","_key":"b542fb2747280"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"Many reports of the use of ECT for comorbid dementia and depression or for behavioral and psychological symptoms of dementia are in the form of a case series.","_key":"624ded4f0d430"},{"marks":["superscript"],"text":"13,14","_key":"7acd29df5290","_type":"span"},{"_key":"2180c08ba958","_type":"span","marks":[],"text":" Rao and Lyketsos"},{"_type":"span","marks":["superscript"],"text":"15","_key":"3fef4c1be5d0"},{"_type":"span","marks":[],"text":" reviewed the medical records of 31 patients with primary dementia who also experienced depression. Compared with before ECT, these patients had lower depression severity scores (12.3 points on the Montgomery-Åsberg Depression Rating Scale) and an overall improvement on the Folstein Mini-Mental State Examination (1.6 points; ","_key":"70280fa6055f"},{"marks":["em"],"text":"P","_key":"a816d2b78deb","_type":"span"},{"_key":"af97f669cb69","_type":"span","marks":[],"text":" \u003c .02)."},{"text":"15","_key":"bbbc302abd2f","_type":"span","marks":["superscript"]}],"_type":"block","style":"normal","_key":"ee41db1288bc","markDefs":[]},{"_type":"block","style":"normal","_key":"005ba2bc3f9a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"One of the larger studies","_key":"7644dab33bfc0"},{"_type":"span","marks":["superscript"],"text":"16","_key":"1a9d5baa6aa3"},{"_type":"span","marks":[],"text":" on the use of ECT in patients with depression and dementia was conducted using Medicare claims data. In this study, 145 patients who received ECT were matched to a control cohort (N = 415) with respect to age, sex, principal diagnosis, medical comorbidities, and baseline scores of activities of daily living. All patients were hospitalized initially and followed for up to 1 year after discharge.","_key":"9fd0c11e1509"}]},{"_type":"block","style":"normal","_key":"8e95b47580fd","markDefs":[],"children":[{"_type":"span","marks":[],"text":"This study found that, among those with dementia who were admitted to the hospital for a psychiatric problem, all patients generally declined in their functional status following discharge. Those patients receiving ECT had more favorable summary scores of activities of daily living compared with the control cohort, although the effects were small.","_key":"0493326198510"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Of note, those receiving ECT did not experience a differential worsening in their cognitive function.","_key":"d7077bcf5b290"},{"_type":"span","marks":["superscript"],"text":"17","_key":"c9c4f71b7c4d"},{"_type":"span","marks":[],"text":" This is in line with another recent retrospective study of ECT in 313 patients with baseline mild to moderate cognitive impairment, which showed an improvement in cognitive functioning as measured by the Montreal Cognitive Assessment.","_key":"9381042a62db"},{"_type":"span","marks":["superscript"],"text":"18","_key":"bfaf7b0af87d"},{"_key":"af83848179c7","_type":"span","marks":[],"text":" This finding concurs with an older report of 44 patients with mild cognitive impairment or dementia who underwent ECT and showed no worsening in cognitive deficits irrespective of preexisting cognitive status."},{"_type":"span","marks":["superscript"],"text":"19","_key":"1be726340471"}],"_type":"block","style":"normal","_key":"268754204dd7"},{"_type":"block","style":"normal","_key":"b86577efe988","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Clinical Considerations","_key":"0fe03fb9af440"}]},{"_key":"1ee4c8f83408","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Given the lack of effective therapies for the behavioral and psychological symptoms of dementia in those with mild cognitive impairment and the profound burden that these symptoms cause to patients and families, it is reasonable to use ECT in select cases. In each case, a thorough analysis of the potential benefits and risks of therapy needs to be conducted and discussed with consenting parties. A few clinical considerations are worth mentioning.","_key":"efa8da84e08d0"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"First, the issue of consent is paramount. The laws governing consent for ECT are administered at the state level, which means requirements vary considerably across the United States. A thorough and legal consent process needs to be carried out prior to therapy initiation, including an appeal to judicial authorities where required. Careful consideration must be given to the level of cognitive impairment and how this affects the patient’s ability to consent, as well as to local laws and regulations.","_key":"0ba56c7ce8740"}],"_type":"block","style":"normal","_key":"0b233edde32a"},{"style":"normal","_key":"4309fe17a76c","markDefs":[],"children":[{"text":"Second is the consideration of comorbid medical issues. Individuals with dementia and cognitive impairment are often advanced in age and have many medical comorbidities. For some older individuals of a frail medical status, an acute series schedule of 2 treatments per week (as opposed to 3 times per week) can allow for a more tolerable treatment course.","_key":"8d18a4ba6de60","_type":"span","marks":[]}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Another consideration involves management of the airway. Sometimes patients with dementia have difficulty managing secretions. The judicious use of an anticholinergic medication (eg, glycopyrrolate) can help improve the safety of airway management during the periprocedural time.","_key":"28ae494b81a00"}],"_type":"block","style":"normal","_key":"82b97091dc65"},{"_type":"block","style":"normal","_key":"ecb39a0831b6","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Concluding Thoughts","_key":"d71bf26e05600"}]},{"_type":"block","style":"normal","_key":"ef763957f80b","markDefs":[],"children":[{"marks":[],"text":"Large database analyses of thousands of patients have essentially ruled out the possibility that ECT causes dementia.","_key":"792e6964c0300","_type":"span"},{"_type":"span","marks":["superscript"],"text":"20,21","_key":"6b45d7b8deb4"},{"marks":[],"text":" Further research involving smaller groups of patients with dementia or cognitive impairment has also supported the reassuring conclusion that ECT does not worsen baseline dementia or cognitive impairment. In fact, some data suggest an improvement in cognitive function following ECT.","_key":"bcc4c92b3539","_type":"span"}]},{"style":"normal","_key":"2d3ddb03f985","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Where resources are available, where patient and family preferences and clinical considerations provide, and when potential benefits outweigh the risks, ECT can be considered in select cases to manage the behavioral and psychological symptoms of dementia.","_key":"1a5dcb569a640"}],"_type":"block"},{"markDefs":[],"children":[{"marks":["strong"],"text":"Dr Rhee","_key":"0ce65bdc6b8a0","_type":"span"},{"_type":"span","marks":[],"text":" ","_key":"39eb18573e09"},{"_type":"span","marks":["em"],"text":"is an associate professor of medicine (psychiatry) and public health sciences in the Department of Public Health Sciences at the University of Connecticut School of Medicine in Farmington and is an adjunct faculty member in the Department of Psychiatry at Yale School of Medicine in New Haven.","_key":"1821fe169e02"},{"marks":[],"text":" ","_key":"90f7d650b36d","_type":"span"},{"_type":"span","marks":["strong"],"text":"Dr Wilkinson","_key":"6eebd2c109ad"},{"text":" is an associate professor of psychiatry and associate director of the Yale Depression Research Program, Psychiatry, at Yale School of Medicine.","_key":"5b4a86973e9b","_type":"span","marks":["em"]}],"_type":"block","style":"normal","_key":"05b673affe15"},{"markDefs":[],"children":[{"text":"References","_key":"9e64feb955700","_type":"span","marks":["strong"]}],"_type":"block","style":"normal","_key":"ad5e3183fdb8"},{"children":[{"_type":"span","marks":[],"text":"1. Alzheimer’s Association. ","_key":"58beb9190fa10"},{"_key":"5f6dc6f8fe98","_type":"span","marks":["1f3ea4b3f986"],"text":"2018 Alzheimer’s disease facts and figures."},{"_type":"span","marks":[],"text":" ","_key":"66ae41d7aed3"},{"_type":"span","marks":["em"],"text":"Alzheimers Dement","_key":"26f4980dc5c4"},{"_type":"span","marks":[],"text":". 2018;14:367-425.","_key":"52092e6ab55a"}],"_type":"block","style":"normal","_key":"3d4f9d43e086","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://www.alz.org/media/homeoffice/facts%20and%20figures/facts-and-figures.pdf","_key":"1f3ea4b3f986"}]},{"_key":"d0e0f0a2cd78","markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/21537355/","_key":"921d2461e3c7","nofollow":true,"blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"2. Byers AL, Yaffe K.","_key":"a711d7f0616b0"},{"_type":"span","marks":["921d2461e3c7"],"text":" Depression and risk of developing dementia.","_key":"218d4df5e038"},{"_key":"daa6bfb58e1d","_type":"span","marks":[],"text":" "},{"_type":"span","marks":["em"],"text":"Nat Rev Neurol","_key":"189a3d519ed2"},{"_type":"span","marks":[],"text":". 2011;7(6):323-331.","_key":"a7d10c53218a"}],"_type":"block","style":"normal"},{"style":"normal","_key":"8657f17eb70b","markDefs":[{"_key":"f57e12f0f9ae","nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/24838521/"}],"children":[{"_type":"span","marks":[],"text":"3. Jaffe R. ","_key":"ce435d688ecf0"},{"_type":"span","marks":["em"],"text":"The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging: A Task Force Report of the American Psychiatric Association.","_key":"a7bdc02f9903"},{"_type":"span","marks":[],"text":" 2nd ed. American Psychiatric Publishing; 2001.\n4. Acharya D, Harper DG, Achtyes ED, et al. ","_key":"e723a805ef67"},{"_type":"span","marks":["f57e12f0f9ae"],"text":"Safety and utility of acute electroconvulsive therapy for agitation and aggression in dementia.","_key":"f3261aa56886"},{"_type":"span","marks":[],"text":" ","_key":"49146357f742"},{"_type":"span","marks":["em"],"text":"Int J Geriatr Psychiatry","_key":"3b1fe0646444"},{"_key":"8abb289bc14c","_type":"span","marks":[],"text":". 2015;30(3):265-273."}],"_type":"block"},{"markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/3531296/","_key":"e2bfd2f17c99"}],"children":[{"_type":"span","marks":[],"text":"5. Cohen-Mansfield J, Billig N. ","_key":"64bdfb95895e0"},{"_type":"span","marks":["e2bfd2f17c99"],"text":"Agitated behaviors in the elderly. I. A conceptual review.","_key":"af5c53ba51b8"},{"marks":[],"text":" ","_key":"f9ba89ed9417","_type":"span"},{"marks":["em"],"text":"J Am Geriatr Soc","_key":"d204d3ead33b","_type":"span"},{"_type":"span","marks":[],"text":". 1986;34(10):711-721.","_key":"318342ed6201"}],"_type":"block","style":"normal","_key":"ea313361c1c9"},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/3760436/","_key":"6e91e7a8eebc","nofollow":true}],"children":[{"text":"6. Cohen-Mansfield J. ","_key":"113abfa4955a0","_type":"span","marks":[]},{"_type":"span","marks":["6e91e7a8eebc"],"text":"Agitated behaviors in the elderly. II. Preliminary results in the cognitively deteriorated.","_key":"d76c6898e9fd"},{"_type":"span","marks":[],"text":" ","_key":"462ebe28b204"},{"_type":"span","marks":["em"],"text":"J Am Geriatr Soc","_key":"40d138478b44"},{"_key":"ec1b72b0ff3f","_type":"span","marks":[],"text":". 1986;34:722-727."}],"_type":"block","style":"normal","_key":"eeb9590b25bb"},{"_type":"block","style":"normal","_key":"4255de9bcc59","markDefs":[{"_key":"69a72f197338","nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/28560807/"}],"children":[{"_type":"span","marks":[],"text":"7. Kupeli N, Vickerstaff V, White N, et al. ","_key":"063de2585c0b0"},{"_key":"848d0c8b2afb","_type":"span","marks":["69a72f197338"],"text":"Psychometric evaluation of the Cohen-Mansfield Agitation Inventory in an acute general hospital setting."},{"marks":[],"text":" ","_key":"14c25c6c6df7","_type":"span"},{"marks":["em"],"text":"Int J Geriatr Psychiatry","_key":"cedd7e244073","_type":"span"},{"_type":"span","marks":[],"text":". 2018;33(1):e158-e165.","_key":"534a88f1b429"}]},{"style":"normal","_key":"6850e2f6ad65","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/7991117/","_key":"3720f9a8977f","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"8. Cummings JL, Mega M, Gray K, et al. ","_key":"cfb1bbfa78350"},{"text":"The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia.","_key":"30a69cec132b","_type":"span","marks":["3720f9a8977f"]},{"marks":[],"text":" ","_key":"a6125cfc0ec7","_type":"span"},{"_type":"span","marks":["em"],"text":"Neurology","_key":"27748fd0d6eb"},{"_type":"span","marks":[],"text":". 1994;44(12):2308-2314.","_key":"29eb0b03b9a8"}],"_type":"block"},{"markDefs":[{"_key":"30ff90e1bb91","nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/9153155/"}],"children":[{"_type":"span","marks":[],"text":"9. Cummings JL. ","_key":"f4c56fe674db0"},{"_type":"span","marks":["30ff90e1bb91"],"text":"The Neuropsychiatric Inventory: assessing psychopathology in dementia patients.","_key":"1cae6c9607bc"},{"text":" ","_key":"46819c95d908","_type":"span","marks":[]},{"marks":["em"],"text":"Neurology","_key":"eaa688fd8a54","_type":"span"},{"marks":[],"text":". 1997;48(suppl 6):S10-S16.","_key":"df9ec8f672ef","_type":"span"}],"_type":"block","style":"normal","_key":"807554707c20"},{"children":[{"marks":[],"text":"10. Guy W. ","_key":"f247c2f9894a0","_type":"span"},{"_type":"span","marks":["em"],"text":"ECDEU Assessment Manual for Psychopharmacology","_key":"3e1fd0801daf"},{"marks":[],"text":". National Institute of Mental Health; 1976.","_key":"b213e3324ca4","_type":"span"}],"_type":"block","style":"normal","_key":"385437f7b4b2","markDefs":[]},{"markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/8994897/","_key":"61966123d299"}],"children":[{"_type":"span","marks":[],"text":"11. Schneider LS, Olin JT. ","_key":"8d512dc44c330"},{"text":"Clinical global impressions in Alzheimer’s clinical trials.","_key":"414fe2e1b9e6","_type":"span","marks":["61966123d299"]},{"_type":"span","marks":[],"text":" ","_key":"97c5537f9604"},{"_type":"span","marks":["em"],"text":"Int Psychogeriatr","_key":"35b534f6b8e3"},{"_type":"span","marks":[],"text":". 1996;8(2):277-290.","_key":"ac20f5dca14f"}],"_type":"block","style":"normal","_key":"b3f3f1ce28ab"},{"_key":"c6e46bcd523e","markDefs":[{"blank":true,"_type":"link","href":"https://classic.clinicaltrials.gov/ct2/show/NCT02969499","_key":"9dbeb0aa6b17"}],"children":[{"_type":"span","marks":[],"text":"12. Safety and efficacy of electroconvulsive therapy (ECT) for behavioural and psychological symptoms of dementia (BPSD) (ECTBPSD). ClinicalTrials.gov. Last updated May 6, 2021. Accessed November 1, 2023. ","_key":"a5ac9317b0ad0"},{"_type":"span","marks":["9dbeb0aa6b17"],"text":"https://classic.clinicaltrials.gov/ct2/show/NCT02969499","_key":"a5ac9317b0ad1"}],"_type":"block","style":"normal"},{"markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/22330702/","_key":"f52efdc1f46f"}],"children":[{"_type":"span","marks":[],"text":"13. Oudman E. ","_key":"3dd9cd1dcec50"},{"_type":"span","marks":["f52efdc1f46f"],"text":"Is electroconvulsive therapy (ECT) effective and safe for treatment of depression in dementia? A short review.","_key":"ac025fcbfbfb"},{"_key":"c25ee07936d8","_type":"span","marks":["em"],"text":" J ECT."},{"_key":"6d99fa1dd08e","_type":"span","marks":[],"text":" 2012;28(1):34-38."}],"_type":"block","style":"normal","_key":"5b28b19e62ac"},{"_type":"block","style":"normal","_key":"855c8398b300","markDefs":[{"href":"https://pubmed.ncbi.nlm.nih.gov/31701804/","_key":"7ed432f26af5","nofollow":true,"blank":true,"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"14. Tampi RR, Tampi DJ, Young J, et al. ","_key":"dc80441e82df0"},{"_type":"span","marks":["7ed432f26af5"],"text":"The place for electroconvulsive therapy in the management of behavioral and psychological symptoms of dementia.","_key":"8f06fecc7659"},{"marks":["em"],"text":" Neurodegener Dis Manag","_key":"44231f4faa75","_type":"span"},{"text":". Published online November 8, 2019.","_key":"54bbeda67c80","_type":"span","marks":[]}]},{"_type":"block","style":"normal","_key":"1e6f7da89193","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/10960885/","_key":"c7478abad6f1","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"15. Rao V, Lyketsos CG. ","_key":"697885fa42ac0"},{"_type":"span","marks":["c7478abad6f1"],"text":"The benefits and risks of ECT for patients with primary dementia who also suffer from depression.","_key":"8d6e70b41c78"},{"_type":"span","marks":[],"text":" ","_key":"754b53f3ad5c"},{"_type":"span","marks":["em"],"text":"Int J Geriatr Psychiatry","_key":"0be9e29552e8"},{"_type":"span","marks":[],"text":". 2000;15(8):729-735.","_key":"db80128dfb56"}]},{"children":[{"_type":"span","marks":[],"text":"16. Wilkinson ST, Sint K, Forester BP, Rhee TG. ","_key":"ad02f1b13bf90"},{"marks":["af89dd97df74"],"text":"Effects of electroconvulsive therapy on functional outcomes among Medicare patients with comorbid depression and dementia: a nationwide 1-year follow-up study.","_key":"c93a7dfd186c","_type":"span"},{"_type":"span","marks":[],"text":" ","_key":"45bd803b1868"},{"_type":"span","marks":["em"],"text":"J Clin Psychiatry","_key":"701fa3b9f6d0"},{"_type":"span","marks":[],"text":". 2023;84(2):22m14583.","_key":"50e939228c66"}],"_type":"block","style":"normal","_key":"408ca8ee089d","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/36700843/","_key":"af89dd97df74"}]},{"_type":"block","style":"normal","_key":"fd0694c9cc5a","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/36700843/","_key":"0f3898ab4fc5"}],"children":[{"_type":"span","marks":[],"text":"17. Wilkinson ST, Sint K, Forester BP, Rhee TG. ","_key":"72843936d83d0"},{"_type":"span","marks":["0f3898ab4fc5"],"text":"Effects of electroconvulsive therapy on functional outcomes among Medicare patients with comorbid depression and dementia: a nationwide 1-year follow-up study.","_key":"b5ce1a65ae5d"},{"_type":"span","marks":[],"text":" ","_key":"2ff98cc36c02"},{"_type":"span","marks":["em"],"text":"J Clin Psychiatry","_key":"235c1b6d2211"},{"text":". 2023;84(2):22m14583.","_key":"95b658cc4a3b","_type":"span","marks":[]}]},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/34996701/","_key":"9ea2439a8bc1","nofollow":true}],"children":[{"_key":"7ff60aeb73d10","_type":"span","marks":[],"text":"18. Luccarelli J, Forester BP, Dooley M, et al. "},{"_type":"span","marks":["9ea2439a8bc1"],"text":"The effects of baseline impaired global cognitive function on the efficacy and cognitive effects of electroconvulsive therapy in geriatric patients: a retrospective cohort study.","_key":"f534b360b1db"},{"text":" Am J Geriatr Psychiatry","_key":"506a86b1f8ef","_type":"span","marks":["em"]},{"marks":[],"text":". 2022;30(7):790-798.","_key":"32c60d349eb0","_type":"span"}],"_type":"block","style":"normal","_key":"0196d6972848"},{"_key":"8159c8fffe16","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/21208587/","_key":"333c48ddb2da","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"19. Hausner L, Damian M, Sartorius A, Frölich L. ","_key":"835e2689f4f70"},{"_key":"57ef0c253997","_type":"span","marks":["333c48ddb2da"],"text":"Efficacy and cognitive side effects of electroconvulsive therapy (ECT) in depressed elderly inpatients with coexisting mild cognitive impairment or dementia."},{"marks":[],"text":" ","_key":"b56a6cf44fe1","_type":"span"},{"_type":"span","marks":["em"],"text":"J Clin Psychiatry","_key":"a61565c6f599"},{"_key":"fa1032fd17ff","_type":"span","marks":[],"text":". 2011;72(1):91-97."}],"_type":"block","style":"normal"},{"markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/30245639/","_key":"a906f6a1a71f","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"20. Chu CW, Chien WC, Chung CH, et al. ","_key":"8b123266c5a50"},{"_type":"span","marks":["a906f6a1a71f"],"text":"Electroconvulsive therapy and risk of dementia—a nationwide cohort study in Taiwan.","_key":"ef9fa8607e5d"},{"marks":[],"text":" ","_key":"2ecd45784460","_type":"span"},{"_type":"span","marks":["em"],"text":"Front Psychiatry","_key":"25883b16de44"},{"_type":"span","marks":[],"text":". 2018;9:397.","_key":"1c9a7ca253db"}],"_type":"block","style":"normal","_key":"14937ca8a0aa"},{"_key":"7903f6477145","markDefs":[{"blank":true,"_type":"link","href":"https://pubmed.ncbi.nlm.nih.gov/29523431/","_key":"592a65aba1c7","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"21. Osler M, Rozing MP, Christensen GT, et al. ","_key":"42d286d4327b0"},{"_type":"span","marks":["592a65aba1c7"],"text":"Electroconvulsive therapy and risk of dementia in patients with affective disorders: a cohort study.","_key":"921234269f6d"},{"_type":"span","marks":[],"text":" ","_key":"578b6dc06ce1"},{"_type":"span","marks":["em"],"text":"Lancet Psychiatry","_key":"4fec730f8e38"},{"_type":"span","marks":[],"text":". 2018;5(4):348-356.","_key":"5d48c8fb8d7a"}],"_type":"block","style":"normal"}],"documentGroupMapping":null,"_rev":"4SrWdkd8yCWXrztQmoQqP4","gptTakeaways":"• Dementia affects over 6 million U.S. adults, with incidence rising due to aging trends, doubling risk every 5 years post-65.\n\n• ECT shows promise in managing dementia's behavioral symptoms, despite no FDA-approved treatments, with nonrandomized studies indicating symptom improvement.\n\n• Retrospective analyses suggest ECT may improve neuropsychiatric symptoms without worsening cognitive function, supporting its potential use.\n\n• Clinical considerations for ECT include consent, comorbidities, and airway management, emphasizing thorough evaluation of patient-specific factors.","taxonomyMapping":[{"_id":"pst_taxonomy_132_dementia","_updatedAt":"2020-06-10T19:45:36Z","identifier":"topics/dementia","parent":{"perKeywordMapping":["Psychiatry","Neurology"],"_createdAt":"2020-03-26T06:11:21Z","parent":{"identifier":"topics","isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z"},"name":"Neuropsychiatry","_id":"pst_taxonomy_35_neuropsychiatry","_type":"taxonomy","cmeType":"per","_updatedAt":"2023-03-31T19:19:55Z","identifier":"topics/neuropsychiatry","_rev":"77mZ7PORfofI3dBGfWcsCF"},"_createdAt":"2020-03-26T06:11:21Z","name":"Dementia","pixelTrackingCode":null,"_rev":"snQqhhB4O8T5bi1viUSkda","_type":"taxonomy"},{"perKeywordMapping":["Psychiatry","Neurology"],"parent":{"name":"Topics","_updatedAt":"2023-03-31T19:15:59Z","_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","parent":null,"isMainTopic":true,"_id":"pst_taxonomy_53202_clinical","identifier":"topics"},"_type":"taxonomy","pixelTrackingCode":null,"_updatedAt":"2023-03-31T19:19:55Z","identifier":"topics/neuropsychiatry","_createdAt":"2020-03-26T06:11:21Z","_rev":"77mZ7PORfofI3dBGfWcsCF","_id":"pst_taxonomy_35_neuropsychiatry","cmeType":"per","name":"Neuropsychiatry"},{"identifier":"topics/ect","_createdAt":"2020-03-26T06:11:21Z","name":"Electroconvulsive Therapy","_id":"pst_taxonomy_152_electroconvulsivetherapy","_updatedAt":"2024-10-21T14:22:00Z","_type":"taxonomy","pixelTrackingCode":null,"parent":{"_type":"taxonomy","perKeywordMapping":["Psychiatry","Neurology"],"parent":null,"name":"Depression","_updatedAt":"2024-02-28T20:45:13Z","_rev":"eEqAv6Sbdk37RM523WcvVR","cmeType":"per","_createdAt":"2020-03-26T06:11:21Z","identifier":"topics/depression","_id":"pst_taxonomy_641_depression"},"_rev":"piyJAhpB4yoL7s3CRcL7EF"}],"url":"electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms","audioUrl":"https://s3.us-east-1.amazonaws.com/ai-generated-audios/www.psychiatrictimes.com/3e1446b1-7a48-4c20-8d3a-a3c033321681_1728915588470.e59f40f3-bfa5-4cb9-8493-b7cc08812f55.mp3","contentCategory":{"_createdAt":"2020-02-06T09:15:47Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Articles","_id":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","_updatedAt":"2020-02-25T09:35:56Z"},"thumbnail":{"_type":"mainImage","alt":"dementia","caption":"SJM Photos/AdobeStock","asset":{"_ref":"image-2172f65e37645ccf10b6977cbddcfd470b116efb-4961x3508-jpg","_type":"reference"}},"summary":null,"factCheckAuthors":null,"title":"Electroconvulsive Therapy for the Treatment of Dementia Symptoms","_id":"3e1446b1-7a48-4c20-8d3a-a3c033321681","documentGroup":null,"drugMentions":"{\"drug_mentions\": [\"glycopyrrolate\"]}","articleType":"Publication","is_visible":true,"_createdAt":"2024-10-14T14:19:38Z","authors":[{"displayName":"T. Greg Rhee, PhD","url":"t-greg-rhee-phd"},{"displayName":"Samuel T. Wilkinson, MD","url":"samuel-t-wilkinson-md"}],"factCheckAuthorMapping":null,"published":"2024-10-14T15:00:06.211Z","ExcludeFromPubMedXML":false,"_updatedAt":"2024-10-14T14:19:48Z","authorMapping":[{"_rev":"fpg6CnoPPsIpIosOohFh6F","_type":"author","_id":"8472cab3-9843-48cf-b772-834bd3ce3e9a","_updatedAt":"2024-04-22T19:29:58Z","url":{"current":"t-greg-rhee-phd","_type":"slug"},"displayName":"T. Greg Rhee, PhD","_createdAt":"2024-04-22T19:29:58Z"},{"url":{"current":"samuel-t-wilkinson-md","_type":"slug"},"displayName":"Samuel T. Wilkinson, MD","_createdAt":"2020-06-11T18:06:00Z","_rev":"5NSo4DlKj6Rwd777Axd62t","_type":"author","_id":"pst_author_690745","_updatedAt":"2020-08-21T07:23:58Z"}],"gptSummary":"Dementia, a prevalent neurodegenerative disorder, affects over 6 million adults in the U.S., with incidence rising due to aging. Electroconvulsive therapy (ECT) is explored as a potential treatment for managing behavioral and psychological symptoms of dementia, despite no FDA-approved treatments. While randomized trials are lacking, nonrandomized studies and retrospective analyses suggest ECT may improve agitation and neuropsychiatric symptoms without worsening cognitive function. Clinical considerations include consent, comorbidities, and airway management. ECT may be considered in select cases where benefits outweigh risks, with careful evaluation of patient-specific factors.","_type":"article","targeting":{"content_placement":["topics/dementia","topics/neuropsychiatry","topics/ect"],"document_url":["electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"TMS for the Treatment of OCD","url":{"current":"tms-for-the-treatment-of-ocd","_type":"slug"},"thumbnail":{"caption":"Dilok/AdobeStock","asset":{"_ref":"image-6e7deea1c577db789477d44ab9518072785d31ee-6000x4000-jpg","_type":"reference"},"_type":"mainImage","alt":"brain lightbulb"},"published":"2024-10-25T15:00:00.000Z"},{"title":"Evaluating Brexpiprazole for the Management of Behavioral and Psychological Symptoms of Dementia","url":{"current":"evaluating-brexpiprazole-for-the-management-of-behavioral-and-psychological-symptoms-of-dementia","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"dementia","caption":"GordonGrand/AdobeStock","asset":{"_ref":"image-32cef1d30b31a8a9054644b3895cd6d7285bd198-4256x2832-jpg","_type":"reference"}},"published":"2024-10-23T16:00:00.000Z"},{"title":"Climate Change, Vector Range, and Alpha-Gal in Psychiatric Practice","url":{"current":"climate-change-vector-range-and-alpha-gal-in-psychiatric-practice","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"tick","caption":"ondreicka/AdobeStock","asset":{"_ref":"image-4d334999fcf64afe7e821bce3a9230aae30a5918-5998x3999-jpg","_type":"reference"}},"published":"2024-10-22T16:00:00.000Z"},{"title":"Don't Fear Older Medications and Treatments for Our Senior Patients","url":{"current":"dont-fear-older-medications-and-treatments-for-our-senior-patients","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"older woman","caption":"yana136/AdobeStock","asset":{"_ref":"image-d41a0f9b8e8701c71a0f100ad08e469352e7ee0a-4146x1969-jpg","_type":"reference"}},"published":"2024-10-22T15:00:00.000Z"},{"title":"Electroconvulsive Therapy for the Treatment of Dementia Symptoms","url":{"current":"electroconvulsive-therapy-for-the-treatment-of-dementia-symptoms","_type":"slug"},"thumbnail":{"caption":"SJM Photos/AdobeStock","asset":{"_ref":"image-2172f65e37645ccf10b6977cbddcfd470b116efb-4961x3508-jpg","_type":"reference"},"_type":"mainImage","alt":"dementia"},"published":"2024-10-14T15:00:06.211Z"},{"title":"Low-Dose Lithium: A New Frontier in Mental Health Treatment","url":{"current":"low-dose-lithium-a-new-frontier-in-mental-health-treatment","_type":"slug"},"thumbnail":{"asset":{"_ref":"image-cf8995b241091a183d4d717ba742dbb75b4b5025-2800x1868-jpg","_type":"reference"},"_type":"mainImage","alt":"lithium","caption":"luchschenF/AdobeStock"},"published":"2024-10-09T14:00:00.000Z"}]}],"relatedVideos":[{"factCheckAuthorMapping":null,"factCheckAuthors":null,"url":"using-brain-science-to-develop-better-safer-more-effective-treatments","published":"2023-12-05T19:30:21.947Z","_id":"731eb4af-b5cf-4db4-9d92-dc7f66db9ece","title":"Using Brain Science to Develop Better, Safer, More Effective Treatments ","thumbnail":{"_type":"mainImage","alt":"brain","caption":"picture-waterfall/AdobeStock","asset":{"_ref":"image-94e7ec981b4e6235c67f4ebfde20d9a3e41c9d04-5000x3863-jpg","_type":"reference"}},"authors":[{"displayName":"Tony P. George, MD, FRCPC","url":"tony-p-george-md-frcpc"}],"summary":"Deep brain stimulation for substance use disorders when everything else fails, the history of the ACNP, and more.","contentCategory":{"_updatedAt":"2020-02-25T09:35:54Z","_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c"},"authorMapping":[{"displayName":"Tony P. George, MD, FRCPC","_rev":"KaqacoJEEFXcYORxJsDJFN","_type":"author","company":"GEM DRUGS GRAMERCY","_id":"pst_author_333825","biography":[{"markDefs":[],"children":[{"text":"Dr George ","_key":"3c6a848594e60","_type":"span","marks":["strong"]},{"_type":"span","marks":["em"],"text":"is Professor of Psychiatry in the Temerty Faculty of Medicine at the University of Toronto, and a Clinician-Scientist at CAMH. He is also an editorial board member at ","_key":"3c6a848594e61"},{"_type":"span","marks":[],"text":"Psychiatric Times","_key":"3c6a848594e62"},{"_type":"span","marks":["em"],"text":", and co-principal editor of Neuropsychopharmacology","_key":"3c6a848594e63"},{"_type":"span","marks":[],"text":" ","_key":"3c6a848594e64"},{"_key":"3c6a848594e65","_type":"span","marks":["em"],"text":"(NPP), the Official Journal of the American College of Neuropsychopharmacology."}],"_type":"block","style":"normal","_key":"7a4d6dcbc47f"}],"url":{"current":"tony-p-george-md-frcpc","_type":"slug"},"address1":"PO BOX 1511","_updatedAt":"2023-07-05T17:32:16Z","_createdAt":"2020-02-21T11:23:21Z"}]},{"published":"2023-12-05T16:44:18.094Z","contentCategory":{"_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z"},"authorMapping":[{"company":"CVS PHARMACY","_id":"pst_author_320269","url":{"current":"dawn-i-velligan-phd","_type":"slug"},"_rev":"5NSo4DlKj6Rwd777Axd5jr","_type":"author","_updatedAt":"2020-08-21T07:23:44Z","address1":"112 WESTLAKE DR","displayName":"Dawn I. Velligan, PhD","_createdAt":"2020-02-21T11:23:21Z"}],"authors":[{"displayName":"Dawn I. Velligan, PhD","url":"dawn-i-velligan-phd"}],"_id":"b0bf428a-4064-4823-a181-e0c90a0e1c8b","title":"Amotivation in Individuals with Schizophrenia: Exciting Research Ideas at ACNP 2023 Annual Meeting","summary":"Exciting research ideas are stirring at the ACNP 2023 Annual Meeting.","thumbnail":{"_type":"mainImage","alt":"brain schizophrenia","caption":"vegefox.com/AdobeStock","asset":{"_ref":"image-18558c5d86e9709750196568183fc48e4e4b34da-5760x3840-jpg","_type":"reference"}},"factCheckAuthorMapping":null,"factCheckAuthors":null,"url":"amotivation-in-individuals-with-schizophrenia-exciting-research-ideas-at-acnp-2023"},{"thumbnail":{"_type":"mainImage","alt":"eating disorder brain","caption":"13smile/AdobeStock","asset":{"_ref":"image-a042b8a2b459a77110e7326e322b7d36287ca733-3500x3500-jpg","_type":"reference"}},"contentCategory":{"_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z","_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs"},"url":"eating-disorders-and-emerging-neuroscience","_id":"3f4af5f3-2c51-46f0-bb07-e36bc18f6a35","title":"Eating Disorders and Emerging Neuroscience","authorMapping":[{"url":{"current":"joanna-steinglass-md","_type":"slug"},"address1":"1 MEDICAL PARK","displayName":"Joanna Steinglass, MD","_createdAt":"2020-02-21T11:23:21Z","_rev":"pI9SawGKsTP14Lioy52fLS","_type":"author","_id":"pst_author_324475","_updatedAt":"2020-08-21T07:23:47Z"}],"authors":[{"displayName":"Joanna Steinglass, MD","url":"joanna-steinglass-md"}],"factCheckAuthorMapping":null,"factCheckAuthors":null,"published":"2023-12-03T14:00:00.000Z","summary":"Don't miss this ACNP 2023 Annual Meeting session!"},{"summary":"Don't miss the the 2023 Psychiatric Times World CME conference, where our Editor in Chief will present on the 14 different types of dementia!","contentCategory":{"_updatedAt":"2020-02-25T09:35:54Z","_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c"},"factCheckAuthorMapping":null,"factCheckAuthors":null,"_id":"70419150-33c0-4a7f-a591-aed27bfa747c","title":"Deep Dive on Dementia at the 2023 Psychiatric Times World CME Conference","authorMapping":[{"biography":[{"markDefs":[],"children":[{"text":"Dr Miller","_key":"1caa3e4a631c0","_type":"span","marks":["strong"]},{"_type":"span","marks":[],"text":" ","_key":"1caa3e4a631c1"},{"text":"is Medical Director, Brain Health, Exeter, New Hampshire; Editor in Chief,","_key":"1caa3e4a631c2","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":" Psychiatric Times","_key":"1caa3e4a631c3"},{"_type":"span","marks":["em"],"text":"; Staff Psychiatrist, Seacoast Mental Health Center, Exeter; and Consulting Psychiatrist, Insight Meditation Society, Barre, Massachusetts.","_key":"1caa3e4a631c4"}],"_type":"block","style":"normal","_key":"b9bc238502dd"}],"_rev":"iETXi7W7pY87NNzCpcZa11","_type":"author","_id":"pst_author_324713","profileImage":{"_type":"mainImage","asset":{"_ref":"image-a429e28c06070418331e927699954a278efa97c9-1500x2100-jpg","_type":"reference"}},"_updatedAt":"2024-03-27T15:40:23Z","url":{"current":"john-j-miller-md","_type":"slug"},"displayName":"John J. Miller, MD","_createdAt":"2020-02-21T11:23:21Z"}],"authors":[{"displayName":"John J. Miller, MD","url":"john-j-miller-md"}],"url":"deep-dive-dementia-2023-psychiatric-times-world-cme-conference","published":"2023-10-20T14:00:00.000Z","thumbnail":{"_type":"mainImage","alt":"dementia","caption":"fizkes/AdobeStock","asset":{"_ref":"image-4736540c1e8dcd5fd953d8eb916005c4d702de19-8192x5464-jpg","_type":"reference"}}},{"factCheckAuthorMapping":null,"published":"2023-08-09T20:00:32.717Z","_id":"4793a7cb-178b-4945-9360-7e2f4a327928","authorMapping":[{"_rev":"geYrsaD3ijmzedpw6GnES1","_type":"author","_id":"pst_author_322595","biography":[{"children":[{"marks":["strong"],"text":"Dr Moffic","_key":"ada5b7a9b843","_type":"span"},{"text":" ","_key":"207bec418af2","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"(he/himhis)","_key":"9766b78b3fdb"},{"_type":"span","marks":[],"text":" ","_key":"5d0b1559606f"},{"_type":"span","marks":["em"],"text":"is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry, and is now in retirement and refirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry \u0026 Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now","_key":"4f58f875b316"},{"_type":"span","marks":[],"text":" The Eastern Religions, and Spirituality","_key":"4a00caaa2c0a"},{"_type":"span","marks":["em"],"text":". He serves on the Editorial Board of","_key":"4f26d5e6d022"},{"marks":[],"text":" Psychiatric Times","_key":"8df506c4a3c3","_type":"span"},{"_type":"span","marks":["em"],"text":".","_key":"f84ef6d63c25"}],"_type":"block","style":"normal","_key":"db4cf1b0a36a","markDefs":[]}],"_updatedAt":"2023-11-06T15:02:13Z","url":{"current":"h-steven-moffic-md","_type":"slug"},"displayName":"H. Steven Moffic, MD","_createdAt":"2020-02-21T11:23:21Z"}],"authors":[{"displayName":"H. Steven Moffic, MD","url":"h-steven-moffic-md"}],"factCheckAuthors":null,"url":"nagasaki-day-the-anniversary-of-atomic-bombing","title":"Nagasaki Day: The Anniversary of Atomic Bombing","summary":"Today is the somber anniversary of the Nagasaki bombing. ","thumbnail":{"_type":"mainImage","alt":"atomic bomb","caption":"2ragon/AdobeStock","asset":{"_ref":"image-2da74e19389e3f05b72d034c501a51615a06c4a4-3000x2000-jpg","_type":"reference"}},"contentCategory":{"_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z"}},{"_id":"7b1aa945-36ce-49de-a4f6-0243c5f4d880","title":"Wrestling With the Fallout From the Atomic Bomb","authorMapping":[{"_updatedAt":"2023-11-06T15:02:13Z","url":{"current":"h-steven-moffic-md","_type":"slug"},"displayName":"H. Steven Moffic, MD","_createdAt":"2020-02-21T11:23:21Z","_rev":"geYrsaD3ijmzedpw6GnES1","_type":"author","_id":"pst_author_322595","biography":[{"_type":"block","style":"normal","_key":"db4cf1b0a36a","markDefs":[],"children":[{"marks":["strong"],"text":"Dr Moffic","_key":"ada5b7a9b843","_type":"span"},{"text":" ","_key":"207bec418af2","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"(he/himhis)","_key":"9766b78b3fdb"},{"_type":"span","marks":[],"text":" ","_key":"5d0b1559606f"},{"_type":"span","marks":["em"],"text":"is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry, and is now in retirement and refirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry \u0026 Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now","_key":"4f58f875b316"},{"_type":"span","marks":[],"text":" The Eastern Religions, and Spirituality","_key":"4a00caaa2c0a"},{"_type":"span","marks":["em"],"text":". He serves on the Editorial Board of","_key":"4f26d5e6d022"},{"marks":[],"text":" Psychiatric Times","_key":"8df506c4a3c3","_type":"span"},{"_type":"span","marks":["em"],"text":".","_key":"f84ef6d63c25"}]}]}],"authors":[{"displayName":"H. Steven Moffic, MD","url":"h-steven-moffic-md"}],"factCheckAuthorMapping":null,"published":"2023-08-02T20:00:21.601Z","summary":"Have you seen \"Oppenheimer\"? This movie has H. Steven Moffic, MD, contemplating the long-lasting fallout...","thumbnail":{"caption":"holwichaikawee/AdobeStock","asset":{"_ref":"image-40806405cc8452a075e6db696b82115511a6692f-5760x3840-jpg","_type":"reference"},"_type":"mainImage","alt":"atomic fallout"},"contentCategory":{"name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z","_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory"},"factCheckAuthors":null,"url":"wrestling-with-the-fallout-from-the-atomic-bomb"},{"factCheckAuthors":null,"published":"2023-06-14T20:00:03.717Z","_id":"fec28890-8e16-4fdd-94ad-740139966e3b","summary":"Are we still traumatized? It seems so. ","contentCategory":{"_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z"},"authorMapping":[{"_updatedAt":"2023-11-06T15:02:13Z","url":{"current":"h-steven-moffic-md","_type":"slug"},"displayName":"H. Steven Moffic, MD","_createdAt":"2020-02-21T11:23:21Z","_rev":"geYrsaD3ijmzedpw6GnES1","_type":"author","_id":"pst_author_322595","biography":[{"children":[{"marks":["strong"],"text":"Dr Moffic","_key":"ada5b7a9b843","_type":"span"},{"text":" ","_key":"207bec418af2","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"(he/himhis)","_key":"9766b78b3fdb"},{"_type":"span","marks":[],"text":" ","_key":"5d0b1559606f"},{"_type":"span","marks":["em"],"text":"is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry, and is now in retirement and refirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry \u0026 Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now","_key":"4f58f875b316"},{"_type":"span","marks":[],"text":" The Eastern Religions, and Spirituality","_key":"4a00caaa2c0a"},{"_type":"span","marks":["em"],"text":". He serves on the Editorial Board of","_key":"4f26d5e6d022"},{"marks":[],"text":" Psychiatric Times","_key":"8df506c4a3c3","_type":"span"},{"_type":"span","marks":["em"],"text":".","_key":"f84ef6d63c25"}],"_type":"block","style":"normal","_key":"db4cf1b0a36a","markDefs":[]}]}],"authors":[{"displayName":"H. Steven Moffic, MD","url":"h-steven-moffic-md"}],"title":"We Are Still a Traumatized Nation","thumbnail":{"asset":{"_ref":"image-25915ddcccc02663a5fcf1708abe072b73d2446c-7360x4912-jpg","_type":"reference"},"_type":"mainImage","alt":"trauma","caption":"tadamichi/AdobeStock"},"factCheckAuthorMapping":null,"url":"we-are-still-a-traumatized-nation"},{"title":"Keeping Communities Safe: Early Intervention to Prevent School Shootings","thumbnail":{"_type":"mainImage","alt":"stop violence","caption":"Patrick Daxenbichler/AdobeStock","asset":{"_ref":"image-38d82ae8fdc5ecc888cf4090fd82efbd62cf29ba-6239x3715-jpg","_type":"reference"},"crop":{"bottom":0,"_type":"sanity.imageCrop","right":0.28767123287671237,"top":0,"left":0},"hotspot":{"_type":"sanity.imageHotspot","width":0.7123287671232876,"x":0.3561643835616438,"y":0.5,"height":1}},"contentCategory":{"_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z"},"authors":[{"displayName":"Daniel Nicoli, DO","url":"daniel-nicoli-do"},{"displayName":"Shanila Shagufta, MD, MPH","url":"shanila-shagufta-md-mph"},{"displayName":"Greg A. Concepcion","url":"greg-a-concepcion"},{"displayName":"Andrew Nanton, MD","url":"andrew-nanton-md"}],"factCheckAuthorMapping":null,"published":"2023-05-21T16:00:00.000Z","_id":"b9520b68-eff1-4299-96de-6a9e9ebb57f5","summary":"If you missed this session, check out the highlights here! ","authorMapping":[{"url":{"current":"daniel-nicoli-do","_type":"slug"},"displayName":"Daniel Nicoli, DO","_createdAt":"2023-05-21T04:50:11Z","_rev":"kaFUKKhy8u4SosiY3sTAzB","_type":"author","_id":"f6125afc-6876-4b92-a848-0d413dfc973d","biography":[{"_key":"38d270557f69","markDefs":[],"children":[{"_key":"586defab924e","_type":"span","marks":["strong"],"text":"Dr Nicoli"},{"_type":"span","marks":[],"text":" ","_key":"7c0c7681080f"},{"_key":"8270c1bd18b5","_type":"span","marks":["em"],"text":"is a child \u0026 adolescent psychiatrist at Unity, Doernbecher Children’s Hospital, Donald E Long Juvenile Detention Center, and a private forensic evaluator from Oregon. "}],"_type":"block","style":"normal"}],"_updatedAt":"2023-05-21T04:52:32Z"},{"_rev":"o9D7rFB7pDG5dAMMEC8CVf","_type":"author","_id":"56980046-2d65-4e08-8ed8-c0ae6d2aedac","biography":[{"_key":"6ca9e191fb99","markDefs":[],"children":[{"text":"Dr Shagufta","_key":"d63381815425","_type":"span","marks":["strong"]},{"_key":"85343184636e","_type":"span","marks":[],"text":" "},{"_type":"span","marks":["em"],"text":"is a child \u0026 adolescent fellow at Oregon Health \u0026 Science University. ","_key":"5ceda7c0df43"}],"_type":"block","style":"normal"}],"_updatedAt":"2023-05-21T04:54:30Z","url":{"current":"shanila-shagufta-md-mph","_type":"slug"},"displayName":"Shanila Shagufta, MD, MPH","_createdAt":"2023-05-21T04:54:30Z"},{"_createdAt":"2023-05-19T20:11:55Z","displayName":"Greg A. Concepcion","lastName":"Concepcion","_rev":"o9D7rFB7pDG5dAMMECAUST","_type":"author","_id":"a652e762-7c7e-40dd-98a8-c647d1e5e0f1","biography":[{"_type":"block","style":"normal","_key":"6a355091eeec","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Mr Concepcion","_key":"9a8adcd69245"},{"_type":"span","marks":[],"text":" ","_key":"b1cf2c4de28d"},{"marks":["em"],"text":"is a special agent and threat management coordinator with the FBI San Francisco field office. ","_key":"f7df9e86a466","_type":"span"}]}],"_updatedAt":"2023-05-21T04:57:10Z","url":{"current":"greg-a-concepcion","_type":"slug"},"firstName":"Greg"},{"_updatedAt":"2023-05-21T04:59:26Z","url":{"current":"andrew-nanton-md","_type":"slug"},"displayName":"Andrew Nanton, MD","_createdAt":"2020-02-21T11:23:21Z","_rev":"o9D7rFB7pDG5dAMMECCTNR","_type":"author","_id":"pst_author_316966","biography":[{"_type":"block","style":"normal","_key":"12457dd7af0e","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Nanton","_key":"7f8a16442921"},{"text":" is a forensic psychiatry expert witness at Park Dietz \u0026 Associates.","_key":"b3a143a35c55","_type":"span","marks":["em"]}]}]}],"factCheckAuthors":null,"url":"keeping-schools-communities-safe-early-intervention-to-prevent-school-shootings"},{"factCheckAuthors":null,"published":"2023-05-20T20:06:55.767Z","contentCategory":{"_createdAt":"2020-02-10T10:49:36Z","_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z"},"authors":[{"displayName":"Karie Gibson, PsyD","url":"karie-gibson-psyd"}],"thumbnail":{"asset":{"_ref":"image-aa0a7220daef0aa71261a02c71ff9316892ff878-8688x5792-jpg","_type":"reference"},"_type":"mainImage","alt":"together","caption":"Andrey Popov/AdobeStock"},"authorMapping":[{"_createdAt":"2023-05-20T19:33:19Z","_rev":"jL0D8wZpd5VxsgvFqW6oVm","_type":"author","_id":"205c27b8-d9d8-4932-83f3-6cbeb8c05e90","biography":[{"markDefs":[],"children":[{"_key":"a2fc42f1227d","_type":"span","marks":["strong"],"text":"Dr Gibson"},{"_key":"330aecd750c7","_type":"span","marks":[],"text":" "},{"_type":"span","marks":["em"],"text":"serves as the Unit Chief for the FBI’s Behavioral Analysis Unit-1, Behavioral Threat Assessment Center (BTAC). ","_key":"9b300bbdef78"}],"_type":"block","style":"normal","_key":"5f9de7348082"}],"_updatedAt":"2023-05-20T19:33:19Z","url":{"current":"karie-gibson-psyd","_type":"slug"},"displayName":"Karie Gibson, PsyD"}],"factCheckAuthorMapping":null,"url":"working-together-to-prevent-acts-of-terrorism-and-violence","_id":"f67e636f-a50f-4f11-9717-3d40e8d8090c","title":"Working Together to Prevent Acts of Terrorism and Violence ","summary":"Don't miss this APA workshop led by experienced psychologists and psychiatrists from the FBI’s Behavioral Threat Assessment Center and the Department of Homeland Security’s National Threat Evaluation and Reporting Office!"},{"_id":"98674515-b96f-4ab1-8f6b-dced9cb48769","summary":"Check out this session at the APA 2023 Annual Meeting in San Francisco!","authors":[{"displayName":"Susan Hatters Friedman, MD, MSt","url":"susan-hatters-friedman-md"}],"authorMapping":[{"_type":"author","_id":"pst_author_333096","biography":[{"_key":"6abfd1f08d07","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Dr Hatters Friedman ","_key":"0b8f51fbc349"},{"_key":"304fe6456618","_type":"span","marks":["em"],"text":"serves as the Phillip Resnick Professor of Forensic Psychiatry at Case Western Reserve University in Cleveland, Ohio. She is editor of "},{"_type":"span","marks":[],"text":"Family Murder: Pathologies of Love and Hate","_key":"dcb088e7be4e"},{"text":", which was written by the Group for the Advancement of Psychiatry’s Committee on Psychiatry and the Law. She was awarded the 2020 Manfred S. Guttmacher Award by the American Psychiatric Association. She is a coeditor of ","_key":"9aeeb9b13be8","_type":"span","marks":["em"]},{"marks":[],"text":"Malpractice and Liability in Psychiatry","_key":"477682097455","_type":"span"},{"marks":["em"],"text":".","_key":"5b9906841d76","_type":"span"}],"_type":"block","style":"normal"}],"_updatedAt":"2024-08-21T14:26:24Z","url":{"current":"susan-hatters-friedman-md","_type":"slug"},"displayName":"Susan Hatters Friedman, MD, MSt","_createdAt":"2020-02-21T11:23:21Z","_rev":"YxZdQkV09rr5GaWdXwKDJG"}],"factCheckAuthorMapping":null,"factCheckAuthors":null,"url":"fictional-portrayals-of-mental-illness-impact-on-stigma","published":"2023-05-18T14:00:00.000Z","title":"Fictional Portrayals of Mental Illness: Impact on Stigma","thumbnail":{"_type":"mainImage","alt":"stopping stigma","caption":"Feodora/AdobeStock","asset":{"_type":"reference","_ref":"image-7997ca17732af13050b2477a75d78be6d273234a-1601x1069-jpg"}},"contentCategory":{"_rev":"snQqhhB4O8T5bi1viURsgs","_type":"contentCategory","name":"Videos","_id":"42000fd0-0d05-4832-9f2c-62c21079b76c","_updatedAt":"2020-02-25T09:35:54Z","_createdAt":"2020-02-10T10:49:36Z"}}],"relatedTopics":[{"id":"pst_taxonomy_415_traumaandviolence","name":"Trauma And Violence","type":"taxonomy","url":"/topics/topics/trauma-and-violence"},{"id":"pst_taxonomy_35_neuropsychiatry","name":"Neuropsychiatry","type":"taxonomy","url":"/topics/neuropsychiatry"},{"id":"pst_taxonomy_132_dementia","name":"Dementia","type":"taxonomy","url":"/topics/topics/dementia"},{"id":"pst_taxonomy_149_alzheimerdisease","name":"Alzheimer Disease","type":"taxonomy","url":"/topics/topics/alzheimer-disease"}],"algoliaData":{"algoliaDocGroup":[],"algoliaTax":[{"id":"pst_taxonomy_415_traumaandviolence","name":"Trauma And Violence","type":"taxonomy","url":"/topics/topics/trauma-and-violence"},{"id":"pst_taxonomy_35_neuropsychiatry","name":"Neuropsychiatry","type":"taxonomy","url":"/topics/neuropsychiatry"},{"id":"pst_taxonomy_132_dementia","name":"Dementia","type":"taxonomy","url":"/topics/topics/dementia"},{"id":"pst_taxonomy_149_alzheimerdisease","name":"Alzheimer Disease","type":"taxonomy","url":"/topics/topics/alzheimer-disease"}],"excludeIDs":["abd80119-fed6-4089-bf72-0a1a7be185e1"],"articleCategoryID":"8bdaa7fc-960a-4b57-b076-75fdce3741bb","podcastsCategoryID":"93d57b69-2d72-45fe-8b8a-d18e7e7e5f20","videoCategoryID":"42000fd0-0d05-4832-9f2c-62c21079b76c"}},"targeting":{"content_placement":["topics/trauma-and-violence","topics/neuropsychiatry","topics/dementia","topics/alzheimer-disease"],"document_url":["traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases"],"document_group":[],"content_group":[],"rootDocumentGroup":[],"issue_url":[],"publication_url":[],"tags":[],"hostname":"www.psychiatrictimes.com"},"mediaSeries":null,"videoData":{}},"queryString":{"slug":["view","traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases"]}},"host":"www.psychiatrictimes.com"},"__N_SSG":true},"page":"/view/[...slug]","query":{"slug":["traumatic-brain-injury-s-impact-on-normal-aging-and-neurodegenerative-diseases","?utm_source=www.psychiatrictimes.com\u0026utm_medium=relatedContent"]},"buildId":"9NxASLqZOtjGmsCDs4KHX","isFallback":false,"gsp":true,"appGip":true,"scriptLoader":[]}</script></body></html>