Joseph S. Weiner, MD, PhD, FAPM is Chief of Consultation Liaison Psychiatry at North Shore University Hospital in Manhasset, NY, and Associate Professor of Clinical Psychiatry and Medicine at Albert Einstein College of Medicine. He received his MD from New York University Medical School and his PhD in Physiology and Biophysics from New York University.   He did residency training in psychiatry at NYU/Bellvue and a fellowship in public psychiatry at Columbia College of Physicians and Surgeons.  Dr Weiner has received numerous national and regional awards.  In 2001, his Program in the Patient-Doctor Relationship at Long Island Jewish Medical Center won APM's first Alan Stoudemire Award for Innovation & Excellence in Psychosomatic Medicine Education.  He also received a Faculty Scholar Award from the Project on Death in America in 2002.  Dr. Weiner has published many articles about communication and medical decision making.  He has also received research, program development, and educational grants in palliative care. 

Jose Maldonado, MD, FAPM is an Associate Professor of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. There he serves as Chief of the Medical and Forensic Psychiatry Section, Director of the Medical Psychotherapy Clinic, and Medical Director of the Consultation-Liaison Service. Dr. Maldonado's research interests include: management of delirium, confusional states and other acute organic brain syndromes; neuropsychiatric sequelae of medical illness and its treatment; and application of hypnosis in psychiatry and medicine. He has numerous peer-reviewed publications and has received many awards for his research and as a medical educator.

The field of dementia (particularly Alzheimer's disease) is rapidly changing with new therapies and diagnostic tests currently being validated in clinical trials. The current state of knowledge of the biology of Alzheimer's disease will be reviewed, with reference to the impact of new biological findings on biomarker and treatment development as well as results of recent trials. Additionally, differential diagnosis of the dementias will be reviewed, with emphasis on the distinctions between Alzheimer's, frontotemporal dementia, Parkinson's disease, and dementia with Lewy bodies.

Paul B. Rosenberg, MD is Associate Director of the Division of Geriatric Psychiatry and Neuropsychiatry at Bayview Medical Center and Assistant Professor of Psychiatry in the Johns Hopkins School of Medicine. Dr. Rosenberg's clinical and research interests focus on improving treatment and diagnosis of Alzheimer's disease and its neuropsychiatric complications. This includes depression, psychosis, and caregiver stress.  In addition to Alzheimer's Disease, Dr. Rosenberg has expertise in the assessment and treatment of mild cognitive impairment. He has conducted research in the antidepressant treatment of depression in Alzheimer's disease and has explored the use of cytokines as biomarkers for this disorder.

This advanced review will cover cutting edge addiction-medicine knowledge: 1) evolving patterns of substance abuse in the US; 2) hospital screening and assessment for substance use disorders; 3) management of intoxication and withdrawal; 4) medical complications of substance abuse; and 5) selection of appropriate treatment options.

Paul Desan, MD, PhD is Director of the Psychiatric Consultation Service at Yale New Haven Hospital and is Assistant Professor of Psychiatry at Yale University School of Medicine. Dr. Desan received his MD from Yale and his PhD in neurobiology from Harvard University, followed by fellowships in neurological sciences and neurobiology at Stanford and the University of Colorado respectively. Dr. Desan's research interests focus on comorbid alcoholism and depression as well as seasonal affective disorder. He has also written about the preoperative assessment of patients with psychiatric disorders.

The lifetime risk for major depression (MDD) in women is well known to be twice the risk in men. One proposed hypothesis explaining this discrepancy is that women have the capacity to experience depression triggered by times of hormonal change, or reproductive depression, leading to an added risk for depression. Reproductive depression, as seen during the premenstrual phase of the menstrual cycle, the postpartum period, and the perimenopause, may have unique risk factors separate from depression occurring at other stages of a woman’s life and is common in women with mood disorders including MDD and bipolar disorder.  Specific treatment options, such as hormonal interventions, exist for reproductive depression, which have not been found to be useful for non-reproductive depression. Data from multiple studies demonstrates that one type of reproductive depression is associated with a higher risk or other types of reproductive depression, and, in addition, genetic studies support the hypothesis that particular types of reproductive depression may have a genetic basis. Identification of women at risk for, and suffering from, reproductive depression is important in order to minimize suffering and maximize treatment outcomes. This presentation will address 1) common presentations of depression during times of hormonal change; 2) risk factors for the development of depression during times of hormonal change; and 3) treatment considerations for reproductive depression including hormonal treatments and standard approaches for women with either MDD or bipolar disorder.

Jennifer L. Payne, MD is Assistant Professor of Psychiatry and Co-Director, Women's Mood Disorders Center, Johns Hopkins School of Medicine. Dr. Payne's research interests focus on the underlying pathophysiology of mood disorders as well as the genetics and treatment of postpartum depression. She has been awarded a number of honors including the Passano Physician-Scientist Award and a NARSAD Young Investigator Award, and is currently funded by the NIMH and the Stanley Bipolar Research Foundation.  She is also the author of a number of research papers examining hormonally triggered mood symptoms in women with depression and bipolar disorder.

While transplantation has become a life sustaining procedure for those with end-stage organ disease, the psychological and physiological stresses inherent in the process (e.g., severe medical illness of the candidate, lack of available organs and the uncertainty of surviving to transplantation, risk of surgery, and the challenges of post-operative recovery) place enormous demands on transplant candidates, recipients, and their caregivers. Psychosomatic medicine specialists are frequently involved in the evaluation, selection, treatment, and long-term care of transplant candidates and recipients. Transplant-specific psychiatric and psychological issues essential to caring for these complex and unique patients will be covered in this lecture.

Andrea DiMartini, MD, FAPM is an Associate Professor of Psychiatry and Surgery at the University of Pittsburg Medical Center, Thomas Starzl Transplant Institute. She has worked as a psychiatrist in the area of solid organ transplantation for the past 16 years. She has extensively researched and written about posttransplant outcomes complicated by addictive disorders, mood and affective disorders, and non-adherence with treatment. She has also researched issues related to living donation and posttransplant quality of life. She currently is funded by the NIH to investigate long-term outcomes in patients transplanted for alcoholic liver disease.

Stephen Ferrando, MD, FAPM is Professor of Clinical Psychiatry and Clinical Public Health and Vice Chair for Psychosomatic Medicine in the Department of Psychiatry at the New York-Presbyterian Hospital, Weill Medical College of Cornell University. He attended Northwestern University Medical School, did his psychiatry residency training at the University of California, San Francisco, and subsequently did an NIMH-funded HIV/AIDS research training fellowship at Weill Cornell.  He has focused his clinical research on the neuropsychiatric and quality of life aspects of chronic illnesses such as HIV/AIDS and neurological diseases.  He has authored numerous peer-reviewed articles and book chapters and is a peer-reviewer for journals that span medical specialties.  He is senior editor of “Psychiatry In-Review,” a yearly updated multimedia psychiatry board review guide.  In addition, he is co-editing, with James Levenson, MD and James Owen, PhD, the upcoming Manual of Psychopharmacology in the Medically Ill, to be published by American Psychiatric Publishing, Inc.  Dr. Ferrando is immediate past president of the New York Area Society for Liaison Psychiatry and for over ten years has been involved with the APA’s HIV/AIDS programs.

This lecture will describe the bidirectional adverse interaction between depression and diabetes. Major and minor depression occur in approximately one in five patients with diabetes and are associated with increased medical symptom burden, additive functional impairment, poor self-care (adherence to medications, diet, exercise, and cessation of smoking), increased medical costs, and increased diabetes complications and mortality. Improving quality of depression care with collaborative care interventions has been shown to be associated with enhanced depression outcomes and savings in medical costs that last for up to five years.

Wayne Katon, MD, FAPM is Professor of Psychiatry, Director of the Division of Health Services and Epidemiology, and Vice Chair of the Department of Psychiatry and Behavioral Sciences at the University of Washington Medical School. Dr. Katon is internationally renowned for his research on the prevalence of anxiety and depressive disorders in primary care, the relationship of psychiatric disorders to medically unexplained symptoms such as headache and fatigue, and the impact of depression and anxiety on patients with chronic medical illness. He is editor-in-chief of General Hospital Psychiatry.

This course will review the pertinent literature and the presenters’ experience in the use of CAM treatments for anxiety, PTSD, depression, and cognitive dysfunction.  The course will cover the use of herbal and nutraceutical treatments.  The course will present barriers to the use of CAM treatments and countertransference responses to patients’ use of CAM, and foster discussion about how CAM approaches can be used along with, or instead of, traditional approaches to treatment. Non-pharmacological treatments will be presented including data on the use of meditation, yoga, and breathing techniques.  Participants will learn to use a basic but powerful yoga breathing technique during the course, which is easily applied in the clinical setting.

Objectives:

1. Participants will review about the literature supporting the use of CAM treatments for anxiety, cognitive dysfunction, and depression.
2. Participants will learn non-pharmacological approaches to the treatment of anxiety, cognitive dysfunction, and depression.
3. Participants will learn a technique of yoga breathing and how to incorporate the technique into clinical practice.

References:

Muskin PR (ed): Complementary and alternative medicine and psychiatry, Review of Psychiatry Vol. 19, Section 1. American Psychiatric Publishing, Inc., 2000

Lake JH, Spiegel D (eds): Complementary and alternative treatments in mental health care. American Psychiatric Publishing, Inc., 2007

Brown RP, Gerbarg P, Muskin PR: How to use herbs, nutrients and yoga in mental health care. WW Norton & Co., 2009

Philip R. Muskin, MD, FAPM is Chief of Consultation Liaison Psychiatry at Columbia University Medical Center where he is also Professor of Clinical Psychiatry.  He is the editor of Complementary and Alternative Medicine and Psychiatry, published by American Psychiatric Press, Inc. in 2000, one of the editors of Psychosocial Treatment for Medical Conditions (2003), and an editor of Psychological Effect of Catastrophic Disasters: Group Approaches to Treatment (2006). Dr. Muskin has received many awards, including Outstanding Teacher of the Year at the New York State Psychiatric Institute (NYSPI) on three separate occasions, the Association for Academic Psychiatry Regional Teacher of the Year Award, and the Society for Liaison Psychiatry award for outstanding contributions to the field of Consultation-Liaison Psychiatry.  Dr. Muskin's research and publications include mood disorders and AIDS, the psychodynamics of the failure of empathy towards patients with AIDS, panic disorder, treatment of anxiety and depression in medically ill patients, maladaptive denial of physical illness, personality disorders in the primary care setting, the role of religiosity in patients' decisions regarding do-not-resuscitate status, the psychodynamics of physician-assisted suicide, and the impact of intercessory prayer on medical outcomes.

Richard P. Brown, MD is Associate Clinical Professor of Psychiatry at Columbia University Medical Center. Since 1998, he has taught full-day courses on complementary and alternative medicine (CAM) at American Psychiatric Association meetings and other conferences. He gives over 200 medical lectures every year. Dr. Brown developed a neurophysiological theory of the effects of yoga breathing on anxiety, depression, trauma, and violence. Having studied yoga and meditative practices including Zen, QiGong, and yoga breath practices, he is a certified teacher of Aikido (4th Dan) and yoga, combining asanas, pranayamas, and meditation. Dr. Brown has authored over 90 articles and book chapters on pharmacological and clinical studies in psychiatry. He co-authored Stop Depression Now (1999), describing a holistic approach to depression using SAMe; The Rhodiola Revolution (2004), a fresh approach to the problems of stress and energy; "Alternative Treatments in Brain Injury" in Neuropsychiatry of Traumatic Brain Injury (APPI 2004, 2009); "Complementary and Alternative Treatments in Psychiatry" in Psychiatry (Wiley & Sons 2003, 2007); and his latest book, How to Use Herbs, Nutrients, and Yoga in Mental Health Care (WW Norton 2009).

Patricia L. Gerbarg, MD is Assistant Clinical Professor of Psychiatry at New York Medical College. She has lectured on psychoanalysis, trauma, neurobiology, and alternative treatments in psychiatry at meetings of the American Psychiatric Association, the American Psychoanalytic Association, the International Combat and Military Stress Conference, and other medical conferences. Dr. Gerbarg's research focuses on Integrative Psychiatry (combining standard and complementary treatments) for anxiety, PTSD, and depression in survivors of trauma, masses disasters, and military service. She co-authored The Rhodiola Revolution (Rodale 2004); "Complementary and Alternative Treatments in Psychiatry" in the textbook Psychiatry (Wiley & Sons 2003, 2008); "Alternative Treatments in Brain Injury" in Neuropsychiatry of Traumatic Brain Injury (APPI 2004); "Yoga in Psychiatry" in Clinical Manual of Complementary and Alternative Treatments in Psychiatry (APPI 2007). Her chapter, "Yoga and Neuro-Psychoanalysis," was published in Bodies in Treatment: The Unspoken Dimension (Analytic Press 2007).

Dr. Brown, Dr. Gerbarg, and Dr. Muskin write about Integrative Psychiatry in How to Use Herbs, Nutrients, and Yoga in Mental Health Care (WW Norton 2008). See www.haveahealthymind.com

Evaluation of cognitively impaired patients is an essential skill for clinicians in consultation-liason settings.  Many patients have both dementia and delirium, and an important aspect of consultation is diagnosing and managing dementia.  These issues often extend long past hospitalization and take into account functional changes in the patient’s ADLs and IADLs, cognitive changes, caregiver stress, and the effect of dementia on the family support system.

This course is designed to teach the practicing C-L clinician an integrated approach to dementia assessment and management.  Topics covered will include:

• An integrated approach to history-taking including caregiver input and assessment of functional as well as cognitive changes
• Specialized aspects of the mental status exam for dementia
• Bedside cognitive assessment
• Assessment and management of caregiver stress
• Supportive interventions for the caregiver including disease education, behavioral strategies, and home safety assessment including driving
• Pharmacologic management of behavioral issues in dementia

Paul B. Rosenberg, MD is Associate Director of the Division of Geriatric Psychiatry and Neuropsychiatry at Bayview Medical Center and Assistant Professor of Psychiatry in the Johns Hopkins School of Medicine. Dr. Rosenberg's clinical and research interests focus on improving treatment and diagnosis of Alzheimer's disease and its neuropsychiatric complications. This includes depression, psychosis, and caregiver stress.  In addition to Alzheimer's Disease, Dr. Rosenberg has expertise in the assessment and treatment of mild cognitive impairment. He has conducted research in the antidepressant treatment of depression in Alzheimer's disease and has explored the use of cytokines as biomarkers for this disorder.

Ann Morrison, PhD, RN is an Instructor of Psychiatry at the Johns Hopkins School of Medicine, Division of Geriatric Psychiatry and Neuropsychiatry.  She is also the Radlick Scholar at the Copper Ridge Institute as well as the Education Specialist for the Alzheimer’s Disease Research Center.  Dr. Morrison has been providing care to Alzheimer’s patients and families and directing clinical research since 1986. Dr. Morrison has directed research projects related to the identification of risk factors for Alzheimer’s disease, FDA drug trials for the treatment of Alzheimer’s disease, caregiver and family research, and home-based assessment of the elderly.  As the education specialist, Dr. Morrison has lectured extensively on topics such as Alzheimer’s research, biological issues related to Alzheimer’s disease, and nursing and sociological issues related to care of Alzheimer’s patients and families. In addition, Dr. Morrison has served as mentor/master clinician to nursing, social work, medical, and gerontology students.

This is an advanced course intended to provide a critical overview of current findings and controversial issues in delirium research. The course will provide an in-depth review of the following topics:

• Risk factors associated with the development of delirium
• Phenomenology: clinical symptoms and presentation
• Diagnostic Techniques & Differential diagnosis (e.g., dementia, withdrawal states)
• Temporal course, including motor subtypes & subclinical delirium
• EEG & motor monitoring
• Latest understanding of etiology, including neurochemistry, brain regions and neurocircuitry
• Treatment (efficacy and prohylaxis)

Even though we will review diagnostic scales and techniques, our focus will be on discussing the contemporary understanding of the neuropathogenesis of delirium and reviewing the latest research on prevention; will review evidence-based approaches to treatment; and will postulate about new research trends and promising techniques. This course is intended to “push the envelope” regarding our understanding of delirium and future trends on treatment and research.

Jose Maldonado, MD, FAPM is an Associate Professor of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. There he serves as Chief of the Medical and Forensic Psychiatry Section, Director of the Medical Psychotherapy Clinic, and Medical Director of the Consultation-Liaison Service. Dr. Maldonado's research interests include: management of delirium, confusional states and other acute organic brain syndromes; neuropsychiatric sequelae of medical illness and its treatment; and application of hypnosis in psychiatry and medicine. He has numerous peer-reviewed publications and has received many awards for his research and as a medical educator.

Paula T. Trzepacz, MD, FAPM is best known for her research and publications in delirium, geriatrics, and neuropsychiatry. She joined Eli Lilly & Company in 1999 and is Clinical Professor of Psychiatry at the University of Mississippi, Tufts University, and Indiana University medical schools. She served as medical director of US Neurosciences for five years and as medical fellow in global neurosciences working in drug development research in Phase 3 ADHD and Phase 2 Alzheimer's disease. Dr. Trzepacz has served as senior examiner for the ABPN Part II oral examination and on the examination committes for the ABPN Part I neurology for psychiatrists examination and the USMLE Part 2 psychiatry examination. She publishes and lectures extensively, has written two books, and serves on the editorial boards of the Journal of Neuropsychiatry and Clinical Neurosciences, General Hospital Psychiatry, and Psychosomatics. She continues to do many peer reviews for psychiatric, geriatric, neurologic, and medical journals and collaborates internationally in academic research in delirium and traumatic brain injury. She was APM president in 2004-2005 and is president-elect of the American Neuropsychiatric Association. Among her numerous honors and awards is the 1997 APM Research Award. She is listed in all four editions of Best Doctors in America for neuropsychiatry and is internationally recognized for her work in the phenomenology and neuropathogenesis of delirium.