BRAINST RMS Quarterly Publication of the University of Miami Department of Psychiatry and Behavioral Sciences
2018 In This Edition: De-stressing During The Most Wonderful Time of the Year Sharing the Holidays with a Loved One with Dementia Study Points to Novel Epigenetic Target for Alzheimer’s Disease Double Trouble: Mixing Drinking with Depression at the Holidays
A Message from the Interim Chairman ear Friends, 2019 is on the horizon and thus it is an appropriate time to reflect on where we were, where we are, and where we are going. It has been an eventful year, both inside and outside the department. Back in June, we welcomed Dr. Henri Ford as Dean of the Miller School of Medicine. Having had the opportunity to meet and share our visions for both the school and the Department of Psychiatry with one another, I am excited about working with Dean Ford particularly in the areas of research and education.
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Though the departure of Dr. Nemeroff, our beloved
Chairman, was difficult for many of us, we remain excited about future collaborations with him. I am delighted to have assumed the role of Interim Chairman, and while my duties have grown and shifted, I am immensely grateful to our faculty and staff who have rallied around this leadership change and provided me so much support. Collectively, our department achieved many successes this year, making strides in ongoing projects. Our joint venture with Acadia Healthcare to build a comprehensive behavioral health campus in Miami-Dade County continues to mature. We remain on track for a June 2020 opening. Our research enterprise continued to thrive, as our investigators received new grants in excess of $12 million. We are in the middle of recruiting and interviewing our next psychiatry residency class and I am pleased to report that the strength of applicants is outstanding. We are also recruiting for several clinical and research faculty positions in the department. I am looking forward to visiting with these impressive applicants in the coming months. Amidst these triumphs, however, we unfortunately also faced unexpected tragedies in 2018. All of our lives were disrupted when a 19-year-old gunman opened fire at Marjory Stoneman Douglas High School in Parkland, just an hour north of Miami, killing seventeen. We saw the #MeToo movement erupt and both men and women come forward with harrowing stories of sexual harassment and abuse, breaking their silence after decades. 2 | BrainStorms | Q4 | 2018
Natural disasters wreaked havoc in regions all across the country from Hurricane Harvey (Texas) to Hurricane Florence (Carolinas) to Hurricane Michael (Florida). Recently, we watched in dismay as entire cities in California were swept away after the most destructive wildfires on record raged throughout the state. And, sadly, suicides were as prevalent as ever, claiming the lives of two wellknown public figures, fashion designer Kate Spade and chef, author and TV host Anthony Bourdain— in the same week. Each of these events, in their own ways, impact the mental health of those affected, undoubtedly changing them forever. They are solemn reminders of how important it is to have those often-difficult conversations about our mental wellbeing, to ask that friend, family member, colleague, “are you okay?” We all must make mental health a priority in 2019. In closing, I want to thank each of you for your continued support of the department, and commitment to helping further our mission of transforming lives through teaching, research and service. We couldn’t do it without you. Wishing all of you a very joyous holiday season and a happy and healthy new year. Sincerely,
Radu
The Brain Behind BrainStorms: Get to Know Executive Editor Samantha Richter By Guest Author Jared Abramson, Vice Chairman for Administration and Finance, Department of Psychiatry and Behavioral Sciences very three months more than 2,000 people receive and read BrainStorms. In it, we always aim to share news on a variety of behavioral health topics and upcoming events, provide information on our clinical and educational programs as well as the cutting-edge research our faculty are doing, and highlight faculty and staff members for their exceptional work. Here in the department, we value our people above all else. We recognize how fortunate we are to have such a talented team and I am personally proud to be part of a department that includes so many hard-working individuals. Our leadership is committed to providing our people with the tools and autonomy to excel. At any given time, our faculty and staff are working to launch, operate, improve and expand dozens of services, programs and initiatives, further the science behind mental health, and uncover promising new treatments and therapies that can save lives. Making sure our team and all of our various constituencies are aware and informed of the many different things that we are doing is almost as important as actually doing them! Our inclination and ability to communicate effectively and bilaterally is what creates a cohesive culture of belonging, and pride that each individual’s work is noticed, appreciated and important. As BrainStorms has become a central piece to keeping us in lockstep and emphasizing a culture where we all feel connected by our common purpose, involved in overcoming our challenges and instrumental to our success, I thought it was about time to get to know the mind behind it—Executive Editor Samantha Richter.
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This is your first position at an academic medical center. What were you doing before and how is it similar or different? Prior to UM, I spent four years in Chicago at a non-profit committed to funding research in epilepsy, with the ultimate mission of finding a cure.
Similarly, my role there included elements of science and healthcare. I was tuned in to neurology and neuroscience, and the study of the brain. I was surrounded by brilliant scientists and novel research. With both psychiatry (affecting 1 in 5) and epilepsy (affecting 1 in 26), the prevalence is so high; yet there remains substantial stigma around both. That has been an ongoing challenge, especially in communications. As for differences, that organization was 11 people. So the structure was quite different than here, where campus is overflowing with 15,000 people. Also, UM offers a multidisciplinary environment with access to resources and experts in various fields. It’s a privilege to work among them. One of the best differences, however, is the coldest it has gotten in Miami since I moved was 50 degrees; in Chicago it was 50 below! One of the first things you did when you joined the department in 2016 was overhaul BrainStorms. This is the eighth edition; how did you conceptualize its format and content? Words and images have always made sense to me, which is fortunate since, as most know, my math skills are severely lacking. The majority of the time I know what I want something to look like before I even draft the piece. Visualizing colors and images helps me frame the tone and appearance of articles or stories and make it appealing to the reader. Content was easy; there is so much exciting work going on within the department I’ve had plenty to write about each quarter. People in the department seem to have responded positively to the publication and do a wonderful job keeping me apprised of their accomplishments. Additionally, I’ve enjoyed integrating guest author pieces, which offer new and different perspectives on mental health. There is so much talent here.
Clearly it’s working because you were recently recognized for your creative work at UM. Yes... I received two Gold MarCom awards for a brand refresh of the department’s communications portfolio and 2017 Annual Report. The MarCom Awards are an international competition for excellence in marketing and communications. There are around 6,000 applicants. Each submission is judged on its own merit, one award per category. But I can’t take full credit. I am fortunate enough to work with a renowned graphic designer (also named Sam!) who brings my wild ideas and concepts to life better than I could ever imagine. It is a true partnership; we’ve been working together for six years. Little-known fact about yourself? I can rap. Music? Yes. Jay Z, Tupac, Biggie, Drake… and under no circumstances will I ever do it in public!
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Sharing the Holidays with a Loved One with Dementia | By Guest Author Dr. Rosie Curiel Cid, Assistant Professor and Neuropsychologist, Department of Psychiatry and Behavioral Sciences heerful anticipation, joy and gratitude are marked emotions as the “most wonderful time of the year” approaches. Even between the rustle and bustle of the season, many experience highly positive sentiments as they anticipate festivities with family and friends. Families and care partners of a person with dementia, however, may experience heightened stress levels and a more complex array of emotions including compounded feelings of sadness and emotional loss. The holidays have a way of underscoring a sense of nostalgia over changes or recognition of losses that have ensued throughout the years. This is especially true if a loved one affected by dementia is unable to fulfill their traditional role within the family, has had a notable change in personality, or seems less engaged in customary activities. While many individuals with early-stage dementia are well able to travel and maximally enjoy the holidays, persons with more moderate levels of dementia may be vulnerable to feeling overwhelmed by the sensory overload that is commonplace during the holiday season. They may experience moments of confusion and usually need greater assistance to manage holiday stress and stay safe and organized if traveling. So often, the spouses and children of persons affected by more profound dementia have to extend an extraordinary effort to maintain traditions while trying to keep a stabilized environment for their loved one. Over time, that great effort may lead to exhaustion and generally be less possible. For example, it may be difficult to explain to family members or friends who do not have regular contact that observed behavioral changes such as repetition, impulsivity, disinhibition or reclusiveness are part of the illness. In addition, greater needs for supervision and care may lead care partners to miss holiday activities; so resentment, guilt, and feelings of isolation are not uncommon. It may be helpful for a loved one living with dementia to have the assistance of care partners that can facilitate their active participation in the holiday
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activities that bring them fulfillment by making some adjustments. For example, if gift giving is important, avoiding large shopping mall crowds and ordering gifts through catalogs or online makes this activity possible from the comfort and safety of their own home. Sharing old photos and fun family memories, or making traditional family dishes may be a nice way to engage a loved one with dementia in the celebration. For individuals who are directly providing care, travel outside the home or care facility may not possible. Families can be supportive by focusing on the activities that bring happiness and peace for the care partner and affected loved one with more advanced illness. Letting go of expectations can help make the holidays less overwhelming and less stressful. Families can make these adjustments by asking someone else to host the celebration, simplifying the meal, or changing the time of the meal to earlier in the day to minimize evening confusion. Developing new and simplified traditions, such as watching holiday movies or singing holiday songs may be a better fit with caregiving responsibilities. It may also be helpful to familiarize children with what they may expect to encounter if they are visiting a grandparent who has significant dementia. Informing children that it is possible that their grandmother or grandfather may confuse them or not recognize them because they can be
forgetful from time-to-time can usually help reduce moments of discomfort. Persons with dementia and the people who love them may find themselves faced with the opportunity to redefine how they wish to experience meaning during the holidays. It is okay to put feelings and comfort before traditions and it’s okay to decline participating in activities that may take you away from what is most important for you during the holiday season. It is also okay to seek expert respite care if you need to. Being compassionate with and embracing you and your loved one’s new needs may be one of the greatest and most meaningful gifts you can share. Spending time with loved ones: Ivan Curiel offering a final toast with his daughter, Rosie Curiel Cid. Christmas Eve 2017.
Study Points to Novel Epigenetic Target for Alzheimer's Disease research team at the University of Miami Miller School of Medicine’s Center for Therapeutic Innovation (CTI) has identified a novel epigenetic drug target to simultaneously normalize multiple deficits in Alzheimer’s disease (AD), the most common form of dementia in the elderly and the sixth leading cause of death in the U.S., according to the Alzheimer’s Association. The study, titled “Inhibition of HDAC3 Reverses Alzheimer’s Disease-related Pathologies in vitro and in the 3xTg-AD Mouse Model,” was published on November 5 in the Proceedings of the National Academy of Sciences (PNAS). The researchers demonstrated that epigenetic “eraser” enzyme, histone deacetylase 3 (HDAC3) is connected to multiple Alzheimer’s disease hallmarks, including beta-amyloid (Aβ), hyperphosphorylated tau and several other aberrant genes. “Importantly, none of the FDAapproved treatments available to date are efficacious at addressing these hallmarks, let alone multiple hallmarks,” said senior author Claes Wahlestedt, M.D., Ph.D., professor of psychiatry and behavioral sciences, associate dean for therapeutic innovation, and director of
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“Most importantly, this work endorses a multipronged approach to the treatment of AD and supports the broad therapeutic potential of a single epigenetic small molecule, bypassing the need for developing multiple drugs to be used in combination.” Dr. Claes Wahlestedt
the Center for Therapeutic Innovation. His laboratory conducted the new study, which was supported by the National Institutes of Health and the State of Florida Department of Health (the Ed and Ethel Moore Alzheimer’s Disease Research Program). Karolina J. Janczura, first author of the study, a Ph.D. candidate at the Center for Therapeutic Innovation and an American Heart Association predoctoral fellowship recipient, stated: “This was an incredibly rewarding experience. We were able to demonstrate that it is possible to re-program neuronal cell gene expression and thereby achieve a very striking reversal of deteriorating memory in our Alzheimer’s disease model.” Claude-Henry Volmar, Ph.D., co-corresponding author, director of research laboratory at the Center for Therapeutic Innovation and associate director of Molecular Therapeutics Shared Resource at the Sylvester Comprehensive Cancer Center, added: “We discovered that treatment with RGFP-966, an experimental HDAC3 inhibitor drug, normalizes Alzheimer’slike pathology in multiple cellular and animal models. Considering that the majority of clinical trials focused on traditional AD targets have failed to date, our group focused on the multifactorial aspect of the disease, and we hope our recent discovery will guide
From left, Karolina J. Janczura, Claes Wahlestedt, M.D., Ph.D., and Claude-Henry Volmar, Ph.D
the development of AD therapeutics.” “Further support of the potential role of HDAC3 in Alzheimer’s in this work comes from the fact that its inhibition in AD patient-derived neurons also resulted in reversal of AD phenotype,” Janczura said. “Interestingly, a novel interaction between the protein tau and HDAC3 was discovered in this project, suggesting a possible role of HDAC3 in other tau-related pathologies in addition to AD,” Volmar said. “Most importantly, this work endorses a multipronged approach to the treatment of AD and supports the broad therapeutic potential of a single epigenetic small molecule, bypassing the need for developing multiple drugs to be used in combination,” Wahlestedt said. Based on these new findings, the University of Miami CTI team is now working to bring related strategies from the laboratory into clinical settings. Miller School co-authors were Shaun Brothers, Ph.D., Gregory C. Sartor, Ph.D., Sunil J Rao, Ph.D., Natalie Ricciardi, BS and Guerline Lambert, MPH. This article was written by Robert Benchley and originally appeared in INVENTUM.
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Double Trouble: Mixing Drinking with Depression at the Holidays | By Guest Author Dr. Ihsan Salloum, Chief, Division of Alcohol and Drug Abuse: Treatment and Research, Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences
olidays are joyful occasions where the opportunity to celebrate multiplies. For some, however, holidays may also be associated with sorrows and painful memories. Alcoholic beverages have been part of celebrations since time immemorial. But for those who are struggling to stay sober, holidays can be a particularly high-risk period, as “just one drink is too many, and one-thousand are not enough” as the Alcoholics Anonymous (AA) aphorism aptly states, capturing the essence of addiction symptoms of loss of control over drinking behavior. Sorrows, painful memories, negative feeling and thoughts are well-known risks for relapse to excessive drinking. Thus, the holidays, instead of being a reinvigorating and joyful time, could easily become a trying and difficult downward spiral into heavy drinking and deeper depression with catastrophic consequences. Clinical depression and alcohol use disorder (commonly called alcoholism) are among the most frequent mental disorders seen in patients. Often the same individual suffers from both
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problems at the same time. The symptoms and suffering caused by either condition alone can be daunting, but when an individual is dealing with both conditions (dual disorders or ‘double trouble’ as some like to call them), the suffering and burden on the patient and their families becomes unbearable. These dual disorders are associated with the highest occurrence of dysfunctions, need for hospitalizations and complications such as suicidal behavior. They are also less responsive to available treatment. The exact cause of why so many people develop both problems is still unknown. Chronic alcoholism is known to cause depression as well as worsen existing depression. Many people with depression resort to heavy drinking to “drown out” their sorrows. Studies have also pointed to the significant role of heredity in developing these conditions. Recent scientific evidence has highlighted the role of inflammation and alterations to the immune system in both clinical depression and chronic excessive alcohol drinking. Studies suggest that inflammation plays a bidirectional role in both depression and alcoholism. On one
hand, inflammation seems to cause depression and increases the propensity for drinking alcohol. On the other hand, both depression and excessive alcohol use, through different mechanisms, increase the level of inflammation in the brain. This holiday season, be mindful of your health and the health of those around you. A good time can be had by all, even alcohol-free.
A version of this article appeared in the Miami Herald on December 3rd.
Stem cell therapy holds great promise for decreasing inflammation in the body as studies have shown that one session of this treatment can decrease inflammation over a one-year period. Stem cell therapy may undercut a major mechanism underlying the dual disorders of depression and alcoholism and provide new hope for people suffering from these disabling disorders. The Department of Psychiatry at the University of Miami Miller School of Medicine, in collaboration with the University of Miami’s Stem Cell Institute, is conducting a new study funded by the National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health to test the usefulness of stem cell therapy for people suffering from the “double trouble” of clinical depression and alcoholism. In early 2019, the Department will hold an informational seminar that will delve deeper into the relationship between depression, alcohol use, and inflammation. The seminar is free to the public and will include mental health screenings in addition to opportunities for participation in innovative stem cell research. Individuals who are interested in attending the seminar should contact the UM Department of Psychiatry at 305.243.5840.
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Clinical Trials Corner ne of the missions of the Department of Psychiatry is to conduct highly innovative research to increase our understanding about difficult to treat psychiatric conditions and advance new treatments in these areas. In this column, we will spotlight clinical trials in a breadth of focus areas.
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ALZHEIMER’S DISEASE Novartis Generation 1 & 2 Studies: These two studies examine the effects of investigational medications on cognition, global clinical status, and underlying pathology in participants at risk for Alzheimer’s Disease (AD). Genetic testing is used to confirm potential participants’ risk level. Neurim: Alzheimer's disease (AD), a progressive neurodegenerative disorder, is the leading cause of dementia in the elderly population. People progressing to AD develop distressing changes in memory, thought, function, and behavior, which worsen over time. This study aims to determine whether an investigational medication, piromelatine, may improve clinical outcomes in patients with mild dementia.
Bipolar/AUD: Excessive alcohol use can exacerbate the symptoms of Bipolar Disorder and present an obstacle to treatment. This study looks to compare the effectiveness of two “Nutraceutical” supplements (available over-the-counter) in reducing symptoms of Bipolar Disorder and Alcohol Use Disorder (AUD). Takeda: Vortioxetine for Treatment of PTSD: There are some treatments for PTSD that are approved, but their level of efficacy is not optimal. This study examines whether a newly approved antidepressant therapy, Vortioxetine, may be effective in treating PTSD. Vortioxetine is unique because it is the only medication approved by the US FDA to improve cognitive functioning in people with mood symptoms. Thus, the cognitive changes seen in PTSD may also benefit from this treatment.
Lithium Study: Agitation is an issue that often presents itself in patients with Alzheimer’s Disease (AD), even when they are already taking medication. This study evaluates whether treatment with a mood stabilizer, Lithium, improves agitation/aggression in individuals with AD.
SCHIZOPHRENIA Boehringer Ingelheim 1289-0049: Schizophrenia is a chronic and disabling illness affecting approximately 1% of the population, with the majority of patients experiencing multiple relapses during the course of the illness. It is clear that acute psychotic exacerbation in these individuals has serious negative consequences. This study evaluates the potential of an investigational medication to prevent the relapse of schizophrenia symptoms in patients already taking an antipsychotic.
MOOD/ANXIETY ALAUNUS Study: This study looks to compare the effectiveness of a single Stem Cell infusion in reducing symptoms of Depression and Alcohol Use Disorder. For patients with Major Depressive Disorder, AUD, and elevated levels of inflammation, a Stem Cell infusion may reduce inflammation and provide a non-pharmaceutical approach to improving symptoms.
Roche: Patients with schizophrenia often exhibit cognitive deficits in areas such as attention, speed of processing, reasoning, working memory, visual learning, verbal learning and social cognition. For some patients, these deficits may remain even after their psychotic symptoms are controlled with medication. This study seeks to examine the effectiveness of an adjunctive (add-on) medication in treating cognitive impairment in patients with schizophrenia.
EMA: Introspective Accuracy, Bias, and Everyday Functioning in Severe Mental Illness: Self-awareness can be markedly impaired in severe mental illnesses, including both schizophrenia and bipolar disorder. This impairment spans awareness of symptoms as well as the ability to directly evaluate one’s own abilities and performance, a skill referred to as introspective accuracy (IA). This study will use smartphones to administer daily repeated naturalistic assessments (EMA) to participants for a 30-day period, and upon completion a series of comprehensive assessment of performance based measures important for selfassessment of functioning will be performed.
TOURETTE SYNDROME T-Force Platinum: Tourette syndrome (TS) is a movement disorder characterized by the presence of chronic motor and one or more vocal tics that often appear in childhood or early adolescence. To date there is no cure and although symptoms typically subside during adulthood, the effect of the tics on everyday functioning in childhood warrants the development of effective treatment. This study is designed to evaluate the safety and efficacy of an investigational medication in reducing TS symptoms during open-label treatment and doubleblind withdrawal phases. ARTISTS-II: Tourette syndrome (TS) is a movement disorder characterized by the presence of chronic motor and one or more vocal tics that often appear in childhood or early adolescence. To date there is no cure and although symptoms typically subside during adulthood, the effect of the tics on everyday functioning in childhood warrants the development of effective treatment. This study is designed to evaluate the safety and efficacy of an investigational medication in reducing TS symptoms in an adolescent population. For more information about participating in a clinical trial, please see the back cover of this publication.
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Department of Psychiatry Consultation-Liaison Team Represents UM at ACLP Meeting he 2018 Annual Meeting of the Academy of ConsultationLiaison Psychiatry was held on November 13–17, 2018 in Orlando Florida. This year’s theme was Branding CL Psychiatry: Defining the Breadth and Depth of Our Subspecialty. Dr. Lujain Alhajji, CLP Faculty member, represented UM and the THRIVE Clinic at the poster session. The University of Miami THRIVE Clinic (Trafficking Healthcare Resources and Intra-Disciplinary Victim Services and Education) is a multi-disciplinary, trauma-informed, collaborative care clinic where survivors of human trafficking can access comprehensive healthcare—including primary care, gynecological and psychiatric services—as well as case management and peer support outreach coordination. Dr. Alhajji presented two academic posters, one in collaboration with Dr. Jeff Newport, Professor of Psychiatry, and Director of Women’s Reproductive Mental Health, and another in collaboration with Dr. Vanessa Padilla, Assistant Professor of Clinical Psychiatry and postgraduate Dr. Maher Almatrafi. The first poster was entitled THRIVE: Our
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Collaborative Care Clinic for Survivors of Human Trafficking. It addressed that human trafficking is a public health issue that deserves attention from all medical providers and especially psychiatrists. THRIVE’s collaborative care model holds the potential to identify vulnerable patients and improve healthcare access through collaboration with healthcare providers, local agencies, organizations, and local shelters. The second poster, The “Smart Pill” High: A Case of Phenibut Intoxication and Withdrawal, was a case report that highlighted the abuse potential of phenibut (a depressant with stimulant effects) with the associated clinical presentation of intoxication, withdrawal,
and relapse, as well as the use of baclofen as a potential treatment of phenibut withdrawal. This was the first identified case of phenibut dependence and withdrawal at the JMH ConsultationLiaison Psychiatry service. Congratulations to Dr. Alhajji and all of the UM ACLP participants!
The Academy of Consultation-Liaison Psychiatry represents psychiatrists dedicated to the advancement of medical science, education, and health care for persons with comorbid psychiatric and general medical conditions, and provides national and international leadership in the furtherance of those goals.
The Most Wonderful Time of the Year? | he holiday season is often portrayed with excitement and positive energy. After all, it’s a time usually spent indulging in delicious food, exchanging gifts, taking time for faith, and being among family and friends. But for many, the holidays can also be a time of increased levels of stress and depressed mood. With more demands, financial constraints, isolation from friends or family, less daylight, and fewer opportunities to be outside due to inclement weather (luckily not an issue for Florida!), the holiday season can bring about the “holiday blues.” Fortunately, there are several tips you can implement to battle these blues. During the holiday season, it is important to surround yourself with supportive friends and family; however, setting limits for commitments is also beneficial for your mood. List your responsibilities and commitments and prioritize them. Be realistic about what you can and cannot accomplish during the holiday season, and share responsibilities
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By Guest Author Dr. Lisa Oliveri
with friends and family to reduce the burden on yourself. The holidays can be difficult particularly after suffering a loss of a friend or family member. Rather than comparing this year to years past, create new traditions to honor the memory of your loved ones. For instance, if your mother always took great pride in baking holiday cookies, start a new tradition of baking and decorating holiday cookies with a friend or another family member. This will be a great way to honor your loved one, enjoy a new yearly tradition, and strengthen existing relationships with friends and family. If you live far away from loved ones, you can seek out social groups to join, such as religious groups or hobby-specific groups. You can also broaden your social network while giving back to your community by volunteering for a cause that is important to you. Helping others in need is another way to improve your mood. Although the holidays can be busy, be sure to continue to get a good night’s sleep, exercise at least three days per
week, and maintain a healthy diet (as much as you can outside of the holiday parties). You can also set aside a few minutes each day to focus on yourself by practicing mindfulness, meditation, reading, or listening to music. With proper planning and implementation of some of these tips, you can reduce your stress level, improve your mood, and enjoy a holly jolly holiday season!
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Faculty Feature | Dr. Edmi Cortes-Torres | Assistant Professor, Department of Psychiatry and Behavioral Sciences, Chief, Inpatient Psychiatry, UHealth Tower r. Edmi Cortes has been a faculty member in the Department of Psychiatry and Behavioral Sciences for more than eight years. In July 2010, she became Chief of Inpatient Psychiatry at the UHealth Tower (formerly known as University of Miami Hospital [UMH]). There, she has worked diligently at developing, implementing and improving a number of psychiatric services offered to our community. Get to know Dr. Cortes below, and more about the vital services she is responsible for leading.
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Developing and running a program is no easy task. Can you tell us about some of the services at UHealth Tower? We have a wide variety of services to treat a number of different disorders. These include: Psychiatry Inpatient Services for the acute treatment and stabilization of patients in a secure hospital environment, Psychiatry Consultation Service available throughout the hospital to all other medical specialties, psychiatry residency training site to broaden the educational experience offered to our trainees, psychiatry clerkship training site to broaden the educational experience offered to our medical students. Electroconvulsive Therapy treatment (ECT) Program and Repetitive Transcranial Magnetic Stimulation (rTMS) Program. I also had the pleasure of opening the physician
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office-based outpatient psychiatry clinic in the South Building of UHealth Tower. It was a very hands-on role from designing the office layout to choosing the paint and furnishings. When did you know you wanted to be a psychiatrist? For as long as I can remember, I wanted to work in the mental health field. I initially considered studying psychology to become a clinical psychologist but later discovered a passion for biology and decided to complete a bachelor’s degree in biology. I then pursued and completed studies in medicine and psychiatry was my clear choice of specialty. Many psychiatrists get extra certification in subspecialties and treat patients according to their areas of focus. But your team is often tasked with recognizing and diagnosing co-occurring disorders that make some inpatient cases so complex. Are you required to be familiar with all of the subspecialties? We have a fantastic team with a diverse training background, and I personally pursued two subspecialty trainings, one in Child and Adolescent Psychiatry and another in Forensic Psychiatry. I did both of my fellowships right here at Jackson Memorial Hospital, which is a wonderful training ground for the treatment of most psychiatric disorders
The UM Department of Psychiatry and Behavioral Sciences extends a warm welcome to new members of the team: Giselle Leal, PsyD Postdoctoral Fellow
Talytha Campos Research Assistant
Gabriella Grau Research Assistant
Nadja Soares De Andrade, PhD Post Doctoral Associate
Maria Cruz Research Assistant
Luis Sierra Research Associate
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Nelson Milhet, ARNP, Drs. Musselman, Cortes and Sharma
and provides a unique, multicultural environment. Currently, I mostly work with adults at UHealth Tower but my additional training has served me well since we treat patients from all different backgrounds with a variety of psychiatric disorders. Everyone receives the same diligent treatment and careful attention. I am so proud to be part of such cohesive and competent group of clinicians who lead different service lines and provide exceptional care to our patients. We share the same goals for outstanding service delivery, passion for mental health treatment and advocacy for our patients. Among these caring and dedicated colleagues are Dr. Rakesh Sharma, Nelson Milhet, ARNP, Dr. Elizabeth Crocco and Dr. Dominique Musselman—a truly extraordinary team!
Staff Star | Stephanie Stewart | Administrative Assistant, Department of Psychiatry and Behavioral Sciences he Staff Stars column highlights the commitment and accomplishments of an individual in the Department of Psychiatry and Behavioral Sciences. Nominations may be submitted to Samantha Richter at psychiatry@miami.edu. Please include a brief description of the nominee’s job responsibilities and why you believe they should be the next Star!
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Where are you from originally? I am from Jamaica, a breathtaking island situated in the Caribbean Sea. Kingston, where I was born, is the country’s largest city. Its gorgeous white-sand beaches, clear blue waters, graded mountains and people with a generally laid back, unruffled demeanor make Jamaica a very popular vacation getaway. The favorite Jamaican phrase, “No problem mon,” is indicative of an atmosphere of less stress and more relaxation. When did you join UM? I joined the UM team in December 1980 in the capacity of Staff Associate in the Department of Medicine. My tenure at the University of Miami thus far has allowed me to embrace so many valuable lessons. Even the challenges that I have encountered over the years have helped me to mature and increased my capacity for sharing knowledge with others. U of M has become an invaluable learning sphere that I treasure.
Have you worked in other departments besides Psychiatry? I have worked in the Department of Medicine with two Chairs: Dr. John McKenzie and Dr. Lawrence Gardner; and three Vice Chairs: Teri Thompson, Jane Davidson and Jerry Broderick. Their diverse work techniques and extraordinary knowledge taught me so very much about the operations of the University. You play an important role in the department – interfacing with staff, faculty and patients. What’s your favorite part of your job? My job is a very integral part of my life. The innate passion for helping others and for interacting with people from all walks of life, with which I have been blessed, serves me well in administering my job. In performing my duties on a daily basis, I get a sense of satisfaction from assisting people (both external and internal) in attaining their objectives, which may include resolving issues quickly and scheduling appointments with the right doctor. In interacting with the various physicians and their diverse requirements, I have to tailor assistance in specific ways rather than take a general approach. This helps me maintain my aptitude for working under pressure. Last, but not least, is the rewarding working relationship I enjoy with Jared Abramson, to whom I report directly. He consistently demonstrates an exceptionally high degree of knowledge, which he, unreservedly, passes to me in delegating job duties. I have learned extensively from working closely with Jared. He maintains high expectations of his staff, and that encourages me to give 100% every day. He is committed to the growth of not just the institution but also his team’s personal growth. For this I am grateful. What would you be doing if not this? As a youngster, I dreamed of becoming a flight attendant. However, as fate ordained, that was not realized. I wanted to travel the world at minimal financial
cost while helping folks enjoy their flight experiences. Despite not having become a flight attendant, I still have traveling the world on my bucket list. I also wanted to have my own flower shop. I have always maintained that flowers make people happy, and I enjoy making people happy. Growing up in Jamaica, I was surrounded by exotic flowers and plants that were beautiful and very aromatic. Although I did not open my very own flower establishment, I have surrounded my house with beautiful, colorful plants and spreading trees that I enjoy immensely. This is the next best thing to my owning a flower shop! Do you have a favorite holiday tradition? I love the Christmas season. I get to experience the thrill of gathering with family and friends to exchange gifts, enjoy a wide variety of Caribbean cuisine and engage in much laughter and cheer. I still maintain the Jamaican tradition of making rum (fruit) cakes and preparing Sorrel, our national Christmas drink. Sorrel, in appearance, resembles dried hibiscus leaves and is magenta in color. It is a very refreshing drink but will quickly intoxicate you if you consume too much. In Jamaica at Christmas time, we also attend fancy carnival-like street parades (called “Junkanoo”) with music and dancing. The participants dress as various comedic characters or in scary, but funny, costumes. It is an exhilarating experience.
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What to Do & Where to Go For a Mental Health Emergency, CALL 911 if you believe someone is in danger of hurting themselves or others. University of Miami Hospital (UMH) Mental Health Admissions/ER 305.689.4444 Jackson Behavioral Health Hospital Triage 305.355.7332
Common Purpose
Transforming lives through teaching, research and service.
Silver Alert If your loved one has gone missing, please CALL 911 immediately. Silver Alert is a statewide initiative to involve the public in locating a cognitively impaired person who has gotten lost driving or while on foot. For more information visit florida silveralert.com.
Chairman’s Office 305.243.6400
Soffer Clinical Research Center 305.243.2301
Jackson Behavioral Health Hospital 305.355.9028 *Option 2
Courtelis Center 305.243.4129
University of Miami Hospital 305.689.1352
Center on Aging 305.355.9081
Office Numbers Main Psychiatry Appointment Scheduling 305.355.9028 *Option 1
Boca Raton 561.939.4044
Brain Fitness Pavilion 305.355.9080 *English, Option 3
Child & Adolescent 305.355.7077
Memory Disorders Clinic 305.355.9065
Deerfield Beach 954.571.0117
The University of Miami Leonard M. Miller School of Medicine Department of Psychiatry and Behavioral Sciences is committed to: Conduct research that deepens our understanding of the development, pathophysiology, and prevention of psychiatric illness and the nature of human behavior, and apply this knowledge to the development and delivery of more effective, evidence-based treatments.
Offer comprehensive treatment and consultation to our patients, their families, and the community. Provide outstanding mental health education and multidisciplinary training to the next generation of healthcare providers and investigators. DIRECCT Core values l Diversity l Integrity l Responsibility l Excellence l Compassion l Creativity l Teamwork
Clinical trials are the backbone of evidence-based medicine. Broadly speaking, clinical trials evaluate the safety and effectiveness of a medical strategy, treatment, or device. Moreover, clinical trials provide an opportunity for the general public to participate in the process of developing novel treatments for a variety of conditions. The results from these clinical trials provide the data necessary to assist in future medical decision-making. The Department of Psychiatry & Behavioral Sciences is dedicated to generating the scientific knowledge behind the clinical best practices we incorporate in the treatment of difficult and complex mental health conditions. The Behavioral Research Assessment Center (BRAC) is the research hub that fulfills the Department’s mission to develop the next line of treatments. For more information on participating in available clinical trials, please email brac@miami.edu or call 305.243.5840.
Q4 | 2018
BRAINSTORMS Quarterly Publication of the University of Miami Department of Psychiatry and Behavioral Sciences Executive Editor Samantha Richter Soffer Clinical Research Center 1120 NW 14th Street | Suite 1457 Miami, FL 33136
Health
UNIVERSITY OF MIAMI HEALTH SYSTEM Psychiatry & Behavioral Sciences
12 | BrainStorms | Q4 | 2018
