BrainStorms Q3 2018

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Q3| 2018

BRAINSTORMS Quarterly Publication of the University of Miami Department of Psychiatry and Behavioral Sciences

In This Edition: The CBNd of an Era — Dr. Charles B. Nemeroff Steps Down as Chairman of the Department Q&A with Dr. Luca Pani on the Sustainability of Healthcare Funding Back to School: The Transition from Elementary to Middle School

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A Message from the Chairman his is the most difficult of Chair messages to write because it is my final message as chair of the Department of Psychiatry & Behavioral Sciences at the University of Miami Miller School of Medicine. After nine years in this position, I am relocating to the University of Texas Dell Medical School in Austin, Texas.

It is, therefore, a time of reflection of what we have accomplished in the past nine years and a brief look into the future.

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When I arrived here in 2009, the department had been relatively leaderless for some time. Morale was low and faculty were largely mistrustful. With the help of then President Donna Shalala and Dean/VP Pascal Goldschmidt, resources were identified to allow me to recruit a number of new faculty, researchers, educators and clinicians. Both new space and funding was made available and we were fortunate in attracting a phenomenal group of faculty. With that success came a remarkable crop of residents, year after year, more and more competitive. Both the faculty and the residents came from regions throughout the United States.

I will not be able to name everyone, but some of the notable recruitments included Claes Wahlestedt, MD, PhD from the Scripps Research Institute with a large team that has now developed into independently funded and successful investigators, including Drs. Shaun Brothers, Nagi Ayad and Zane Zeier. Phil Harvey, PhD joined us from Emory and has been phenomenally successful as both the Psychology Division Chief and the leader of research in schizophrenia and related disorders.

Dominique Musselman, MD also joined us from Emory and took on the task of running the Jackson consultation-liaison service with aplomb.

Jeffrey Newport, MD developed a Women’s Reproductive Mental Health Program that has included a major residency teaching component. Richard Jope, PhD and Eleonore Beurel, PhD were recruited from the University of Alabama and have exceeded all expectations in their remarkable extramural funding and peer reviewed publications in basic neuroscience/ neuroimmunology. Stephen McLeod-Bryant, MD, joined us from Meharry Medical College and has been tireless in his attending role on the inpatient service at Jackson. More recently, we were fortunate in 2 | BrainStorms | Q3 | 2018

recruiting Firdaus Dhabar, PhD from Stanford and Barbara Coffey, MD from Mt. Sinai in New York; both are acclaimed leaders in their fields. Firdaus in Stress Neurobiology and Barbara landed with a new NIH grant and is a world renowned expert in Tourette’s syndrome.

Most remarkable were the gems I discovered who were already here when I arrived. They included Ihsan Salloum, MD, Deborah Weiss-Jones, PhD and Steve Weiss, PhD of HIV research fame, Ana Campo, MD, Associate Dean, extraordinaire, Joseph Henry, MD, a remarkable psychopharmacologist (80,000+ admissions to the inpatient service at JMH) and David Loewenstein, PhD, one of the world leaders in Alzheimer’s research.

Together with Elizabeth Crocco, MD who had about five distinct jobs that she does well and Edmi Cortes, MD who holds UMH together, the faculty leadership was quite remarkable. Add to that the recruitment of Radu Saveanu, MD as Vice Chair for Education and then Executive Vice Chair for Education and Clinical Services (and soon to be Interim Chair) and the very best Vice Chair for Administration in the School (and perhaps the nation), Jared Abramson, and the team was an A+.

I have never known a harder working group of faculty— the high service load and our chronic shortage of personnel constantly demanded effort from the faculty unlike any I had witnessed in my many years in academic medicine, and they always stepped up to meet the challenge. Whether asked to see one more patient or teach one more class or run one more program (Drs. Samir Sabbag, Marisa Enchenique, Dante Durand, Vanessa Padilla, Ingrid Barrera, Nicole Mavrides, Rosie Curiel, Anthony Castro), they never said no. And a special thanks to Felicia Gould, PhD who juggled her research responsibilities working with me on my many projects with her clinical duties. I would be remiss

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if I did not mention Carmen Alsina, my executive administrative assistant who has been my face to the department, the other departments in the school and to the outside academic community. I have never had a more dedicated and tireless colleague.

To the external advisory board of families and friends in the community who have supported the department through good times and bad and allowed us to move forward when school resources were meager, I am very grateful. I will not list all of those who have contributed but the previous chairs of that board, Harley Tropin and Susan Racher and the current chair, Alfredo Frohlich deserve a special shout out. Samantha Richter who has overseen the BrainStorms publication and the external board activities has been extraordinary in both content and style. And to all of those not singled out, I do not wish to minimize your contributions to our successes—to the many staff and faculty not mentioned, we could not have done it without you.

Our successes have been many, too many to document in this essay. First and foremost, the thousands of patients that we, together, have helped over the last many years. A few other successes to highlight would be our climbing into the top 25 of NIH rankings, the success of the Comprehensive Diagnostic and Treatment Evaluation Program which has seen

approximately 300 patients, and the plans for the new comprehensive behavioral health campus. The latter plan, in partnership with Acadia, will create the very best behavioral health facility for patients in South Florida. Three years in the planning, I look forward to seeing it open in 2020.

Many have asked me why I have made this major life decision as I enter the final lap in my academic career. The reasons are manifold. First, I have been given the opportunity by the University of Texas to establish an Institute for Early Life Adversity Research.

All of you who know me know that my passion in research in the last three decades has been investigating the deleterious effects of child abuse and neglect. I have been given sufficient resources to make a serious impact on this major public health problem. Second, after 28 years as a department chair, I am delighted to relinquish that heavy administrative burden to focus on research, education and patient care.

Third, in addition to directing this new institute, I have been asked by the Dean/VP for Health Affairs at the University of Texas to serve as a Special Advisor to the Dean overseeing all clinical research and quite a lot of the translational research in the medical school.

Finally, our son Ross and our two granddaughters live in Austin and being able to watch them grow and see them often is a big draw.

It is therefore bittersweet to say goodbye to the University of Miami. I will remain a Hurricanes fan, hard as that sometimes is. I will retain my UM appointment as an Emeritus Professor. I will continue to collaborate with several of the faculty in research projects. I will miss many of you. I learned a long time ago that to enjoy serving as a department chair requires that one loves the faculty. That was never an issue here.

The faculty deserved to be loved for all they do.

My very best wishes to all of you as the department moves forward and continues to thrive.

Sincerely,

Charlie 3 | BrainStorms | Q3 | 2018

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A Message from Dr. Radu Saveanu, Interim Chair, Department of Psychiatry and Behavioral Sciences

ear friends, As you’ve heard by now, our beloved Chair of the Department Dr. Charlie Nemeroff has stepped down after accepting a position at Dell Medical School in Austin, Texas.

In addition to moving closer to his grandchildren, he will be leading the newly established Institute for Early Life Adversity Research.

Though Dr. Nemeroff will be tremendously missed, it is truly a wonderful opportunity for him to continue pursuing work he is passionate about. We wish him nothing but the best and look forward to watching him grow this important new Institute.

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In light of this leadership change, I wanted to take the opportunity to introduce myself as the new Interim Chair for UM’s Department of Psychiatry and Behavioral Sciences as well as provide an update on our current work.

I joined the faculty at UM in 2011 as Vice Chair for Education. In the years since, in addition to education and the training of our outstanding residents, I became the director of all departmental clinical services.

Prior to joining UM, I spent 10 years at The Ohio State University, my alma mater, where I served as Chairman of the Department of Psychiatry and Executive Director of OSU Harding Psychiatric Hospital.

I received my M.D. from Tufts University Medical School in Boston, Massachusetts, where I also completed my internship before residency at the Tufts–New England Medical Center Hospitals.

The focus of my clinical research has been on developing effective treatment interventions for patients with mood and anxiety disorders and comorbid medical and psychiatric disorders (such as cardiac disease and HIV infection). This includes extensive experience in conducting pharmacotherapy trials for mood and anxiety disorders.

Here in our department, we have an exciting gamut of projects ahead and I hope you will join me in embracing the possibilities these projects offer.

Our joint venture with Acadia Healthcare will bring a new, state-of-the-art behavioral health facility to Miami that will provide outstanding clinical care to our community and opportunities for research and education. We continue to grow the department, 4 | BrainStorms | Q3 | 2018

welcoming new faculty with expertise in a variety of subject areas including neuropsychology, psychooncology, emergency psychiatry, child/adolescent and adult psychiatry. And, our commitment to training the next generation of leaders in the field of psychiatry goes unchanged. We are thrilled to welcome our newest class of 15 residents from all around the world, each of whom wields a promising future in mental health treatment.

Our brand new Center for Cognitive Neuroscience and Aging led by Dr. David Loewenstein is poised to become an international leader in understanding the aging brain, and a hub to develop and employ the most cutting-edge techniques for the study of brain disorders such as dementia and Alzheimer’s disease.

While change is never easy, it is inevitable. After a an exceptional nine years, the departure of Dr. Nemeroff, our exceptional Chair, will undoubtedly be difficult and require time to adjust.

I am pleased to have the opportunity to lead this terrific department and am confident that with positive energy and an unending commitment to bettering the lives of people with mental health disorders, we will continue to flourish.

Most Sincerely,

Dr. Radu Saveanu

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The Next Steps: Help Your Child Transition from Elementary to Middle School ransitions are hard for everyone.

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Now, imagine if you were in a new job in a larger office where, instead of having one supportive manager, you have several bosses and a whole new group of coworkers, as well as mood swings and acne.

That description is similar to what your child may experience when they transition from elementary to middle school. Although you can’t keep them home and shield them from it, you can help make things less challenging. All it takes is a little communication, preparation and organization, and it's never too early to start.

Middle school is different Your child’s daily school routine is about to change drastically.

Most children go from having one teacher and staying in the same classroom all day to having several teachers in different classrooms.

Dr. Nicole Mavrides, child and adolescent psychiatry expert at the University of Miami Health System, explains that fear of getting lost is a common source of anxiety for kids.

“Luckily, most schools these days offer things like orientation to help

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with the transition,” she says.

“Encourage your child to write down questions to ask teachers during the event and take the opportunity to let your child walk around; help them find the cafeteria and gym.”

Many schools are open after the school day ends, so you may be able to go a few times. If your child is worried about using a locker, buy a lock and let them practice opening it at home.

Make it fun Getting the school supply list and taking your child shopping can be fun.

Have a special day where you take them to get everything they need and maybe some new clothes, too. “This is a perfect opportunity to give your child your undivided attention as well,” says Dr. Mavrides. “Take them to lunch and use that time to answer any questions they may have.” Let them pick stuff out so they really feel like they are being grown up.

She also suggests using this time to help your child organize, especially if they have any special considerations like attention deficit hyperactivity disorder or a learning disability.

“Having to keep track of several different subjects can be overwhelming but simple things like color-coding can help a great deal,” she adds.

FACES

The UM Department of Psychiatry and Behavioral Sciences extends a warm welcome to new members of the team: Lujain Alhajji, MD Assistant Professor

Marcela Kitaigorodsky, PsyD Assistant Professor

Stefania Prendez-Alvarez, MD Voluntary Assistant Professor

Raul Poulsen, MD Assistant Professor Director, Child and Adolescent Inpatient Unit

Start early The more prepared your child feels—both physically and mentally— the better. If you talk to them about it early in the year, then you may be able to lessen your child’s anxiety.

Especially if your child is prone to “anticipation anxiety.” Dr. Mavrides says that a lot of kids—and adults— experience this about the first day of school or work, and if you dwell on it, it can be very distressful.

“Start the conversation early and continue it through the first few months of school. Be available if they need to talk,” she says. “Tell your child that everyone goes through it and that they shouldn’t worry; that very soon they will have settled in and the feeling will go away.”

It’s also important to get your child back into the routine of going to school. Helping them become familiar with their schedules can ease some of the worry.

“In the couple of weeks before school, set up a bed time and a morning schedule,” Dr. Mavrides says. “This will also help the kids know what to expect and to be ready for it.”

This article was written by Natasha Bright and originally appeared on the UMiami Health News blog.

Congratulations!

Dr. Elizabeth Perkins won the Florida Psychiatric Society resident grant for the FPS 2018 Fall CME Meeting in Orlando.

The grant is made available through the FPS Alliance’s Tom and Donna Buchanan Resident Grant.

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New! 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 one of our investigators, Philip D. Harvey, PhD, whose research explores the cognitive impairments and their functional importance in different psychiatric conditions.

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MOOD AND ANXIETY ANU: Stem Cell Therapy and Treatment Resistant Depression Associated with Inflammation Depression responds poorly to antidepressant therapy in almost half of all cases. Augmentation therapies add some benefit, but often also has side effects and less than complete effectiveness. Some research has suggested that treatment-resistant depression is associated with elevations in inflammation and some anti-inflammatory treatments have been tried before.

This study uses the anti-inflammatory benefits of human stem cell therapy to treat previously unresponsive depression.

A single infusion is administered and patients are followed for depression, anxiety, cognitive performance, and inflammation for a year.

Vortioxetine for Treatment of PTSD PTSD is quite common and persistent after trauma exposure. There are some treatments for PTSD that are approved, but their level of efficacy is not optimal. As a result, we are using a newly approved antidepressant therapy, Vortioxetine, to treat 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.

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The University of Miami Miller School of Medicine Behavioral Research Assessment Center (BRAC) Research Team at “Memory Loss: What Are You Going to Do?” event held at the Newman Alumni Center. The knowledgeable and passionate team reinforces departmental initiatives through their work with investigators and research participants.

First row—from left to right—Claudia Yaranga, Gabriela Vargas, Nicolette Gomez, Danielle Sepulveda. Second row—from left to right—Belinda Robertson, Andrew Kimmel, Cynthia Fundora and Luis Sierra.

PSYCHOSIS AND BIPOLAR CONDITIONS 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). As we continue to lack interventions that reliably lead to full functional recovery, IA represents a novel and promising target for rehabilitation.

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 self-assessment of functioning will be performed.

Psychopharmacologically Augmented Cognitive Training Cognitive impairments are very common in people with schizophrenia. Computerized cognitive training (CCT) is commonly used for treatment of these deficits in people with schizophrenia and other conditions. However, the rate of treatment response is only about 60%. Further, pharmacological treatments aimed at schizophrenia have been limited in their success, but have a number of possible advantages. This study will combine the two therapies to see if there is a beneficial synergistic effect.

All participants will receive cognitive training and the drug treatment will be administered to half of the participants in a placebo-controlled randomized trial.

For more information about participating in a clinical trial, please see the back cover of this publication.

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200 Attendees Gather for Lecture on Memory Disorders Hosted By Dr. Elizabeth Crocco n August 10th, Dr. Elizabeth Crocco, Director of the Memory Disorders Clinic and Chief of Geriatric Psychiatry, gave a lecture at the UM Coral Gables campus on memory disorders and Alzheimer’s disease. A crowd of 200 individuals attended, all eager to learn more about healthy aging and cognition.

The lecture, titled Memory Loss: What Are You Going to Do? aimed to inform and educate the 60+ aged population on identifying early signs of AD, risk factors, and available clinic and research options. Free memory screenings were also available and more than 50 attendees participated.

Pleased with the lecture turnout, Dr. Crocco said, “It is essential here in South Florida to educate our seniors on Alzheimer’s disease and what is

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available to help prevent and delay its progression.”

Dr. Crocco also discussed the differences between normal cognitive aging versus the onset of cognitive memory disorders, noting that those with dementia, for example, will present with additional problems affecting neurological, psychiatric, and functional activities.

Early detection of Alzheimer’s disease has fast become a major public health issue. Significantly, worldwide projections of its prevalence estimate 106 million people will be affected by 2050.

Despite these astounding numbers, there is some good news.

With the rapidly aging population, early detection of individuals at risk for Alzheimer’s disease has become a global priority. Dr. Crocco and colleagues at UM’s newly established Center for Cognitive Neuroscience and Aging

(CNSA) are leading efforts to shift the focus from clinical diagnosis and treatment to get out in front of the disease with early targeted interventions and pre-symptomatic neuroprotective therapies. For these strategies to be optimally effective and successful, it is critical to accurately identify and target individuals at risk.

An important way to do this is through clinical trials and studies.

“We understand very little about aging and the elderly and in order to fight Alzheimer’s and other dementias, we need volunteers in our research studies,” Dr. Crocco explained.

By participating, you are not only taking an active role in your own brain health, but also helping to further science and help the generations to come.

For more information on the CNSA and Memory Disorders Clinic, please visit issuu.com.

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Novel Strategy Shows Promise for Earlier Detection in Alzheimer’s Disease Dr. David Loewenstein, Director of CNSA, Published in Neurology inding an effective way to identify people with mild cognitive impairment who are most likely to go on to develop Alzheimer’s disease has eluded researchers for years. But now, a team of researchers led by David Loewenstein, Ph.D., director of the Center for Cognitive Neuroscience and Aging (CNSA) and professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, has devised a novel strategy that could do just that.

The study, “Utilizing Semantic Intrusions to Identify Amyloid Positivity in Mild Cognitive Impairment,” funded by the National Institute on Aging, was published in the September issue of Neurology and earlier online.

Along with study co-author Rosie E. Curiel, Psy.D., assistant professor of psychiatry and clinical neuropsychology, and their colleagues, Loewenstein studied 88 patients with amnestic mild cognitive impairment (aMCI). They identified 34 people in this cohort with underlying, prodromal Alzheimer’s disease (AD) by history and amyloid positive scans.

Amyloid-beta is an abnormal protein in the brain long associated with the development of AD. Among the 54 aMCI participants negative for amyloid-beta, 29 were classified as having a clinical course suggestive of AD but suspected non-AD pathology or “SNAP.” The remaining 25 amyloid negative patients had major depression, anxiety or other psychiatric disorders; cerebral infarctions; diffuse Lewy Body disease, or other non-AD neurologic conditions.

The investigators predicted those at greatest risk for AD using the Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L), a tool developed at the University of Miami. The LASSI-L allowed researchers to uncover specific memory deficits that aligned with imaging findings for abnormal brain amyloid accumulation.

“Developing more sensitive and effective measures to tap the earliest Alzheimer’s changes in the brain is

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Brain scans were one method used to identify study subjects.

essential for providing earlier and more effective treatment, to better understand the neuropathology of the disease, and to monitor emerging interventions,” said Loewenstein.

The LASSI-L measure is a novel “cognitive stress test” validated in both English and Spanish. Researchers ask patients to read 15 words. The words come from three categories — fruits, musical instruments and articles of clothing — of five words each. They ask participant to repeat the list of words, and then cue their recall by category. A second trial repeats this learning task and the cued recall to strengthen their recall.

Next researchers present a list of 15 different words from the same three categories. The patients are asked to recall these new words as a measure of “proactive semantic interference” (PSI). PSI occurs where there is interference in new learning based on previous learning and correlates with risk of developing AD. Researchers also present the second word list a second time, and repeat the cued recall. This component of the LASSI-L measures how well people can recover from the proactive semantic interference. It’s called failure to recover from PSI (frPSI) — and a second indicator of AD risk.

A major finding outlined in the Neurology paper was that the amyloidbeta imaging-positive patients committed a significantly higher number of semantic intrusion errors — specifically on the

PSI and frPSI measures – compared to the SNAP and other non-AD patients.

Traditional cognitive measures to identify AD risk do not include PSI or frPSI, so the LASSI-L may represent a specific, non-invasive test that could successfully differentiate true AD from SNAP, the researchers noted.

“The association of the LASSI-L with amyloid positivity makes it useful in the clinical evaluation of preclinical Alzheimer’s disease and for appropriate recruitment for clinical and prevention trials,” Loewenstein said. “This also provides an effective and inexpensive way of screening at-risk populations.”

The research is ongoing. Curiel received a new federal grant to computerize the LASSI-L and other novel cognitive measures. In addition, current studies are underway to compare progression on the LASSI-L to brain biomarkers such as MRI, fMRI and PET scans, as well as new agents that assess pathology in the brain.

“We are assisting our national and international institutional partners in developing this cognitive stress test for their investigations and clinical practice,” Loewenstein said. “It is a goal of our Center for Cognitive Neurosciences and Aging and the University of Miami Miller School of Medicine to be at the forefront of these efforts.”

This article was written by Damian McNamara and originally appeared in INVENTUM.

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Dr. Luca Pani on the Sustainability of Healthcare Funding his summer, Dr. Luca Pani, professor of psychiatry and behavioral sciences at UM, attended the DIA 2018 Global Annual Meeting in Boston. DIA, founded as the Drug Information Association, has provided a global, yet neutral stage, for collaboration to address healthcare challenges for more than 50 years. At the conference, Dr. Pani was interviewed on the topic of sustainability of healthcare funding. Below, we did a follow-up Q&A with Dr. Pani on this ever-evolving area and its significance.

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You previously served as director general for AIFA, the Italian Medicines Agency, which is comparable to our FDA. How do the operations related to healthcare affordability differ between these two administrations?

LP: Yes, from 2011 to 2016 I was the head of AIFA, which is the government agency entrusted to regulate and to reimburse all drugs for the public single payer of the national market. Part of AIFA’s mission is to set fair pharmaceutical policies and manage the value and cost of medicines. The FDA is more centrally focused on regulating public health initiatives encompassing drugs, medical devices, food supply, cosmetics and more.

As important as this is for the safety of the nation, the agencies prioritize activities differently.

You mention there is a gap between technologies that are maturing in the medical space. What did the model used to be and what has it become?

LP: Our initial work in this field has identified some elements of the problem where the gaps may reside. 1), healthcare systems are increasingly socio-economically vulnerable. 2), a mismatch between the demands for healthcare delivery and resources allocated for the purpose.

3), far-reaching changes are required.

4), the total health care value chain should be (re)addressed. Five, healthcare systems must shift focus to patientrelevant outcomes and lastly, alternative funding sources may need to be explored.

Inka Heikkinen, DIA, Dr. Kenneth Kaitin of Tufts University School of Medicine, and Dr. Luca Pani

How do pharmaceutical companies determine the prices of their drugs?

LP: Many factors such as the cost of R&D, the cost of patents, the value of the uniqueness of the drug such as being first in its class and most importantly how effective the active principle is and how innovative, both in terms of mechanism of action and safety. These are some of the traditional parameters, however we are suggesting that pharmaceutical companies start considering the certification of the avoided costs and put these into their negotiation strategies. In other words, the real value of a new drug becomes a percentage of what the drug is able to save.

Can you tell us about the different stakeholders who need to come together to make sure medications remain affordable and accessible to the population?

LP: In drug health technology assessment, there are only five stakeholders who need to be involved: patients, healthcare providers, drug companies, regulators and payers. They all must be represented at the highest level of competence and capacity. According to our evaluations, specific actionable items will be on patient and cross-stakeholder alignment, data and infrastructure and new payment models.

Why are medications/treatments for certain diseases so much more than others?

LP: Because the factors I was referring to are more incidental. A drug that is very difficult to synthesize, unique for the single patient, and able to definitely cure up to the point of eradication of diseases previously considered to be mortal are, of course, of the greatest value.

What will have to change to decrease prices and increase accessibility?

LP: We need to build a framework for future payment models where negotiations of innovative therapies could be performed even in conditions of uncertainty at the time of decision.

We have published some work on exploring novel solutions to adjust for future non-conventional therapies using new payment strategies, and unifying them with theoretical advances such as changing the negotiation strategies and linking them with outcomes- and value-based pricing model. In brief, we agree with the Pharma companies that if a given product does not deliver what they say it should, we want our money back. Decreasing prices, if not proven to be justified and the most logical choice, makes no sense and has the side effect of shading away innovative companies to find new and important cures that we still need for the patients.

What is the biggest factor that contributes to skyrocketing prices for certain medications?

LP: Drugs which have increased their price overnight by 5,000% are the consequences of lust due to pure financial maneuvering by their shameless marketing authorization holders. But, in the United States this happens for deeper reasons. Here we do not regulate or negotiate the prices of prescription drugs when they come onto market. At AIFA, I had a total budget of about $30 billion per year for 60 million citizens. When we met with pharmaceutical companies to haggle over an appropriate price, our negotiating power was pretty big. The result is that Italy has some of the lowest drug prices of the G20.

For the full interview, please visit the digital version of BrainStorms on issuu.com/umpsych

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Get to Know the Chair’s Office

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lthough the department is undergoing a change of leadership, we remain committed to building on the incredible foundation Dr. Nemeroff laid in his nine years here. This includes seeing all current projects through and continuing to grow our department of talented faculty and staff.

At the helm of the Office of the Chairman are Interim Chair Dr. Radu Saveanu and Vice Chairman for Administration and Finance Jared Abramson. Get to know more about these exceptional leaders below.

Dr. Radu Saveanu “My father, who also was a physician, was recruited by the World Health Organization (WHO) to lead the smallpox eradication program in Mauritania. While in Africa, I went to a French high school and developed a real love for French literature. For a time, I seriously considered becoming a literature professor! I even minored in French while I was a premed student in college. I remained torn between becoming a physician or a literature professor until I realized that psychiatry, and in particular psychoanalysis, could afford me a way of combining them both. Psychoanalysis provided me the opportunity to study and appreciate narrative–whether it be that of an individual in pain or a character in a literary work.

To this day, I love working with patients in long-term psychotherapy and, in my spare time, reading and analyzing literature.

Jared Abramson “My leadership philosophy is to build a high-performing team by fostering a culture of trust, confidence, and empowerment.

In my view, the role of the administration is to serve not only the department and the university but also our South Florida community, so many of whom are affected by behavioral health issues. Successful and impactful service is achieved by building a solid infrastructure, developing suitable and efficient processes, and accumulating and allocating the necessary resources.

I take so much pride in our department knowing that our work contributes to improving the health— and lives—of individuals in our community and society at large.”

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Dr. Claes Wahlestedt “This is an incredibly exciting time for we who are passionate about science and biomedical research. Jaw-dropping progress has been made in so many areas of science and we are now getting an even better understanding of the human brain—the ultimate frontier. In my career, I have been fortunate enough to work in a number of world-class environments (in academia as well as industry) and seen amazing scientific progress, such as the elucidation of the human genome. As well as the development of fundamentally new treatments being developed to help patients in need. Almost invariably, however, success stories have been based on multidisciplinary pursuits.

This means that researchers with different backgrounds have been brought together to collaborate. I am thrilled that we are now creating such an environment here at the University of Miami–with numerous links to other top academic institutions as well as leading companies.”

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The CBNd of an Era

We will miss you, Dr. Nemeroff! Best wishes in Austin.

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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.

Q3| 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 | Q3 | 2018