Michigan Medicine Department of Psychiatry January 2020 E-Newsletter
Greetings and Happy New Year!

I hope you had a restful holiday season with friends and family. Before turning to the new year, I wanted to reflect upon successes the department saw during 2019. Our 201 faculty members served thousands of people during outpatient appointments; garnered over $30 million in NIH funding; published 359 manuscripts; and achieved ranking as the 13 th best training program in the country once again.

Our January 2020 newsletter offers a snapshot of the incredible work we completed during 2019. We share new research highlights in medical intern stress, aging, opioids, and more. We share faculty investigations comparing the price of talk therapy vs. medication, explore mental health in the workplace, and highlight the country’s need to place a larger emphasis on alcohol addiction.

The Department of Psychiatry’s 2019 annual newsletter was released in November - if you have not read it yet, click here. Additionally, please keep Michigan Psychiatry in mind when you are polled through Doximity for top hospital rankings next month.

Looking forward to discoveries in the next decade and beyond.

Best wishes,
Gregory Dalack, M.D., chair
Follow me at @DalackMD
Michigan Medicine Psychiatry in FY19: a Snapshot
Highlighted News
A study conducted by Srijan Sen, M.D., Ph.D., found that the long work hours of an intern’s first year of medical residency are associated with accelerated cellular aging. 

The findings, which were published in Biological Psychiatry, show the effect of residency on stretches of DNA called telomeres, which keep the ends of chromosomes intact, like the plastic end of shoelaces. The discovery that telomeres shrink in an accelerated way among interns suggests the importance of ongoing efforts to reduce the strain of medical training. 
Nearly half of Americans in their 50s and early 60s think they’re likely to develop dementia as they grow older, but only 5% of them have actually talked with a doctor about what they could do to reduce their risk, a new study conducted by Donovan Maust, M.D. finds. The results which appear in a research letter in JAMA Neurology, suggest a need for better counseling for middle-aged Americans about the steps they can take to keep their brains healthy as they age.
A dramatic rise in opioid overdose deaths among American veterans in recent years has happened mainly among veterans dying from heroin and synthetic opioids, a new study published in The American Journal of Preventative Medicine finds.

The study, conducted by Allison Lin, M.D., highlights a pressing need to find and provide care to veterans who need help for use of non-prescription opioids, whether or not they are also taking prescription.
Courtney Polenick, Ph.D., published a paper in the Journals of Gerontology Series B: Psychological Sciences and Social Sciences finding that as married couples age and develop chronic conditions, the daily demands of coping with their own health demands and those of their spouse may take a mental toll.
Escaping the grip of opioid addiction doesn’t come easily for anyone. But a new study conducted by Amy Bohnert, Ph.D. and colleagues reveals sharp racial and financial divides in how Americans receive effective treatments for opioid addiction. Those differences have only grown larger as the national opioid crisis has intensified, the research, which was published in JAMA Psychiatry shows.
A U-M program led by Elizabeth Koschmann, Ph.D. called TRAILS (Transforming Research into Action to Improve the Lives of Students) works with schools across the state to provide effective mental health resources to students impacted by depression and anxiety.

Additionally, the Peer-to-Peer Depression Awareness Campaign was created to empower students to demystify and normalize mental illness and treatment. These two programs have created lasting impact in the schools and communities in which they reside. Together, the two programs have reached thousands of students. Learn more by watching the video at the link above.
Suicides and drug overdoses kill American adults at twice the rate today as they did just nearly two decades ago, and opioids are a key contributor to that rise, a review and analysis conducted by Drs. Mark Ilgen and Amy Bohnert found. Reversing this deadly double trend will take investment in programs that have been shown to prevent and treat opioid addiction.

Writing in the New England Journal of Medicine, the authors also call for more research to identify who is most at risk of deliberate or unintentional opioid overdoses so these individuals can get better pain management, mental health care and medication-assisted therapy for opioid addiction.
Recent Michigan Medicine Blog Coverage
Spending an hour in talk therapy with a trained counselor costs much more, and takes more time, than swallowing an inexpensive antidepressant pill. But for people with a new diagnosis of major depression, the costs and benefits of the two approaches end up being equal after five years, a new study conducted by Drs. Kara Zivin, Marcia Valenstein and Erin Miller shows. 
Srijan Sen, M.D., Ph.D., and colleagues published results from their test of a genetic risk-prediction tool for depression, using data from the national study of first-year medical residents they run. The research, which was published in Nature Human Behavior suggests the power of a tool that uses a range of genetic information to predict a person’s chance of developing depression when they’re under intense stress. 
One in five Americans experience symptoms of depression during their lifetime. And yet, a distinct stigma still exists around the topic, especially in the workplace, according to the book Mental Health in the Workplace, co-authored by Michelle Riba, M.D., M.S., Sagar Parikh, M.D., and John Greden, M.D.
For several years, the national spotlight has shone on the need to prevent and rapidly treat opioid overdoses. But a new study suggests a need for more focus on the risk of alcohol overdoses among people who use opioids of all kinds, cocaine, marijuana and certain prescription drugs, too.

Researchers from the U-M Addiction Center find that 90% of 660 people surveyed in a residential recovery center had overdosed on alcohol at least once in their lives – blacking out or suffering alcohol poisoning severe enough to need medical treatment.
Expanding Medicaid to more low-income adults helped many of them feel healthier, and do a better job at work or a job search, in just one year after they got their new health coverage, a U-M study found. But people with behavioral health conditions, including mental health disorders such as depression or addiction to alcohol or drugs, got an especially big boost in many health and work-related measures. Half of the sample of Medicaid enrollees in the study had at least one such condition.

In a new paper in the journal Psychiatric Services, Kara Zivin, Ph.D. and colleagues document the results from a survey of a representative sample of more than 4,000 adults at or near the poverty level who had coverage under the Healthy Michigan Plan — Michigan’s Medicaid expansion program — for at least one year.
Research Funding & News
  • On Sept. 27, the NIH announced that it is devoting nearly $1 billion in funding towards addiction research and treatment. Several faculty members have been awarded funding including Drs. Maureen Walton, Erin Bonar, Mark Ilgen, Allison Lin, Cheryl King, Fred Blow, Amy Bohnert, and Daniel Clauw. Learn more about their projects: U-M teams receive $25.5 million for opioid-related prevention and treatment research.
  • Dr. Adrienne Lapidos (and co-authors) wrote a perspective piece for NEJM on how to sustainably finance the work of community health workers. Read it here.
  • Dr. Nasuh Malas was part of the committee that developed the first national consensus guidelines on the evaluation and management of pediatric delirium through the American Academy of Child and Adolescent Psychiatry. Learn more: A Clinical Pathway to Standardize Care of Children With Delirium in Pediatric Inpatient Settings.
  • Dr. Paul Jenkins was awarded a NARSAD Young Investigator Grant by the Brain & Behavior Research Foundation. Learn more.
  • Dr. Benjamin Hampstead recently received both a competitive revision and supplement to expand his R01 entitled, “Treating mild cognitive impairment with transcranial direct current stimulation.” This project now has over $1.8 million in funding per year and will continue for at least the next four years.
  • Drs. Erin Bonar, Anne Fernandez, and Maureen Walton received an award from the NIH for their project titled, “A social media intervention for high-intensity drinking in a national sample of emerging adults.” The total direct cost budget is $450,000, this project received a perfect score.
  • Dr. Helen Burgess received an R61 grant from the National Institute of Mental Health: “Morning Light Treatment for Traumatic Stress: The Role of Amygdala Reactivity.” Jim Abelson, Liz Duval, Adam Horwitz, Myra Kim, and Ann Mooney are co-investigators.
  • The U.S. VA announced funding for the Suicide Prevention Research Impact NeTwork (SPRINT), Dr. Mark Ilgen is serving as a principal investigator. The goal of this research is to accelerate suicide prevention research that will lead to improvements in care, and that will ultimately result in reductions in suicide behaviors among Veterans. Learn more.
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