Question of the Day: What would you like your colleagues to know about your research?

Medical students, residents, and professors presented their research findings at yesterday’s poster sessions. Psychiatric News asked them: What would you like your colleagues to know about your research?

For Duncan Honeycutt, M.D., a psychiatry resident at Southern Illinois University School of Medicine, the message was straightforward: “If you’re going to start lamotrigine in a patient with hepatic impairment, especially advanced cirrhosis, go low and go slow.” Honeycutt presented on a rare case of lamotrigine-induced encephalopathy in a 54-year-old woman.

Similarly, Hobab Aslam, M.D., a psychiatry resident at Baptist Hospitals of Southeast Texas, presented posters on two of the rarest cases she has seen during her training. One involved loperamide withdrawal–induced psychosis. Loperamide is an over-the-counter medication that’s frequently used to treat diarrhea—and OTC meds are evolving rapidly. “When you are dealing with addiction patients,” Aslam said, “that’s something to keep in mind.”

Aslam also presented on a case of late-onset psychosis caused by a frontal meningioma. This experience, she said, shows the importance of working collaboratively, as both the patient’s neurologist and primary care provider were involved in helping determine a diagnosis and treatment. Her message for her colleagues: “Please, please don’t hesitate to do some medical workup, some imaging. Because this is a rule in psychiatry: You have to rule out organic causes before you diagnose any psychiatric disorder.”

In the realm of digital mental health, Kennth Fung, M.D., professor of psychiatry at the University of Toronto, presented on Resilience Buddy, an app that he and his colleagues developed. “The concept of resilience is very attractive,” Fung said. “However, it’s kind of hard to know what it is. Some people describe it as the ability to bounce back after adversity. But can we know what resilience is if a person hasn’t experienced adversity? And, it can often sound like an internal trait such that, if people are not okay, we’re saying, ‘You’re not resilient.’ In other words, it can sound like we’re blaming the victim.”

Fung emphasized that resilience is both internal and external. “If there are no accessible supports … you’re not going to have resilience,” he said.

Resilience Buddy supports users in strengthening resilience across multiple domains. It uses brief psychoeducation, interactive exercises, and guided meditations to build internal and external resilience. The preliminary analysis that Fung presented in his poster included 46 patients whose resilience scores increased while their psychological distress decreased, suggesting the app may provide a scalable approach to mental health promotion on a large scale.

Junaid Rana, M.D., a resident at Ocean University Medical Center in Brick, New Jersey, presented on a meta-analysis that he and his colleagues conducted on the relationship between childhood maltreatment and the development of obsessive-compulsive disorder (OCD). They included 10 studies comprising 1,611 OCD patients, all of which consistently demonstrated that childhood maltreatment—especially emotional abuse and physical neglect—were associated with the development of OCD.

Rana stressed the importance of teaching children how to recognize physical and sexual abuse. Many don’t realize they’ve been abused until later in life, in part because they received sexual education very late. Parents should teach their children what signs to look out for, Rana said, and “how they can tell other people and seek help.” ■