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Teaching, Administrative and Research Role

Research

Our trainees and faculty members engage in cutting-edge, translational research to develop novel and improved strategies to prevent or treat psychiatric conditions among the medico-surgical patients. The three primary research goals of the Yale PM Service are:

1. To elucidate etiopathogenesis and discover innovative treatment strategy of common psychiatric syndromes among medico-surgical patients.

2. To examine the impact of presence, incidence, detection, and treatment of psychiatric co-morbidities in the quality of life, morbidity and mortality of the medico-surgical patients.

3. To develop innovative ways to efficiently deliver medico-surgical services for mentally ill patients both in the inpatient and outpatient setting and bridge the disparity gap in health service between those with severe mental illness and without.

Health Services

Three Strategies for Implementing Motivational Interviewing on Medical Inpatient Units: See One, Do One, Order One

PI: K. Yonkers, MD/S. Martino, PhD; Funding Source: NIDA R01.

The goal of this project is to compare the success of three strategies geared to implementation of motivational interviewing. Interviewing techniques would be provided by physician assistants in the general medical units of Yale New Haven Hospital.

Behavioral Intervention Team: A Model of Proactive, Multidisciplinary CL Psychiatry Service

PI: W. Sledge, MD; Funding Source: The George D and Esther S Gross Professorship Endowment.

The goal of this on-going study is to assess the quality and cost-effectiveness of an innovative, proactive model of screening for psychiatric issues among and delivering mental health services to medical inpatients with psychiatric co-morbidity

Study of Very High Cost Primary Care Patients in a University Clinic

PI: W. Sledge, MD; Funding Source: The George D and Esther S Gross Professorship Endowment.

The goal of this on-going study is to assess the quality and cost-effectiveness of an innovative, proactive model of screening for psychiatric issues among and delivering mental health services to medical inpatients with psychiatric co-morbidity.

Transplant Psychiatry

Pre-Transplant Behavioral Weight Loss Treatment Trial for Patients with End-Stage Liver Disease

PI: D. Fehon, PsyD; Funding Source: Yale Transplant Psychiatry Development Fund.

This is a Stage 1A treatment development study which examines the feasibility and preliminary effectiveness of a group behavioral weight loss intervention for liver transplant candidates.

Eating disorders and body image beliefs in liver transplant recipients

PI: P. Zimbrean, MD; Funding Source: Yale Transplant Psychiatry Development Fund.

This cross-sectional study examines the prevalence of eating disorder symptoms and body-image issues among post-liver transplant patients.

Transplant psychiatry training- a curriculum for advanced psychiatry trainees

PI: Paula Zimbrean, MD. Funding Source: Yale Transplant Psychiatry Development Fund

This study is assessing the effect of a teaching curriculum in Transplant Psychiatry upon the level of knowledge and communication skills of psychiatric trainees.

PMS, Perinatal, and Postpartum Psychiatry

Progesterone Augmentation for Smoking Cessation in Women

PI Kimberly Yonkers, MD and Mehmet Sofuoglu, MD, PhD; Funding source: National Cancer Institute, R21 198187

This study will manipulate the hormonal milieu by adding progesterone to the follicular phase of the menstrual cycle in order to enhance women’s response to nicotine replacement therapy.

Prenatal Substance Use Screening Measures

PI Kimberly Yonkders, MD; Funding source: Centers for Disease Control, R21 DP006082-01

This study would test the validity and reliability of 6 screening measures for substance use and misuse in pregnancy.

Progesterone Augmentation for Smoking Cessation in Women

P.I. Kimberly Yonkers, MD and Mehmet Sofuoglu, MD, PhD; Funding source: National Cancer Institute, R21 198187

This study will manipulate the hormonal milieu by adding progesterone to the follicular phase of the menstrual cycle in order to enhance women’s response to nicotine replacement therapy.

Prenatal Substance Use Screening Measures

P.I. Kimberly Yonkers, MD; Funding source: Centers for Disease Control, R21 DP006082-01

This study would test the validity and reliability of 6 screening measures for substance use and misuse in pregnancy.

Progesterone for Smoking Relapse Postpartum: Feasibility, Breastfeeding and Infant Safety

PI: A. Forray, MD; Funding Source: NIDA R21

The purpose of this study is to examine the utility of oral micronized progesterone as an intervention to prevent smoking relapse in postpartum women.

Ecological Momentary Assessment and Postpartum Smoking Relapse: A Pilot Study

PI: A. Forray, MD; Funding Source: NIDA K12

This is a pilot study using ecological momentary assessments (EMA) to evaluate the impact of situational and affective stimuli on relapse to smoking in the postpartum period. Abstinent smokers, recruited during pregnancy, are asked to carry a small handheld computer (PDA) which will prompt the women to complete an assessment about cravings, affect and environmental cues at four random times per day. The results from this study will provide an assessment of the process of relapse in relation to a number of covariates.

Chronic pian and Obesity

Neural Mechanisms of Obesity in Chronic Low Back Pain

PI: P. Geha, MD; Funding Source NIDA K08

The purpose of this grant is to examine the interrelation between chronic pain and obesity using psychophysical testing and functional brain imaging. Chronic pain is associated with changes in the limbic system; the limbic system is in turn critical in determining the risk of over eating in an environment where highly caloric food abounds. Therefore, the project examines pain patients’ response to food and feeding behavior early in the course of their back pain and one year later as they convert or not to the chronic phase.

Cancer/Tobacco Treatment

Gain-framed Messages and NRT Sampling to Promote Smoking Cessation in Lung Cancer Screening Programs

PI: Benjamin Toll, PhD; Yale Site PI: Lisa Fucito, PhD. Funding Source: NCI R01

The purpose of this study is to test a combined behavioral and pharmacological tobacco intervention for promoting smoking cessation among smokers receiving lung cancer screening.

Yale SPORE in Lung Cancer: Core Project: “Personalized prevention: smoking cessation in lung nodule patients

PI: Roy Herbst, MD; Co-Investigator: Lisa Fucito, PhD. Funding Source: NCI P50

The purpose of this study is to develop and test the efficacy of a new personalized approach to gain-framed messaging to improve smoking cessation in Americans with asymptomatic lung nodules who continue to smoke.

Sickle Cell

Psychiatric Screening of Adults Living with Sickle Cell

PI: A. Forray, MD; Funding Source: Adult Sickle Cell Fund

The purpose of this study is to screen adults living with sickle cell disease for psychiatric disorders and symptoms and determine the impact of psychiatric conditions on patient outcomes such as inpatient hospitalizations, emergency room visits, adherence to treatment and opiate medication utilization.

Resting State Connectivity and Pain Processing in Adults with Sickle Cell Disease

PI: A. Forray, MD; Funding Source: Adult Sickle Cell Fund

While acute episodes of pain are the hallmark of sickle cell disease, many patients also experience chronic daily pain. Intrinsic brain connectivity has been shown to play a role in sickle cell related pain. The default mode network (DMN) has been implicated in the expression and modulation of spontaneous chronic pain. The purpose of this study is to utilize functional magnetic resonance imaging (fMRI) to assess the resting state connectivity of adults with SCD and its potential link to frequent hospitalizations and high pain burden.