RESEARCH
Introduction Other Research Programs:
Division of Biological Psychiatry Addiction Psychiatry
Clinical Research Center Consultation/Liaison Psychiatry
Brief Psychotherapy Research Program Schizophrenia Spectrum Disorders Center
Geriatric Psychiatry Zirinsky Mood Disorders Center
Anxiety and Trauma Center  

Introduction
The Department of Psychiatry at Mount Sinai Beth Israel is dedicated to clinical research because we recognize it’s importance for the development of new and more effective treatments for psychiatric and behavioral disorders. Our innovative research encompasses a wide range of psychiatric disorders—from persistent and serious mental illnesses such as schizophrenia to more widespread behavioral disorders such as social phobia, anxiety, and psychological trauma. Equally diverse is our research into different treatment modalities, including trials of novel psychopharmacological treatments and innovative non-pharmacological psychotherapeutic modalities such as brief psychotherapy.

All research in the department is approved by the Institutional Review Board. Funding sources include federal granting agencies (National Institute of Mental Health, National Institute for Drug Abuse), pharmaceutical companies, and private granting agencies. The Department has six dedicated Research Divisions: The Division of Biological Psychiatry, the Clinical Research Center (CRC), the Schizophrenia Spectrum Disorders Center, Zirinsky Mood Disorders Center, Anxiety and Trauma Center and the Brief Psychotherapy Research Program, all of which are described below.

Division of Biological Psychiatry
The Division of Biological Psychiatry, located within the Department of Psychiatry at the Mount Sinai Beth Israel, is dedicated to high quality research into the critical questions of contemporary psychiatry. One of it’s major areas is broadly defined addictive behaviors—including traditionally defined chemical addictions (i.e. opiate dependence) and behavioral addictions such as excessive and deviant sexual behaviors. Other areas of research have included schizophrenia, mood and anxiety disorders, impact of education on cognitive functioning, negative symptoms and apathy, and research integrity.

The chemical addiction research focuses primarily on opiate abuse, while addictive behavior studies focus on pedophilia. Past opiate addiction research included a NIDA-funded PET investigation of negative mood and attention in methadone-maintained and abstinent opiate addicted individuals. Associated studies included extensive descriptive studies on neuropsychological, personality, and neurosensory abnormities in opiate abuse. Current research studies focus on mood disorders in opiate abusers in protracted abstinence. These include fMRI studies, in collaboration with the Columbia University fMRI Imaging Center, of negative mood induction, as well as treatment studies of opiate abuse associated dysphoria.

Past pedophilia studies have investigated the personality, neuropsychology, childhood abuse history, phallometric response, and brain function (as measured by FDG PET) of male pedophilia. At present we are continuing our investigation of personality and cognitive profiles of pedophiles with the goal of eventually identifying those with the highest risk of recidivism. As part of this study we are also investigating recently compiled public databases of sex offenders.
Other current research projects include investigation of the relationship between pharmaceutical company funding and outcomes in clinical research and the analysis of the effects of education on the fuctional neuroanatomy of attentional processes. In addition the division is conducting a joint research program with the Brief Psychotherapy Program to study attachment behavior. The division is using fMRI to study brain function in attachment and investigating central nervous system changes during the process of psychotherapy.

Division personnel include Igor Galynker, M.D., Ph.D., Director, Lisa Cohen, Ph.D., Associate Director, James Prosser, MD, Instructor, and 15 additional staff members, five of whom are full-time. In its eight-year history, the Division has obtained more than 20 grants, totaling about 2 million dollars, from outside funding agencies, including NIH, pharmaceutical companies, and private granting agencies. In addition, the Division has produced approximately 30 published papers and 100 presentations.

From its inception, the Division of Biological Psychiatry has been centrally involved in training. Trainees from Beth Israel’s psychiatric residency, university psychology departments, and medical schools, as well as foreign-trained doctors applying for American residency programs, have all participated in research. Many have had the opportunity to progress to the next level of their career, whether it involves obtaining a prestigious research fellowship or entering a psychiatric residency or a psychology doctoral program.

For more information on the Division of Biological Psychiatry, please call (212) 844-1598.

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Clinical Research Center
The Clinical Research Center (CRC), in collaboration with clinical divisions, conducts pharmaceutical trials w ithin the Department. Both multi-center and investigator-initiated drug trials have been sponsored by numerous pharmaceutical companies. The investigational drugs studied targeted symptoms of schizophrenia, depression, anxiety and panic, dysthymia, dementias, and other disorders.

The center is staffed with clinical research coordinators and raters, who are trained in the administration of psychometric scales and data management, and are inter-rater reliable. A single centralized database is maintained for all studies.

The CRC is integrated with the teaching programs in the Department. Trainees from the Beth Israel psychiatry residency training program, foreign trained doctors applying for American residency programs, and graduate and undergraduate students have all participated in research. Most have used their training experience to progress to the next level in their clinical and research careers.

For more information on the Clinical Research Center, please call (212) 844-2204.

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Schizophrenia Spectrum Disorders Center
This Center in collaboration with the Clinical Research Center assesses the use of novel treatments (medications, psychotherapies, rehabilitation) for the schizophrenia spectrum disorders. We are investigating factor influencing adherence to treatment and designing new methods to improve treatment adherence. Other research projects address capacity to consent to research and to understand the informed consent process.

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Zirinsky Mood Disorders Center
The Zirinsky Center specializes in research of bipolar illness and major depressive disorder, and in the treatment of individuals with these conditions. The center also conducts state-of-the-art, clinical trials in collaboration with the Clinical Research Center. Recent research projects include studies of treatment adherence and health behaviors, and development of new methods to improve both of these issues. Other projects address the relationship between anxiety, panic, and suicidality. Plans are underway to develop a family centered research and treatment program for bipolar patients and their families.

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Center for Anxiety and Trauma Disorders
The Center for Anxiety and Trauma Disorders engages in treatment and research into new medications in collaboration with the Clinical Research Center for patients with anxiety and trauma disorders. The main focus of the Center is on the relationship between panic, dissociation, PTSD, and suicidal and dangerous behaviors. The Center also conducts a number of treatment groups for trauma and anxiety disorder patients.

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Brief Psychotherapy Research Program
The Brief Psychotherapy Research Program conducts innovative studies of factors that influence the effectiveness of psychotherapy for treatment of depression, anxiety, and personality disorders. Designed to shorten the therapy process, brief psychotherapy focuses on very specific problem areas and involves high levels of therapist activity. A major focus of our brief psychotherapy research is the patient/therapist relationship. These studies investigate the process of forming a therapeutic alliance, maintaining it, and repairing ruptures in the alliance.

The Brief Psychotherapy Research program offers specialized treatment for adults who suffer from the following: depression, anxiety, low self-esteem, and/or interpersonal problems. If thorough evaluation indicates that short-term treatment is appropriate, a therapist is assigned to the patient. Treatment consists of 30 psychotherapy sessions and involves a number of different psychotherapy models. An NIMH funded study is investigating the training of therapists in an integrated brief psychotherapy, consisting of cognitive-behavioral and interpersonal/relational approaches.

In addition, the Brief Psychotherapy Research Program is engaged in collaborative research with the Division of Biological Psychiatry studying the process of attachment (see section on Research in the Division of Biological Psychiatry).

For more information on the Brief Psychotherapy Research Program, please call (212) 420-3819.

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Other Research Programs

Research in Addiction Psychiatry:

The Addiction Psychiatry Division conducts research in 3 areas -- in collaboration with the large, multimodal substance abuse treatment facilities of the Chemical Dependency programs of Mount Sinai Beth Israel.

First, we conduct descriptive studies to characterize the prevalence and nature of dual diagnoses and secondary substance use in patients with identified primary substance use disorders.

Second, we conduct treatment studies to develop new approaches to improve retention and outcome among patients entering Chemical Dependency programs, who are readily prone to early drop-out. These approaches include psychopharmacologic and behavioral treatments.

Third, we conduct services research studies to identify patterns, as well as barriers to and promoters of, adherence to treatment.

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Research in the Division of Consultation-Liaison Psychiatry (Psychosomatic Medicine)

Clinical research in this field of psychiatry looks at the different psychological and psychiatric manifestations of and reactions to medical-surgical illness. Past research efforts have looked at "Psychiatric Diagnosis Among Women with HIV/AIDS", "Psychological Outcomes of Ambulatory Mastectomy", "Drug-drug Interactions Between Protease Inhibitors and Psychotropic Medications", and "Personality Styles Among People Attending a Diabetes Clinic" to name a few. The Division's interests remain strongly influenced by issues connected to HIV/AIDS, Oncology, and Delirium. New research projects are currently being developed in these areas. Examples include studying the psychological implications of lipodystrophy among women with AIDS, and identifying potential risk factors or vulnerabilities for the development of delirium.

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GERIATRIC PSYCHIATRY RESEARCH PROGRAM

1. Geriatric Depression
  The division is currently involved in a study treating depression in elderly women with a combination of antidepressant medication and vitamin supplementation.
   
2. Parkinson’s disease
  Current research work in Parkinson’s disease (PD) looks at the effects of surgical treatment of PD on mood and the effect of PD on olfaction.
   
3. Dementia
  Research interests in dementia include treatment of cognitive impairment in vascular dementia and the treatment of agitation in nursing home patients with dementia.
   
4. Training in Geriatric Psychiatry
  Research focuses on the usefulness of home-visits to mentally ill seniors as a tool for teaching systems-based practice to medical students and residents.
   
5. Sexual Function in the Elderly
  The division is studying the effects of neurological and psychiatric illness on sexual health in the elderly. A further goal is to determine the sexual functioning of sample elderly in the community.

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