Penn Psychiatry Fall 2006 · 2016. 4. 7. · ease, generating side effects from pain-killing...

Aaron T. Beck, MD, Uni-versity Professor Emeri-

tus of Psychiatry, is therecipient of the 2006 AlbertLasker Clinical MedicalResearch Award, consideredthe most prestigious honorbestowed in American sci-ence. Called “America’sNobel,” the Lasker Award isoften a precursor of a NobelPrize. Since the first LaskerAward was conferred in1962, 71 awardees have laterwon a Nobel.

In a stellar career stretching over fivedecades, Dr. Beck revolutionized the psy-chological understanding and treatmentof depression and other psychiatric disor-ders, pioneered the development of Cog-nitive Therapy to treat these maladies,developed sophisticated instruments forassessing the severity of specific psychi-atric syndromes, and continues to makeseminal additions to our understanding ofsuicide classification, assessment, predic-tion, and prevention.

Dr. Beck, featured in the Faculty Spotlightcolumn in the Winter 2006 issue of PennPsychiatry Perspective, is widely known asthe “Father of Cognitive Therapy,” the

fastest growing short-termpsychotherapy in the world.

Since 1954, Dr. Beck has beena faculty member in Penn’sDepartment of Psychiatry, anassociation that has provedbeneficial to his path-breakingresearch. “I have been partic-ularly helped by the warmatmosphere in the Departmenttoward clinical research datingback many decades to thechairmanships of Dr. KennethAppel (1953-1962) and Dr.

Albert Stunkard (1962-1973),” he says.

Dr. Beck views the Lasker Award as morethan personal recognition. “This awardacknowledges that psychologicalapproaches to the understanding andtreatment of mental ills presents a scientif-ically valid form of investigation,” Dr.Beck emphasizes. “Specifically, it recog-nizes the value of Cognitive Therapy inclarifying and ameliorating various prob-lems.”

The School of Medicine is holding a recep-tion to honor Dr. Beck on November 6 atthe Union League, 5:00-7:00 pm. AllDepartment faculty and staff are invitedto attend. Please contact Tina Callaghanat (215) 662-2818 for details. �

Psychiatry Perspective

Aaron T. Beck, MD2006 Albert Lasker Clinical Medical Research Award

FFaallll 22000066

PENN

CHAIRMAN’S REPORT . . . . . . . . 2

PROGRAM HIGHLIGHTS

Pain Medicine . . . . . . . . . . . . . . 3Behavioral Genetics . . . . . . . . . . 5

OUR DISTINGUISHED FACULTY

Awards and Honors . . . . . . . . . . 7News & Goings-On . . . . . . . . . . 9Research News . . . . . . . . . . . . .11Research Grants . . . . . . . . . . . .14Faculty in the News . . . . . . . . .16

CORNERSTONES

Faculty Spotlight . . . . . . . . . . . .17Voluntary Faculty Profile . . . . .19Employee Snapshot . . . . . . . . .21

EDUCATIONAL HIGHLIGHTS

Resident Class of 2010 . . . . . . .22Resident Activities . . . . . . . . . .23Family Systems Program . . . . .24

DEPARTMENT PICNIC . . . . . . . .26

CALENDAR OF EVENTS . . . . . . .27

Communicating better...

Department of Psychiatryand

PENN Behavioral HealthUniversity of Pennsylvania

IInn TThhiiss IIssssuuee

Penn Psychiatry Perspective has a new look. We have created distinct sections within the newsletter and have utilized a two- orthree-column page structure to make it easier to locate our features and read our stories. We have also added the portrait of

Benjamin Rush to our cover page. Rush, the first Chair of Chemistry in America and one of the earliest teachers in Penn’s medicalschool, was the world’s leading expert on mental diseases in the late 18th and early 19th centuries. In 1812, Rush published Med-ical Inquiries and Observations Upon Diseases of the Mind, the first American textbook of psychiatry. Rush is recognized as the“Father of American Psychiatry.”

We have also redesigned the Department web site to improve ease of use and to expand the information available to users. Start-ing in November, the new web site address will be: www.med.upenn.edu/psych. This and future issues of Penn Psychiatry Per-spective will be posted on the web site. Also, we are developing a new web site for the Department’s residency program, to belaunched in November (www.med.upenn.edu/psychres). �

PENN PSYCHIATRY PERSPECTIVE � FALL 2006 PAGE 2

www.med.upenn.edu/psych

About a decade ago, biomedical researchers began touse a term which succinctly describes what we do.

According to the NIH, translational research is the processby which “scientific discoveries [are] translated into practi-cal applications.”

Translational research is the place where science and medi-cine meet to conquer disease.

Conducting research to improve patient care is one of thefundamental reasons why academic medical centers anddepartments such as ours exist. How well we create knowl-edge to improve the public health largely determines ourvalue to society and our reputation among our peerdepartments.

Translational medicine takes many forms, from laboratoryor “bench” research to studies of human subjects, and viceversa, with the same goal – improved drugs, therapies, andother treatments.

While the boundaries are somewhat blurred, I like to viewthe translational research efforts in our Department in threecategories: 1) basic research; 2) behavioral medicineresearch; and 3) clinical research.

Basic Research – The path from basic investigation to thebedside is not always straightforward. Basic science inves-tigators may pursue questions without immediate clinicalsignificance, though their efforts may produce findings thatultimately unlock medical puzzles to improve patient care.Other basic researchers stick closer to clinical applications,such as identifying genes that cause or exacerbate disease.

The Center for Neurobiology and Behavior is the focalpoint for our basic translational work. Here, scientistsstudy the neurobiology of disease, working at cellular ormolecular levels to understand how the essential buildingblocks of the neural system develop and change. Theysearch for genes that may predispose individuals to certaindisorders, including mood and anxiety disorders andschizophrenia. Others seek the genetic basis for humanobesity or examine how anti–depressant, anti-anxiety, andanti-psychotic drugs work in the human body.

Behavioral Medicine Research – Behavioral medicine exam-ines the role of behavioral and cognitive factors in the etiol-ogy, prevention, treatment, and outcomes of major medicalillnesses. The Center for Studies of Addiction and theTreatment Research Center focus on addictive illness. TheDivision of Sleep and Chronobiology investigates the basisfor sleep disorders, the Weight and Eating Disorders Pro-gram focuses on the prevention and treatment of obesity,the Transdisciplinary Tobacco Use Research Center studiestobacco use and nicotine addiction, and the HIV Preven-tion Research Division tests HIV/AIDS prevention inter-ventions.

In this issue, we pay tribute to Aaron T. Beck, MD, founderand director of the Psychopathology Research Unit, who is

the recipient of the presti-gious 2006 Albert LaskerClinical Medical ResearchAward. Over five decades,all spent in our Department,Dr. Beck developed the theo-ry and practice of cognitivetherapy, used world-wide totreat patients suffering froma wide range of mental andmedical disorders.

Clinical Research – At theclinical research end of theinvestigative spectrum, faculty in the Neuropsychiatry Sec-tion, including the newly established Center for Transla-tional Research in Psychiatry and the Center for Neu-roimaging in Psychiatry, study brain-related disordersassociated with complex behavior change, particularlyschizophrenia. The Center for the Treatment and Study ofAnxiety explores new psychotherapeutic approaches totreat posttraumatic stress disorder and other anxiety disor-ders, and the Mood and Anxiety Disorders Program givesspecial attention to drug therapies for mood and anxietydisorders. The Center for Cognitive Therapy developstreatments for depression and borderline personality disor-der, the Depression Research Unit conducts studies in bipo-lar disorder and depression, and the Center for Psychother-apy Research identifies the appropriate therapies for specif-ic disorders. The Center for Mental Healthy Policy and Ser-vices Research seeks to improve the delivery of care to peo-ple with serious mental illness and the Section on GeriatricPsychiatry studies the mental disorders that most afflict theelderly.

To answer their questions, Department researchers inte-grate scientific disciplines and methodologies and tap theexpertise of researchers across Penn’s departments andschools and at other universities and research institutions.Through formal training programs – such as the highlyregarded Clinical Research Scholars Program – and infor-mal mentorship, Department faculty pass on their researchexpertise to residents and other trainees, transferring tofuture generations the necessary tools to conduct transla-tional research.

The ultimate goal of this interdisciplinary and interinstitu-tional effort is to translate science into improved clinicalcare. It’s a responsibility our faculty take seriously and, asthe results show, fulfill expertly.

Dwight L. Evans, M.D.Ruth Meltzer Professor and ChairProfessor of Psychiatry, Medicine and Neuroscience

Chairman’s Report

www.med.upenn.edu/psych PAGE 3

PENN PSYCHIATRY PERSPECTIVE � FALL 2006

UNDERSTANDING AND TREATING THE NATION’S SILENT EPIDEMIC:The Center for Pain Medicine, Research and Policy Begins Its Work

Program Highlights

If you experience pain on a fre-quent basis, the numbers sug-

gest that you have company.

• Over 50 million Americans suf-fer from chronic pain, one-fifthof whom are severely affected.This number is rapidly increas-ing as our population ages,accruing risk for pain-causingdisease and injury.

• 80 percent of physician visitsare tied to complaints aboutchronic pain.

• Over $100 billion is spent annu-ally on medical costs, disabilitypayments, worker retraining,and lost productivity resultingfrom pain.

Pain affects personal relationships,the ability to work productively, toenjoy life, to carry out every dayactivities. It has psychological con-sequences – causing fear, anger,worry, and loss of sleep, and erod-ing self-esteem. Pain can exacer-bate medical conditions – reducingthe body’s capacity to ward off dis-ease, generating side effects frompain-killing medications, andinducing clinical depression.

The direct cause of acute pain isusually identifiable and remedia-ble, but chronic pain presents a dif-ferent challenge. Often, its under-lying cause cannot be eliminated,and comprehensive pain manage-ment is needed to relieve suffering.

Ministering to patients who sufferwith chronic pain is the primarymission of the Center for PainMedicine, Research and Policy,launched in September 2005 by

PENN Behavioral Health. TheCenter complements the work ofthe Penn Pain Medicine Center inthe Department ofAnesthesiology andCritical Care, under theleadership of Lee A.Fleisher, MD, chair ofthe department. Itdraws upon the expert-ise of cliniciansthroughout the Univer-sity of PennsylvaniaHealth System to carefor patients sufferingfrom persistent paincaused by injuries, dis-eases, and other condi-tions, including cancer.The ultimate goal of treatment is toimprove quality of life and func-tion.

The Center for Pain Medicinebecame a reality thanks to thevision and commitment of twograteful patients, who workedwith Director Rollin Gallagher,MD, MPH to develop the originalconcept for the Center. They havecontinued to nourish it with gener-ous financial support and adeptguidance.

Dr. Gallagher, Clinical Professor ofPsychiatry at Penn, has been criti-cally involved in the developmentof the new specialty of Pain Medi-cine, which he characterizes as “aconvergence of neuroscience, psy-chology, and clinical medicine.”His interest in the causes and per-vasive effects of chronic pain cameearly in his career, when he pro-vided consultation/liaison psychi-atry services on an inpatient

orthopaedic trauma ward at theUniversity of Vermont. He caredfor the same patients in follow-up

at a family practice center, whilerunning an NIH-funded trainingprogram for primary care physi-cians and psychiatrists in biopsy-chosocial medicine. He recollectsthat “about half the difficult chron-ic disease management problems Isaw at Vermont were patients withintractable pain.”

With a background in family prac-tice, medical psychiatry, epidemi-ology, and academic medicaladministration, he established amulti-disciplinary pain program atVermont, featuring an outpatientclinic and inpatient beds. Hebecame attracted to the researchand training aspects of Pain Medi-cine, and went on to develop paincenters and fellowship trainingprograms at SUNY Stony Brookand MCP Hahnemann University,before coming to Penn and the Vet-erans Administration Medical Cen-ter in 2004.

Continued on page 4

Director Rollin Gallagher, MD, MPH and Clinical Coordinator Maripat Welz-Bosna, MSN, CRNP



Pain is serious, and real, yet it isneither well understood norappreciated, even by many physi-cians and health care providers.Dr. Gallagher explains that themajor reason for this is “inade-quate education in medical schooland training in residencies, per-petuated until now by the rela-tively few medicaldepartments dedi-cated to the missionof pain research,education, and train-ing. Pain is often thepoor step child ofone or more depart-ments, and rarely apriority.” Chronicpain represents a“silent epidemic” inAmerica, its victims the “walkingwounded.”

Dr. Gallagher has sought to cor-rect this imbalance at every insti-tution he has worked, as well as ata national level. He has been anactive leader in major nationalpain medicine organizations,including the American Academyof Pain Medicine (AAPM), theAmerican Board of Pain Medicine(ABPM), and the National PainFoundation. Among his manycontributions to the field, he is thefounding, and current, editor-in-chief of AAPM’s academic journal,Pain Medicine.

Heightened attention at the insti-tutional and national levels isachieving results. Over the lastfour decades, there has been alarge increase in the number ofresearch publications dedicated tothe science of pain, as indicatedby a medline search using the keyword “nociception” (the activationof pain) – from 45 in the 1970’s,532 in the 1980’s, 1391 in the1990’s, to 1708 in the half decade

from 2000 to 2005.

“The biggest breakthroughs,” saysDr. Gallagher, ”have come aboutbecause of advances in the disci-plines of epidemiology and theneurosciences. Epidemiologicstudies have established thatchronic pain is not a psychiatric

condition, but rather that manydifferent injuries and diseases ini-tiate the chronic pain process inthe peripheral and central nervoussystem, with negative psychologi-cal and social consequences suchas psychiatric morbidity. Specificpain conditions are each uniquelyaffected and complicated by psy-chological and social factors,including higher rates of co-occur-ring psychiatric disorders than inother chronic diseases.” Thiscomplexity suggests why chronicpain is so little understood, saysDr. Gallagher.

But there is cause for optimism.“The rapid development of theneurosciences, including neu-roimaging,” says Dr. Gallagher,“has increased our understandingof the anatomy, molecular biology,and pathophysiology of differentpain disorders, demonstrating theneuroplastic changes in the spinalcord and brain that cause, perpet-uate, and worsen pain conditionsand diseases. The proliferation ofavailable treatments for pain hasgreatly expanded the toolbox of

the pain medicine specialist forwhat is still considered the clinicalart of selectively integrating thesetreatments for each individualpatient with chronic pain.”

The Center for Pain Medicinedraws upon the newest researchadvances in treating patients with

a multi-disciplinaryapproach. It is not tiedto any specific therapyor class of therapies,and clinical recommen-dations are chosenfrom among traditionaland complementary,non-invasive and inva-sive treatments. Treat-ment regimens arecarefully tailored to fit

the special goals, needs, and cir-cumstances of each patient.

The patient’s care is personallymanaged by a pain medicine spe-cialist who is expert at coordinat-ing and orchestrating diversetreatments. Maripat Welz-Bosna,MSN, CRNP, the Center’s ClinicalCoordinator and a pain manage-ment nurse practitioner highlyexperienced in both palliative careand pain medicine, plays a keyrole in assuring personalizedattention to every patient’s indi-vidualized treatment program.

Complementing its clinical focus,the Center is also actively engagedat the national and regional levelsin educating health care profes-sionals about how to treat pain,conducting pain research, formu-lating and advocating public poli-cy to improve the access ofpatients to pain treatment andhealth care in general, and pro-moting greater awareness of paintreatment and research among thegeneral public and health careprofessionals. For example, on

Continued from page 3

The Center for Pain Medicine draws uponthe newest research advances in treating

patients with a multi-disciplinaryapproach...Treatment regimens are carefullytailored to fit the special goals, needs, and

circumstances of each patient.

Continued on page 5



June 13, Dr. Gallagher present-ed the public health challengeof chronic pain and the need forbetter education and moreresearch at a CongressionalBriefing: “The Epidemic of Painin America”. (For his testimo-ny, please access www.national-painfoundation.org and followthe links.) Dr. Gallagher recent-ly was awarded a grant fromthe Department of VeteransAffairs, working with a teamfrom Walter Reed Army Med-ical Center and the Universityof Pennsylvania, to study thecourse and outcomes of soldierswith combat-related limbinjuries.

“Chronic pain used to bethought of as psychosomatic,”says Dr. Gallagher, “but we cannow demonstrate the patho-physiology of chronic pain inthe central nervous system. Weknow much more about howand where in the CNS emotionsinteract with pain disease andways that treatments – fromneurostimulation to pharmaceu-ticals to psychotherapy – bringrelief.” The Center for PainMedicine, Research and Policyis playing a continuing role inadvancing and disseminatingknowledge about pain andusing the latest research find-ings to assist those afflictedwith pain’s devastating effects.

To schedule an appointment orfind out more about the Centerfor Pain Medicine, please callthe PENN Behavioral HealthContact Center (Mon. – Fri. 8:00am to 6:00 pm) at 1-866-301-4PBH, or access the Center forPain Medicine Website athttp://www.med.upenn.edu/painmedicine/ �


Experts disagree on the precise numbers, but the danger is clear – obesity represents a major public health risk in the United States

and the world, and the trends are not favorable.

Researchers in the Department of Psychia-try are taking on obesity from severaldirections. They are playing leadershiproles in the School of Medicine’s Institutefor Diabetes, Obesity and Metabolism,established in 2005 to support the efforts ofPenn faculty to better understand the seri-ous disorders cited in its name. Closer tohome, the Department’s widely recognizedWeight and Eating Disorders Program isparticipating in multiple clinical trialsfocused on preventing and treating obesity.

Meanwhile, in the new TranslationalResearch Laboratories, the BehavioralGenetics Laboratory (BGL) is seeking to discover the genetic basis forhuman obesity. Established in 1987, the BGL is one of the componentlaboratories of the Center for Neurobiology and Behavior, the focalpoint for the Department’s basic science research programs.

Prior research indicates that genes may account for up to two-thirds ofindividual differences in obesity, and Director and Professor of Psy-chology in Psychiatry R. Arlen Price, PhD and his team are trying toidentify the precise genes that account for these differences.

Dr. Price acknowledges that the task he and his colleagues face is chal-lenging. “As with all behaviorally mediated traits,” he explains, “theinheritance of obesity is complex, involving genes, the environment,and their interactions.” Just as no unique diet or product has beenfound to control weight gain, no single causal factor is likely either.

The work begins with genetic material drawn from members of over500 families who have volunteered to participate in BGL’s studies. Thisunique sample allows BGL researchers to compare the genetic materialof family members with normal weight to that of their overweight rela-tives. The BGL has also developed a comparison sample of over 500“controls” from a diminishing minority of the population, those whohave never been overweight.

Using specialized areas of expertise, such as molecular epidemiology

Director R. Arlen Price, PhD

SEARCHING FOR THE GENETIC CAUSESOF OBESITY:

The Behavioral Genetics Laboratory in the Center for Neurobiology andBehavior

Continued on page 6



and quantitative and molecular genetics, BGLinvestigators analyze the genetic material to teaseout meaningful genetic dissimilarities that mayaccount for obesity susceptibility and resistance.

The BGL is carefully building the scientific plat-form from which to launch a targeted search forobesity-related genes. In two studies, Dr. Price’sgroup demonstrated that some gene effects dependon the presence ofvariation in other partsof the genome. Of par-ticular interest arefindings that indicateeffects for genes onchromosome 20 occurprimarily in the pres-ence of variations onchromosome 10. Thisinteraction may be animportant clue to helplocate genes that influ-ence obesity.

Another hint to solv-ing the puzzle may liein the BGL’s explo-rations in the emerg-ing area of genomicimprinting. Studies inthis area identify andinvestigate those geneswhich express them-selves differently – i.e.,how they act within the body – depending uponwhether they are inherited from the male or femaleparent. Genomic imprinting is known to affectbody size and composition in animals, such as miceand pigs. BGL researchers recently found threechromosome regions that have genes with strongparental effects, two maternal and one paternal,suggesting that imprinting may be common inhumans as well. A BGL paper describing evidencefor genomic imprinting effects on human obesitywas published last year (Dong, C, Li, W-D, Geller,F, Lei, L, Li, D, Gorlova, OY, Hebebrand, J, Amos,CI, Nicholls, RD, Price, RA. Possible genomicimprinting of three human obesity-related geneticloci. American Journal of Human Genetics 2005, 76:427-437).

In carrying out these basic science inquiries, Dr.Price works with a talented research group. Thecomplex analyses for the studies on gene interac-tion and imprinting were completed by ResearchAssociate Chuanhui Dong, PhD, who has expertisein quantitative genetics and molecular epidemiolo-gy. Research Assistant Professor Wei-dong Li, MD,PhD mainly focuses on molecular genetics. Dr.Price also collaborates with mathematical geneticist

Hongyu Zhao, PhD,of Yale University.

The BGL is also con-ducting more clinical-ly oriented research.The drug Olanzapineis effective in treatingschizophrenia andbipolar disorder.However, it causessignificant weightgain in many individ-uals. The Laboratoryhas been workingwith scientists at EliLilly and PerlegenSciences to determinewhether the samegenes that influenceobesity account for thedrug-associatedweight gain. Thisstudy is one of the

first to scan the entire human genome by testingmore than 1.3 million genetic markers in weightgain-susceptible and resistant individuals. BGLinvestigators have replicated several of these geneeffects in their family samples, finding a previouslyunknown genetic pathway influencing weight gainand obesity.

The BGL’s work is about establishing relationshipsamong genes and their impact on human behaviorand physiology. Understanding these relationshipshas required the BGL to develop bonds of a differ-ent sort – collaborations among scientists, bridgesbetween scientific disciplines, and connectionsbetween clinically-inspired questions about obesityand basic research at the molecular level. �


The BGL Research Team: (from left) Sahib Shinde, PhD; Wei-DongLi, MD, PhD; Guang Ming Yuan, BS; Director R. Arlen Price, PhD;

and Chuanhui Dong, PhD



Departmental Honors

The Albert Stunkard Faculty Recognition Award is givenannually to faculty members who are outstanding teach-ers and mentors. The graduating resident class selectsaward winners who have significantly influenced theireducation and training. Named for Albert J. Stunkard,MD, Emeritus Professor of Psychiatry and former Chair ofthe Department, this award recognizes Dr. Stunkard’senormous contribution to the education, training, andsupport of Department housestaff. James Stinnett, MD,Joseph DiGiacomo, MD, Jody Foster, MD, MBA,Alexandra McLean, MD, and John O' Reardon, MDreceived this honor in 2006.

The 2006 PGY-3 & 4 Teaching Award was awarded to Clau-dia Baldassano, MD and the 2006 PGY-1 & 2 TeachingAward was awarded to Christos Ballas, MD. Theseawards honor those individuals whom the residents con-sider the most effective teachers of the academic year andexemplary in shaping their overall education.

Moira Rynn, MD was the 2006 recipient of the Earl BondAward. Initiated by the efforts of Dr. William Peltz, thisannual award is given to a Department member who hasdistinguished himself/herself for teaching at the medicalstudent, resident and/or graduate level.

Christian Kohler, MD was awardedthe 2006 Martin P. Szuba Award for Excel-lence in Clinical Teaching and Research.This award is presented annually to aDepartment faculty member with out-standing teaching abilities, ongoingclinical research, and a focus on trans-lating research concepts into clinically

useful teaching, all of which Dr. Szuba embodied in hiswork.

Teaching by the residents is an invaluable part of medicalstudent education. The Medical Student Teaching Award isgiven to residents who have been consistently outstand-ing in their ability to teach. Juliette Galbraith, MD andJohn Mitchell, MD received this award in 2006.

The Psychodynamic Psychotherapy Award is given annuallyby the Psychoanalytic Cluster Steering Committee tograduating residents in recognition of their excellence inproviding psychodynamic psychotherapy. C. Pace Duck-ett, MD and Geoffrey Neimark, MD received this awardin 2006.

Joseph DiGiacomo, MD was the second recipient of theAnnual Award for Clinical Faculty. This award, funded bya clinical faculty member, is given to a volunteer clinicalfaculty member who has demonstrated long-term loyaltyto the Department and excellence in teaching and/orsupervising.

Cory F. Newman, PhD was the recipient of the Fifth PennPsychotherapy Professorship, which entails a special invita-tion to lecture to the Psychiatry residents on advancedclinical issues. Dr. Newman presented the lecture in June.

School of Medicine & University Honors

Robert M. Weinrieb, MD received a 2006 Penn PearlsTeaching Award. This award is given by the medical stu-dents to honor their best clinical teachers, both facultyand residents. In addition, he was appointed Director ofthe Consultation/Liaison Psychiatry Service at HUP.

Regional, National & International Honors

Treating and Preventing Adolescent Men-tal Health Disorders, What We Knowand What We Don’t Know received the2005 Best Book in Clinical Medicine Awardfrom the Association of American Pub-lishers, the principal trade association ofthe book publishing industry. The vol-ume is edited by Dwight L. Evans, MD,

Edna B. Foa, PhD, Raquel E. Gur, MD, PhD, HerbertHendin, MD, Charles P. O’Brien, MD, PhD, Martin E. P.Seligman, PhD, and B. Timothy Walsh, MD. The book,designed for both mental health professionals and the laypublic, is a product of the Adolescent Mental Health Ini-tiative, supported by the Annenberg Foundation Trust atSunnylands and the Annenberg Public Policy Center atPenn. Oxford University Press is the publisher.

Two Department of Psychiatry faculty were listed in the“Top Doctors” issue of Philadelphia Magazine (May 2006):Anthony L. Rostain, MD (Child & Adolescent PsychiatryADD/ADHD, autism) and Edward S. Brodkin, MD(autism, learning disorders – social).

Aaron T. Beck, MD was the recipient of the 2006 AlbertLasker Clinical Medical Research Award from the Albert andMary Lasker Foundation – please see this issue’s CoverStory for more details about this major honor. Dr. Beckwas also the recipient of the Gustav O. Lienhard Award

AAWWARDSARDS & H& HONORSONORS

Our Distinguished Faculty

Continued on page 8



from the Institute of Medicine for outstanding achievementin improving health care services in theUnited States. Dr. Beck also received theLifetime Achievement Award from theAmerican Foundation for Suicide Preven-tion for “his 50 years of pioneeringresearch into suicide.” Foundation Presi-dent Dwight L. Evans, MD presented theaward to Dr. Beck at the AFSP’s 18th

Annual Lifesavers Dinner in May.

Stanley N. Caroff, MD was appointed a member of thePennsylvania Psychiatric Society Committee on VeteransAffairs and State Hospital Issues in 2006.

Judith A. Coche, PhD was appointed to the CertificationBoard of the American Group Psychotherapy Association.In February 2007, she is scheduled to teach the certificationcourse required for national certification in group psy-chotherapy.

In June, Charles Dackis, MD received aResearch Award from The Caron Founda-tion, a non-profit addiction treatmentorganization. Dr. Dackis was cited as anindividual who has made an “outstandingcontribution towards the on-going battleagainst addiction and chemical dependen-cy.”

Joseph DiGiacomo, MD received the Lifetime AchievementAward from the Philadelphia Psychiatric Society. Dr. DiGia-como was also one of the recipients of the second annualIrma Bland Award for Teaching Residents from the AmericanPsychiatric Association and its Council on Medical Educa-tion and Lifelong Learning. The award was established tohonor Irma Bland, MD in tribute to her unique and creativecontributions to psychiatric education.

David F. Dinges, PhD was named Editor-in-Chief of Sleep, the leading journal forsleep research and sleep medicine. Sleep isthe official publication of the AssociatedProfessional Sleep Societies, LLC, a jointventure of the American Academy of SleepMedicine and the Sleep Research Society.

Ruth S. Fischer, MD was elected by TheCOPE Committee on Women’s Issues in PsychoanalyticEducation of the American Psychoanalytic Association tobe The National Women’s Scholar for 2007-2008. She will visitseveral institutions around the country to talk and teachabout female psychology and educational issues.

Edna B. Foa, PhD received a Fulbright Senior SpecialistAward. In June, Dr. Foa worked closely with the faculty ofthe School of Social Work at Haifa University, teachinggraduate students and consulting on research projectswhich examine issues related to psychological reactions totraumatic experiences and their treatment.

Michael P. Kowitt, PhD was elected Chairman of the Edu-cation Committee of the Psychoanalytic Center of Philadel-phia in 2005.

Paul J. Moberg, PhD was elected to the Board of Directorsof the American Academy of Clinical Neuropsychology. Hewas also the recipient of the award for Distinguished Contri-butions to the Science and Profession of Psychology from thePennsylvania Psychological Association.

Since October 2005, David W. Oslin, MD has been theNational Director of the Center of Excellence in SubstanceAbuse Treatment and Education (CESTATE) of the Depart-ment for Veterans Affairs.

Robert L. Sadoff, MD received the 2006 Isaac Ray Awardfrom the American Psychiatric Association, the highestnational award in forensic psychiatry. Isaac Ray, MD wasone of the founders of the APA in 1844 and is consideredthe “Father of Forensic Psychiatry” in the United States.

David B. Sarwer, PhD was named Chair of the BariatricSurgery Section of the North American Society for theStudy of Obesity.

Jeffrey P. Staab, MD was elected to membership in theAmerican Neurotology Society and the internationalBárány Society for his research on psychiatric and neuroto-logic morbidity in patients with chronic dizziness.

Albert J. Stunkard, MD was awarded a Doctorate of Hon-oris Causa from Louisiana State University in May.

Richard F. Summers, MD was one of the recipients of thesecond annual Irma Bland Award for Teaching Residents fromthe American Psychiatric Association and its Council onMedical Education and Lifelong Learning. He was alsoselected as Chair of the American Psychoanalytic Associa-tion's Committee for University and Medical Education.

Paul Root Wolpe, PhD will assume therole of President of the American Societyfor Bioethics and Humanities (ASBH) inOctober. The ASBH is the national profes-sional organization for scholars inbioethics and the medical humanities. Ithas over 1,600 members, including physi-cians, nurses, social scientists, legal schol-

ars, historians, philosophers, and others who study the eth-ical, social, legal, and historical issues in medical ethics.

George E. Woody, MD and Dr. EdwinZvartau received the 2006 National Instituteon Drug Abuse International Program Awardof Excellence in Collaborative Research. Dr.Zvartau is the Vice Rector for Science atPavlov State Medical University in St.Petersburg, Russia. The award was pre-sented at the June meeting of The College

on Problems of Drug Dependence. �




Jay D. Amsterdam, MD was selected to serve asAdvisory Board Member and lecturer in the"Insight into Depression" Penn CME Lecture Series.In addition, he serves as a Fellow and AdvisoryBoard member of Penn’s Center for Spiritualityand the Mind, which examines the interfacebetween our social and cultural beliefs and neuro-science.

Howard Scott Baker, MD gave a talk in October2005 in Baltimore at the 28th Annual InternationalConference on The Psychology of the Self, spon-sored by The International Association for Psycho-analytic Self Psychology. The presentation focusedon the relationship between religion and psycho-analysis, specifically exploring how self psycholo-gy offers a paradigm that can make sense of apatient’s spiritual experience.

Stanley N. Caroff, MD delivered a lecture on“Neuroleptic Malignant Syndrome, Catatonia, andRelated Conditions” to the Northeastern Pennsyl-vania Psychiatric Society in May.

In Basel, Switzerland in May, David F. Dinges,PhD delivered a Keynote Address at an Interna-tional Conference of the European Union 6thFramework Integrated Project SENSATION. TheSENSATION project focuses on the technology andphysiology of monitoring sleep and sleepiness. Dr.Dinges spoke on "Fatigue Management Technolo-gies: What Technologies, Deployed in What Ways,

for What Purposes?" In April, he gave a lecture inLaurel, Maryland on "Sleep, Fatigue and Stress:Monitoring Human Behavioral Capability" at a col-loquium sponsored by the Johns Hopkins Univer-sity Applied Physics Laboratory.

In 2005 and 2006, Edna B. Foa, PhD conductedintensive workshops on "Prolonged ExposureTherapy: A Cognitive Behavioral Treatment forPosttraumatic Stress Disorder" for mental healthprofessionals for several Veterans Affairs medicalcenters and other sites in the U.S. and abroad,including Switzerland, Korea, and Israel. In Febru-ary, she presented "Success and Challenges in Dis-seminating Evidence-Based Treatment: The Case ofPTSD" at The Community Stress Prevention Centerin Haifa, Israel.

This year, Michael P. Kowitt, PhD chaired a panelon relational theories in psychoanalysis at a facultysymposium at the Psychoanalytic Center ofPhiladelphia.

Caryn Lerman, PhD deliveredthe Clinical Research KeynoteLecture in February at the annualmeeting of the Society forResearch on Nicotine and Tobac-co. The lecture was entitled"Pharmacogenetic Approaches toNicotine Dependence Treat-ment.” In July, she presented a

NNEWSEWS & G& GOINGSOINGS OONN

Continued on page 10

James L. Stinnett, MDPortrait UnveilingNovember 9, 2006

Please join us on November 9 at 1:00 pm inthe BRB II/III Lobby for the unveiling of Dr.Stinnett’s portrait. The portrait unveiling cere-mony and reception will follow Dr. Stinnett’sGrand Rounds lecture in the BRB II/III Audito-rium at 12:00 pm.

Aaron T. Beck, MDLasker Award Reception

November 6, 2006

The School of Medicine is holding a reception tohonor Dr. Beck, recipient of the 2006 Lasker Clini-cal Medical Research Award, on November 6 at theUnion League, 5:00-7:00 pm. All Department fac-ulty and staff are invited to attend. Please contactTina Callaghan at (215) 662-2818 for details.



lecture on "The Role of the Endogeneous OpioidSystem in Nicotine Reward" at Oxford Universityat a meeting of the British Association for Psy-chopharmacology.

Marion Lindblad-Goldberg, PhD delivered a Ple-nary Address on "Our Sacred Models of RelationalTherapy: Relevant or Passé" and conducted aWorkshop on "Effective In-Home Therapy" at the63rd Annual Conference of the American Associa-tion for Marriage and Family Therapy in KansasCity, Kansas in October 2005. In May, she spoke on"Effective In-Home Therapy" and "A Model of Cou-ples Therapy" at the Wheeler Clinic in Hartford,Connecticut.

Cory F. Newman, PhD presenteda clinical workshop and researchpaper on "Cognitive Therapy forBorderline Personality Disorder"at the VI Congreso Latinoameri-cano de Psicoterapias Cognitivasin Buenos Aires, Argentina inMay. Displaying other talents, Dr.Newman played an all-Chopin

and Beethoven program in Dunlop Auditorium forhis 11th annual piano recital in July

Robert L. Sadoff, MD was named the Albert Biele,MD lecturer for 2006 at Jefferson Medical School.

David B. Sarwer, PhD gave lec-tures on several topics in the win-ter and spring, including the“Behavioral, Pharmacologic, andSurgical Treatment of Obesity”(Linden Oaks Hospital,Naperville, Illinois), the “Psycho-logical Aspects of BariatricSurgery and Body Contouring

after Massive Weight Loss” (ASPS/PSEF/ASAPSBody Contouring after Massive Weight Loss Sym-posium, Dallas, Texas), the “Management of LateDiabetes” and “Managing Patients with Difficult-to-Treat Hypertension” (Diabetes Xchange: Effec-tively Managing the Metabolic Syndrome, Founda-tion for Better Health Care, Philadelphia).

Albert J. Stunkard, MD delivered lectures at theKarolinska Institute in Stockholm and the Penning-

ton Biomedical Research Institute in Baton Rouge.In June, he spoke before the Society of BariatricSurgeons in San Francisco. In August, he lecturedon eating disorders at the Eating DisordersResearch Society Meeting in Port Douglas, Aus-tralia and in September he spoke at the Internation-al Congress on Obesity in Sydney, Australia.

Richard F. Summers, MD is Co-Chair of the collab-orative effort between Penn and the PsychoanalyticCenter of Philadelphia to develop interdisciplinaryeducational and research programs.

In March, Elizabeth B. Weller, MD presentedGrand Rounds at the Penn State University Collegeof Medicine on "Depression and Its Treatment inChildren and Adolescents: The SSRI Saga." InAugust, she gave Grand Rounds at Cooper Hospi-tal in New Jersey on "Diagnosis and Treatment ofDepression in Children and Adolescents." Dr.Weller presented the Samuel and Audrey LangMemorial Lectureship at William Beaumont Hospi-tal in Berkley, Michigan on "Phenomenology, Diag-nosis, and Medical Treatment of Childhood BipolarDisorder" in September and Grand Rounds atReading Hospital in Reading, Pennsylvania on"Evidence-Based Treatment of Depression in Chil-dren and Adolescents."

Paul Root Wolpe, PhD authored the first article onbioethics ever published in Cell, “Reasons ScientistsAvoid Thinking About Ethics” (125: 1023-1025,2006), and wrote an editorial in the PhiladelphiaInquirer on the Terry Schiavo case, "TechnologyAlters Dying in America" (April 30).

George E. Woody, MD delivered a lecture, "Treat-ment Approaches for Opioid and Alcohol Depen-dence: Medication Development and EmergingInterest from the Pharmaceutical Industry," at theannual meeting of the American College of Physi-cians in Philadelphia in April. In June, Dr. Woodypresented at the annual meeting of The College onProblems of Drug Dependence on "HIV RiskReduction Through Treatment: An Overview ofExperience with Opioid Agonist Therapies in Rus-sia and Former Soviet States" and "EmergencyDepartment Visits Involving Buprenorphine Abuse:2003-2005." He also co-chaired a session on"Progress in Buprenorphine Treatment." �




RRESEARESEARCHCH NNEWSEWS


The News Is In -- Psychiatry Again Ranked #2!

For the sixth straight year, the Department of Psychiatry is ranked #2 amongall psychiatry departments nationwide in its level of funding from the

National Institutes of Health. For FY2005 (the most recent year for which data areavailable), faculty in the Department received $52.2 million in total NIH funding,second only to the University of Pittsburgh and ahead of the psychiatry depart-ments at Yale, Duke, and the University of California, San Diego. While NIHranking is only one indicator of the quality of the Department’s investigativestudies, the peer-review process which govens all NIH awards ensures that sci-entific quality is the major criterion for successful applications. The Department’selite standing among its peers speaks volumes about the depth and breadth of thescientific expertise of our faculty and staff.




Jay D. Amsterdam, MD has launched new researchinitiatives in the field of Complementary and Alter-native Medicine for mood and anxiety disorders.He will study the use of Chamomile to treat Gener-alized Anxiety Disorder and Black Cohosh to treatmenopause-related anxiety symptoms. Dr. Amster-dam has also begun a new research project toexplore dopamine transporter binding affinity usingSPECT brain imaging in patients with depression,and how these brain images may visually portraythe impact of psychotherapy and pharmacotherapyin treating depression. Finally, Dr. Amsterdam hasrecently been involved in the development of thefirst transdermal antidepressant patch, and hasauthored the leading publications on the initial piv-otal trials with this drug.

Edward S. Brodkin, MD helpedorganize the March 2006Penn/CHOP research retreat enti-tled, “Research Perspectives inAutism.” He delivered a lecture atthe retreat on “A Mouse ModelSystem for Genetic Analysis ofSociability, An Autism Endophe-notype.” Dr. Brodkin also helped

organize a Penn session in March on “High Func-tioning Autism and Asperger Syndrome: PromotingSuccessful Outcomes Across the Life Cycle.”

Stanley N. Caroff, MD is the Site Director for anNational Institute of Mental Health-funded Schizo-phrenia Trials Network study to examine the effec-tiveness of switching antipsychotic medications. Heis also Site Director for a Department of VeteransAffairs Cooperative Studies Program investigationof the use of long-acting injectable risperidone totreat schizophrenia.

Edna B. Foa, PhD and her team have received athree-year grant from the National Institute on Alco-hol Abuse and Alcoholism to continue their study"Naltrexone and CBT (Cognitive Behavioral Thera-py) in Patients with Alcoholism & PosttraumaticStress Disorder." Investigators are exploring treat-ments for patients suffering from both alcoholdependence and PTSD. The project evaluates therelative efficacy of naltrexone, prolonged exposuretherapy, and their combination in treating symptomsof both disorders.

Ellen W. Freeman, PhD published an article in theArchives of General Psychiatry in April entitled, "Asso-ciations of Hormones and Menopausal Status withDepressed Mood in Women with No History ofDepression” (Freeman EW, Sammel MD, Lin H, Nel-son DB. 2006; 63:375-382).

Paul J. Moberg, PhD received anIndependent Investigator Awardgrant from the National Alliancefor Research on Schizophrenia andDepression entitled, “OlfactoryDysfunction in Schizophrenia: AModel System to Investigate Aber-rant Neurodevelopment.”

Richard J. Ross, MD, PhD, and Joan M. Cook,PhD, have continued work on a grant funded by theDepartment of Veterans Affairs pertaining to thetreatment of sleep and nightmare disturbances inVietnam combat veterans with posttraumatic stressdisorder.

David B. Sarwer, PhD was the lead editor on Sarw-er DB, Pruzinsky T, Cash TF, Goldwyn RM, PersingJA, Whitaker LA (eds.), The Psychology of Reconstruc-tive and Cosmetic Plastic Surgery: Clinical, Empirical,and Ethical Perspectives, Lippincott, Williams, &Wilkins, 2006. Dr. Sarwer, Thomas A. Wadden, PhD,and Noel Williams, MD (Department of Surgery)were co-editors for a supplemental issue of the jour-nal Obesity. In addition, Dr. Sarwer received a grantfrom the American Society of Plastic Surgeons tocontinue his study entitled, “Psychological StatusFollowing Cosmetic Breast Augmentation.”

A paper by Albert J. Stunkard,MD has recently been accepted forpublication in the Journal of ClinicalPsychiatry . The paper, “A Para-digm for Facilitating Pharma-cotherapy at a Distance: Treatmentof the Night Eating Syndrome,”describes a novel method of psy-

chopharmacology.

Richard F. Summers, MD was the Templeton Foun-dation Senior Fellow at the Positive PsychologyCenter in May and June, 2006, studying the integra-tion of psychodynamic psychotherapy theory andtechnique with principles of positive psychology. �




Naltrexone, discovered by the Addictions Research Center at the Philadelphia VA in the 1980sas a new treatment for alcoholism, was approved by the FDA in depot (injectable) form (Viv-

itrol®). In June, the drug went on sale in a depot form that will prevent relapse for 30 days after asingle injection. This new treatment is expected to have a major impact on the treatment of alco-holism. Related to this, Charles P. O’Brien, MD, PhD received a Dana Foundation Grant to coor-dinate a national study of depot naltrexone to prevent relapse in probationers and parolees with ahistory of heroin addiction.

Investigators at the TRC are playing leading roles in clinical trials designed to appraise the effectsof specific drugs on cocaine and alcohol dependence.

Kyle M. Kampman, MD, Charles Dackis, MD, Kevin G. Lynch, PhD, Helen Pettinati, PhD,Carlos F. Tirado, MD, Peter W. Gariti, PhD, Thorne Sparkman, MD, Michal Atzram, andCharles P. O’Brien, MD, PhD participated in a trial to evaluate the efficacy of amantadine,propranolol, and their combination in cocaine dependent patients with severe cocaine with-drawal symptoms.

Under the direction of Dr. Pettinati, the TRC participated in the COMBINE trial, the largestgovernment-sponsored pharmacotherapy study of alcohol dependence done to-date. Theresults demonstrate that naltrexone treatments with structured medical management or incombination with specialized alcohol counseling by a behavioral specialist are equally effec-tive in treating alcohol dependence. This finding was published in the Journal of the AmericanMedical Association [Anton RF, O'Malley SS, Ciraulo DA, Couper D, Donovan DM, GastfriendDR, Hosking JD, Johnson BA, Locastro JS, Longabaugh R, Mason BJ, Mattson ME, MillerWR, Pettinati HM, Randall CL, Swift RM, Weiss RD, Williams LD, Zweben A: CombinedPharmacotherapies and Behavioral Interventions for Alcohol Dependence. The COMBINEstudy: a randomized controlled trial. JAMA 2006;295(17):2003-17].

Also under Dr. Pettinati’s direction, TRC investigators conducted a pilot trial of the atypicalantipsychotic medication, quetiapine (trade name Seroquel®), for the treatment of alcoholdependence. The results demonstrate that quetiapine significantly increased the rate of com-plete abstinence as compared with placebo treatment. Findings have been presented at theannual meeting of the American Psychiatric Association in May 2006, and also at the annualNew Clinical Drug Evaluation Unit Meeting in June 2006.

In addition, under the direction of David W. Oslin, MD, the Philadelphia Veterans Affairs Med-ical Center developed a telephone-based systematic assessment service called the BehavioralHealth Lab (BHL). The utility of this system was assessed, and the results were published [OslinDW, Ross J, Sayers SL, Murphy J, Kane V, Katz IR. Screening, assessment, and management ofdepression in VA primary care clinics: The Behavioral Health Laboratory. J Gen Intern Med 21:46-50, 2006]. The introduction of the BHL into primary care resulted in the identification of mentalhealth and substance misuse problems in more patients.

Dr. Dackis and David S. Metzger, PhD are starting a new study entitled, “Community-basedModafinil Treatment of Women with Cocaine Dependence and HIV High-Risk Behavior.” �

At the Treatment Research Center ...




New NIH Awards (includes New and Competing Renewals)

Name Sponsor Project Title

Arnold, Steven NIH / Rush-Presbyterian-St.Luke’s Medical Center

Neurobiologic Study of Psychological Distress and Dementia

Crits-Christoph, Paul F. NIH Patient Feedback Effectiveness Study

Crits-Christoph, Paul F. NIH Psychotherapy for Major Depression in the Community

Foa, Edna NIH Naltrexone and CBT for Patients with Alcoholism and PTSD

Foa, Edna NIH Treating Adolescents with CSA-related PTSD

Gur, Ruben NIH The Neurobiology of Affective Dysfunction in Schizophrenia

Lucki, Irwin NIH Training Program in Neuropsychopharmacology

Sarwer, David NIH / Drexel University Prevention of Obesity at Universities: A Randomized Trial

Schnoll, Robert A. NIH Smoking Cessation for Head and Neck Cancer Patients

Wadden, Thomas A. NIH Look Ahead: Action for Health in Diabetes

Wadden, Thomas A. NIH / Temple University The Safety and Efficacy of Low and High Carbohydrate Diets

Woody, George E. NIH / UCLA Delaware Valley Node of the National Drug Abuse Clinical Trials Network --Protocol 0027 Start

Zubritsky, Cynthia NIH / Indiana University Simulation Model for Mental Health Systems Planning

RRESEARESEARCHCH GGRRANTANTSS

The following sponsored research funding was received by the Department during the period January 1, 2006 through August 31, 2006.

Other Federal Agencies


Brennan, Francis Department of VeteransAffairs

Biomedical Markers and Treatment for Impaired Avoidance Learning inFMR1 KO Mice

Caroff, Stanley N. Department of VeteransAffairs

Long-Acting Injectable Risperidone in the Treatment of Schizophrenia

Dinges, David F. National SpaceBiomedical Research

Minicog: A Portable and Fast Assessment of Cognitive Functions

Dinges, David F. DHHS / Washington StateUniversity

Individualized Biomathematical Modeling of Fatigue and Performance

Ehrman, Ronald Department of VeteransAffairs

Integrating Practice Guidelines for Smoking Cessation into Mental HealthCare for PTSD

Oslin, David Department of VeteransAffairs

Improving Behavioral Health Care: Implementation of the BHL-SP

Ross, Richard Department of VeteransAffairs

Randomized Controlled Psychotherapy Trial for Combat-Related Night-mares in Vietnam Veterans with PTSD

Other Agencies and Organizations


Bechtholt, Anita National Alliance for Research onSchizophrenia and Depression

Examining the Mechanisms of Chronic Antidepressant Efficacy

Li, Wei-Dong American Heart Association Genetics of Lipid Related Phenotypes in Obesity Cohorts



Other Agencies and Organizations (continued)


Lohoff, Falk W. American Psychiatric Association Bipolar Disorder

Lohoff, Falk W. American Philosophical Society Genetics of Schizophrenia and Bipolar Disorder

Lohoff, Falk W. National Alliance for Research onSchizophrenia and Depression

Shared Bipolar/Schizophrenia Susceptibility Genes on Chromosome8P

Rodriguez, Daniel Cancer Research and Prevention Mediators of the Adolescent Physical Activity and Smoking Relation-ship

Sarwer, David Plastic Surgery Educational Psychological Status Following Cosmetic Breast Augmentation

Schnoll, Robert A. American Cancer Society Comparing the Lozenge to the Patch for Smoking Cessation

Stunkard, Albert J. Robert Wood Johnson Foundation Statistician Support for Childhood Obesity Studies

Wadden, Thomas A. William Wrigley Jr., Company Use of Chewing Gum to Facilitate Appetite Control and Weight Loss inOverweight Individuals Treated by Lifestyle Modification

Wadden, Thomas A. Commonwealth of Pennsylvania /CHOP

Primary Care Network for the Treatment of Adolescent Obesity

Wenzel, Amy National Alliance for Research onSchizophrenia and Depression

Cognitive and Behavioral Predictors of Suicide Behavior in SuicideAttempters

Clinical Trials


Amsterdam, Jay D. Eli Lilly and Company A Functional Change and Efficacy of Duloxetine in Patients with Co-MorbidMajor Depression Soft Tissue Discomfort

Amsterdam, Jay D. Sanofi-Synthelabo, Inc. A Multi-Center Randomized, 30-52 Week Double-Blind, Placebo-ControlledStudy to Evaluate the Efficacy, Safety, and Tolerability of Saredutant 100 mgOnce Daily in the Prevention of Relapse of Depressive Symptoms in Outpa-tients with Major Depressive Disorder Who Achieved an Initial Response to12 Weeks of Open-Label Treatment with Saredutant 100 mg Once Daily

Langleben, Daniel D. No Lie MRI CLTR: Detection of Deception and Concealed Information with FunctionalMRI

Lucki, Irwin Predix Pharmaceuticals Evaluation of PRX-00023 in Rodent Antidepressant Tests

O’Reardon, John P. Cyberonics, Inc. Randomized Comparison of Outcomes in Patients with Treatment-ResistantDepression Who Receive VNS Therapy Administered at Different Amountsof Electrical Charge

O’Reardon, John P. Neuronetics, Inc. A Compassionate Use Treatment Protocol for Patients with Major Depres-sion Previously Responsive to RTMS Treatment with the NeuroneticsModel 2100 CRS Repetitive Transcranial Magnetic Stimulation System

Pettinati, Helen AstraZeneca LP A Multi-Center, Randomized Parallel-Group, Double-Blind Phase IV Com-parison of the Efficacy and Safety of Quetiapine Fumarate to Placebo asAdjunct Therapy

Pettinati, Helen Forest Laboratories, Inc. Initiating Acamprostate Within Versus Post-Detoxification in the Rehabilita-tive Treatment for Alcohol Dependence

Siegel, Steven Nupathe, Inc. Development of Implantable Formulations for CNS Applications

Weintraub, Daniel Myriad Pharmaceuticals, Inc. Phase 3 Multicenter, Randomized, Double-Blind, Placebo Controlled Studyof the Effect of Daily Treatment with MPC-7869 on Measures of Cognition,Activities of Daily Living and Global Function in Subjects with Mild Demen-tia of the Alzheimer’s Type



In December 2005, Judith A. Coche, PhDappeared on NBC’s Today to discuss “whygift-giving is so hard.”

Associated Press medical writer Ms. LauranNeergaard interviewed Charles Dackis, MDfor an article in April about the efficacy ofModafinil for the treatment of cocaine depend-ence. The piece was widely syndicated.

David F. Dinges, PhD was interviewed aboutsleep-related issues for stories appearing inTime Magazine, Forbes, PENN Medicine, and TheBaltimore Sun, as well as for an Associated Pressarticle. In May, he contributed to two CNNshows on sleep - "America is Sleep-Deprived:Long-Term Health Consequences Related toLack of Sleep; Car Accidents Caused by Lack ofSleep" and a primetime sleep special entitled"Sleep."

Marion Lindblad-Goldberg,PhD was interviewed for anarticle on "Adolescents andDivorce" which appeared onthe MSN.com Website, on"Mothers and Children Partic-ipating in the Same Activities"in Time Magazine (March), and

on "Three Generation Vacations" in ParentingMagazine (August). She was also quoted onsingle parenting issues in a book by Ellie SlottFisher, Mom, There's a Man in the Kitchen andHe's Wearing Your Robe (De Capo Press, 2005).

David B. Sarwer, PhD was interviewed for sto-ries across a spectrum of topics. These includ-ed: “Can We Ward Off Aging?” (PENNMedicine), “Face Transplantation” (RadioTimes—WHYY), “Surgically Slim: A Cure forObesity and Why It’s Risky” (ConsumerReports), “10 Shocking Truths about PlasticSurgery” (Cosmopolitan), “Saving Face” (Self

Magazine), “New you? New us” (Los AngelesTimes), and “Sultan of Skin” (Riverfront Times –St. Louis, Missouri).

Albert J. Stunkard, MD was interviewed byMs. Lynne Lamberg for an article on Night Eat-ing Syndrome for Psychiatric News.

Richard F. Summers, MD was interviewed foran article on dreams, which appeared in theMay 6 issue of U.S. News & World Report.

Daniel Weintraub, MD inter-viewed for the Paula ZahnShow on CNN, along withMatthew Stern, MD (Depart-ment of Neurology). The seg-ment, which aired on March22, was about impulse controldisorders in Parkinson's dis-ease and their possible associ-

ation with dopamine agonist treatment. Drs.Weintraub and Stern and colleagues publisheda paper on their work in this area in theArchives of Neurology on July 10, 2006, "Associa-tion of dopamine agonist use with impulse con-trol disorders in Parkinson's disease." (63: 969-973, 2006).

Paul Root Wolpe, PhD was interviewed onCBS News by Elizabeth Kaledin in April aboutemerging issues in neuroethics, appeared onABC's show Top Priority in May to discuss eggdonation, and was on National Public Radio'sTalk of the Nation in June (with Daniel D. Lan-gleben, MD) describing the science and ethicsof neuroimaging for lie detection. Dr. Wolpewas also quoted extensively in Nature on brainimaging for lie detection (441: 918-919, 22 June2006) and in The Scotsman's Sunday Magazinein “'Bionic Man' Uses Power of Thought toControl TV” (July 13). �

FFAACULCULTT YY ININ THETHE NNEWSEWS



“One thing I am known for,”says Paul F. Crits-

Christoph, PhD, “is being thefather of 12-year old triplets– twoboys and a girl.” A lesser knownfact is that he and his wife Kather-ine, also a clini-cal psychologist,and the entirefamily areexpertly trainedand avid scubadivers, and eagerlylook forward toexploring the myster-ies that lie just below the surface.

It’s an apt avocation for Dr. Crits-Christoph, whose professionalcareer is founded on proficienttraining, solid teamwork, andboundless curiosity about thesecrets of the mind.

Dr. Crits-Christoph, Professor ofPsychology in Psychiatry, is theDirector of the Department of Psy-chiatry’s world-renowned Centerfor Psychotherapy Research. Forover 20 years, the former Presi-dent of the Society for Psychother-apy Research and widely pub-lished scholar has pursued twointriguing lines of inquiry.

“What continues to fascinate me,”remarks Dr. Crits-Christoph, “isthat while psychotherapy is wide-ly practiced, we know little abouthow it works. Additionally, thereare multiple forms of psychothera-py, and we need to figure outwhat works best for what kinds ofpatients.”

For Dr. Crits-Christoph, the pathto these questions has largelywound through Penn’s leafy cam-

pus. He earned a BA at the Uni-versity of Pennsylvania, majoringin biology with a particular inter-est in environmental biology. Askilled athlete, he played baseballand basketball on Penn’s fresh-

man teams, at a time when the IvyLeague did not allow freshmen toplay varsity.

As part of his financial aid pack-age at Penn, he was randomlyassigned as a freshman to a work-study position with PsychiatryProfessor Lester Luborsky, PhD, acelebrated psychotherapyresearcher. To borrow a line fromRobert Frost’s “The Road NotTaken”, Dr. Crits-Christoph’s rela-tionship with Dr. Luborsky “hasmade all the difference.” Heworked for Dr. Luborsky for allfour of his undergraduate years.Upon graduation, he first soughtjobs in biology, and was offered a

position at the Food and DrugAdministration. But when Dr.Luborsky offered him a full-timeresearch assistant position, Dr.Crits-Christoph accepted. As mat-ters turned out, he had chosen his

road.

During the nexttwo years, he

worked forDr. Luborsky,and took psy-chologycourses at

Penn. He then went on to gradu-ate school, earning an MS, MPhil,and PhD in Clinical Psychology atYale University.

With his post-graduate degrees inhand, at least one decision seemedclear. “I was always more interest-ed in an academic path,” says Dr.Crits-Christoph. “The scientificquestions were what interestedme. I had considerable training instatistics and methodology, soaspects of the process of doingresearch, not just the content, werealso of interest to me.”

Coming out of graduate school in1984, he applied for positions inpsychology departments, butagain accepted a position with Dr.Luborsky who had a grant to hirea junior faculty member. He tookthe faculty position at Penn,because Dr. Luborsky’s primeinterest was in psychotherapyresearch, and he had an active andsuccessful research program.Moreover, Dr. Crits-Christophemphasizes, “we had successfullycollaborated on quite a few papersup to that point, so I knew it

FACULTY SPOTLIGHT

Recognizing the significant achievements of our faculty and staffCornerstones

Paul F. Crits-Christoph, PhD




would be a productive environ-ment.”

Penn was, indeed, an ideal placeto do psychotherapy research.There were two well known andsuccessful programs –- one onpsychodynamic therapy with Dr.Luborsky, and one withthe Department’s Aaron T.Beck, MD, who developedthe theory and practice ofcognitive therapy. Likemost more recentlytrained clinical psycholo-gists, Dr. Crits-Christophhad been exposed to avariety of clinicalapproaches and was inter-ested in comparing andpotentially integrating them.

By the late 1980’s, the time wasright for Dr. Crits-Christoph toassume a leadership role in thiseffort. Dr. Crits-Christoph saw theopportunity to expand the scopeof psychotherapy research at Pennwith support from the NationalInstitute of Mental Health(NIMH). In 1990, with Dr. Beck’sand Dr. Luborsky’s approval andcollaboration, Dr. Crits-Christophreceived an NIMH Center granton comparative psychotherapyresearch, including both cognitiveand psychodynamic approaches.It was the only NIMH ClinicalResearch Center in the U.S.focused solely on psychotherapyresearch. At the time, Dr. Crits-Christoph, only 36, was probablythe youngest director of an NIMHClinical Research Center.

Over the past 16 years, the Centerfor Psychotherapy Research hasfurthered its international reputa-tion, both for teaching andresearch. Dr. Crits-Christoph andother faculty at the Center teachPenn medical students, residents,post-doctoral fellows, and Univer-sity undergraduates, and mentor

PhD psychology graduate stu-dents.

The Center’s research agenda hasbeen equally broad and deep,comparing the effectiveness ofvarious psychotherapies – andpharmacotherapy – for different

maladies, such as cocaine depend-ence, generalized anxiety disorder(GAD), panic disorder, anddepression.

“Penn has been a great place towork in terms of colleagues, thequality of the research programs,and access to patients for researchstudies,” says Dr. Crits-Christoph.Departmental collaborations havebeen developed with George E.Woody, MD on substance abuse,with Karl Rickels, MD on a studyof combining medication and cog-nitive behavioral therapy forGAD, and with Trevor R. Hadley,PhD on new initiatives in commu-nity-based research. Collabora-tions continue with Dr. Beck toexplore the use of cognitive thera-py for suicidal patients. Dr. Crits-Christoph has also been collabo-rating with Andrew B. Newberg,MD in the Department of Radiolo-gy on brain imaging of patientsbefore and after psychotherapy.(Dr. Newberg has a secondaryappointment in the Department ofPsychiatry.)

Investigators at the Center haveproduced many research findings,perhaps none as surprising as the

results of a multicenter study ofthe treatment of cocaine depend-ence. “The majority of studies ofactive forms of different psy-chotherapies find no differencesbetween the different treatments,”says Dr. Crits-Christoph. “In ourcocaine treatment study, we

hypothesized that doctor-al-level professional psy-chotherapists, using tech-niques developed specifi-cally for cocaine depend-ence, would have betteroutcomes than individualand group drug counselingpracticed by addictionscounselors.” But the dataindicated that, contrary to

expectations, “the package of indi-vidual and group drug counselingwas significantly better than pro-fessional psychotherapy, plusgroup drug counseling.”

When the NIMH ended its Clini-cal Research Center program afew years ago, Dr. Crits-Christophand his colleagues turned to theNIMH’s new program encourag-ing studies in community settings.For the past few years, the Centerhas been making the transition tocommunity-based research, andhas recently received an NIMHgrant to partner with a communi-ty mental health center inPhiladelphia (NorthwesternHuman Services of Philadelphia).This work represents a majorfuture direction for the Center,providing the opportunity to testand disseminate evidence-basedpsychotherapies in routine clinicalsettings.

Determining the best psychothera-pies to treat particular disorders isnot easy, but the solutions, Dr.Crits-Christoph underscores, willhave “very real and direct implica-tions for public health and thelives of many people. “ �

Determining the best psychotherapies to treatparticular disorders is not easy, but the solu-tions, Dr. Crits-Christoph underscores, willhave “very real and direct implications for

public health and the lives of many people. “




Six weeks a year, Joseph DiGia-como, MD leaves his teaching

and clinical responsibilities to sailthe warm waters of the Gulf ofMexico off Naples and Key West,Florida. His “mini-sabbatical”allows him time to rejuvenate andkeep current withthe latest medicalliterature.

An experiencedsailor, he and hiswife, Madonna,tack into the windor run with it, maneuver-ing to take advantage ofwind shifts and avoid shoalsthreatening to interrupt their voy-age. Much as he navigates hisnautical journeys, Dr. DiGiacomohas steered his career in medicinewith a sense of adventure, andwith consummate skill.

Dr. DiGiacomo, Clinical Professorof Psychiatry, has been at Penn for39 years, but his trip did not beginhere, nor even with psychiatry forthat matter. He received hisundergraduate and medicaldegrees from Wayne State Univer-sity before an internship in medi-cine at the Detroit Receiving Hos-pital. This was followed by a resi-dency and fellowship in Medicineat Mt. Sinai Hospital in New York.He then served as an internist inthe U.S. Air Force from 1959 to1962 at MacDill Strategic Air Basein Tampa, returning to Mt. Sinai aschief resident in Cardiology.

While in the Air Force, he wasimpressed with a psychiatrist see-ing patients on the floor. “I real-ized that there was more to medi-cine than what I was doing,” saysDr. DiGiacomo, and he altered hiscareer direction.

From 1964 to 1967, Dr. DiGiacomo

trained in Psychiatry, includingpsychoanalysis, at Tulane Univer-sity, developing the first of hiscareer interests – psychosomaticmedicine. Tulane encouraged himto establish an institute in the fieldbut, before he could get started,

Albert Stunkard, MD, then Chair-man of Penn’s Department of Psy-chiatry, invited him to Philadel-phia.

That visit proved to be a course-changing event. Dr. DiGiacomovividly remembers that he was“blown away” by the “incredible”quality of the faculty and resi-dents, and the possibility to carefor ward patients afflicted withboth medical and psychiatric ail-ments. Responding to the Chair-man’s suggestion that he stayawhile, Dr. DiGiacomo recallsthinking that he was “not leavinguntil they kick me out.”

At Penn, Dr. DiGiacomo took fulladvantage of the opportunity topractice and teach in multiple set-tings and to see a wide spectrumof patients. Taking Dr. Stunkard’sadvice, he opened a private prac-tice, which he still maintains, to

better under-stand the fulldimensionsof the field.

He alsopracticedinstitu-tionalmedicine,seeing

patients and teaching at the Hos-pital of the University of Pennsyl-vania, the Institute of Pennsylva-nia Hospital, the U.S. Naval Hos-pital, Harrisburg State Hospital,Trenton State Hospital, AllentownState Hospital, and WernersvilleState Hospital. His monthly con-ferences and grand rounds at thestate hospitals brought him intoclose contact with the seriouslymentally ill, and he developed aninterest in treating patients suffer-ing from chronic schizophrenia.

From 1970 to 1980, Dr. DiGiacomoserved as Chief of Psychiatry atthe Veterans Administration Med-ical Center, Philadelphia, where hedeveloped a comprehensive pro-gram in general hospital psychia-try, including an inpatient psychi-atric unit, consultation-liaisonservice, alcohol treatment unit,drug dependence treatment center,and emergency psychiatric serv-ice. His contributions at the VAhelped earn him tenure at Penn.Second-year psychiatric residentsand medical sudents now rotatethrough the VA program.

During his time at the VA, Dr.DiGiacomo developed a new

VOLUNTARY FACULTY PROFILE

Joseph DiGiacomo, MD




interest in forensic psychiatry, anatural fit with his data-drivenand evidence-based approach tomedicine. He was frequentlyengaged as an expert witness incriminal trials for either the prose-cution or defense. Perhapshis most publicly visibletestimony was given indefense of Edward J. Leary,accused and ultimately con-victed of detonating a fire-bomb on a Manhattan sub-way car, which injured 48people. Dr. DiGiacomo tes-tified that a combination ofprescription drugs taken byMr. Leary contributed to his“descent into madness.”

The case stirred strongemotions in New York. Afterappearing at trial one day, Dr.DiGiacomo, at a local tavern withthe defense attorney, overheard apatron say, “someone shouldblow his house up.” The individ-ual referred to was not the defen-dant, but the psychiatrist speak-ing in his defense. Fortunately,Dr. DiGiacomo was an anony-mous presence at the scene.

The Leary case was an importantturning point. While Dr. DiGiaco-mo still believes that Mr. Leary’sactions were influenced by druginteractions, and that each defen-dant is entitled to a robustdefense, he recognized his ownpersonal responsibility “to be partof civilization and to do the rightthing.”

Dr. DiGiacomo now limits hiswork primarily to civil cases, suchas malpractice work. Most of hislegal work is for the defense, butwhether working for the plaintiffor defense, he emphasizes that “if

I don’t believe in a case, I’ll sayit.”

Dr. DiGiacomo’s career has bene-fited from the timely intercessionof valued mentors who have

directed him into exciting newwaters. It is entirely fitting thatone of his great loves is helpingfuture generations of physiciansto sail their own uncharted seas.“When I teach residents, I losetrack of my age.” He praisesChairman Dwight L. Evans, MDfor revitalizing the Department’sresidency program and raising thequality of the matriculants to ahigh level. And Penn’s medicalstudents, he adds, “are verybright, the epitome of idealism.”

Dr. DiGiacomo is an active andenthusiastic participant in themedical student curriculum andhousestaff training. He has beenhighly honored for his teachingcontributions, clinical expertise,and his life-long contributions topsychiatry. He is the recipient ofthe Earl Bond Award from theDepartment for teaching medicalstudents, residents, and/or gradu-ate students; the Dean’s Awardfor Excellence in Teaching fromthe School of Medicine; and the

Psychiatric Residents’ Excellencein Teaching Award. In 2006 hereceived the second annual IrmaBland Award for Teaching Resi-dents from the American Psychi-atric Association, the Clinical Fac-

ulty Award from theDepartment of Psychia-try, the LifetimeAchievement Awardfrom the PhiladelphiaPsychiatric Society, andwas again named asone of American’s TopPsychiatrists.

Dr. DiGiacomo’s vesselhas sailed to manyintellectual destinationsduring his distin-guished career, but

there is no doubt that his homeport is here at Penn. Initially ven-turing out as an “insecure” psy-chiatrist, clothed in a white coatand bearing a stethoscope, Dr.DiGiacomo’s interactions with hiscolleagues at Penn have helpedhim to explore new subspecialtiesin psychiatry. Penn, he says, “isan eclectic place where one cansample the hors d’oeuvres whiledeciding on the main course.”

Learning remains his constant joy.It is little wonder that retirementis not a concept that Dr. DiGiaco-mo embraces. Looking to thehorizon, he says he would like tocontinue to do “more of thesame,” a blend of teaching, lectur-ing, consulting, seeing patients,and discovering. He prefers tolook ahead, but when he steals aglance sternward, and reflects onhis Penn years, one thoughtstands out. “I can’t believe it’strue,” he says. “I could not haveasked for anything more.” �

When Dr. DiGiacomo reflects on his Pennyears, one thought stands out. “I can’t

believe it’s true,” he says. “I could not haveasked for anything more.”




The Department has beenbuilding its clinical pro-

grams at an increasinglyrapid clip, and Bobbie Pughis right atthe heart ofthis effort.Bobbiedoes theessential –and oftenunrecog-nized – workthat helps practi-tioners navigatethe complex and confusingworld of regulatory require-ments.

Bobbie has been at Penn for17 years. She held severalpositions prior to coming tothe Department, mostnotably as Assistant to sever-al Associate Deans in theSchool of Arts and Sciences.She also found time to enrollin the Wharton managementdegree program, before mov-ing to the Department ofPsychiatry in September 1996as Assistant to RosellenTaraborrelli, the Depart-ment’s Chief Financial andAdministrative Officer.

At the very start, Bobbiefaced a big challenge. Shewas given responsibility forplanning and coordinatingthe departmental staff holi-day dinner at Dave andBuster’s, only three monthsaway. Bobbie says that “Ididn’t think that I could doit, but it went off without ahitch.” The 1996 party is nowregarded as legendary. “Itwas phenomenal,” Bobbie

recalls. “To this day, peoplestill talk about that party. Ittruly felt like the Departmentwas family.”

Over time, Bobbie assumedincreasing responsibilities inthe Department. Today, she isthe Manager of ProviderRelations for the Departmentand PENN BehavioralHealth Corporate Services.The office provides criticalsupport services to faculty, aswell as to providers in thePBH specialty network whodeliver care to enrollees inPBH’s various service pro-grams. The office helpsproviders complete neces-sary paperwork related tocredentialing, billing enroll-

ment, and malpractice cover-age. Bobbie also overseesprovider relations and net-work operations for PBH

Corporate Ser-vices, workinghard to fosterstrong relation-ships with the

growingnumber ofnetworkproviders.

Bobbie inter-acts with people and con-fronts deadline pressures ona daily basis. “I havelearned,” she says, “not totake things personally. Dur-ing the course of the day, Iliterally communicate withmany diverse personalities.Maintaining a professionaland calm demeanor enablesme to see the bigger picture –getting the job done!

It’s not all work, however,and in her non-Penn time,Bobbie enjoys being with hereleven-year-old daughter,reading, gardening, and“catching a good sale!” Bob-bie is also a budding entre-preneur. She manages Bob-bie’s Basics, created in 1999,through which she teachesbasic corporate and officeskills, offers typing services,and assists small businesseswith administrative paper-work. She is also a NotaryPublic.

With all this going on, Bob-bie is still smiling, and con-tinually keeps things movingas she does. �

EMPLOYEE SNAPSHOT

Bobbie Pugh



The Department of Psychiatry welcomes the Class of 2010 to the residency-training program.The current class of interns in psychiatry was chosen from 499 applicants of whom 89 were

ranked. These 10 individuals are extremely talented young doctors who were at the top of theirmedical school classes and demonstrated a strong commitment to the field, as well as great leader-ship potential. They have shown themselves to be very fine house officers, eager to learn and dedi-cated to providing outstanding clinical care to their patients. This year’s recruitment efforts willbegin on November 10th and continue until January 24, 2007. �

Educational Highlights

Sibel Algon, MDUMDNJ-Piscataway

Joshua Blume, MDJefferson University

Scott Campbell, MDUniversity of Pennsylvania

Julie Chilton, MDUCSF

Amy Huberman, MDJohns Hopkins

Margot O’Donnell, MDJefferson University

Matthew Prowler, MDJefferson University

Theodore Satterthwaite, MDWashington University

Lilly Sehgal, MDNew York University

Alexander Threlfall, MDTexas Tech University

INTRODUCING THE RESIDENT CLASS OF 2010

Additional and updated information about the Residency Training Program can befound on the Residency Program web site -- www.med.upenn.edu/psychres



The Psychiatry residents have been active in improving our program in a variety of ways.Ryan Connolly,MD, MS, Ben Pumphrey, MD, and Jenny Kim, MD, PharmD have

restarted Journal Club with a focus on a critical review of evidence-based literature. A newelective has been implemented to allow PGY-2 residents to focus on specialized aspects ofpsychiatric treatment, such as pain medicine, sleep medicine, or inpatient child and adoles-cent psychiatry.

The Veterans Administration Medical Center inpatient addictions rotation has been enhancedwith greater involvement of the Treatment Research Center. TRC staff are graciously offeringtheir time for supervision and teaching, including didactics on motivational interviewing.Laura McNicholas, MD, PhD has been active in creating a mandatory free buprenorphine cer-tification course for all PGY-3 and PGY-4 residents. Valerie Nordquist, MD is creating a semi-nar with a focus on accessing and utilizing Alcoholics /Narcotics Anonymous, with speakersand an introduction to the twelve steps.

Our “crash course in psychiatry” for interns has been reformatted to create an intensiveteaching curriculum that includes a psychopharmacology review, consultation/liaison issuesand “real world” practical didactics on emergency psychiatry, including medical emergencies,clinical interviewing, managing involuntary commitments, and capacity evaluations.

Samar Jasser, MD and the chief residents are working together to create a website and resi-dent manual that will include resident-based information, pivotal articles in psychiatry, and adetailed handbook of evidenced-based practice guidelines and protocols. John O’Reardon,MD is also assisting this project by contributing his extensive collection of psychopharmacol-ogy notes and lectures.

Movie Club, a popular event last year, will continue with Anthony Rostain, MD, Henry Bleier,MD and other faculty members screening and discussing movies, including The Squid and the

Whale and Tarnation. All are welcome to attend!

Lisa Rosenthal, MD has restarted the Community Psychiatry elective with seminars whichinclude consumers, advocates, providers, and policy makers in the public mental health sys-tem (and dinner!), and field trips that include shelters, jails, residential programs, psychoso-cial rehabilitation programs, and a state psychiatric hospital.

Kate Blumner, MD, MPH also has been active in creating a seminar entitled “AlternativeTreatments in Psychotherapy.” Her recent seminar focused on hypnosis with Peter Bloom,MD as a discussant.

We look forward to these exciting developments and more in the coming months! �

RESIDENT ACTIVITIES

From the Chief Resident for the Affiliated Sites--Dhwani Shah, MD



Medical student education is an important aspect of the Penn psychiatry program. This year,we find more and more senior residents returning to the inpatient side of psychiatry to teach

medical students and junior residents. Every Wednesday and Friday morning, we have a specialmedical student morning report run by the HUP chief resident, as well as many hours of direct one-on-one supervision and clinical observation on the Consultation-Liaison Service by senior residents.Several fourth-year residents are working as junior attendings and provide valuable leadershipskills and exceptional teaching to the medical students and junior residents. They bring the perspec-tive of outpatient experience back to the inpatient unit and the Consultation-Liaison Service.

Residents have also been involved in teaching Brain and Behavior and the Doctor-Patient inter-viewing course to the first and second-year medical students. The medical students have givenexcellent feedback with regard to resident teaching. We look forward to continuing to enhance med-ical education, working closely with the medical student education director, Benoit Dube, MD.

This year, we are continuing Professors Rounds on Friday mornings and welcome many esteemedPenn faculty members to Founders 11 to participate in this activity. Professors Rounds are gearedtoward enhancing resident education, patient care, and introducing residents to some of our moresenior faculty. On that note, we will also be having a Masters Dinners series with senior facultymembers and residents at the Chairman's house. We look forward to a rewarding year of bothlearning and mentorship. The chief residents have made medical education a priority in their workthis year and are excited to participate in this long tradition of Penn teaching. �

FROM THE HUP INPATIENT CHIEF RESIDENT--Kari Groff, MD

THE FAMILY SYSTEMS PROGRAM IN THE GENERAL RESIDENCYEllen Berman, MD and Robert Garfield, MD

The couple and family sys-tems program in the

Department of Psychiatry,under the direction of EllenBerman, MD and RobertGarfield MD, is now fullyintegrated into all four yearsof training in adult psychia-try. The program teaches asystems orientation to psy-chiatric care, emphasizingthe critical role family mem-bers play in successful treat-ment and how best toinvolve and support patientsand their families in the ther-apy regimen. Residents

become familiar with com-mon family and couplesissues and developmentalmilestones faced by adultchildren and their parentsthroughout the life cycle,especially in the presence ofpsychiatric illness in eithergeneration. A separate mini-course covers sexual functionand dysfunction and sexualorientation issues. The pro-gram’s fundamental messageis that families are an asset tothe psychiatrist's work ratherthan a burden.

Research has shown that the

support of partners and fami-ly is critical to the patient’srecovery from illness.According to national resi-dency training guidelines,residents must learn the abil-ity to communicate with,assess, and educate patientsand families. In addition,they need to be familiar withthe basics of family therapy.

The Penn Psychiatry familysystems training program isnow recognized nationallyfor its extensive and compre-hensive nature. The curricu-lum has been presented at




major conferences, includingthe American Association ofDirectors of Residency Train-ing and Academic Psychiatry.Dr. Berman is also the Chairof the Family Committee ofthe Group For Advance-ment of Psychiatry andChair of the Associationof Family Psychiatrists,allied with the AmericanPsychiatric Association.She is co-author of a text-book, Marital and FamilyTherapy, and articles onthe state of family sys-tems training in psychia-try in this country.

The program begins inthe PGY-1 and 2 yearswith faculty demonstra-tions of family interviewingon the inpatient unit. Thegoal is to teach residents howfamily systems affect psychi-atric illness and hospitaliza-tion, to learn about caregiverburden, and to understandhow families can be support-ed in their care of the patient.Concurrent lectures introducesystems concepts and reviewnormal family developmentand attachment theory.

In the PGY-3 year, the resi-dents observe faculty assess-ments of outpatient couplesand adult children and theirparents, and courseworkfocuses on the theory andpractice of assessment. Resi-dents begin to do evaluationsof the families or partners oftheir individual outpatients,and often begin one or twofamily therapy cases. Systemssupervisors support theirwork.

In the PGY-4 year, course-work focuses on specific tech-niques of couples therapyand common relational issues(for example, secrets and

affairs, substance abuse, fami-ly violence, and divorce andremarriage) that are frequent-ly seen in both individual andfamily therapy. Residentsobserve an ongoing couplestherapy case conducted by asenior faculty person. Familysystems training is also repre-sented in the coursework forthe psychotherapy track.

By the end of the program,residents are expected tocomplete numerous evalua-tions of individual patientswith their “significant others”or other family members, andto have conducted at leasttwo couple and two familytherapy cases. For residentswishing more in-depth expe-rience, a family therapy elec-tive is available.

Several teaching methods arewidely used in the program.

Classes are taught using anextensive video collection ofmovies and demonstrationtapes. Role play is an integralpart of the process, to honeskills of dealing with multi-

ple family members atonce. Personal reflectionis an important part oftraining, as one's own his-tory and beliefs are par-ticularly likely to affectone's ideas of what is nor-mal for families. Unlikethe majority of residencytraining programs, familysystems thinking is intro-duced at adult inpatientand outpatient sites,rather than limited tochild and geriatric set-tings or family clinics.

This encourages residents tosee how family involvementcan be useful in psychiatrictreatment in most patientpopulations, although familytherapy is not always neces-sary.

Current instructors in theprogram include DavidWohlsifer, DHS,LCSW,MSW(who was instrumental inbeginning the program),Mickey Bernstein, MD, BenoitDube, MD, Guy Diamond,PhD, Nancy Gambescia,PhD.Carol Gantman, PhD, C.Wayne Jones, PhD, DeborahLuepnitz, MD, Bill OberfieldMD, Anthony Rostain, MD,and Leda Sportolari, MSWLCSW. The family systemsfaculty are well-known at thelocal and national levels, andmany have published widelyin the field. �


Robert Garfield, MD and Ellen Berman, MD



DDeeppaarrttmmeenntt ooff PPssyycchhiiaattrryyOn July 8, members of the Department of Psychiatry’s

extended family gathered at the home of Dr. and Mrs.

Evans to take part in the annual departmental picnic.

The event introduces new housestaff to the Department

and their new colleagues, and is always a wonderful

opportunity for new and old members of the Depart-

ment to reconnect. The sun shone warmly on the lawn

of the Evans’ home as the children, parents, and grand-

parents delighted in clowns and ice cream. Everyone

enjoyed the activities, food and fellowship, and the

annual picnic was a fitting start for a new and exciting

year in the Department of Psychiatry.

22000066 AAnnnnuuaall FFaammiillyy PPiiccnniicc



Calendar of Events

SEPTEMBER 20067 Dissecting the Disease Process of Schizophrenia: From Pathogenetic Mechanisms to Treatment Interventions

David A. Lewis, MD, Professor, Departments of Psychiatry and Neuroscience; Director, Translational Neuroscience Program;Director, Conte Center for the Neuroscience of Mental Disorders; University of Pittsburgh

21 Translational Research in Schizophrenia: Promises and ChallengesRaquel E. Gur, MD, PhD, The Karl and Linda Rickels Professor; Vice Chair for Research Development, Departments of Psy-chiatry, Neurology & Radiology; Director, Neuropsychiatry Section; University of Pennsylvania

OCTOBER5 Psychosocial and Pharmacological Interventions for Improving Functional Outcomes in Schizophrenia

Stephen Marder, MD, Professor of Psychiatry; UCLA Medical Center19 Title TBA - Psychosis Module (Case Presentation)

Christian Kohler, MD, Associate Professor of Psychiatry and Neurology, University of PennsylvaniaNOVEMBER2 Genetics of Bipolar Disorder

Wade Berrettini, MD, PhD, Karl E. Rickels Professor of Psychiatry; Director, Center for Neurobiology and Behavior; Universi-ty of Pennsylvania

9 Title TBAJames L. Stinnett, MD, Professor Emeritus of Psychiatry; University of PennsylvaniaDr. Stinnett’s portrait unveiling and reception will follow in the BRB II/III Lobby.

16 Marijuana and the Endocannabinoid System: Promises and ProblemsHerbert D. Kleber, MD, Professor of Psychiatry; Director, Division of Substance Abuse; Columbia University College ofPhysicians & Surgeons; New York State Psychiatric Institute

30 Interventions for CocaineCharles A. Dackis, MD, Assistant Professor of Psychiatry; University of Pennsylvania

DECEMBER14 Title TBA -- Substance Abuse Module (Case Presentation)

Kyle Kampman, MD, Associate Professor of Psychiatry; University of Pennsylvania

JANUARY 200711 Neurobiology and Suicide

J. John Mann, MD, Paul Janssen Professor of Translational Neuroscience in Psychiatry and Radiology, Columbia University;Chief, Department of Neuroscience, New York State Psychiatric Institute

25 Cognitive Therapy for Suicide PreventionGregory K. Brown, PhD, Research Associate Professor of Clinical Psychology in Psychiatry; Associate Director, Center forIntervention and Prevention of Suicide; University of Pennsylvania

FEBRUARY8 Title TBA -- Suicide Module (Case Presentation)

Aaron T. Beck, MD, Professor Emeritus of Psychiatry; Director, Center for Intervention and Prevention of Suicide; Universityof Pennsylvania

22 Translational Research and SuicideDavid Brent, MD, Professor of Psychiatry; University of Pittsburgh

MARCH22 Depression and Menopause

Ellen W. Freeman, PhD, Research Professor, Departments of Obstetrics & Gynecology and Psychiatry, University of Pennsyl-vania

APRIL5 Translating Research on Mechanisms of Neurodegeneration into Disease Modifying Therapies

John Q. Trojanowski, MD, PhD, William Maul Measey-Truman G. Schnabel, Jr, MD Professor of Geriatric Medicine andGerontology; Director, Institute on Aging; Director, Alzheimer’s Disease Center; Co-Director, Center for NeurodegenerativeDisease Research and Marian S. Ware Alzheimer Drug Discovery Program, University of Pennsylvania

19 Psychological Distress, Aging, Neurodegeneration and DementiaSteven E. Arnold, MD, Associate Professor of Psychiatry and Neurology; University of Pennsylvania

MAY3 Title TBA -- Neurodegenerative Module (Interventions)

Bruce G. Pollock, MD, PhD, FRCPC, Sandra A. Rotman Chair in Neuropsychiatry & Head, Division of Geriatric Psychiatry,University of Toronto; The Rotman Research Institute, Baycrest Centre for Geriatric Care, Toronto

17 Title TBA -- Neurodegenerative Module (Case Presentation)Daniel Weintraub, MD, Assistant Professor of Psychiatry and Neurology, University of Pennsylvania

PSYCHIATRY GRAND ROUNDS12:00-1:00 pm BRB II/III Auditorium

The Psychiatry Grand Rounds schedule will be posted on-line on the Department of Psychiatry web site at www.med.upenn.edu/psych

Department of PsychiatryOffice of the Chairman3 Blockley Hall423 Guardian DrivePhiladelphia, PA 19104-6021Telephone: (215) 662-2818Fax: (215) 662-6911www.med.upenn.edu/psych

PENN PSYCHIATRY PERSPECTIVE

Editor:

Rosellen TaraborrelliTelephone: (215) 662-2899E-mail: [email protected]

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