http://www.psychiatrygrandrounds.com Cutting-edge presentations on clinical neurosciences, behavior, and mental health Sun, 28 Jan 2007 10:00:00 PST en-us Copyright 2007 Ian A Cook MD editor@psychiatrygrandrounds.com wm@psychiatrygrandrounds.com UCLA Semel Institute; Ian A Cook MD, Course Dir. No Psychiatry, Psychiatry Grand Rounds, CME, Mind, Brain, Behavior, Mental Health, psychology, psychopharmacology, therapy Podcast Summary Edition - PsychiatryGrandRounds.com Summaries, interviews, and discussion with leaders in Psychiatry, Neurobiology, Human Behavior, Mental Health, Social Sciences, and Health Care Policy. comments@psychiatrygrandrounds.com Ian A Cook, MD, Course Director Psychiatry Grand Rounds Medicine Ian A Cook MD editor@psychiatrygrandrounds.com Ian A Cook MD Launching our podcast summaries - PsychiatryGrandRounds.com As a complement to our weekly in-person and webcast presentations of Psychiatry Grand Rounds from UCLA's Semel Institute for Neuroscience and Human Behavior, we're now offering summaries via podcasting. Please share your comments with us via email to comments@psychiatrygrandrounds.com http://psychiatrygrandrounds.com/podcast/PsychiatryGR200700.m4a Tue, 02 Jan 2007 22:00:00 PST 1:41 psychiatry, grand rounds, mental health, introduction, UCLA Stephen C Scheiber MD & Ian A Cook MD Update on ABPN Board Certification Stephen Scheiber MD updated us on the current trends in assuring quality via ABPN board certification. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200701.m4a Tue, 09 Jan 2007 22:00:01 PST 2:06 board certification, ABPN, professional, competence, psychiatry, grand rounds, mental health, UCLA Robert Kern PhD & Ian A Cook MD Addressing the disability of schizophrenia through new approaches to learning Dr Robert Kern described work addressing the disability associated with schizophrenia and psychotic illnesses using "errorless learning." This technique circumvents the cognitive deficits in learning, memory, and executive function that commonly contribute to functional disability. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200702.m4a Tue, 23 Jan 2007 22:00:00 PST 3:12 schizophrenia, psychosis, learning, disability, function, executive, frontal lobe, rehabilitation, psychiatry, grand rounds, mental health, UCLA Anthony Lehman MD MSPH & Ian A Cook MD Biological and psychotherapeutic treatments for schizophrenia supported by evidence Dr Lehman updated us on the latest scientific evidence supporting the use of specific biological and psychotherapeutic treatments for patients with schizophrenia and other psychotic disorders (Philip May Memorial Lecture). http://psychiatrygrandrounds.com/podcast/PsychiatryGR200703.m4a Tue, 30 Jan 2007 22:00:00 PST 2:32 evidence, schizophrenia, psychosis, psychiatry, grand rounds, mental health, UCLA Marc A Schuckit MD & Ian A Cook MD Genetic and environmental factors contributng to alcoholism Dr Schuckit described data on the contributions of genetics and the environment to the development of alcoholism. The study of intermediate endophenotypes may help clarify the pathophysiology of alcoholism and identify patient groups that may benefit from different treatments. Research also suggests new possible avenues for prevention. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200704.m4a Tue, 06 Feb 2007 22:00:00 PST 3:31 alcoholism, alcoholic, genetics, endophenotype, psychiatry, grand rounds, mental health, UCLA Stephen Marder MD & Ian A Cook MD Lessons from CATIE and CUtLASS Trials Dr Marder identified key findings and lessons from the CATIE and CUtLASS trials, two large-scale clinical trials in schizophrenia which were supported by the NIMH in the US and the NHS in the UK, respectively. These projects compared clinical outcomes with older and newer antipsychotic medications in treating schizophrenia. Findings call into question what advantages the newer agents may have over older medications. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200705.m4a Tue, 13 Feb 2007 22:00:00 PST 4:37 alcoholism, alcoholic, genetics, endophenotype, psychiatry, grand rounds, mental health, UCLA Michelle Craske PhD & Ian A Cook MD Advances from Translational Research Dr Craske described new fundamental research in learning, memory, attention, and reactivity, and how these advances may be translated into improvements in our cognitive and behavioral treatments for anxiety disorders. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200706.m4a Tue, 27 Feb 2007 22:00:00 PST 2:24 anxiety, cognitive, behavior, behavioral, cbt, psychotherapy, psychology, learning, memory, attention, psychiatry, grand rounds, mental health, UCLA Gary Sachs MD & Ian A Cook MD Key findings to improve care for Bipolar Disorder Dr Sachs updated us on the design and practical findings from the NIMH's STEP-BD project, "Systematic Treatment Enhancement Program for Bipolar Disorder." http://psychiatrygrandrounds.com/podcast/PsychiatryGR200707.m4a Tue, 06 Mar 2007 22:00:01 PST 2:43 bipolar disorder, manic depression, STEP-BD, NIMH, psychiatry, grand rounds, mental health, UCLA Andrew F Leuchter MD, Carole Klove RN JD, & Ian A Cook MD Introducing the new UCLA Guidelines on COI The potential for conflicts of interest to exist has led many Universities to promulgate guidelines and rules to clarify what sorts of behaviors and activities are permissible and which may be construed as unprofessional and corrosive to the relationship of trust between physician and patient. Drs. Andrew Leuchter and Carole Klove address this important topic in this week’s Psychiatry Grand Rounds program, http://psychiatrygrandrounds.com/podcast/PsychiatryGR200708.m4a Tue, 13 Mar 2007 22:00:00 PST 2:49 bipolar disorder, manic depression, STEP-BD, NIMH, psychiatry, grand rounds, mental health, UCLA Peter S Jensen MD & Ian A Cook MD Lessons from the MTA Trial (Multimodal Treatment of ADHD) The NIH conducted the Multimodal Treatment of ADHD, or MTA, Trial to examine outcomes in Attention Deficit Hyperactivity Disorder for children treated by experts with medications, therapy, or the combination, or who received care as usual. Dr. Peter Jensen discussed over a decade of findings from the MTA trial in this week’s Psychiatry Grand Rounds program, http://psychiatrygrandrounds.com/podcast/PsychiatryGR200709.m4a Tue, 20 Mar 2007 22:00:01 PST 2:32 ADD, ADHD, Attention Deficit Hyperactive Disorder, MTA, NIMH, psychiatry, grand rounds, mental health, UCLA Alexander Bystritsky MD PhD & Ian A Cook MD Practical algorithms in treatment resistant anxiety disorders, and research for new interventions A large proportion of patients with anxiety disorders respond well to treatment with SSRI medications and/or Cognitive Behavioral Therapy, but a subset of individuals have treatment-resistant forms of their illness. Dr. Bystritsky is a Professor of Psychiatry at the David Geffen School of Medicine at UCLA and is Director of the Anxiety Disorders Program at the Semel Institute. He updated us on current treatment algorithms and some new interventions for anxiety disorders. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200710.m4a Tue, 27 Mar 2007 22:00:22 PST 2:32 Anxiety, social anxiety, phobia, obsessive compulsive disorder, OCD, panic, psychiatry, grand rounds, mental health, UCLA Mary-Frances O'Connor PhD & Ian A Cook MD Neuroimaging, autonomic, endocrine, and immunologic studies, and their treatment implications The similarities and differences among grief, bereavement, and major depression have constituted an area of considerable attention and debate for many years. Advances in neuroimaging are allowing new work to delineate better these experiences by examining the physiology associated with each. Dr. Mary Frances O'Connor has made this the focus of her research. Dr. O'Connor is a post-doctoral fellow here at UCLA and is the Friends of the Semel Institute Fellow this year. In this week's Psychiatry Grand Rounds program, Dr. O'Connor updates us on current research in this area its clinical implications. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200711.m4a Tue, 03 Apr 2007 22:00:00 PST 3:06 Grief, bereavement, loss, mourning, depression, Friends of the Semel Institute, psychiatry, grand rounds, mental health, UCLA Rita Charon MD PhD & Ian A Cook MD Listening and writing about the interior lives of our patients and ourselves Physicians and other healthcare professionals have a special privilege in knowing our patients in ways outside the ordinary. Patients share with us their stories of struggles with illness, and from this, we are able to know them from a unique perspective. These glimpses of the interior life of our patients invariably impacts on our own lives, yet this is not often acknowledged. Writing about experiences with patients is one way to gain a deeper understanding of these interactions, and a leader in this nascent field of narrative medicine is Dr. Rita Charon. An Internist and Professor of Clinical Medicine, Dr. Charon is Director of the Program in Narrative Medicine at the College of Physicians and Surgeons of Columbia University. Her Psychiatry Grand Rounds program "Narrative Psychiatry: Storied Approaches to Patient Care" introduces us to her approach and suggests ways in which practitioners might adopt some of these techniques into their own practices. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200712.m4a Tue, 10 Apr 2007 22:01:01 PST 2:34 Literature, medicine, narrative, stories, psychiatry, grand rounds, mental health, UCLA Helen Lavretsky MD & Ian A Cook MD Update on the management of late-life depression While major depression is a common psychiatric disorder at any age, depression in late life has some unique features, including differences in the presenting signs and symptoms and in the response to treatment, in comparison with other age groups. The demographic trends associated with aging of the Baby Boom generation suggest that a staggering number of older Americans will develop depression in the coming decades; one of the clear implications is that practitioners will need to be adept at managing depression in older adults. Updating us on new treatment approaches in late-life depression is Dr. Helen Lavretsky. Dr. Lavretsky is an Associate Professor of Psychiatry at the David Geffen School of Medicine at UCLA and a Research Scientist at the Semel Institute. Her Psychiatry Grand Rounds program reviews the setting of late-life depression and presents important new data on the clinical management of depression in older adults. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200713.m4a Tue, 10 Apr 2007 22:02:02 PST 2:00 Depression, late-life, aging, elderly, MDD, psychiatry, grand rounds, mental health, UCLA Murray B Stein MD MPH & Ian A Cook MD Perspectives on genetics and endophenotypes in anxiety disorders Our understanding of anxiety has come a long way from clinical descriptions advanced over the past two centuries. Some advances have come from theories that specific brain regions function together in a neural circuit, and that this circuit may function differently in people with anxiety disorders. The processing of information in such circuits is influenced by a number of so-called susceptibility genes. These genes may lead to what is called a phenotype, such as exhibiting enhanced brain reactivity when seeing a picture of someone who looks frightened. These intermediate phenotypes or "phenes," may identify subsets of individuals within the diagnostic categories in the anxiety disorders. One of the critical thinkers in this area is Dr. Murray Stein. Dr. Stein is a Professor of Psychiatry and of Family and Preventive Medicine at the University of California, San Diego. His Psychiatry Grand Rounds program reviews for us the conceptual approach for understanding complex human behaviors by looking at constituents parts that may have a more clearly-defined neurobiological basis. This has implications for the heritability of anxiety disorders, for understanding the interaction between genes and environment, and for developing new targets for treatments. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200714.m4a Tue, 17 Apr 2007 22:01:01 PST 2:33 Anxiety, phenotype, endophenotype, psychiatry, grand rounds, mental health, UCLA James J Hudziak MD & Ian A Cook MD Review of genetic and environmental factors and resilience vs vulnerability to mental illness In previous decades, the relative roles of genetic and environmental factors were sometimes framed as a debate of "nature vs nurture." Contemporary perspectives find that both sets of factors are important contributors to mental health and illness, and that they interact. Dramatic structural and functional changes occur in the brain as children mature and these changes are influenced by both genes and environment. These changes in turn influence each person's vulnerability or resilience to psychopathology. Many adult psychiatric patients have their first onset of illness in childhood or adolescence, making this of importance not only to child psychiatrists and psychologists, but to mental health practitioners more broadly. This approach is sometimes phrased as "what is inherited is the manner of reaction to a given environment." Important contributions in this area have been made by Dr. James Hudziak. Dr. Hudziak is Director of the Child Psychiatry and Behavioral Genetics program at the University of Vermont. His Psychiatry Grand Rounds program reviews for us this new approach to studying interactions of genes and environment across a wide range of psychiatric illnesses. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200715.m4a Tue, 24 Apr 2007 22:01:01 PST 2:19 Gene, genetics, environment, children, child psychiatry, child psychopathology, psychiatry, grand rounds, mental health, UCLA Susan Bookheimer PhD & Ian A Cook MD New research examining the complexities of Autism Spectrum Disorders Humans are social creatures, and social communications and behaviors help define us. Autism spectrum disorders are marked by problems with social behaviors and by dysregulation in the systems in the brain that support these behaviors. Autism spectrum disorders are defined by three features: 1) delayed language development, 2) poor social skills such as difficulties with joint attention and referencing, and 3) repetitive behaviors, such as hand flapping or rocking. Genetic factors account for much of the prevalence of autism, with perhaps a dozen genes exerting a joint effect. Ultimately, multiple brain systems appear to be involved with autism, and one way to unravel the complexity of the autism spectrum is to use neuroimaging to delineate phenotypes. Imitation of expressions, interest in faces, eye contact, and detecting the emotional content of speech from tone of voice all are areas of study that illuminate the differences between children with autism and typically-developing children. Dr. Susan Bookheimer leads research in this area at UCLA. Dr. Bookheimer is with the Center for Cognitive Neurosciences at UCLA where she is a Professor in the Department of Psychiatry and Biobehavioral Sciences. Her Psychiatry Grand Rounds program reviews for us some new research that uses neuroimaging to understand the neurobiology of autism spectrum disorders. http://psychiatrygrandrounds.com/podcast/PsychiatryGR200716.m4a Tue, 01 May 2007 22:00:10 PST 3:30 Autism, Autism spectrum disorders, fMRI, neuroimaging, communications, social behavior, children, child psychiatry, child psychopathology, psychiatry, grand rounds, mental health, UCLA Michael Gitlin MD & Ian A Cook MD New research examining the difference between symptomatic and functional outcomes Bipolar disorder or manic depression has a profound effect on the lives of individuals who have this illness. The classic symptoms of mood swings with euphoric highs and devastating lows are but part of the picture. The disability experienced can be marked and can impact on individual relationships, function in the family, and occupational achievements. Updating us on new research findings is Dr. Michael Gitlin. Dr. Gitlin is the Director of the UCLA Mood Disorders Clinic and Director of the Division of Adult Psychiatry at the David Geffen School of Medicine, where he is also Professor of Psychiatry and a Research Scientist at the Semel Institute. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-101.m4a Wed, 10 Sep 2008 16:00:01 PST 2:23 Bipolar, Manic, Depression, Manic depression, treatment, function, outcome, psychiatry, grand rounds, mental health, UCLA Jeanne Miranda PhD & Ian A Cook MD Data on the impact of healthcare disparities among ethnic minorities The role of ethnicity in psychiatric illnesses is gaining attention at the national level and is a topic particularly appropriate to examine in Los Angeles, arguably the most ethnically-diverse region in our country. Ethnic and racial differences may exert influences which can impact on the development, course, and treatment for psychiatric disorders. Access to care is an important part of this picture, and a topic which is particularly germane in election-year discussions of public policy. Our Grand Rounds presentation on this important area is being made by Dr. Jeanne Miranda. Dr. Miranda is Assistant Director of the UCLA Health Services Research Center and is a Professor of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA and the Semel Institute. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-102.m4a Tue, 16 Sep 2008 16:00:01 PST 2:15 Ethnicity, ethnic, minority, minorities, race, racial, disparity, insurance, healthcare, medicare, medicaid, medi-cal, treatment, function, outcome, psychiatry, grand rounds, mental health, UCLA Robert M Bilder PhD & Ian A Cook MD Update on a Phenomics-based approach to Psychiatry Our understanding of mental illness is frequently organized around our diagnostic framework, particularly as codified by the Diagnostic and Statistical Manual from the American Psychiatric Association. Heterogeneity within any given diagnostic category has added challenges to efforts to link genes to diagnosis. These thwarted efforts have focused new attention on the characterization and refinement of endophenotypes, namely, quantitatively-measurable traits believed to be intermediate between disease phenotypes and the biological processes that underlie them. This update on new advances in phenomics is presented by Dr. Robert Bilder. Dr. Bilder is Director of the Consortium for Neuropsychiatric Phenomics and is Chief of Medical Psychology and Neuropsychology and a Professor of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA and the Semel Institute. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-103.m4a Tue, 07 Oct 2008 16:00:01 PST 3:30 phenomics, cognitive phenomics, endophenotype, diagnosis, treatment, function, outcome, psychiatry, grand rounds, mental health, UCLA Ronald M Harper PhD & Ian A Cook MD Impact of sleep-disordered breathing on brain structure and function Many psychiatric disorders include sleep dysregulation among their formal diagnostic criteria or associated symptoms. Patients may experience sleep disturbances from medical conditions such as obstructive sleep apnea, a problem frequently caused by obesity. Difficulties with breathing during sleep have been associated with daytime impairments in cross-sectional studies and with increased mortality rates in longitudinal studies, and but the mechanistic pathways linking these phenomena are still being elucidated. As these relationships become clearer, so too does the importance of accurate diagnosis and appropriate intervention. In this Grand Rounds program, Dr. Ronald Harper presents new research into the neurobiology of sleep disorders and their health consequences. Dr. Harper is the Distinguished Professor of Neurobiology at the David Geffen School of Medicine at UCLA and the UCLA Brain Research Institute. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-104.m4a Tue, 14 Oct 2008 16:00:01 PST 4:26 sleep, apnea, obstructive sleep apnea, breathing, mood disorder, substance abuse, autonomic, mood, cognition, diagnosis, treatment, function, outcome, psychiatry, grand rounds, mental health, UCLA Madhukar H Trivedi MD & Ian A Cook MD Management of Depression, new questions after STAR*D Depression is among the most common and disabling psychiatric disorders, in large measure because it frequently takes a considerable amount of time for individual patients to recover fully. The NIMH funded the STAR*D Project to examine a sequence of treatments and expand the evidence base for what to do when the first treatment doesn’t lead to remission. Over four thousand outpatients with depression and a variety of medical and psychiatric co-occurring disorders enrolled in that study; these “real world” treatment-seeking patients participated in up to 4 different levels of treatment, with measurement-based care to guide dose adjustments and the objective of achieving remission. The pipeline of hundreds of reports from this massive project will continue to inform us for a number of years to come, but already we have learned much about the strengths and shortcomings of our current strategies to manage depression. Speaking to us on the next steps after STAR*D is an internationally-known depression researchers and one of the prime movers behind the STAR*D project, Dr. Madhukar Trivedi. Dr Trivedi is Director of the Mood Disorders Program at the University of Texas Southwestern Medical Center in Dallas, where he is also the Betty Jo Hay Distinguished Chair in Mental Health, and the Lydia Bryant Test Professor in Psychiatric Research. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-105.m4a Tue, 21 Oct 2008 16:00:01 PST 3:44 depression, clinical depression, major depression, mood disorder, STAR*D, sequenced, mood, diagnosis, treatment, function, outcome, psychiatry, grand rounds, mental health, UCLA Kay Jamison PhD & Ian A Cook MD Self disclosure and public and professional reaction Personal experiences with illness have often played pivotal roles in the lives of health practitioners, steering youngsters to pursue a career in the healing professions or renewing the humanity of someone who has been in practice for years. Narratives about these experiences can be found in private diaries, in published memoires, and in Hollywood film scripts. On the other hand, self-disclosure by mental health practitioners has long been debated in many circles, tracing back to dicta about the importance of the therapist being able to serve as a “blank screen.” Considerable time is spent in many psychiatry residency programs in supervising trainees on when, why, and how much self disclosure might be appropriate to introduce into the therapeutic setting. Against that historical background, our Grand Rounds speaker, Dr. Kay Jamison, had established herself as an expert in Bipolar Disorder for many, many years before she went public with her autobiographical descriptions of her own experiences with that illness. Kay Redfield Jamison, has published extensively in the area of mood disorders, both in the scientific literature and in books accessible to interested members of the public. She is Professor of Psychiatry and Behavioral Sciences at The Johns Hopkins University School of Medicine, Baltimore and has returned to UCLA to participate in our day-long conference, “Mood Disorders in the 21st Century,” a Symposium from the UCLA Integrative Study Center for Mood Disorders. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-106.m4a Tue, 28 Oct 2008 16:00:01 PST 3:15 depression, manic depression, mania, bipolar, narrative, self disclosure, mood disorder, mood, outcome, psychiatry, grand rounds, mental health, UCLA Gary W Small MD & Ian A Cook MD Maintaining brain health during aging As one's brain ages, many potential trajectories exist between normal healthy brain function in adulthood, and the possibilities on the one hand of healthy older brains, or on the other, the brain disorders of Alzheimer's Disease and other forms of dementia. As members of the Baby Boom generation enter their senior years, questions of brain health and healthy aging are taking on even greater public health significance than before. The factors that may lead to these different aging pathways have been the focus of much research, not just in terms of mitigating the impact of degenerative brain disorders but also in terms of steps towards optimal health and function at the other end of the spectrum. A leader in this area of biomedical research is our grand rounds speaker, Dr. Gary W. Small. Dr. Small is Director of the UCLA Center on Aging. He is also the Parlow-Solomon Professor on Aging at the David Geffen School of Medicine at UCLA, and is a Professor of Psychaitry and Biobehavioral Sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-107.m4a Tue, 11 Nov 2008 16:00:01 PST 4:20 aging, memory, vitality, dementia, optimal, exercise, Alzheimer, Alzheimers, stroke, health, psychiatry, grand rounds, mental health, UCLA Sally A Frautschy, PhD MS & Ian A Cook MD New therapeutic agents for Alzheimer's Diease http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-108.m4a Tue, 02 Dec 2008 16:00:01 PST 2:00 alzheimer, alzheimer's, dementia, aging, elderly, neuroprotection, cumin, NSAID, psychiatry, grand rounds, mental health, UCLA Tyrone D Cannon, PhD & Ian A Cook MD Longitudinal findings about onset of schizophrenia Clinical lore and retrospective studies have long reported that individuals who develop significant psychotic illnesses, such as schizophrenia, often have a prodromal period that precedes a first fully-developed psychotic episode. Prodromal periods can last for months to years, and are marked by changes in a person's behavior, sense of self, mood, or how the person handles stress. Changes in personal hygiene, difficulties at school or work, or social withdrawal from family and friends are commonplace. The prodromal period often happens during adolescence, and differentiating this from normal adolescent behavioral phases can be challenging at times. Nonetheless, studies of the behavioral and biological harbingers of a first psychotic episode may shed important light on the pathophysiology of schizophrenia and may suggest new directions for treatment. Prospective monitoring of a large cohort of youth who are at risk for developing psychosis can illuminate these issues, and this Grand Rounds presentation by Dr. Tyrone Cannon focuses on developments in these areas. Dr. Cannon is the Staglin Family Professor of Psychology and Psychiatry and Biobehavioral Sciences at UCLA, the Carol Moss Spivak Scholar in Neuroscience, and the Director of the Staglin Music Festival Center for Cognitive Neuroscience at UCLA. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2008-109.m4a Tue, 09 Dec 2008 16:01:02 PST 4:29 psychosis, schizophrenia, prodrome, prodromal, conversion, onset, adolescence, DISC1, gray matter, grey matter, neuroimaging health, psychiatry, grand rounds, mental health, UCLA Larry J Siever MD & Ian A Cook MD Neurobiological factors and the management of Axis II disorders Historically, much of the psychiatric literature on personality disorders has focused on psychological factors, particularly early childhood experiences, that may lead to dysfunctional behavioral patterns in adulthood. In recent years, research has expanded our understanding of these diagnoses to include recognition of important neurobiological factors and how the biological and psychological features relate to one another. In studies of borderline personality disorder, diminished top-down control of affective responses may underlie the excessive emotional dysregulation in this disorder, a phenomenon potentially related to abnormal function in specific midline regions of prefrontal cortex. In addition, genetic, neuroendocrine, and neuroimaging findings point to a role for serotonin in this problem of affective disinhibition. UCLA is pleased to welcome Dr. Larry J. Siever, to update us on how the growing body of neurobiological research may impact on the care of individual patients with Axis II disorders. Dr Siever is the Director of the Special Evaluation Program for Mood and Personality Disorders at the Mount Sinai School of Medicine in New York, where he is also a Professor of Psychiatry. Additionally, he is the Director of both the Outpatient Psychiatric Division and the VISN 3 MIRECC at the James J Peters VA Medical Center in the Bronx. http://psychiatrygrandrounds.com/podcast/PsychiatryGR2009-001.m4a Thu, 01 Jan 2009 16:00:00 PST 5:05 psychosis, schizophrenia, prodrome, prodromal, conversion, onset, adolescence, DISC1, gray matter, grey matter, neuroimaging health, psychiatry, grand rounds, mental health, UCLA