A5067161403- Substance Abuse Treatment and Outcomes
- Mental Health Treatment and Access
- Alcohol Consumption and Health Effects
- Suicide and Self-Harm Studies
- Schizophrenia research and treatment
- Opioid Use Disorder Treatment
- Treatment of Major Depression
- Neurotransmitter Receptor Influence on Behavior
- Alcoholism and Thiamine Deficiency
- Mental Health Research Topics
- Health disparities and outcomes
- Posttraumatic Stress Disorder Research
- Health Systems, Economic Evaluations, Quality of Life
- Dementia and Cognitive Impairment Research
- Sleep and related disorders
- Geriatric Care and Nursing Homes
- Pain Management and Opioid Use
- Health Policy Implementation Science
- Pharmaceutical Practices and Patient Outcomes
- Homelessness and Social Issues
- Healthcare professionals’ stress and burnout
- Child and Adolescent Psychosocial and Emotional Development
- Primary Care and Health Outcomes
- Bipolar Disorder and Treatment
- Health and Well-being Studies
Philadelphia VA Medical Center
2016-2025
University of Pennsylvania
2016-2025
Mental Illness Research, Education and Clinical Centers
2016-2025
Veterans Health Administration
2010-2025
United States Department of Veterans Affairs
2018-2025
VA Pittsburgh Healthcare System
2011-2025
VA Western New York Healthcare System
2023-2025
VA Connecticut Healthcare System
2023-2025
VA Healthcare-VISN 4
2014-2024
California University of Pennsylvania
2005-2024
Existing evidence suggests that military veterans with mental health disorders have poorer family functioning, although little research has focused on this topic.To test whether psychiatric symptoms are associated reintegration problems in recently returned veterans.Cross-sectional survey of a clinical population. Respondents who were referred to behavioral evaluation from April 2006 through August 2007 considered for the survey.Philadelphia Veterans Affairs Medical Center, Pa.199 served...
The authors sought to determine whether integrated mental health services or enhanced referral specialty clinics results in greater engagement health/substance abuse by older primary care patients.This multisite randomized trial included 10 sites consisting of and clinics. Primary patients 65 years old (N=24,930) were screened. final study group consisted 2,022 (mean age=73.5 years; 26% female; 48% ethnic minority) with depression (N=1,390), anxiety (N=70), at-risk alcohol use (N=414), dual...
Objective: The Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) evaluated the impact a care management intervention on suicidal ideation and depression older primary patients. This is first report outcomes over 2-year period. Method: Study participants were patients 60 years age or (N=599) with major minor selected after screening 9,072 randomly identified 20 practices assigned to provide either PROSPECT usual care. consisted services 15 trained managers, who...
<h3>Importance</h3> Alcohol dependence comorbid with posttraumatic stress disorder (PTSD) has been found to be resistant treatment. In addition, there is a concern that prolonged exposure therapy for PTSD may exacerbate alcohol use. <h3>Objective</h3> To compare the efficacy of an evidence-based treatment (naltrexone) plus (prolonged therapy), their combination, and supportive counseling. <h3>Design, Setting, Participants</h3> A single-blind, randomized clinical trial 165 participants...
<h3>Importance</h3> Selecting effective antidepressants for the treatment of major depressive disorder (MDD) is an imprecise practice, with remission rates about 30% at initial treatment. <h3>Objective</h3> To determine whether pharmacogenomic testing affects antidepressant medication selection and such leads to better clinical outcomes. <h3>Design, Setting, Participants</h3> A pragmatic, randomized trial that compared guided by vs usual care. Participants included 676 clinicians 1944...
<h3>Background</h3> This study examines the risk of development significant depressive symptoms after a new diagnosis cancer, diabetes, hypertension, heart disease, arthritis, chronic lung or stroke. <h3>Methods</h3> The used 5 biennial waves (1992-2000) Health and Retirement Study to follow sample 8387 adults (aged 51 61 years without in 1992) from 1994 2000. Time-dependent Cox regression models estimated adjusted hazard ratios (HRs) for an episode each 7 medical conditions....
Empirical evidence has only weakly supported antidepressant treatment for patients with co-occurring depression and alcohol dependence. While some studies have demonstrated that antidepressants reduce depressive symptoms in individuals dependence, most not found helpful reducing excessive drinking these patients. The authors provide results from a double-blind, placebo-controlled trial evaluated the efficacy of combining approved medications (sertraline) dependence (naltrexone) treating both...
Naltrexone has repeatedly been shown to reduce drinking in alcohol‐dependent patients. Previous clinical research suggests that naltrexone may be more effective at reducing among patients with high levels of alcohol craving the beginning treatment. In addition, laboratory studies suggest efficacious a familial loading problems. We explored both these possibilities context first 12‐week phase double blind, placebo‐controlled trial. A total 121 were randomized receive 100 mg/day and 62...
Clinicians treating older patients with bipolar disorder mood stabilizers need evidence from age-specific randomized controlled trials. The authors describe findings a first such study of late-life mania.The compared the tolerability and efficacy lithium carbonate divalproex in 224 inpatients outpatients age 60 or I who presented manic, hypomanic, mixed episode. Participants were randomly assigned, under double-blind conditions, to treatment (target serum concentration, 0.80-0.99 mEq/L)...
<h3>Importance</h3> Implementation of pharmacogenetic testing to guide drug prescribing has potential improve response and prevent adverse events. Robust data exist for more than 30 gene-drug pairs linking genotype phenotypes; however, it is unclear which tests, if implemented, would provide the greatest utility a given patient population. <h3>Objectives</h3> To project proportion veterans in US Veterans Health Administration (VHA) with actionable variants evaluate how might be associated...
Alcohol use disorder is one of the leading causes disability worldwide. While effective pharmacological treatments exist, they are efficacious only in certain individuals, contributing to their limited use. Secondary analysis clinical trial data suggests that a functional polymorphism (rs1799971, Asn40Asp) µ-opioid receptor gene (OPRM1) associated with risk relapse heavy drinking following treatment opioid antagonist naltrexone.To prospectively examine whether rs1799971 predictive naltrexone...
1) To determine the efficacy of Cognitive Behavioral Therapy for Insomnia (CBT-I) improving insomnia, alcohol-related outcomes, and daytime functioning at post-treatment 3- 6-month follow-up, in a largely African American Veteran sample; 2) Evaluate whether improvement insomnia is associated with reduction outcomes post-treatment. An RCT CBT-I (n = 31) compared to Quasi-Desensitization therapy (QDT, n 32), eight weekly in-person sessions, assessments baseline, end treatment (8 weeks),...