MGH McLean Adult Psychiatry Residency Program

Michael Rohan, a physicist at McLean Hospital’s Brain Imaging Center, demonstrated the low-field magnetic stimulation (LFMS) device he developed.

Individuals with major depressive disorder or bipolar disorder who receive low-field magnetic stimulation (LFMS) show immediate and substantial mood improvement, McLean Hospital researchers report in the Aug. 1 issue of Biological Psychiatry.

“LFMS is unlike any current treatment. It uses magnetic fields that are a fraction of the strength but at a higher frequency than the electromagnetic fields used in TMS [transcranial magnetic stimulation] and ECT [electroconvulsive therapy],” explained first author Harvard Medical School.

According to Rohan, although other brain stimulation treatments like ECT and TMS are often effective for the treatment of depression, they typically take longer to impact mood, and ECT is associated with side effects such as memory loss. Similarly, while antidepressant medications can be highly effective for treating depression, it can take between four to six weeks before mood changes are detected.

“Importantly, LFMS appears to have an immediate effect on mood and thus has the potential to provide relief in emergency situations,” explained Rohan, who first reported the potential use of LFMS to treat depression in a groundbreaking study in 2004. “In addition to providing quick relief from symptoms, the other exciting piece about LFMS is that no side effects have been observed.”

National Depression Screening Day has been taking place since 1991 and is designed to screen those who may be suffering from depression but not know it. Participants fill out an anonymous questionnaire and, depending on their answers, are referred to mental health professionals for follow-up.

The screenings are given at colleges, workplaces, community-based organizations and military installations and will be available on line at the organization’s special web site, www.HelpYourselfHelpOthers.org. The website also lists local sites where screenings will be given.

A study done in 2009 showed that depression screenings are effective in connecting at-risk individuals with treatment. It showed that 55 percent of those who completed the screening online and who agreed to take part in a follow-up survey sought depression treatment within three months.

While McLean has held screening events in the past, this is the first time the hospital will be co-sponsoring the national event and will publicizing it via social media, including Facebook and Twitter.

The questionnaire allows individuals to screen themselves, in an anonymous way, for mood and anxiety disorders, eating disorders and alcohol use disorders. The online screenings provide an assessment of the user’s mental health, information on whether the user’s results are consistent with a mental health disorder, an overview of signs and symptoms of treatable disorders and help getting access to local treatment options.

More than 700 colleges and over 300 community-based organizations participate, resulting in more than 120,000 screenings each year.

If you or a loved one is experiencing suicidal thoughts, please reach out to the National Suicide Prevention Lifeline at 1.800.273.TALK (8255) or a mental health professional.

Article content sourced from a McLean Hospital press release. Image source: Recovery Friendly Taos.

Joan Camprodon, MD, MPH, PhD (Class of 2012), demonstrates the use of TMS on Amanda Arulpragasam, MGH Research Assistant

For patients suffering from depression, the Massachusetts General Hospital Department of Psychiatry now offers another treatment option – a new clinic based in Charlestown that uses transcranial magnetic stimulation (TMS). The clinic is part of a broader effort that includes a research enterprise program, both led by Joan Camprodon, MD, MPH, PhD, (Class of 2012) director of the Laboratory for Neuropsychiatry and Neuromodulation at Mass General. Dr. Camprodon’s team aims to understand how the brain’s structure and function affect disease and how interventions such as TMS can change the mechanisms that contribute to disease.

During a TMS procedure, focused magnetic impulses are directed to the brain. The electrical currents produced stimulate nerve cells involved in mood regulation that may be underactive in diseases such as depression. By restoring the equilibrium, TMS helps reset this imbalance of chemicals. from a diseased brain to a healthy one.

The MGH/McLean Adult Psychiatry Residency is committed to fostering the research aspirations of promising psychiatric scientists. While our NIMH-funded Research Concentration Program provides support to residents during clinical training, a critical time for a researcher's career is immediately following their residency, before they have received extramural funding (e.g. a NIH Career Development, or K, Award). But as a newly announced fellowship shows, this crucial "bridge" period is increasingly well-supported by a range of opportunities for MGH/McLean residents.

On November 18th, the Stanley Center for Psychiatric Research, which is part of the Broad Institute of Harvard and MIT, announced a new post-graduate residency research fellowship exclusively available to MGH/McLean residents. The Stanley Center Fellowship for Psychiatric Genetics and Neuroscience will provide one to two years of post-residency salary support, representing at least 70% effort, for recently graduated residents beginning careers in psychiatric research. The effort represents a new partnership between the residency and the Stanley Center, which is directed by Steve Hyman, MD, a former McLean resident who later served as head of NIMH and then Harvard Provost, before taking on the Stanley Center post. Read the full announcement for this award here.

This new fellowship joins a host of other research opportunities available to MGH/McLean residents during their PGY5 and PGY6 years. (more…)

Pictured: Claire Brickell discusses the topic of free will in the context of psychodynamic psychotherapy.

Over the past two weeks, the Class of 2012 presented their work in the annual Senior Talks Symposium at McLean and MGH. Topics during week one covered a wide range and included a discussion of evil and psychopathy, group psychotherapy for patients with psychotic disorders, the neural correlates of emotional experiences in depression, and the epigenetics of schizophrenia. Week two featured a discussion of combined neuromodulation and neuroimaging, the psychodynamics of psychopharmacology, and the rise of "Bath Salts" as a new illicit drug. The full schedule is listed below.

Wednesday, June 6, 2012 McLean, de Marneffe, Room 132

• 1:00 – Jeff DeVido, M.D. – The Question of Evil
• 1:30 – Karen Adler, M.D. – From object to subject: The role of the patient's experience of the therapist's subjectivity as a catalyst for change
• 2:00 – Ellen House, M.D. – A Safe Arena: Group Psychotherapy and Psychosis
• 2:30 – Chris Tangren, M.D. – The Couch and the Anchor: The Use of Metaphors in Psychotherapy
• 3:30 – Brad Ruzicka, M.D. Ph.D. – Nature, Nurture, and Chromatin Structure
• 4:00 – Claire Brickell, M.D. – Psychotherapy and Free Will
• 4:30 – Sharmin Ghaznavi, M.D., Ph.D. – Neural Evidence for the Struggle To Feel Good in Major Depression

Wednesday, June 13, 2012 MGH, Haber Auditorium

• 1:00 – Brian Schulman, M.D. – The Psychodynamics of Psychopharmacology
• 1:30 – Amelia Dubovsky, M.D. – A Brief History of Graduate Medical Education: the Birth of Duty Hours
• 2:00 – Hannah Brown, M.D. –Bath Salts: The Rise of a New Drug
• 2:30 – Joan Camprodon, M.D., M.P.H., Ph.D. – Simultaneous combination of TMS and fMRI: a window into mechanisms of neuropsychiatric disease and recovery
• 3:15 – Argo Caminis, M.D. – At the Couch-side: Teaching for Medical Students and Junior Residents in Inpatient Psychiatry
• 3:45 – Nicole Christian, M.D. – Traditional Mental Health Care in a Post-Conflict Society
• 4:15 – Kelly Irwin, M.D. – Is everyone having a baby? Or is it just me?

In a study of responses to St. John's wort, sertraline, and placebo, Justin Chen, Class of 2013, and colleagues showed that patients who believed they were receiving active therapy rather than placebo obtained greater improvement, independent of treatment. They found that patient beliefs regarding treatment may have a stronger association with clinical outcome than the actual medication received, and the strength of this association may depend upon the particular combination of treatment guessed and treatment received.

Chen JA, Papakostas GI, Youn SJ, Baer L, Clain AJ, Fava M, Mischoulon D. (2011) Association between patient beliefs regarding assigned treatment and clinical response: reanalysis of data from the Hypericum Depression Trial Study Group. J Clin Psychiatry. 2011 Dec;72(12):1669-76.