Condition: Geriatric psychiatry/psychology

Randall Espinoza

I am currently the Medical Director at the Garvey Institute Center for Neuromodulation and am providing leadership to help grow our portfolio in the area of Neuromodulation and Interventional Psychiatry. Before coming to the UW, I was the Muriel Harris Chair of Geriatric Psychiatry and Professor of Clinical Psychiatry at UCLA. While at UCLA, I held many administrative, clinical and teaching leadership positions including serving as Medical Director of Inpatient Geriatric Psychiatry, Chief of Staff of the UCLA Neuropsychiatric Hospital, Founding Faculty of the UCLA Neuromodulation Division, Medical Director of the ECT and Interventional Psychiatry Program, among others.

I recently became Editor-in-Chief of the Journal of ECT and Related Therapies, the official publication of the International Society of ECT and Neurostimulation. My research projects have included investigating various neuromodulation and interventional therapies and developing novel educational programs and curricula. I have an abiding interest in mentoring and helping faculty at the start of their careers and a commitment to fostering the advancement of women and underrepresented minority (URM) faculty in academic medicine.

Douglas Lane

I am a clinical psychologist with board certification in geriatric psychology.  I am based in the Geriatrics and Extended Care Service of the VA Puget Sound Healthcare System.

Wade Reiner

I have always been interested in the thoughts and feelings that drive us. This led me to major in Psychological and Brain Sciences at Johns Hopkins University and to later enroll in the psychiatry residency training program at Washington University in St. Louis. Since completing training, I have had an excellent experience working at UW/Harborview’s emergency and inpatient psychiatry services. My teaching interests include the psychiatric interview, documentation, and fundamentals of clinical decision-making. Clinically, I enjoy taking a holistic approach to care, utilizing interventions across behavioral changes, pharmacology, and psychotherapy.

Merrill Berger

I am a seasoned clinical psychologist who has worked with children and adults in a wide variety of settings.  Currently, I provide evidenced based psychotherapies in the Adult Outpatient Psychiatry Clinic at the University of Washington Medical Center.  This includes Acceptance and Commitment Therapy (ACT) Cognitive Processing Therapy for trauma, Trauma informed care, CBT for anxiety and depression, and  CBT for Adult ADHD.

I am particularly interested in providing care to health care professionals who have met many challenges over the last few years.   I also provide treatment to adults experiencing psychosis and bipolar disorder.

Michael J. Schrift

Dr. Michael Schrift is a Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. He currently is an attending neuropsychiatrist at the Brain & Memory Center at Harborview Medical Center. He is he the director of the Behavioral Neurology/Neuropsychiatry Fellowship Training Program. He previously was the Division Director of Geriatric Psychiatry & Neuropsychiatry in the Department of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine in Chicago. He was also the director of the fellowship training program in Geriatric Psychiatry, co-director of the Clinical Neuroscience Fellowship program, and the director of the Neuromodulation Program and the Cancer Neuropsychiatry Program. He has many years of experience treating patients with Parkinson’s disease, Huntington’s disease, and Wilson’s, among other neuropsychiatric disorders. He also is an attending neuropsychiatrist in the Harborview Memory and Brain Wellness Clinic.

Dr. Schrift is the Book Review Editor for the Journal of Neuropsychiatry and Clinical Neurosciences.

He is board-certified in Psychiatry by the American Board of Psychiatry and Neurology as well as board certified in Behavioral Neurology and Neuropsychiatry by the United Council for Neurologic Subspecialties. He has training in Bioethics and serves on the ethics committee at Harborview Medical Center. Dr. Schrift is a fellow of the American Neuropsychiatric Association.

Gail Li

My research has focused on the clinical and epidemiological study of brain aging, Alzheimer’s dis-ease (AD), and, most recently, mild traumatic brain injury (mTBI).

The epidemiological study of aging and AD. Over the past 20 years, I have pursued studies investigating the putative risks and protective factors for AD in a large community-based longitudinal cohort known as Adult Change in Thought (ACT). I have used the ACT, which is led by Drs. Eric Larson and Paul Crane, to characterize the associations between an array of risk factors, ranging from cardiovascular traits to depression, and both the incidence of dementia and the neuropathological changes seen at autopsy. In collaboration with experts in environmental and occupational health, I am now co-leading an NIH-funded R01 study to investigate the adverse effects of air pollution on brain aging, cerebrovascular disease, and neurodegenerative diseases.

Using biomarkers to identify the preclinical stage of AD, understand brain aging, and assess out-comes in clinical trials. The neuropathological changes of AD begin decades prior to a clinical diagnosis of AD. In collaboration with Dr. Elaine Peskind at VA Puget Sound, I have investigated several established (e.g., Ab42) and novel (e.g., E-selectin) AD biomarkers in cerebrospinal fluid (CSF) as we seek a way to improve both the early diagnosis of AD and the differential diagnosis of dementing diseases. Leveraging a large biorepository bank at VA Puget Sound, we have studied several of these CSF biomarkers in a cohort of cognitively normal subjects, and through this work, we have shown that (a) high CSF concentrations of F2-isoprostane, a biomarker for oxidative stress, are associated with poor executive function, cigarette smoking, and elevated body mass index; and (b) reduced levels of CSF brain-derived neurotrophic factor, a protein critical to the organization of neuronal networks and synaptic plasticity, are associated with poorer memory and predict cognitive decline over the next 3 years. Finally, we have established the feasibility of using CSF biomarkers, such as phosphorylated tau, as surrogate markers for AD in clinical trials during the pre-clinical stage of AD.

Primary prevention for AD: From observational study to clinical trial. The 3-hydroxy-3-methylglutaryl-coenzyme A (HMGCoA) reductase inhibitors, known as statins, decrease mortality from coronary heart disease and stroke. Our epidemiological studies found that the use of statins at relatively younger ages (e.g., prior to age 80) is associated with a decreased incidence of AD, especially in APOE ε4 allele carriers; statin exposure was also associated with fewer AD neuropathologies, especially in terms of neurofibrillary tangle burden. To provide further evidence of a potential protective effect of statins for AD, I recently completed a proof-of-concept, double-blind clinical trial in collaboration with Drs. Elaine Peskind, Eric Petrie, and Cynthia Mayer on the effects of simvastatin on CSF AD biomarkers in cognitively normal individuals. In that study, we found that simvastatin-related reductions in CSF p-tau181 concentrations may be dependent on low-density lipoprotein (LDL) cholesterol. To learn more, we will next investigate the potential disease-modifying effects of simvastatin on tau phosphorylation in persons with hypercholesterolemia.

mTBI research. Because neurodegenerative diseases like chronic traumatic encephalopathy (CTE) are the long-term consequences of repeated head injuries, I recently expanded my research interests to understand the risk of mTBI in combat Veterans with blast-related injuries for neurodegenerative diseases. To that end, I am an active member of a multidisciplinary research team at VA Puget Sound that seeks effective treatments for Veterans with mTBI. As a collaborator in this work, which is led by Dr. Elaine Peskind, I am striving to develop strategies to reduce the long-term sequelae of mTBI.

Shaune DeMers

Personal Statement

I am a geriatric and consultation liaison psychiatrist with expertise in diagnosing and managing cognitive disorders. I attend in the Memory and Brain Wellness Center, where I see primarily middle aged and elder patients with concerns about their memory or thinking. Although most of my patients have Alzheimer or vascular dementia, I have experience in diagnosing and managing less common types of neurodegenerative disease as well, for example frontotemporal dementia, dementia with Lewy Bodies, and Parkinson disease dementia. I have a particular interest in palliative medicine and end of life issues. I am board certified in both psychiatry and psychosomatic medicine. I am also the medical director of the psychiatry consultation service at Harborview Medical Center, which is where I spend most of my clinical time. That service is a large team busy with consultations throughout the hospital, and sees patients with serious medical and surgical illnesses who require psychiatric assessment and care. In all of my clinic work, I am proud to be part of teams of very talented professionals, which include other attending psychiatrists, neurologists, geriatric internists, nurse practitioners, neuropsychologists, social workers, nurses, and addiction specialists. I enjoy training fellows, psychiatry, psychology, and neurology residents, and medical students. There is a sense of mission and a level of commitment to clinical excellence at Harborview that I value greatly.

Amanda Focht

Personal Statement

I am experienced in the evaluation and treatment of a range of psychiatric conditions including anxiety and panic, mood disorders, psychosis, obsessive-compulsive disorder, posttraumatic stress disorder and personality disorders. I work with adult and geriatric patients in the outpatient setting.

Suzanne Murray

Personal Statement

My passion for patient care is the core of who I am as a physician.  As a consultation-liaison (C-L) psychiatrist, I have unique and broad teaching opportunities. The C-L role lets me teach non-psychiatrist peers, trainees from other specialties, and professionals from other disciplines. I particularly like helping providers to understand their patients’ psychiatric ailments, the complex interplay among psychiatric conditions and general medical problems, and the goals for recovery. Furthermore, I provide active support to patients and their families as they navigate our highly complex medical system with their illnesses and fears. Since the beginning of my tenure, I have been involved in the administrative aspects of medical student, resident and fellow training and curricular development.  Education is the common thread that unites all of my academic activities.  I have served as an Associate Program Director for 13 years at UWMC, Program Director of the Adult Psychiatry Residency program for 5 years and now work in CL psychiatry at the VA Puget Sound Health Care System.  I am currently the Associate Program Director (APD) for the site and a core APD for Evaluation of our residency program.