After COVID infection, 10-50% of people experience persistent symptoms such as fatigue, palpitations, insomnia, cognitive problems, and headache – often with significant associated distress and functional impairment. The exact combination of symptoms varies from person to person, and it is expected that the specific causes vary from person to person as well.
Because of this variability, the current recommendation is for an evaluation by a multidisciplinary team. This creates a demand on our medical system that far outstrips current resources, and risks exposing patients to long, complex medical evaluations whose results are hard to interpret. In addition, clinical treatment trials that mix patients with similar symptoms but different underlying causes have high failure rates.
To address these challenges, a team of investigators including Rebecca Hendrickson, MD, PhD (Department of Psychiatry and Behavioral Sciences), John Oakley, MD, PhD (Department of Neurology), and Aaron Bunnell, MD (Department of Rehabilitation Medicine) are testing an online platform to identify patients whose pattern of symptoms suggest a particular underlying cause that is common after certain physiologic (i.e. illness or injury) and psychological stressors: increased adrenergic (adrenaline/noradrenaline) signaling in the brain and peripheral nervous system. We will pair this with a smaller number of detailed in-person assessments to validate our symptom-based measures and characterize associated biomarkers.
Our results will provide a detailed assessment of the patterns of symptoms caused by high amounts of adrenergic signaling that are seen in persistent post-COVID syndrome, how they change over time, and their association with objective measures of cognition and physiology. The project will provide the information needed to begin clinical treatment trials using existing, well-tolerated treatments that modulate adrenergic signaling. We hope the results will also have strong relevance to other potentially related disorders such as Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia.
The purpose of this study is to: 1) compare schools randomized to the RUBIES intervention or a usual-care in-service training on teacher burnout and disruptive behavior in children with autism spectrum disorder; and 2) test RUBIES’ mechanisms of change (knowledge and skills) on teacher (burnout), child (disruptive behavior), and implementation outcomes (fidelity).
Explore and suggest policy solutions in response to the public health challenges of high tetrahydrocannabinol potency cannabis. ADAI will host stakeholder sessions to gain perspectives, seek common ground, evaluate, and assess potential policy solutions culminating in a final recommendation report.
The major goal of this project is to evaluate the feasibility and effectiveness of an integrated intervention approach for co-users of marijuana and tobacco who are seeking treatment for tobacco addiction.
Of every 10 women in rural
India, one suffers from a common mental disorder such as depression. For many,
depression goes untreated and is associated with increased morbidity and
mortality rates. Several factors, specifically for women in rural India,
including stigma, lack of provider mental health workforce, and travel times.
Therefore, there is an urgent need to improve detection and treatment rates
among women without overburdening the scarce mental health resources in rural
India.
The “Mobile Mental Health in Community-Based
Organizations: A Stepped Care Approach to Women’s Mental Health” study
aims to develop and implement a mobile mental health intervention for women
through community-based organizations. The intervention is delivered in a
stepped-care approach where women receive different levels of intervention
depending on the severity of their mental health needs.
Standardized measurements of unhealthy drinking and alcohol use disorder symptoms are integral to addressing alcohol problems. However, surprisingly little is known about how measures of alcohol consumption and alcohol use disorder symptoms function when they are used in real-world routine care settings and documented in electronic health records (EHRs).
We propose to leverage EHRs to understand how measures of alcohol consumption and DSM-5 alcohol use disorder symptoms function in the context of real-world routine care, including by understanding how these measures function psychometrically overall and across demographic groups (age, sex, race, and ethnicity) and how they are associated with subsequent health outcomes obtained from EHRs.
Deaths related to the opioid overdose epidemic remain at an all-time high
across the country despite significant efforts to reduce them. There is a
pressing need to support medication treatment for opioid use disorder (OUD) to
help people stay in treatment and reduce the risk of overdose death and other
serious health consequences of untreated addiction. Smartphone-based apps can
facilitate the delivery of an evidence-based approach called contingency
management that incentivizes use of medications for OUD, reduces use of
non-prescribed opioids and improves retention in OUD treatment.
This study will leverage a commercially available smartphone app that can
bring this much-needed behavioral support to patients receiving OUD treatment
in a primary care clinic and in a specialty OUD treatment clinic. The approach
offers a potentially non-labor intensive, cost-effective and highly scalable
means of delivering OUD care.
This research develops and tests digital technology to help clinicians and patients systematically measure and monitor clinical progress during addiction treatment. The technology is being developed based on end-user input and user-centered design methods and will be pilot tested as an add-on to real-world care in an addiction treatment clinic.
