Daniel Medeiros Almeida, MD

Dr. Daniel Medeiros Almeida, MD, working with colleagues at University of Cincinnati and Lindner Center of HOPE, reviewed cross-national, and cross-sectional, studies that appraised the compelling association between polyunsaturated fatty acids (PUFAs) and recurrent mood disorders. Recent evidence suggests that low n-3 PUFA biostatus coincide with, and may precede, the initial onset of mood disorders. Reviewed translational evidence also provided a convincing rationale for this association. In addition to incorporation into cellular phospholipid membranes, the n-6 PUFAs including rachidonic acid and the n-3 PUFAs including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) serve as precursors of immune-inflammatory signaling modulators. Furthermore, there is a growing body of evidence implicating n-3 PUFAs in neuronal differentiation, synaptogenic and synaptic function. While the notion of nutritional medicine has been slow to impact conventional psychiatric training and practice, the extant evidence of n-3 PUFA insufficiency among patients with mood disorders may represent a “modifiable risk factor” and therefore represent a suitable therapeutic candidate incorporated into clinical practice. Published work, from 2017, is in Progress in Lipid Research.

Discovery of a Novel Drug Treatment Approach to Enhance Gains from Therapy in Children with Autism

Drs. Logan K. Wink, MD, and Craig A. Erickson, MD, discovered that low dose use of the glutamate modulator d-cycloserine (DCS) given weekly prior to social skills group therapy promotes continued social skill gains three months after the cessation of treatment. As published in Molecular Autism those children with autism who received the weekly DCS treatment continued to make social skill gains for a three month period following 10 weeks of social skills training compared to regression, or loss of gains, initially made during therapy noted in those who received placebo treatment. This is the first work showing drug-associated augmentation of gains from therapy in children with autism. Additionally, they showed that use of quantitative computer-based eye gaze tracking can work to predict which individuals with autism best respond to treatment and track positive treatment-associated change over time.

Meeting the Acute Care Needs of the Community by Growing Services and Improving Safety

The Division of Child and Adolescent Psychiatry has had the busiest year in its history. The number of emergency room assessments, inpatient admissions, inpatient days, and outpatient encounters are each at an all time high, with most increasing over 10% over the previous year. In addition, new services improve disposition and treatment options for patient's in acute need. A bridge clinic that offers urgent psychiatric services is now in place to offer intensive outpatient care for serious mental health difficulties, but not requiring inpatient care. Specialized services developed along similar methods with the use of care managers for patients with developmental disorders. Perhaps most importantly even with these increasing numbers, several safety measures have improved significantly in the past year. Over FY 16, there is a reduction of OSHA recordable staff injuries by 42%. There is a 88% reduction in patient mechanical restraints. This combination of higher levels of service, improved care options, and enhanced safety is a significant accomplishment for both the division and Cincinnati Children's.