October 01, 2020
MUSC Psychiatry Chair Update

Thomas W. Uhde, M.D.
Department of Psychiatry and Behavioral Sciences
Institute of Psychiatry
Did you know that MUSC researchers
are testing brain stimulation in zero gravity?
Not many researchers get the chance to float, weightless, 32,000 feet above the Earth. Medical University of South Carolina scientists usually conduct research in labs – controlled settings where they can carefully repeat experiments to double-check results. But with an eye toward what real astronauts might experience in future space travel, a few scientists recently took to the skies to do brain research in zero gravity.

Neuroradiologist Donna Roberts, M.D., and neuroscientist Bashar Badran, Ph.D. collaborated on the project to conduct transcranial magnetic stimulation, or TMS, on themselves and a group of volunteer assistants, mostly from the Department of Psychiatry and Behavioral Sciences in the MUSC College of Medicine.

Roberts has spent years studying how zero gravity and microgravity affect the human brain – in fact, that was her motivation for going to medical school. This experiment was primarily a test case to show that TMS could be safely used in zero gravity and to compare participants’ results under the force of Earth’s gravity to their results in zero gravity.

During a TMS procedure, a magnetic pulse is sent through the skull into the brain to stimulate electrical activity. The pulse is highly localized – it doesn’t reach the entire brain. The TMS administrator places a coil over the subject’s head; when the subject’s thumb twitches, the administrator knows the TMS coil is in the right spot.

Here on Earth, TMS is FDA approved for hard-to-treat depression. Scientists at MUSC and elsewhere are also investigating using TMS for post-traumatic stress disorder; to treat cravings and pain in people under treatment for opioid use disorder; and in physical and mental rehab for stroke patients. Depression could be a concern for people on long-term missions far from Earth who don’t expect to set foot on solid ground for years, and Roberts and Badran said TMS could be a useful and space-saving tool to pack on long-term space missions, rather than an entire pharmacy’s worth of medications.

Dr. Pat O'Neil is presenting a free webinar titled, "Lessons Learned from Working with Patients with Obesity during COVID-19." The webinar will be available October 15, 2020 at 11:30 am through the Robard Corporation.

The Day of Remembrance event took place last Friday and was a collaborative effort between the National Crime Victims Research & Treatment Center, the Charleston County Sheriff's Office, the 9th Circuit Solicitors Office, and Coastal Crisis Chaplaincy. Congratulations to the NCVC team and their partners on a successful virtual ceremony!

The Police Executive Research Forum (PERF) is a large national NGO with over 3,200 police executives throughout the U.S. who are senior leaders in police departments or Sheriff's departments. The National Crime Victims Research & Treatment Center collaborated with PERF who interviewed police chiefs and sheriffs who were involved with responding to large-scale mass violence incidents. PERF prepared a report and has distributed it to the over 3,200 senior executives who are members of PERF. This report is a great way to teach senior law enforcement executives about the role of law enforcement in assisting mass violence victims after these terrible incidents. Angie Moreland, Vickey, and Dr. Dean Kilpatrick worked with PERF closely on this project. Congratulations to you all on your outstanding work!
We are excited to announce that TF-CBT Web 2.0 is now available in Spanish! The National Crime Victims Research & Treatment Center has pioneered the development of online courses for various evidence-based trauma treatments including Trauma Focused Cognitive Behavioral Therapy (https://tfcbt2.musc.edu).

Dr. Rosaura Orengo-Aguayo (NCVC) and Drs. Regan Stewart, Andel Nicasio, Bianca Villalobos, and Katherine Teefey, MA (Mental Health Disparities and Diversity Program led by Dr. Michael A. de Arellano) spearheaded the translation efforts. In collaboration with Dr. Dan Smith, co-developer of TF-CBT Web 2.0 in English, and MUSC’s web development team (led by Andrew Cates) we now have available the first CBT, self-paced, online training course completely in Spanish. This resource, highlighted by the National Child Traumatic Stress Network, is now available to trauma providers across the world serving trauma-exposed Spanish-speaking children and adolescents. TF-CBT Web 2.0 Español can be found at: https://tfcbt-es.musc.edu and providers can receive 11 CEUs approved by the APA through the Department of Psychiatry Continuing Education Office.
Congratulations to Dr. Eva Serber on being named the 2020 winner of "Charleston's Choice" for Therapist/Psychiatrist/Psychologist!
Dr. Mark George will be presenting a one-day conference on Thursday, October 1st (today) starting at 11:00 AM. The conference is regarding an exciting new brain stimulation technology which may evolve to being the next big thing.

As part of her Fulbright Award, Dr. Lindsay Squeglia is establishing a cross-national collaboration between the United States and Australia to improve health outcomes globally for youth struggling with substance use problems. As part of this fellowship, Dr. Squeglia collaborated with Briana Lees (pictured) at the University of Sydney on a project examining how prenatal alcohol exposure affects mental health and behaviors in children, which was just published in the American Journal of Psychiatry.

In a sample of almost 10,000 youth, 1 in 4 were prenatally exposed to alcohol. They found that even very low level alcohol use during pregnancy impacted the child’s brain development and was linked to emotional and behavioral problems, like depression, anxiety, and poor attention. Low level use and exposure to just 2 drinks per week during early pregnancy (the first 6-7 weeks of pregnancy) was linked to negative impacts. Generally, the more a child was exposed to alcohol in utero, the more severe the outcomes were. For example, slightly higher levels of exposure during early pregnancy (3+ drinks/occasion, 36 drinks total in first 6-7 weeks) were linked to increased risk of ADHD (+25%) and oppositional defiant disorder (+30%). The data indicates that even low level alcohol consumption from conception throughout the entire pregnancy is related to negative effects on the developing brain.
Dr. Christopher Pelic was interviewed about the availability and use of tele-mental health services and therapy during the COVID-19 crisis. The interview is available on South Carolina Public Radio and can be streamed here.
Three Genes Predict Success of
Naltrexone Alcohol Dependence Treatment

Kristin Marquardt | September 23, 2020
Considering a patient's genetics could inform clinicians which medications would be most effective in controlling cravings and treating alcohol use disorder. 

Twenty million Americans currently struggle with an alcohol use disorder. Of those who seek treatment, only 20% receive medications, either alone or in addition to counseling.

Medications are not used more often, according to Charleston Alcohol Research Center scientific director Raymond Anton, M.D., in part because they do not work equally well for everyone. Many patients with alcohol use disorder would benefit from a personalized medicine approach, in which a medication is prescribed based on a patient's genetic code. 

Anton and his team report in Alcoholism: Clinical and Experimental Research that doing a few relatively simple genetic tests to identify variations in just three brain genes makes it possible to predict which patients with an alcohol use disorder will benefit most from the addiction treatment medication naltrexone.

In previous studies, Anton's team showed that treating alcohol use disorder with medications that work on specific brain chemicals can reduce the relapse rate by up to a third.

“Alcohol dependence is a brain disease known to affect certain brain chemicals,” said Anton, “So, it's important to use treatment methods that address not only the behavioral but also the biological/brain components of the problem.”

Naltrexone, a Food and Drug Administration (FDA)-approved addiction medication, is somewhat unique in that it targets just a single protein in the brain –the mu-opioid receptor. When activated by either an internally produced or externally introduced opioid-like chemical, the mu-opioid receptor signals a positive experience. Drinking alcohol releases natural opiates in the brain that activate the mu-opioid receptor. Naltrexone blocks the mu-opioid receptor to prevent the reward and pleasure that comes from drinking alcohol and can even reduce the craving to consume it.

The gene that produces the mu-opioid receptor protein in the brain is not the same in every patient. In the current study, Anton and his team considered the influence of a small gene variation that results in a slight difference in the mu-opioid receptor protein structure. That slight difference does not affect how people act under normal situations, but it does cause a subtle difference in how strongly the mu-opioid receptor becomes activated when alcohol is consumed, with one variation having a greater response than the other.

Anton and his team hypothesized that this subtle difference in brain chemistry might affect how well naltrexone works in any given patient.

Psychiatry Administration

ICCE Chief (UNIV, Full-Time): The Chief of the Mental Health Integrated Center for Clinical Excellence reports to the Chief Physician Executive of MUSC Health and works in close collaboration with other MUSC Health leaders including the Chief Operating Officer and Chief Nursing Officer. As Vice Chair, this position also reports to the Chair of the Department of Psychiatry and Behavioral Sciences. The ICCE Chief is expected to provide at least 75 percent administrative time in the role devoted to strategic leadership and administrative activities.

Addiction Sciences Division

Open Rank/Assistant Professor (UNIV, Full-Time): The successful applicant for this position will have either an MD or a PhD degree and will be expected to have an established and independent research program that will interface with the multidisciplinary NIAAA P50 Charleston Alcohol Research Center at MUSC. 

Open Rank/Professor (UNIV, Full-Time): The successful applicant for this position will have either an MD or a PhD degree and will be expected to have an established and independent research program that will interface with the multidisciplinary NIAAA P50 Charleston Alcohol Research Center at MUSC.

Child & Adolescent Psychiatry Division

Social Worker (MUSCP, Full-Time): This position is for a licensed independent social worker (LISW-CP) who will be working in a team environment in the Outpatient Clinic of the Child and Adolescent Division of the Department of Psychiatry and Behavioral Health Services at the Medical University of South Carolina. Specific responsibilities include interviewing clients and or families; developing and discussing proposed treatment plans with the client and detailing the recommendations and the reasoning for them; monitoring and documenting the progress of clients, and making service treatment plan adjustments as necessary.

Psychiatry Hospitalist Division

Open Rank - Psychiatry (UNIV, Full-Time): Candidate must be a psychiatrist with the ability to hold an unrestricted license to practice in South Carolina. The candidate must be board-eligible or board-certified if having completed residency training greater than five years ago. Candidate will be a member of the Psychiatry Hospitalist Division and provide inpatient care on a general adult psychiatry unit and provide coverage across other inpatient areas as needed. Candidate will provide care as a Consult Liaison, and have research coverage. *Note: This position is coded under an ECT identifier through Human Resources; however, it is not ECT for doctors. This position is for the Psychiatry Hospitalist Division.

Advanced Practice Provider (APP - NP/PA) (MUSCP, Part-Time): Part-time (20 hours per week) APRN/PA working in the Emergency Department in a collaborative role with the ED providers to assist in the triage and management of psychiatric patients who present to the MUSC ED, under the supervision/collaboration of a psychiatrist. Will work as part of a multidisciplinary team and work with a team of ED based psychiatrists as part of the Mental Health ICCE, within the Department of Psychiatry. Currently eligible or licensed as an Advanced Practice Nurse in the state of SC or Licensed (or certification eligible) as a Physician Assistant by the National Board of Medical Examiners or the American Academy of Physician Assistants. Requires certification in Basic Life Support.

Mental Health Disparities and Diversity Program

Program Coordinator I (UNIV, Part-Time): This Program Coordinator provides coordination services for the Tele-mental health Outreach Program (TOP) to include assessment of referrals and assignment of, monitoring of data, completion of progress reports, consultation with schools and other sites regarding telehealth equipment, and other administrative duties.

Sleep and Anxiety Treatment and Research Program

Human Services Coordinator II (Resiliency Program Clinician) (UNIV, Full-Time): This Human Services Coordinator II will provide evidence-based resiliency building skills and curricula for health care providers across the Medical University of South Carolina. This position will serve as coordinator and clinical provider within the COVID-19 Resiliency Program in the Sleep and Anxiety Treatment and Research Program (SATRP). Evidence based interventions including psychological first aid, skills for psychological recovery, cognitive behavioral interventions for anxiety and sleep will be provided during individual sessions as well as in group formats and workshops. Assisting health care providers in assessment of and implementing communication skills and fostering group cohesion to strengthen support and resilience will be core components of responsibilities. Individual counseling sessions will also be provided within the SATRP clinic. This position includes conducting early intervention and longer-term counseling via in person and virtual platforms. Interdisciplinary team collaboration is essential.
This is an important reminder to the research community of the requirements to follow the latest University Directives for MUSC Faculty, Staff and Students for Staying Safe (some information updated as of 9/16). To clarify, these directives supersede recommendations issued to research teams in May 2020 for the incremental reactivation of research, including wearing masks indoors even when social distancing is possible. These requirements can be reviewed via the link above. We also urge you to review MUSC’s Academic Plans for Fall 2020.
The Department of Psychiatry and Behavioral Sciences is pleased to announce that it will begin accepting applications for the Fall cycle of the Chair’s Research Development Fund Pilot Grant Program (CRDF) from junior faculty members (i.e. assistant professors or below in rank) or trainees within the Department of Psychiatry and Behavioral Sciences. The CRDF provides funding for pilot research grants to collect preliminary data designed to enhance the viability and success of independent external funding in the future. The CRDF will support several awards each year to be determined by available financial resources. Most awards will be in the $5,000 – 10,000 range. Applications must be submitted to Romeka Washington ([email protected]) by 5:00 PM on November 1, 2020. Please see link for further details. Any inquiries should be directed to Dr. Alyssa Rheingold at [email protected].
A call for nominations is underway for the MUSC Advancement, Recruitment, and Retention of Women (ARROW) Award for Advancement of Women Faculty. The purpose of the award is to recognize the MUSC faculty member who best demonstrates excellence in his/her commitment to the advancement and promotion of women faculty at the Medical University of South Carolina.

A nomination form is attached and the deadline for submissions is 5:00 pm, Friday, October 9, 2020. Note that nominations will require a mentoring table (attached) to be considered. Please contact the ARROW program coordinator, Rachel Simmons at [email protected] if you have any questions.

2020-2021 GRAND ROUNDS
**Last Day to Register!**
Dear Friends,

Every day brings a new challenge but also a ray of hope. This year’s NAMIWalks event is definitely both: an experiment in solidarity during a pandemic and an example of what true commitment to the cause can accomplish. Either way, thanks to you, we see bright things ahead for the NAMI programs and services you make possible.

The first challenge: How does someone participate in a virtual walk? Where do you begin? How do you get started on preparing for NAMIWalks Your Way Charleston: A Virtual Event on October 10? What’s training even look like? And where do you get your gear — whatever it is?

No need to fret. If you’ve walked with us before, you get ready for NAMIWalks the way you always have, minus the emphasis on the huffing and puffing perhaps. If you’re new to NAMIWalks, it’s easier and more fun than ever. Follow these sure-fire steps, including the three steps below.

  1. Register – If you previously registered for our 2020 walk, you are already registered for NAMIWalks Your Way: A Virtual Event on October 10. If you have not registered, go to www.namiwalks.org/charleston
  2. Self-Donate – In times of uncertainty and flux, mental health services are needed more than ever. The best way to show your support is to make a self-donation on your fundraising page. People who self-donate raise 8x more than those who don’t!
  3. Decide What to Do – Will you track 3,500 steps, the equivalent of a 5K? Will you hula-hoop until you reach your fundraising goal? Will you sip and paint with your friends on Zoom? The only limit of NAMIWalks Your Way is the reach of your imagination and the breadth of your compassion.

We encourage participants to take photos and video and share their activities on social media—use the hashtags #NotAlone and #MentalHealthForAll—as a way to stay connected.

Together in the difficult times — and because of them — we can and will prevail.

If you have questions or ideas, reach out to us at (843) 467-5224 or [email protected]

Warm regards,

Kelly Troyer

P.S. On October 10, we will be joined by multiple NAMIWalks sites across the country in a day of solidarity and awareness. The day itself will be called A National Day of Hope. We are grateful that you and other NAMIWalks supporters will be a part of it.
WebEx Information

Meeting number (access code): 120 226 2525
Meeting password: mT2BqenKW78
The following resource provides MUSC Health lab and testing options pertaining to COVID-19. Included on this page is information regarding drive-thru and “pop-up” mobile COVID testing locations, antibody or serology tests, drive-in lab and nurse visits, and original/classic lab testing.

In addition to updates provided by MUSC Enterprise, the Department of Psychiatry and Behavioral Sciences will also provide updates through our employee intranet, The Horseshoe. Updates will be provided regularly as new information becomes available. For your convenience, direct links are provided below.


Given the COVID-19 pandemic and until further notice, all volunteers and observers are barred from participation in departmental and MH-ICCE based activities. If there are circumstances wherein this policy causes a significant and critical issue, it should be brought to my attention for consideration of a written waiver (on an individual basis) of this policy. Thank you.

Thomas W. Uhde, M.D.
Professor and Chair
Department of Psychiatry and Behavioral Sciences
Due to the activity of COVID-19 within the hospital and community, all employees, residents, fellows and students within all MUSC entities are directed to begin daily self-monitoring for COVID-19 symptoms. This applies regardless of whether you have been working remotely on a full-time or intermittent basis. You need to continue daily self-monitoring, even if symptoms are not present.

NAMI Connection and NAMI Family Support Offered Online 

Social distancing does not mean that you have to go through difficult times alone. NAMI is here to help! We are offering NAMI Family Support and NAMI Connection online. 
NAMI Connection Support is offered every Monday at 6PM until further notice.

NAMI Family Support Group is offered the 2nd and 4th Thursdays
of the month at 6PM until further notice.

By clicking HERE you can sign up to receive the meeting login information or you can email us at [email protected] or call/text 843-284-3091. 
If you would like to submit content to include in next week's
Chair Update, please submit to Dr. Jamie Fisher
by 12:00 pm on Monday. Thank you.