Treatment Resistant Depression (TRD) and Psychosis: A Biopsychosocial Perspective

Presented by: 

Anish Shah, MD, Psychiatrist

Friday, Jan. 6, 2023

9:00 am - 12:15 pm

Zoom

3.0 CEs

RESCHEDULED TO APRIL 7TH

Course Description         

This presentation will include how to evaluate and treat treatment resistant depression and associated psychosis. Most studies suggest that about 10%–30% of patients with clinical depression do not improve or show a partial response coupled with functional impairment, poor quality of life, suicide ideation and attempts, self-injurious behavior, and a high relapse rate. Treatment resistant depression is a complicated psychiatric issue which has a significant cost in our society when it comes to economic and social factors.

The pathology is difficult to treat with standard treatment. It requires a novel treatment approach and comprehensive biopsychosocial treatment involving addressing all psychosocial factors with evidence based psychotherapy. Our patients with repeated episodes of depression, bipolar disorder, elderly population, women , severe chronic pain and sleep problems are especially vulnerable to TRD.

Psychotic depression, or major depressive disorder with psychotic features, is a serious illness during which a person experiences the combination of depressed mood and psychosis, with the psychosis commonly manifesting itself as nihilistic or somatic-type delusions.

In the STOP-PD study, the diagnosis of psychotic depression was missed 27% of the time, which was likely a conservative estimate because patients with comorbid conditions, such as substance abuse in the past three months, or unstable medical conditions were excluded.

In the United States, despite the APA practice guideline recommending the combination of an antidepressant and antipsychotic for the acute treatment of psychotic depression since 2000 , studies have shown that only 5% of patients with psychotic depression receive an adequate combination of an antidepressant and an antipsychotic. Up your game with this fascinating 3 hour presentation! 

Learning Objectives

1. Evaluate clients for Treatment Resistant Depression and Psychosis.
2. Describe the Biological Theory of Clinical Depression and Psychosis.
3. Understand Psychopharmacological Treatment of Clinical Depression and Psychosis.
4. Understand Transcranial Magnetic Stimulation Treatment for Clinical Depression: Theory and Treatment approach.
5. Describe a novel approach with Ketamine for Treatment resistant depression.

RSVP here.  Please note that once you have RSVP'ed for this event you will receive a link to register for the Zoom Meeting. You must complete this second step to gain access to your personal Zoom-join link to access the event.

About Anish Shah, MD, Psychiatrist

Dr. Anish Shah, MD has been a practicing psychiatrist in Northern California for 19 years, gaining experience in several behavioral health settings, including Lake County Mental Health, Kaiser Permanente, and Sonoma County Mental Health. In addition to direct patient care, I also served as the Medical Director of Napa State Hospital before launching his practice in 2012. As the Medical Director at Napa State Hospital, he led a staff of 220 medical professionals and managed a $4 million medical services budget.

Currently, Dr. Shah is the CEO and Medical Director of Siyan Clinical Corporation (SCC) located in Santa Rosa, California. Established initially as a solo private practice, SCC has since grown into one of the largest psychiatric practices north of San Francisco with ten clinicians (three psychiatrists, three therapists, and four mid-level providers) and more than 5,500 registered patients. The most substantial behavioral health concern among SCC's patient population is generalized anxiety disorder. In his leadership role, he has had the opportunity to collaborate with several leading experts in psychotherapy. This relationship with local providers, as well as an extensive patient database, will enables SCC to obtain valuable input that they can use in the development of a mobile application, ensuring a high-quality product that will genuinely benefit those suffering from generalized anxiety disorder.

Dr. Shah has eight published papers in peer-reviewed journals on topics including bipolar disorder, post-traumatic stress disorder, panic disorder, clinical depression, and opiate dependence treatment. He also has two publications, on chronic pain and overcoming wildfire trauma, in local magazines. Furthermore, he is active in the community as a behavioral health resource, providing behavioral health expertise upon request as well as continuing education programs in the prevention, treatment, and management of depression, post-traumatic stress disorder, and opiate dependence.

In addition, Dr. Shah has extensive experience as a researcher leading clinical trials. He served as the Principal Investigator for two Phase 3 clinical trials investigating therapeutic modalities for treating patients with major depressive episodes associated with bipolar I or bipolar II disorder. He is also currently the Principal Investigator for a study evaluating the efficacy of Vortioxetine in subjects with panic disorder.

Dr. Shah's Publications

1. Shah, A. Posttraumatic Stress Disorder among Law Enforcement Officers: A Review of Risk Factors and Current Trends in Treatment. Forte Journal of Neuroscience and Psychology. 2019 Nov 10;1(3).
2. Shah, A; Sheth, R. Traumatic Reactions after Wildfires: Common Reactions and Coping. Sonoma Medicine. 2018 Feb 23;69(1):29-32.
3. Shah, A; Northcutt, J. An open-label, flexible dose adaptive study evaluating the efficacy of Vortioxetine in subjects with panic disorder. Annals of General Psychiatry. 2018 May 11;17:19.
4. Shah, A; Kettner, A. Detection and Assessment of Malingering in Chronic Pain Patients. Marin Medicine. 2015 Nov 19;61(3):25-8.
5. Shah, A; Kettner, A. Malingering in Patients with Chronic Pain. Sonoma Medicine. 2015 Jul 5;66(3):15-8.
6. Shah, AS. A Review of the Role of Antipsychotics as an Augmentation Agent or Treatment Option for Patients with Treatment Resistant Unipolar Depression. International Journal of Emergency Mental Health and Human Resilience. 2015 Jun;17(2):476-480.
7. Shah, AS; Young, J; Vieira, K. Long-term Suboxone Treatment and its Benefit on Long-Term Remission for Opiate Dependence. Journal of Psychiatry. 2014 Oct 15;17:6.
8. Shah, AS. The Role of Atypical Antipsychotic Therapy for Patients with Treatment-Resistant Bipolar Depression. Journal of Psychiatry. 2014 Sep 30.;17:6.
9. Shah, A. Suboxone Treatment for Opioid Dependency. Sonoma Medicine. 2014 Jul 9;65(3):30-2.

Zoom Meeting. Requires pre-registration with Zoom; please make sure you register with Zoom with the link provided in your confirmation email.

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Redwood Empire Chapter CAMFT  (Provider #57173) is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LCSWs, LPCCs, and/or LEPs. Redwood Empire Chapter CAMFT maintains responsibility for this program/course and its content. 

• Disability Accommodation: To request an accommodation for a disability, please email therapy@recamft.org.

• Refunds: Refunds may be requested up to 7 days before the event by contacting therapy@recamft.org. No refunds are given beginning 7 days prior to the event. If a member cannot attend the event due to a mandatory evacuation or Public Safety Power Shut-off the day of the event, they can request and receive a refund with verification of address.

• CE Certificate: You must attend the entire presentation and complete a post test and an evaluation to receive your CE credit certificate. At the conclusion of this educational event, after confirming attendance, an email with a link to the test and evaluation form will be sent to all attendees who attended the online event. Once you complete and submit your evaluation, you will have immediate access and be able to print or save your CE Certificate. This course meets the qualifications for 3.0 hrs of continuing education (CE) credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences

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