The Q&A below is transcribed from a phone interview with Dr. Lawrence Price, president and COO at Butler Hospital, for Honest Conversations.
What is a major challenge for people with psychiatric illness?
If you have cancer, it’s terrifying, but not in the same way as psychiatric illness, where you doubt your actual sense of yourself. It’s hard to comprehend the illness when the illness is affecting the very faculty with which you would evaluate yourself. It’s your brain, and it strikes at such a central part of who we are as individuals. That is utterly terrifying.
What gives you hope?
I am heartened in my work by the fact that when I talk to my own children, who are now fully grown adults, they think about psychiatric illness differently than I did when I was their age. For them, it’s not stigmatizing. These are problems that people have, just in the same way they might have other kinds of medical problems. So, I do think we’re making progress, but there’s so much more we need to do.
What are the challenges facing psychiatric research?
The fact is that psychiatric illness is at least as prevalent, if not more prevalent, than many of the physical illnesses that we spend much of our research dollars on. Unfortunately, advocacy for psychiatric illness lags behind that of other illnesses. But at Butler Hospital, we’re making research into the diagnosis and treatment of psychiatric illness a priority.
What areas of research is Butler focusing on now?[mks_col] [mks_one_half]
In our psychological therapies arena, we have investigators who are working in two of what I would call the most up-and-coming psychotherapeutic approaches in the last 10 or 15 years – something called acceptance and commitment therapy (ACT) and another approach called mindfulness-based therapy. This group of researchers has a long and distinguished history of conducting very formalized, rigorous studies of how psychotherapy works and how we can make it work better.
This group, which I work with, has been involved in a variety of areas including the first published clinical trial for deep brain stimulation in depression. Our work has helped clarify the risks and benefits of that procedure. We’ve also been very much involved in transcranial magnetic stimulation, known as TMS, and have one of the most active research groups in the country. We’ve also published work on the biological consequences of early life stress. We’ve studied first adults and more recently children who’ve been subjected to early life stress from either abuse or neglect and then looking at some of the biological, hormonal, molecular, and genetic effects of these kinds of stressors as these individuals get older. We know from other work that these individuals are at much higher risk of developing a large variety of psychiatric and medical disorders, not only depression, schizophrenia, OCD, anxiety disorders, and PTSD [post-traumatic stress disorder], but also heart disease, high blood pressure, diabetes, cancer. We’re trying to identify some of the molecular mechanisms that these kinds of early life stresses cause that might lead to these changes later on. Hopefully, by being able to identify molecular changes, we might be able to identify interventions that would ultimately help us reverse the stressors.[mks_button size="small" title="View Current Research Studies" style="rounded" url="http://www.butler.org/research/studies.cfm?f=3" target="_blank" bg_color="#003a5d" txt_color="#FFFFFF" icon="" icon_type="" nofollow="0"]
Mind and body
Butler also has one of the lead investigators in the world looking at how exercise can help people with various addictive disorders such as cigarette smoking, opiate dependence, and alcoholism, as well as psychiatric disorders like depression and schizophrenia. There’s tremendous interest in trying to figure out how we can use lifestyle changes to help people with various physical and psychiatric illnesses.[/mks_one_half] [mks_one_half]
Obsessive-Compulsive Disorder (OCD)
Another group, the obsessive-compulsive disorders group, is involved in numerous studies, including neurosurgical approaches to treating extremely severe, intractable OCD. They published the first study on using a radiological knife – kind of a nuclear medicine knife to actually cut certain pathways in the brain that are involved in what causes OCD in these individuals. These are patients who may be functionally crippled, with truly incapacitating illness. Using particle beam knives, which are not physical knives but rather X-ray knives, you can actually dramatically improve, and in some cases even eliminate, OCD in a substantial number of patients. In their most famous case, they treated a man who was literally unable to feed himself, and now he is a practicing physician in the Midwest. It is truly historic, a heroic story. They’ve also been very much involved in developing deep brain stimulation approaches for OCD that involve implanting electrodes in the brain, similar to how a pacemaker is used to treat heart rhythm problems. This work led to the FDA approving deep brain stimulation for use in people with OCD, which is a really significant breakthrough.[mks_button size="small" title="View Current Research Studies" style="rounded" url="http://www.butler.org/research/studies.cfm?f=5" target="_blank" bg_color="#003a5d" txt_color="#FFFFFF" icon="" icon_type="" nofollow="0"]
Technology and treatment
We’re also doing work at Butler on how we can use portable device-based therapeutic interventions to help people with psychiatric illness. With grants from the National Institute of Mental Health, we’re investigating if smart phones can be useful or not, and if they can, to develop interventions that will help people get better outside of the therapist’s office. These research projects are designed to help us help people with mental illnesses – many of which are chronic conditions. We all need to realize that chronic illness is chronic illness, irrespective of whether it’s in the brain or it’s in the heart or elsewhere.
Butler Hospital’s Programs and Services
Butler Hospital is Rhode Island’s psychiatric hospital focused on treatments, teaching and research for behavioral health. Learn about our inpatient, outpatient and partial hospital programs.[mks_button size="large" title="View Our Programs" style="rounded" url="http://www.butler.org/programs" target="_blank" bg_color="#f68933" txt_color="#FFFFFF" icon="" icon_type="" nofollow="0"] [/mks_one_half] [/mks_col]