Understanding Early Psychosis in Youth

Seventy-five percent of adult mental illnesses emerge by age 24, with the majority appearing between ages 15 and 24. Given increasing evidence for the benefits of early intervention, identifying predictors and indicators of emerging mental illness is a high public health priority. In 2018, The National Institute of Mental Health (NIMH) awarded an Exploratory/Developmental Research Grant to new Faculty Scientist Kristen Woodberry, MSW, PhD to collect dynamic data in adolescents and young adults at risk for or in the early stages of severe mental illness. The project aims to better understand the interaction of emerging symptoms and social context over time.

Research Team (L to R): Kate Powers, Research Assistant, Dr. Woodberry, & Anna Cloutier, Research Nurse Coordinator

Using a smartphone app, the Daily Life Study is collecting 6 mood and symptom reports a day for 21 days in 60 Boston and Portland area youth ages 15-25.  By comparing the daily reports of those with and without psychotic symptoms, Dr. Woodberry hopes to identify whether youth with psychotic symptoms experience greater mood variability than their non-psychotic peers, and whether mood variability predicts psychotic symptoms or thoughts of self-harm. This project is a preliminary step in a line of research examining the interaction of mood and psychosis and identifying patterns or sequences that can predict critical events such as suicide attempts during the early course of major mental illness. Early course symptom dynamics are also expected to inform our understanding of illness progression and help develop novel interventions to interrupt pathological sequences and improve functional outcomes.

This project is one arm of a broader effort to build on Maine Medical Center’s leadership role in Early Intervention in Psychosis, initiated through the nationally-recognized Portland Identification and Early Referral (PIER) Program, pioneered by Dr. William McFarland. Dr Woodberry is working closely with PIER Clinical Director, Sarah Lynch, Drs. Doug Robbins and Susan Santangelo, and Maine Health leadership to build a regional Center of Excellence focused on early psychosis research, training, and coordinated specialty care.

Dr. Woodberry’s Research and Profile:  Read More

Exploring the Effects of Earthquakes in Nepal

On April 25, 2015 a magnitude 7.8 earthquake struck Nepal, killing more than 8,000 people and injuring over 21,000.  As a result, hundreds of thousands of Nepalese were homeless and entire villages were flattened in many areas.  Complicating matters, on May 12, 2015 the largest aftershock occurred (magnitude of 7.4) followed minutes later by a magnitude 6.3 shock.  More than 450,000 people were displaced overall.

The horrific effects of earthquakes go far beyond immediate physical destruction.  It is difficult to imagine the losses both physical and mental that can occur during such devastation. Until now there was limited knowledge regarding post-disaster psychopathology, and even mental health in general in the Nepali population. Through internal funding, Susan Santangelo, the Director of the Center for Psychiatric Research at MMCRI, was able to launch the Nepal PTSD Project in March 2016.

“The goals of the project are to determine the prevalence of PTSD, depression, resilience and factors associated with event impact among earthquake survivors,” says Santangelo. “In addition, we trained college students in Skills for Psychological Recovery (SPR) to enable the students to train villagers to ultimately help each other.”

As of 2019, the research team is currently analyzing data to determine the impact of teaching skills for psychological recovery to the villagers.  They have just published a paper with another one under review. The published paper is:

Schwind, JS; Formby, CS; Santangelo, SL; Norman, SA; Brown, R; Hoffmann-Frances, R; Koss, E; Karmacharya, D. Earthquake Exposures and Mental Health Outcomes in Children and Adolescents from Phulpingdanda Village, Nepal: A Cross-Sectional Study. Child Adolesc Psychiatry Ment Health. 2018 Dec 20;12:54. doi: 10.1186/s13034-018-0257-9. PMID: 30598695

Above:  Maine Behavioral Healthcare Trauma experts, Rebecca Hoffman-Frances and Rebecca Brown, lead discussion of earthquake aftermath with school children. Below:  A destroyed home in Nepal and Nepalese family outside their temporary home.

Research Spotlights


Rebecca Hoffmann-Frances, LMFT

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Sandra Fritsch, MD

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