Traumatic Stressors and PTSD

An experienced psychiatrist with a clinical focus on geriatric psychiatry, Dr. Robert Kohn earned his MD and completed his psychiatry residency at the University of Illinois in Chicago and Brown University, respectively. Dr. Robert Kohn has also conducted research on the rates and risk factors among adults and children for various conditions. His research in geriatric psychiatry has examined the rates of mental illness and its risk factors, including neuropsychiatric risk factors, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).

Exposure to stressful events can result in post-traumatic stress disorder (PTSD), a mental disorder characterized by reliving traumatic events through flashbacks and nightmares, and feelings of guilt, irritability, and isolation. PTSD is typically associated with traumatic stressors that are extremely severe and challenging to cope with, such as rape and combat. These experiences typically overwhelm an individual’s stress response system.

The likelihood of developing PTSD due to subsequent exposure to trauma is high when someone has already experienced a traumatic event. Vulnerability is particularly high when the pathological mechanisms of PTSD manifest before the later stressor. If an individual has experienced a traumatic event but has not developed signs or symptoms of PTSD, this demonstrates that they have successfully managed the previous experience from a psychological perspective and are less likely to develop PTSD if they undergo a similar event later. Most people achieve this by seeking mental health support and modifying their daily routines and lifestyle.

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APA Lauds the Passage of the Consolidated Appropriations Act of 2023

A geriatric psychiatrist, educator, and researcher, Robert Kohn, MD, treats older patients with intellectual and developmental disorders. A recognized presence in the medical profession, Dr. Kohn serves as a temporary advisor to Pan American Health Organization/World Health Organization (PAHO/WHO). Dr. Robert Kohn maintains membership in the American Psychiatric Association (APA), where he is also a distinguished Fellow.

APA is a premier psychiatric association that promotes equitable access to the best available healthcare for people with mental disorders and substance disorders. APA’s advocacy includes working with Congress on the passage of significant bills that affect the practice of psychiatry.

APA lauded the passage of the Consolidated Appropriations Act of 2023, which provides for a $1.7 trillion omnibus package, including investments in the psychiatric workforce, enforcement of mental health parity, and collaborative care. The bill was signed by President Joe Biden on December 29, 2022. APA has advocated heavily for the passage of this bill.

Under the bill, 200 new graduate medical education residency slots will be created. Half of these positions are designated for psychiatry and its subspecialties. The bill will also enforce the Mental Health Parity and Addiction Equity Act of 2008 by granting funds to state insurers. The bill also provides funds for grants and technical assistance for the enforcement of the Collaborative Care Model in primary care settings, thereby increasing early intervention for treatment or prevention of mental and substance use disorders.

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Extrapyramidal Symptoms of Antipsychotic Medications

A resident of Providence, Rhode Island, Dr. Robert Kohn is a geriatric psychiatrist who draws on more than four decades of experience in his field. With an MD from the University of Illinois Chicago, Dr. Robert Kohn is also well-versed in family therapy and psychotherapy.

Antipsychotics, a group of psychiatric medications, are used for treating psychosis, which is associated with mental disorders like schizophrenia, bipolar disorder, and personality disorder, among others. Sometimes, these medications can cause serious side effects called extrapyramidal symptoms.

Extrapyramidal symptoms are triggered by a reduction in the level of a chemical called dopamine in the central nervous system. Extrapyramidal symptoms can manifest as acute or tardive dyskinesias (characterized by erratic muscle spasms in the face and limbs), akinesia (loss of ability to voluntarily move certain muscles in the face, hands, legs, or other areas), and neuroleptic malignant syndrome (characterized by fever, dysautonomia, body rigidity, and mental status change), among other similar symptoms.

Extrapyramidal symptoms sometimes stem from non-antipsychotic drugs. Clinicians must identify the exact cause of the symptoms to determine the appropriate treatment.

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Cogwheel Rigidity in Patients with Psychiatric disabilities.

The recipient of an MD from the University of Illinois College of Medicine in Chicago, Dr. Robert Kohn is a respected psychiatrist who has been in practice for more than four decades. Dr. Robert Kohn owns and operates a private practice in Providence, Rhode Island, where he treats adults with psychiatric disabilities.

Some patients suffering from psychiatric illnesses are vulnerable to the side effects of certain antipsychotic drugs, which are supposed to cure their symptoms. One of these side effects is cogwheel rigidity.

Also known as the cogwheel phenomenon or cogwheeling, cogwheel rigidity is characterized by involuntary stiffness of the muscles in the limbs. The hands are the most commonly affected. Doctors assess patients for cogwheel rigidity by extending and flexing their hands and legs at different speeds. Cogwheel rigidity may be present if a limb feels stiff and inflexible or causes discomfort during motion.

Cogwheel rigidity can be treated if the cause is known. Often, doctors prescribe dopamine agonists to help alleviate symptoms. Symptoms of cogwheel rigidity can also be managed through exercise, stretching, yoga therapy, and stress reduction.

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Assessing the Impact of Culture on Mental Health

Dr. Robert Kohn is a health care provider based in Providence, Rhode Island, with nearly forty years of experience and an MD. He is a consultant to the World Health Organization and the Pan-American Health Organization and a distinguished fellow of the American Psychiatric Association. With a primary specialty in psychiatry, Dr. Robert Kohn focused his academic work on geriatric psychiatry, global mental health, psychiatric epidemiology, and cultural psychiatry.

Cultural psychiatry is concerned with the interplay between cultural diversity and mental health services. There are various ways in which culture shapes and influences mental health.

Cultural or ethnic background influences the aid individuals receive from family and friends. It also impacts their access to therapy when they deal with mental health issues. Different ethnicities recognize stigmas shaping how their members embrace mental health services. In the United States, minorities also have limited access to health care providers.

Culture equally affects mental health access in the area of reporting. A health care provider may not be able to render the requisite care to minorities due to a lack of records of members who previously experienced the condition in question. This invariably affects the therapy sessions that follow.

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New Study Finds Yoga and CBT Helpful in Treating Worry in Older Adults

Dr. Robert Kohn, a physician specializing in geriatric psychiatry, is recognized in the profession. Robert Kohn, MD is a temporary advisor for the Pan American Health Organization/World Health Organization and an author of articles, papers, and presentations. Dr. Robert Kohn maintains his membership in various professional organizations such as the American Association for Geriatric Psychiatry (AAGP).

AAGP is a professional association with about 2,000 geriatric psychiatrists and allied health workers from the US, Canada, and other countries. Its mission is to promote the mental health of older adults through public advocacy, education, and career development of its members. its members can access its scientific journal, the American Journal of Geriatric Psychiatry, where its publications are published.

A new study published in the Journal contained an analysis of secondary data on the long-term effects of yoga and cognitive-behavioral therapy (CBT) delivered by phone on worry, anxiety, depression, sleep disorders, fatigue, and social participation of older adults.

In the study, 500 community-dwelling adults aged 60 and above went through randomized preference trials which compared weekly CBT and bi-weekly yoga for treatment of worry. Six months after the interventions were completed, the participants reported that their baseline worry, anxiety, depression, sleep disorders, fatigue, and social participation have improved. The researchers concluded that yoga and CBT have long-term benefits for treating worry in older adults.

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APA Proposes New Model to Address Psychiatric Bed Crisis in the US

Geriatric psychiatrist Dr. Robert Kohn treats older patients with different intellectual and developmental disorders. Robert Kohn, MD has traveled to many countries as a researcher, scholarship grantee, and temporary advisor for the World Health Organization. Most of his studies abroad focused on psychiatric epidemiology, cultural psychiatry, and global mental health. Dr. Robert Kohn maintains his membership in the American Psychiatric Association (APA) where he is also a distinguished Fellow.

APA is a premier psychiatric association established to promote equitable access to the best available healthcare for all people with mental disorders and substance disorders. To further the rights and interests of patients in this regard, APA created the Presidential Task Force on Assessment of Psychiatric Bed Needs in the US in 2020 to assess the country’s growing psychiatric bed crisis.

In 2022, the Task Force completed its mission. Their report, entitled “Psychiatric Bed Acess in the US: Understanding the Problem and Moving Toward Solution,” was presented at the APA 2022 Annual Meeting in May. The report said that access to psychiatric beds has significantly declined in the past six decades. There is a notable absence of effective means, even at the community level, to measure how many beds are needed to meet the demands. Because of the lack of psychiatric inpatient beds, most patients are boarding in emergency rooms if not discharged prematurely. The social impacts of this crisis include homelessness and even incarceration.

To solve the problem, the Task Force proposes a new model for estimating the needs, including a means to inform community leaders and policymakers about appropriate capacity build-up. The model specified separate approaches for children and adolescents and adults. The model applies even to hypothetical “Anytown, US.”

The University of Michigan is the first to test the new model in its community. Led by the University’s Psychiatry Department, data are now being collected to be fed into the APA model. The University is optimistic that the APA model can help its community and the nation to address the lingering psychiatric bed crisis in the US.

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