David R McduffUniversity of Maryland Medical Center | UMMC · Department of Psychiatry
David R Mcduff
M.D.
About
69
Publications
31,718
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1,960
Citations
Citations since 2017
Introduction
Additional affiliations
May 1988 - present
University of Maryland School of Medicine, Baltimore, USA
Position
- Professor
Description
- Founding Director, Division of Alcohol & Drug Abuse & Addiction Psychiatry Fellowship Program Current Medical Director, Sports Psychiatry Program
Publications
Publications (69)
The misuse of certain substances including alcohol, cannabis, opioid pain medication, and prescribed and over-the-counter stimulants is more common in athletes in certain sports compared to the general population. Sports medicine and mental health providers will routinely encounter substance misuse and less often encounter substance use disorders i...
Objective:
We examined the prevalence of risky alcohol and cannabis use among Brazilian varsity college athletes and whether this group had a greater likelihood of risky use than non-athletes.
Methods:
In 2009, Brazilian college students (n=12,711) were recruited for a national stratified random survey. Their sociodemographic characteristics, me...
The pressure to gain mass, power, explosiveness, and endurance and to obtain a performance edge continues to a part of sports. Anabolic agents, including selective androgen receptor modulators along with peptides, hormones, and metabolic modulators, continues to evolve. Methods to promote transcription to modify gene expression are a part of the ev...
Background: Prior research indicates substance misuse is a prominent risk behavior among collegiate athletes. The authors sought to supplement this literature by expanding the number of substances typically examined and include mental health symptoms covariates related to both sleep and substance use.
Methods: We assessed substance use with the fol...
Objectives To develop an assessment and recognition tool to identify elite athletes at risk for mental health symptoms and disorders.
Methods We conducted narrative and systematic reviews about mental health symptoms and disorders in active and former elite athletes. The views of active and former elite athletes (N=360) on mental health symptoms in...
Objectives
To develop an assessment tool for the early identification of elite athletes potentially at risk for experiencing mental health symptoms and disorders
Stepwise approach
Firstly, narrative and systematic reviews of the scientific literature about mental health symptoms and disorders in active and former elite athletes were conducted. Seco...
Primary objective:
In this review, we detail the issues and disorders athletes present with, guidelines for making diagnostic formulations and treatment goals, and strategies for delivering integrated treatment attuned to the athlete and their team and/or sport. In addition, we highlight special issues associated with athletes and their families....
Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management o...
Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no...
Mental health emergencies require a rapid, effective response. We searched the literature on mental health emergencies in athletes and found five papers. None of these addressed elite athletes. Nonetheless, common mental health emergencies may present in the sports environment and may place the athlete and others at risk. Sports teams and organisat...
Attention-deficit/hyperactivity disorder (ADHD) is a common brain developmental disorder in the general population that may be even more prevalent in elite athletes in certain sports. General population studies of ADHD are extensive and have reported on prevalence, symptoms, therapeutic and adverse effects of treatment and new clinical and research...
Background
Substances from various classes may be used for recreational purposes, self-treatment or to boost performance. When substance use shifts from occasional to regular, heavy or hazardous use, positive and negative effects can develop that vary by substance class and athlete. Regular use of recreational or performance enhancing substances ca...
Opportunities to participate in gambling have dramatically changed during the past 20 years. Casinos have proliferated as have electronic gambling machines, lotteries, sports betting, and most recently online gambling. Gambling among the general population has moved from being perceived negatively to a socially acceptable pastime. As over 80% of in...
Background:
Athletes, like non-athletes, suffer from mental health symptoms and disorders that affect their lives and their performance. Psychotherapy, either as the sole treatment or combined with other nonpharmacological and pharmacological strategies, is a pivotal component of management of mental health symptoms and disorders in elite athletes....
Athletes and coaches at all competitive levels will utilize sports performance and psychiatric services at very high rates if the services are offered on-site and free of charge and are broad in scope and culturally sensitive. Services should be available throughout the team year and cover areas such as team building, mental preparation, stress con...
Athletic competition at higher levels can trigger persistent anxiety that interferes with performance and life balance. While some performance anxiety is expected, when anxiety’s cognitive and somatic symptoms become more severe, organized, and persistent and don’t respond to coaching/teammate support or mental training, then an evaluation for an a...
The world of sport is used to drawing on medical expertise to address the health needs of sportspeople and to support their recovery and return to sport. Whilst there is an established interface between most medical specialities and sport this has been slower to develop in relation to psychiatry. As it is becomes increasingly known that psychiatric...
An comprehensive overview of applied sports psychiatry by the long-term team psychiatrist and mental skills trainer for the Baltimore Orioles (1996-present) and Ravens (1996-2013) and current sports performance physician for the Indianapolis Colts (2015-present). The book contains 10 chapters & more than 150 case studies in key areas such as mental...
The authors review the literature on the high prevalence but underrecognition of substance abuse among hospitalized patients and the general unavailability of hospital-based substance abuse consultation services. They describe the development, clinical operations, staffing, and teaching activities of a large substance abuse consultation service in...
This study describes the creation, operation, patient characteristics, and outcomes of a new hospital-wide, trauma-recovery service in a Maryland state psychiatric hospital. We identified psychiatric admissions who had trauma, causing current distress. Our assessments included a structured clinical interview, the Trauma Symptom Checklist-40, and th...
Numerous reports document that preinjury alcohol use is associated with all modes of injury requiring treatment in a trauma center, with 25% to 50% or more of patients testing positive for alcohol at the time of admission. There is evidence that in trauma patients unaddressed alcohol use problems result in recurrent injury requiring readmission to...
Substance use is significantly associated with physical injury, yet relatively little is known about the prevalence of specific substance use disorders among trauma patients, or their associated sociodemographic characteristics. We evaluated these issues in an unselected sample of 1,118 adult inpatients at the University of Maryland Shock Trauma Ce...
One measure of a substance's addictive risk is the proportion of users who become dependent. This study evaluates the lifetime and current risk of substance dependence among lifetime substance users' among trauma inpatients and provides a relative ranking of addictive risk among the substances. Data on use of 8 substance groups (alcohol, opiates, m...
Athletes use substances to produce pleasure, relieve pain and stress, improve socialization, recover from injury, and enhance performance. Therefore, they use some substances in substantially higher rates that nonathletes. Despite these higher rates of use, rates of addiction may in fact be lower in athletes. This article reviews the prevalence and...
Elite professional and collegiate athletes underuse stress control, mental health, and substance abuse treatment services. Behavioral health services use can be increased by establishing on-site, sports-specific services. Like Employee Assistance Programs of industry and government, Team Assistance Programs (TAPs) address critical issues such as su...
The purpose of this study was to evaluate a 6-month outpatient program developed to improve abstinence and other health and social problems of heroin-addicted persons hospitalized in an urban academic medical center's medical or surgical unit and referred from the Substance Abuse Consult Service. Treatment intervention consisted of methadone therap...
Drinking pattern criteria (drinking frequency and number of drinks per occasion) issued by the National Institute on Alcohol and Abuse and Alcoholism (NIAAA) to screen primary practice patients for alcohol problems were evaluated in 1216 injured patients treated in a regional trauma center. Vehicular crash victims predominated (50.2%, of whom 64.5%...
Alcohol withdrawal is a serious complication of heavy alcohol use and a condition requiring patient stabilization before initiating surgery or implementing lifesaving procedures for injury. Intravenous ethanol (IVE) is used to prevent withdrawal during these maneuvers. This report explores the use and potential problems of this practice in an acade...
A structured in-depth interview employing standardized criteria was used to determine the prevalence of lifetime and current alcohol dependence (alcoholism) in unselected consecutive patients admitted to a regional Level I trauma center. Of 629 patients, 157 (25.0%) were current alcoholics at the time of injury. An additional 87 (13.8%) were diagno...
Objective: To evaluate the accuracy of questionnaire screening instruments to identify lifetime alcohol dependence among trauma center patients.
Methods: The study was conducted at a Level I trauma center between September 1994 and November 1996. Patients meeting eligibility requirements (>or=to18 years old, admission from injury scene, >or=to2 day...
To assess the prevalence of psychoactive substance use disorders (PSUDs) among a large, unselected group of seriously injured trauma center patients, using a standardized diagnostic interview and criteria.
Prevalence study.
A level I regional trauma center.
Trauma center patients fulfilling the following criteria were eligible subjects: aged 18 yea...
Clinical reports and empirical studies published in the past 12 months are beginning to validate the effectiveness of different types of psychotherapy for substance abuse treatment.New theoretical models and practice techniques are being applied and evaluated. Individual, group, and family therapy with some patient groups show initial and lasting t...
The authors review the literature on the high prevalence but underrecognition of substance abuse among hospitalized patients and the general unavailability of hospital-based substance abuse consultation services. They describe the development, clinical operations, staffing, and teaching activities of a large substance abuse consultation service in...
Employee assistance programs have developed from alcoholism assessment and referral centers to specialized behavioral health programs. Comprehensive employee assistance programs are defined by six major components: identification of problems based on job performance, consultation with supervisors, constructive confrontation, evaluation and referral...
Physicians and other health care providers have multiple opportunities in the course of a typical practice year to identify and treat individuals who abuse alcohol and other drugs. Although substance abuse is very common in clinical practice, providers routinely fail to intervene in a timely fashion due to negative attitudes, incomplete knowledge,...
Physicians can play a critical role in influencing patients to seek appropriate treatment for alcoholism and drug dependence. These illnesses are characterized by denial, which may prevent patients from seeking treatment on their own. This article discusses the role of the family in intervening with chemically dependent patients. It is important to...
Physician impairment contributes to patient morbidity, malpractice claims, physician license loss and suicide. This paper describes four years of experience of the University of Maryland's Professional Assistance Committee. The committee is composed of medical staff members. Its mission is to help impaired physicians obtain assessment, treatment an...
The frequent co-occurrence of mental and substance use disorders ("dual diagnosis") has created a role for addiction-trained psychiatric consultants in drug and alcohol treatment programs. The complex treatment needs of the dually diagnosed required that the consultant psychiatrist have knowledge about the existing treatment models of chemical depe...
Benzodiazepines are used by a substantial minority of opioid addicts on methadone maintenance. Alprazolam, now the most widely prescribed benzodiazepine in the United States, appears to have supplanted diazepam as the benzodiazepine drug of choice in this population. Its greater addiction liability, shorter half-life, and more intense withdrawal sy...
During the Persian Gulf War, the U.S. Army provided mental health care to soldiers using a model that emphasized the identification and management of factors associated with combat stress. Nonpathological labels, such as combat stress reaction, a non-hospital-based care delivery system, and simple interventions were used to promote return to duty....
Mental health clinicians have assumed a more important role in the release of individuals held hostage by international terrorists. The author uses his experiences during three hostage releases in the late 1980s--the Achille Lauro incident, the hijacking of Pan Am Flight 73 in Karachi, Pakistan, and the release of a single hostage from Beirut--to i...
The practice of assessing only trauma patients with elevated blood alcohol concentrations (BACs) or positive drug screens for psychoactive substance use disorders (PSUDs) was evaluated.
Twenty-four BAC-negative (BAC-) (BAC, 0) and 21 BAC-positive (BAC+) (BAC, greater than or equal to 22 mmol/L or 100 mg/dL; mean, 41 mmol/L; range, 24.3 to 79 mmol/L...
This paper presents a review of the current literature on hospital professional assistance committees, a discussion of key issues, and a set of guidelines for the design and operation of these committees. The employee assistance program is suggested as a resource to these committees.
This preliminary clinical report describes the usefulness of brief individual psychotherapy as a technique to engage relapse-prone substance abusers in addiction treatment. The authors propose that Mann's model of brief psychotherapy in the context of Brown's developmental model of recovery can be used during the early stages of recovery to improve...
Primary care physicians prescribe benzodiazepines for the treatment of anxiety. Although most patients use the benzodiazepines appropriately, some patients experience benzodiazepine abuse, addiction, or physical dependence, each one of which is a distinct syndrome. Benzodiazepine dependence, which relates to the development of tolerance and an abst...
Primary care physicians routinely treat patients with various anxiety disorders. These patients may have a substance use disorder or may be at high risk for abuse or addiction. Routine treatment of anxiety disorders with psychoactive drugs is successful in many patients, but it can lead to iatrogenic dependence in high-risk patients. This article d...
Primary care physicians encounter many patients with primary and secondary anxiety and substance use problems. Some patients have a dual diagnosis of both an anxiety and a substance use disorder. Symptoms may be overdiagnosed, underdiagnosed, and misdiagnosed. This article provides the primary care physician with an overview of the relation between...
Projects
Projects (3)
https://www.athletetransitionstudy.com/
Understanding the retirement and life experiences of retired collegiate, professional, and national/Olympic athletes.
Understanding the retirement and life experiences of retired collegiate, professional, and national/Olympic athletes. Our goals are to understand: (1) Elite athletes quality of life during and after retirement;
(2) Factors contributing to various retirement outcomes;
(3) Who, what, and how athletes are best supported (if they are supported); & (4) What athletes experience as they adjust to their retirement. Go to www.athletetransitionstudy.com
Description of the scope of practice and typical types of cases encountered by on site psychiatrists and psychologists working with college and pro sports teams.
