Douglas Ziedonis

University of California, San Diego | UCSD · Department of Psychiatry

Objective : Perinatal depression is a common pregnancy complication and universal screening is recommended. The Practice Readiness to Evaluate and address Perinatal Depression (PREPD) was developed to measure obstetric practice readiness to integrate depression care into workflows. Objectives were to describe: (1) the PREPD; (2) associated characte...

Background: Individuals with comorbid opioid addiction and pain (COAP) relapse 3–5 times more often than patients with opioid use disorder (OUD) but without pain. However, psychophysiological responses to pain among a COAP population are unknown. Objectives: We hypothesized that those on Medications for Opioid Use Disorder (MOUD) with chronic pain,...

Background: Depression and anxiety have been recognized as independent risk factors for both the development and prognosis of cardiovascular (CV) diseases (CVD). The Systematic Coronary Risk Evaluation (SCORE) function measures the 10-year risk of a fatal CVD and is a crucial tool for guiding CV patient management. This study is the first in Latvia...

Purpose: The present study sought to examine the diagnosis and treatment of mental disorders comparing Asian American (AA) and non-Hispanic Whites (WNH) drawn from a population accessing a large general hospital for any reason. Socio-demographic predictors of diagnosis and treatment were also explored. Methods: Data were obtained from de-identif...

Background: Opioids have been prescribed and used for chronic noncancer pain at prolific rates in the United States during the past 2 decades. Patients who transition to incident chronic opioid therapy are at increased risk for significant negative health consequences, including cardiovascular risk, endocrine disorders, opioid use disorder, and de...

Background Korean Americans are known for a high smoking prevalence within the Asian American population. This study examined the effects of acculturation and depression on Korean Americans’ smoking cessation and abstinence. Methods This is a secondary data analysis of a smoking cessation study that implemented eight weekly individualized counseli...

Significance: About 50% of young adults with schizophrenia, bipolar disorder, and other severe mental illnesses smoke tobacco, but few studies have evaluated interventions for this group. Methods: We conducted a randomized pilot study among 58 young adult smokers with severe mental illnesses comparing a brief interactive web-based motivational t...

Purpose: This pilot study was designed to inform a larger effectiveness trial by: (1) assessing the feasibility of the PRogram In Support of Moms (PRISM) and our study procedures; and, (2) determining the extent to which PRISM as compared to an active comparison group, the Massachusetts Child Access Psychiatry Program (MCPAP) for Moms alone, improv...

Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as “heat-not-burn” tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention option...

Over 50 million people around the world suffer from schizophrenia, a severe mental illness characterized by misinterpretation of reality. Although the exact causes of schizophrenia are still unknown, studies have indicated that inflammation and oxidative stress may play an important role in the etiology of the disease. Pro-inflammatory cytokines ar...

Conducting semi-structured American Sign Language interviews with 17 Deaf trauma survivors, this pilot study explored Deaf individuals’ trauma experiences and whether these experiences generally align with trauma in the hearing population. Most commonly reported traumas were physical assault, sudden unexpected deaths, and “other” very stressful eve...

Little is known about patients’ electronic cigarette use, interest in and use of smoking cessation treatments, and providers’ attitude towards such treatment. We assessed patients (N = 231) and providers (45 psychiatrists, 97 case workers) in four Community Mental Health Centers. Interestingly, 50% of smokers reported interest in using electronic c...

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility during the design of study methodology. To inform such considerations, we conducted an exploratory secondary analysis of a mixed-methods study that originally explored 16 Deaf trauma survivors' he...

Objective: Deaf trauma survivors are one of the more underserved populations in behavioral health care and experience significant obstacles to seeking help. Repeated encounters with these barriers fuel negative perceptions and avoidance of behavioral health treatment. The current study sought to explore Deaf trauma survivors' help-seeking experien...

Dignity has been described as ‘the inherent and inalienable worth of all human beings irrespective of social status such as race, gender, physical or mental state. Dignity is, therefore, at the core of psychological well-being, social connection and humanity. Mental health interventions that explicitly promote and preserve dignity for people experi...

Open Dialogue (OD) is a Finnish approach to crisis intervention and ongoing care for young people experiencing psychosis and other psychiatric crises. OD engages the individual and family (or other supports) in meetings, with open discussions of all aspects of the clinical situation, and in decision making. Although psychiatric assessment and treat...

Introduction Korean women are reluctant to pursue in-person smoking cessation treatment due to stigma attached to women smokers and prefer treatment such as telephone and online smoking cessation programs that they can access secretively at home. However, there is some evidence that face-to-face interaction is the most helpful intervention componen...

Most women with perinatal depression do not receive depression treatment. The authors describe the development and beta testing of a new program, PRogram In Support of Moms (PRISM), to improve treatment of perinatal depression in obstetric practices. A multidisciplinary work group of seven perinatal and behavioral health professionals was convened...

Tobacco use disorders (TUDs) continue to be overly represented in patients treated in mental health and addiction treatment settings. It is the most common substance use disorder (SUD) and the leading cause of health disparities and increased morbidity/mortality amongst individuals with a psychiatric disorder. There are seven Food and Drug Administ...

The Deaf community - a minority group of 500,000 Americans who use American Sign Language (ASL) - experiences trauma and addiction at rates double to the general population. Yet, there are no evidence-based treatments that have been evaluated to treat trauma, addiction, or other behavioral health conditions among Deaf people. Current evidence-based...

Details about Deaf people’s pattern of posttraumatic stress disorder (PTSD) symptoms remain relatively unknown due to inaccessible methods used in most epidemiological research. We conducted semi-structured American Sign Language interviews with 16 trauma-exposed Deaf individuals to explore their PTSD symptom patterns. Half met criteria for current...

This webinar discusses motivation-based, recovery-oriented treatment plans for co-occurring disorders, including community resources. It describes how to integrate recovery practices such as dual recovery therapy, mindfulness-based interventions, and Open Dialogue into mental health and addiction treatment settings.

OBJECTIVE: To examine a wide range of study designs and outcomes to estimate the extent to which interventions in outpatient perinatal care settings are associated with an increase in the uptake of depression care. DATA SOURCES: PubMed, CINAHL, PsycINFO, ClinicalTrials.gov, and Scopus (EMBASE) were searched for studies published between 1999 and 20...

There are many opportunities for clinicians and leaders in mental health and addiction treatment programs to champion more discussion about wellness and integrate evidence-based treatments that can decrease patient morbidity and mortality. However, many clinicians and staff may not feel trained and prepared to help individuals adequately address we...

Background and Aims—Growing evidence suggests abnormalities in brain morphology including hippocampal structure in patients with methamphetamine (MA) dependence. Yet little is known about the possible gender difference. This study was performed to examine hippocampal volume in abstinent male and female MA users, and to further explore its relations...

To evaluate the feasibility of Addressing Tobaccos through Organizational Change (ATTOC) intervention to Chinese psychiatric patients, and to better address tobacco use through the ATTOC intervention model in the context of China. The study was conducted in Mental Health Center of West China Hospital in 2010. A total of 100 hospitalized psychiatric...

Tobacco use disorder is the most common substance use disorder among individuals with any other psychiatric disorder, resulting in enormous health disparities, shorter lifespan, increased suicide risk, and reduced quality of life compared with others, due in part to general medical conditions caused or worsened by tobacco use. Tobacco use can have...

A video exploring how to engage the deaf community in behavioral health research.

Dysconnectivity between key brain systems has been hypothesized to underlie the pathophysiology of schizophrenia. The present study examined the pattern of functional dysconnectivity across whole-brain neural networks in 121 first-episode, treatment-naïve patients with schizophrenia by using resting-state functional magnetic resonance imaging (rsfM...

Tobacco use and tobacco-related disorders and smoking are two to three times more common in individuals with psychiatric and other substance-related and addictive disorders than in the general population. Social and behavioral factors are important in understanding addiction to tobacco, and psychiatric and addictive comorbidity. There are differenc...

Objective: Veterans with PTSD smoke at rates two to three times higher than the general population, while their quit rate is less than half that of the general population. The present study evaluated the feasibility, acceptability, and preliminary efficacy of Acceptance and Commitment Therapy for Veterans With Posttraumatic Stress Disorder (PTSD)...

Introduction: This study examined factors predicting nicotine withdrawal symptoms following quitting among Korean American smokers who were receiving counseling and nicotine replacement therapy. Methods: The sample comprised 90 Korean American smokers selected from a two-arm randomised controlled trial of a smoking cessation intervention (culturall...

Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is common, affects multiple domains of functioning, and presents complex challenges to recovery. Initial research indicates that individuals with physical disabilities experience higher rates of lifetime trauma and PTSD, and exhibit more severe SUD compared to non-di...

Objectives. The present study was to examine the relationship between serum levels of prolactin and the inflammatory status in drug-naive, first-episode schizophrenia patients with normal weight. Methods. Patients with normal weight, drug-naive, first-episode schizophrenia and healthy controls were enrolled in the study. Serum levels of prolactin (...

Korean men and women have the highest current smoking rates across all Asian ethnic subgroups in the United States. This is a 2-arm randomized controlled study of a culturally adapted smoking cessation intervention. The experimental condition received eight weekly 40-min individualized counseling sessions that incorporated Korean-specific cultural...

IntroductionPerturbations in neural function provoked by a drug are thought to induce neural adaptations, which, in the absence of the drug, give rise to withdrawal symptoms. Previously published structural data from this study indicated that the progressive development of physical dependence is associated with increasing density of white matter tr...

Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) affects multiple domains of functioning and presents complex challenges to recovery. Using data from the National Comorbidity Study Replication, a national epidemiological study of mental disorders (weighted N = 4,883), the current study sought to determine the preva...

Objective: This study examined gender, ethnicity and psychological factors associated with alcohol problems among Asian American college students, using the CAGE questionnaire. Method: The study is a cross-sectional, school-based survey. College students who self-identified as Asian, participated. Results: The sample comprised 258 Asian American co...

Occupational stress and burnout adversely impacts mental health care staff well-being and patient outcomes. Mindfulness training reduces staff stress and may improve patient care. However, few studies explore mental health setting implementation. This qualitative study used focus groups to evaluate stakeholders’ perceptions of organizational factor...

The present study aimed to examine the changes in pro-inflammatory cytokines and body weight during 6-month risperidone treatment in drug naïve, first-episode schizophrenia. Sixty-two drug naïve, first-episode schizophrenia (SZ group) and 60 healthy individuals (control group) were enrolled in the study. Serum interleukin-1β (IL-1β), interleukin-6...

This study examined gender differences in smoking and quitting among individuals diagnosed with schizophrenia in Korea. In addition, the study investigated differences in caffeine use by gender and smoking status. An anonymous self-report survey was conducted with psychiatric inpatients. Compared to males, females were less likely to be current smo...

Unlabelled: This is the first study of Korean Americans' smoking behavior using a topography device. Korean American men smoke at higher rates than the general U.S. Population: Korean American and White men were compared based on standard tobacco assessment and smoking topography measures. They smoked their preferred brand of cigarettes ad libit...

The study was to examine the levels of adiponectin (APN) and other cytokines, and body metabolism in drug naïve, first episode schizophrenia patients with normal weight. Ninety-six drug naïve, first episode schizophrenia patients with normal weight (SZ group), 60 healthy individuals with normal weight (control group), and 60 overweight or obese but...

The tobacco withdrawal syndrome indicates the development of neurophysiologic dependence. Clinical evidence indicates that neurophysiologic dependence develops through a set sequence of symptom presentation that can be assessed with a new 3-item survey measure of wanting, craving, and needing tobacco, the Level of Physical Dependence (PD). This stu...

This preliminary study is the first to identify mothers' perspectives on barriers and facilitators to addressing postpartum depression (PPD) in pediatric settings. We conducted four 90-min focus groups with women (n = 27) who self-identified a history of perinatal depression and/or emotional complications. Barriers reported included stigma and fear...

This study compared characteristics of Korean American men in two studies: a telephone survey with a random sample of Korean American men who reported daily smoking versus a smoking cessation clinical trial with a convenience sample of Korean American men who reported smoking at least 10 cigarettes a day. Guided by the Theory of Planned Behavior (T...

Studies have demonstrated moderate correlations between fractional anisotropy (FA, a measure of white matter organization), and Fagerström Test for Nicotine Dependence (FTND) scores in various white matter brain structures (r=-.52 to -.64). FA increases with smoking in adolescents, but in adult smokers FA declines with the progression of physical d...

Background: Perinatal depression is common and can cause suffering for mother, fetus/child and family. The perinatal period is an ideal time to detect and treat depression due to regular contact between mothers and health professionals. Despite the opportune time and setting, depression is under-diagnosed and under-treated in the obstetric setting....

Veterans with posttraumatic stress disorder (PTSD) have high rates of smoking and significant difficulties with quitting. Acceptance and mindfulness-based techniques may enhance smoking cessation approaches for veterans with PTSD as they are designed to improve emotion regulation skills related to coping with elevated negative affect and withdrawal...

Across the U.S., there is a paucity of mental health and substance abuse services for Deaf individuals. Without the availability of communication accommodations and specialized clinical expertise, Deaf individuals seeking behavioral health services contend with access limitations, misdiagnoses, and superficial treatments. Moreover, while the assess...

Objective: This study examined whether rulers of importance, readiness and confidence (IRC) in quitting smoking could be used to identify subgroups of smokers, with the future goal of potentially tailoring interventions to specific readiness profiles. Methods: Consecutive emergency department patients ≥18 years old were considered for enrolment. Pa...

Open Dialogue is a recovery-oriented psychosocial approach that has been found to be effective with persons in acute psychiatric crisis. Drs. Douglas Ziedonis and Mary Olson are leading a multi-disciplinary team at the University of Massachusetts Medical School / UMass Memorial Health Care to develop implementation tools (manuals, fidelity scales,...

Objective: To identify core barriers and facilitators to addressing perinatal depression and review clinical, programmatic, and system level interventions that may optimize perinatal depression treatment. Method: Eighty-four MEDLINE/PubMed searches were conducted using the terms perinatal depression, postpartum depression, antenatal depression,...

Objective: To explore perinatal health care professionals’ perspectives on barriers and facilitators to addressing perinatal depression. Background: Perinatal depression is common and associated with deleterious effects on mother, foetus, child and family. Although the regular contact between mothers and perinatal health care professionals may mak...

This is the first study evaluating obstetrics and gynecology (OB/Gyn) provider and staff perceptions of barriers to accessing pharmacotherapy for perinatal depression outside the obstetric setting. Four, 90 min focus groups were conducted with OB/Gyn physicians, advance practice nurses, and support and nursing staff (n = 28). Data were analyzed wit...

This pilot feasibility study examined the role of genetics in laboratory-induced cocaine craving. Thirty-four African American, cocaine-depend- ent male subjects underwent a baseline assessment, cue-exposure session, and genetic analysis. Subjects were classified as either cue-reactive or nonreactive. Among single nucleotide polymorphism markers in...

Introduction: This study was conducted to compare gender differences in the psychometric properties of the Fagerström Test for Nicotine Dependence (FTND). Methods: The sample comprised 334 Korean immigrants (97 women and 237 men) who reported daily smoking for the past 6 months. Item-by-item responses and exploratory factor analyses (EFA) were com...

Objectives: This pilot study examined the feasibility, preliminary efficacy, and determined the effect sizes of external qigong therapy (EQT) in reducing cue-elicited cocaine craving and associated symptoms among recently abstinent cocaine-dependent (CD) individuals. Methods: This study randomized 101 CD subjects to either a real EQT (n=51) or s...

We review the current systems of health care delivery for the treatment of substance use disorders and examine the expansion of addiction treatment to include new methods and settings, supported by changing technology, new financing/payment mechanisms, and expanded information management processes. We examine 3 subsets of patients who should be abl...

Introduction: The study examined gender differences in smoking and factors associated with three stages of readiness to quit smoking (precontemplation with no quit intention in the next 6 months, contemplation with a quit intention in the next 6 months but not in the next month, and preparation with a quit intention in the next month) among Korean...

Nicotine dependence continues to be the single most preventable cause of morbidity and mortality in China and the United States. While evidence-based treatments exist, these interventions are only recently beginning to be integrated into routine clinical psychiatric practice in China. This is the first report of an organizational change interventio...

Objective: People with severe mental illness (e.g., schizophrenia and severe mood disorders) are more likely to smoke tobacco and less likely to quit than the general population. Current recommendations for treatment combine evidence-based medications and behavioral interventions tailored to each individual's needs. One way to individualize treatme...

Introduction to the Special Issue on: Innovative Interventions for Treating Tobacco Addiction Among Persons With Co-occurring Mental Illness and Addiction: New Approaches to Improve Outcomes.

We assessed changes in smoking prevalence and other measures associated with the July 2008 New York Office of Alcoholism and Substance Abuse Services tobacco policy, which required that all publicly funded addiction treatment programs implement smoke-free grounds, have "no evidence" of smoking among staff, and make tobacco dependence treatment avai...

Many behavioral interventions, whether for the management of chronic pain, overeating, medication adherence, or substance abuse, are ineffective outside of the clinic or office environments in which they are taught. This lack of utility has spawned interest in enabling technologies that are capable of detecting changes in affective state that poten...

Overview of research on the experiences of women experiencing perinatal depression, with a focus on the value and importance of personal and professional relationships.

China has the highest number of tobacco smokers among the world's nations; however, no systematic review has been conducted of clinical trials on the efficacy of smoking cessation interventions in China. This paper summarizes findings of studies in order to compare the effect of pharmacotherapy, counseling, and Traditional Chinese Medicine (TCM) ap...

The Department of Housing and Urban Development – VA Supportive Housing (HUD-VASH) Program is a joint effort between HUD and VA to move Veterans and their families out of homelessness and into permanent housing. The HUD-VASH Resource Guide for Permanent Housing and Clinical Care was designed to provide case managers, and other who work with homeles...

Background Untreated perinatal depression is common and has deleterious effects on mother, fetus/child and family Despite effective evidence-based treatment for perinatal depression, most women do not get treatment Obstetricians have not traditionally identified and/or responded to the mental health needs of perinatal women Caring and committed pr...

The Clubhouse Model of Psychosocial Rehabilitation offers a variety of supports for members (individuals diagnosed with a Serious Mental Illness [SMI]) to help them recover and lead productive and satisfying lives. Clubhouse services include community-based employment, education, housing, outreach, advocacy, assistance with accessing health care, a...

Nicotine dependence is a psychiatric disorder characterized by a recurrent, periodic compulsion to use tobacco due to neurophysiological, psychological, and social factors. This disorder has behavioral and physiological characteristics that are similar to those of other addictions, but also unique aspects that require special attention because of i...

Treating comorbid pain (nonmalignant) and opioid addiction is a complex endeavor that requires cooperation of multi-modal treatment teams incorporating pharmacological, psychological, and social components. There are multiple barriers for patients, mental health practitioners, and physical health practitioners to provide complete treatment for this...

Smoking prevalence among persons in addiction treatment is 3-4 times higher than in the general population. However, treatment programs often report organizational barriers to providing tobacco-related services. This study assessed the effectiveness of a six month organizational change intervention, Addressing Tobacco Through Organizational Change...

Treating chronic pain in the context of opioid misuse can be very challenging. This paper explores the epidemiology and potential treatments for chronic pain and opioid misuse and identifies educational and regulation changes that may reduce diversion of opioid analgesics. We cover the epidemiology of chronic pain and aberrant opioid behaviors, psy...