Message from the Chairman

The Department of Psychiatry and Behavioral Sciences embraces and passionately pursues EVMS’ tripartite mission of “teaching, discovering, caring.”  Importantly, in order to accomplish these goals, our Department has adopted the best qualities of a “Learning Organization;” specifically, our faculty engages in lifelong continuous learning, accepting this as a professional responsibility.  While not abandoning its cultural traditions, humanistic ideals and the valuable historic contributions of psychodynamic and descriptive psychiatry nor wishing Psychiatry to become a “mindless” medical specialty, increasingly, we recognize that the current academic discipline of Psychiatry is grounded in Basic Neuroscience.  In fact, in many of its aspects, Psychiatry has become a translational discipline of clinical neuroscience.  Thus, the curriculum of the 21^st Century Psychiatrist must include scholarly consideration of embryology, functional neuroanatomy and clinical imaging of the central nervous system; molecular biology and genetics; neurochemistry; psychopharmacology; and cognitive neuroscience; in addition to traditional classes in descriptive psychiatry; nosology; psychodynamic psychiatry; and modalities of psychotherapy, among other areas.  Rigorous diagnostic assessment must be followed by treatment selection that is informed by an evidence base and, whenever possible, goals of treatment must include improvement of functional outcome, as opposed to an almost exclusive focus on attenuation of target symptom severity.  EVMS’ Department of Psychiatry and Behavioral Sciences strives to conduct innovative research and serve as a site for testing, adopting and disseminating novel diagnostic and therapeutic strategies, whose sole purposes are to recognize neuropsychiatric disorders more accurately and earlier in their course in order to exert a disease modifying influence that improves functional outcomes; there can be no other agendas. 

A paradigmatic example among several that could be chosen from within our Department that also reflects the school and department’s community orientation is its specialized program in Autism Spectrum Disorders (ASDs) for Older Adolescents and Young Adults.  For reasons that are not fully understood, the prevalence rates of ASDs are increasing.  Unfortunately, there is a paucity of critical services in the Tidewater-area and across the nation, which are also often poorly coordinated, for the population of persons with ASDs transitioning out of special education between the ages of 18 and 21 years; moreover, as young adults, these persons often lose eligibility and entitlement for a variety of medical, social and vocational services.  Because of the unmet needs of this large and growing underserved special population, EVMS faculty, under the direction and leadership of Dr. Maria R. Urbano, created a special program, whose ambitious agenda includes provision and coordination of direct clinical services; teaching and training; and preclinical and clinical research.  The existence of this program has catalyzed translational interests in genetics; identification of molecular treatment targets; and implementation of clinical trials of novel medication strategies.  Specifically, the ability of glycinergic interventions that target the N-methyl-D-aspartic acid (NMDA) receptor, an example of a glutamate-gated ion channel receptor, to improve sociability in a genetic mouse model of ASDs, and recent data showing that microdeletions of the locus that codes for the α7-nicotinic acetylcholine receptor subunit in the region of chromosome 15q13.3 are more frequent in referred samples of persons with ASDs led Dr. Urbano and her collaborators to begin exploring the safety, tolerability and efficacy of D-cycloserine, a partial glycine agonist, and galantamine, a positive allosteric modulator of nicotinic acetylcholine receptors and cholinesterase inhibitor, respectively, in our special population of older adolescents and young adults with ASDs.  Moreover, because cognitive control of emotion regulation is impaired in this special population that is often prone to temper outbursts, our faculty is engaged in psychotherapy research targeting impaired emotion regulation.  The examples are illustrative and chosen because they show how translational research activities are integral parts of a clinical program that was created to address unmet needs within our community. 

Return to Psychiatry Main Page