|"Researchers at Zucker Hillside Hospital have tried to explore those grey areas in psychiatry, many people are reluctant to talk about, ECT, Clozapine, first episode psychosis being few of them."
-Sohag Sanghani, 2nd year Resident
The Zucker Hillside Hospital has a long history of research productivity and excellence. The Research Division is led by Anila Malhotra, M.D. and includes a faculty of 14 MD/PhDs, level investigators and approximately 60 part-time and full-time Masters level and support staff. The Research Division’s primary facility is the Leon Lowenstein Research Building, which includes offices, testing laboratories, a video studio and a dedicated Research Clinic. The hospital is an ideal setting for clinical psychiatry investigations because of its large and varied patient population and its extensive array of clinical programs. A majority of our patients are local residents, which facilitates engaging family members in providing background data well as in participating in other aspects of research. The treatment setting provides high quality clinical care for both inpatients and outpatients. The very highly trained professional staff is an excellent source of clinical observation data which can often enhance research assessments. As the lead psychiatric facility of the North Shore Long Island Jewish Health System (NSLIJ), investigators at The Zucker Hillside Hospital can also collaborate with other institutions in the network to extend these patient resources. Moreover, the Research Division is a leading Center within the Feinstein Institute of Medical Research, the research component of the NSLIJ Health System.
Zucker Hillside has been the site of a National Institute of Mental Health (NIMH)-funded Research Center in Schizophrenia (PI: John Kane, M.D.) for over 20 years. The Center provides infrastructure support that enables its investigators to compete successfully for federal and foundation funds. In addition to the Center, Zucker Hillside Hospital has multiple ongoing projects funded by the NIMH, and also receives support from foundations and other sponsors. There are usually more than 50 active clinical studies at the hospital at any given time. These include investigations of schizophrenia, bipolar disorder, depression, anxiety disorders and tardive dyskinesia. Patients in these studies range from children at risk for illness to those with geriatric disorders. A major focus, deriving from the presence of two NIMH supported centers, is the study of patients with schizophrenia, covering all phases of the illness from the putative prodromal phase, through the first episode, to chronic patients who are refractory to Clozapine. Zucker Hillside may be unique in terms of its broad span of research activity in schizophrenia. The Zucker Hillside Hospital has recently received a $25 million contract from the NIMH for an innovative study entitled, “The Recovery After an Initial Schizophrenic Episode” (RAISE). Schizophrenia is a chronic debilitating illness that robs people of their lives. The goal of RAISE is to test the impact of the best available treatments with the anticipation that this will alter the course of the illness and allow patients to lead lives that have fulfilling careers and relationships.
Study designs include long-term naturalistic outcome designs, controlled pharmacological treatment trials and intensive cross-sectional biologic assessment protocols. One large-scale project provides long-term treatment and multi-dimensional assessment of patients experiencing their first episode of schizophrenia; neuro-imaging, pharmacogenetic and psychosocial assessments are employed. Another important area of study is severe mental illness in adolescence – represented by studies of adolescent bipolar disorder and refractory childhood schizophrenia. A Geropsychiatry group focuses on characterization and treatment of severe behavioral disturbances and depression in the elderly. Specialized assessment methods include neuropsychology, psychophysiology and brain imaging using magnetic resonance imaging and positron emission tomography. A major area of focus is the use of molecular genetic approaches to understanding psychiatric illness and response to medication treatment.
The Research Division offers a Research Resident Track in Translational Psychiatry, emphasizing clinical, molecular and biological approaches to the heterogeneity of psychiatric disorders. The research track incorporates direct involvement in research activities and a didactic program supervised by senior clinical investigators at the Zucker Hillside Hospital. Instruction in research methodology is provided through courses and supervision. Opportunities are available to work in the following specialized disciplines: clinical phenomenology including diagnosis and assessment, clinical psychopharmacology, neuropsychology, neuroimaging, positron emission tomography (PET) and magnetic resonance imaging (MRI), and molecular genetics. Dedicated research time is available beginning in the PGY-2 year with increasing amounts of research time throughout each subsequent year of the residency program. Previous research residents have successfully competed for grant funding and authored peer-reviewed publications in leading psychiatric journals.
All residents take courses in Research Methodology and Evidence Based Medicine. During the R-2 year residents participate in a weekly Research Diagnostic Consensus Conference and attend a three-day Clinical Trials Workshop. All four years of house staff participate in a Journal Club where residents are taught how to critically evaluate published psychiatric research. Although not mandatory, residents are provided with sufficient elective time to complete a research project. All residents are required to write a paper in publishable format. This may be a research study, a clinical case report, or a review article on a psychiatric topic. This paper is anonymously critiqued by three faculty member to help the resident make the paper more publishable. Many residents eventually have these papers published.
The resident program has a Research Track for selected residents who have a particular interest in pursuing a career in psychiatric research. These residents devote approximately one-third of their R-2 year and one-half of their R-3 and R-4 years to clinical research. The research residents have the opportunity to participate intensively in ongoing research projects, develop individual projects suitable for publication, receive specific instructions in research methods and preparation of grant applications. Moreover, research residents are provided with increased didactic experiences, including participation in research journal clubs and seminar series. Finally, research residents have the opportunity to present their data at national meetings.
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