DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st, 2005
Submitted by Dr. M.L. Donnelly
Director, Division of Geriatric Psychiatry
UBC
1.
OVERVIEW
UBC and Vancouver have continued to attract fellows in Geriatric Psychiatry, as well as graduate
geriatric psychiatrists from across Canada (and the U.S.). The Division has grown to include 35
geriatric psychiatrists in the Lower Mainland. Our strengths continue to lie in our clinical work
and teaching. We also show strong leadership in administration and we are growing in our
research interests and activities.
We are fortunate to be able to work with Dr. John Kozac as research leader at Providence in Elder
Care. Several members of the Division will be collaborating with him on research projects in the
coming years. He is interested in interdisciplinary cross-sectoral research, which will improve
systems of care for seniors. We are also fortunate to have one of our own members, Dr. Elisabeth
Drance, working on improving care in nursing homes in B.C. Her work, as well as the Centre for
Personhood in Dementia at UBC will hopefully decrease the level of suffering of those with
dementing illness’ and improve the quality of their lives as well as their caregivers.
The Division of Geriatric Psychiatry also continues to lead education in ECT in BC and works to
improve ECT delivery and outcomes.
2.
EDUCATION
A. Undergraduate
Martha Donnelly:
Academic
Year
Sept, Oct,
Nov, Dec 04
Sept. Oct,
Nov. Dec 04
Oct 13, 04
Oct 25, 04
Jan 31 05
Audience
Number of
Attendees
IHHS
28
Nature
(lecture,
workshop,
tutorial)
Evening course
Medical
Student 1
Pharmacy #409
Pharmacy #409
FP 401
First Year
Medical
Students
8
Tutorial
75
75
177
Lecture
Lecture
Lecture
Topic
Interdisciplinary
course on aging
Clinical Skills
# hrs
39 hrs
27 hrs
Delirium/Dementia 2 hrs
Depression
1 hr
Introduction
to 3 hrs
Geriatrics
Rainer Persaud:
Supervised 8 medical students from September 2004 to August 2005 at UBC
Peter Chan:
- UBC Phase VI medical student seminar: Doctor-Patient Relations.
- UBC Medical Student Phase II: Delirium (Brain and Behaviour).
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DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
Harpreet Chauhan:
Two medical students for two week elective.
Hem Phaterpekar:
Supervised four medical students.
Stephen Kiraly:
Supervision of two third year medical students at West Side Mental Health Team.
Caroline Choo:
Teaching Diagnostic Formulation to UBC Psychiatry Residents and UBC Medical Students at
weekly formulations workshops at the Richmond Hospital.
B. Post Graduate
PGY III & IV Geriatric Psychiatry Lecture Series Organized by Dr. Caroline Gosselin
July 8th, 2004
Arvind Kang
Introductory Lecture: Physiologic Changes
Associated with Aging.
July 22nd, 2004
Peter Chan
Delirium
July 29th, 2004
Nirmal Kang
Depression in the Elderly.
August 12th, 2004
Martha Donnelly
Grief
September 2nd, 2004
Elisabeth Drance
Mental Health Challenges in the Nursing Home.
September 9th, 2004
Sheila Nolan
Psychotherapy in the Elderly.
September 16th, 2004
Peter Chan/
Caroline Gosselin
ECT in the Elderly - Part I
September 23rd, 2004
Peter Chan/
Caroline Gosselin
ECT in the Elderly - Part II
(Hands-on workshop)
October 14th, 2004
Michael Wilkins-Ho
Harpreet Chauhan
The Dementias - Part II
Diagnosis, Classification, Management
October 21st, 2004
Caroline Gosselin
Legal Issues and Course Evaluation
Martha Donnelly
Supervised two RIII Community Geriatrics Fellows for six months: Constant Leung October
2004 to April 2005 and Keith Spackman February 2004 to July 2004
Supervised twelve Family Practice Residents on Monday afternoon Teaching Clinics at GPOT
from July 1st, 2004 to July 1st, 2005
March 10th, 2005
RI Psychiatry (8): An Introduction to Geriatric Psychiatry 6 hours.
May 19th, 2005
RII, Family Practice (25): Competency 1 hour.
June 22nd, 2005
RII, Rural Family Practice (12): Geriatric Psychiatry 3 hours.
DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
3
Michael Passmore:
Supervised four residents in psychiatry from January 2005 to August 2005 and one Geriatric
Psychiatry Fellow.
Ranier Persaud:
Supervised psychiatry resident Dr. Mark Pattison June to October 2004
Developed and implemented a curriculum on Psychiatry for St. George’s University, Grenada
(nine lectures, two hours each).
Peter Chan:
- UBC 2nd Year Family Practice Geriatric Curriculum: Geriatric Depression
- UBC Resident Emergency Psychiatry (PGY-2): Geriatric Psychiatry in the ER.
Harpreet Chauhan:
Four residents in psychiatry and one geriatric medicine fellow supervision.
Mafalda Musacchio
- Supervised Geriatric Psychiatry Fellow at Riverview for three weeks.
- Supervised a psychology intern at Riverview.
- Supervised three rotating interns at Queen’s Park Hospital.
Hem Phaterpekar:
Supervised three psychiatry residents.
Stephen Kiraly:
- Supervision of psychiatry resident in the West Vancouver Mental Health Team.
- Introduction to Geriatric Psychiatry Phase IV - five hours.
Caroline Choo:
Teaching “Medication and Psychotherapy” to UBC Psychiatry PGY 2 residents as part of an
introduction to Psychotherapy lecture series
Kiran Rabheru:
- Madzia Klimek PGY5 psychiatry resident from the Memorial Elective June 2005
- Julie Nguyen – Family Practice Geriatrics Rotation July 2005
- Mary Grace Miraflor - Family Practice Geriatrics Rotation July 2005
- Sarah Thompson - Geriatric Psychiatry Fellow – Clinical and Academic
Supervisor February 2005 to present.
C. Conferences and Continuing Medical Education
Martha Donnelly:
September 7th, 2004
Grand Rounds
Division of Geriatric Psychiatry At Mount St. Joseph’s Hospital
‘The GPOT Shared Care Project”
Vancouver, B.C.
October 15th, 2004
“Care for Elders: An Interprofessional Modular Curriculum
for Geriatrics” – poster. Canadian Psychiatric Association
Montreal, Quebec
October 17th, 2004
Canadian Academy of Geriatric Psychiatry, Montreal, Quebec
DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
4
October 22nd, 2004
Canadian Association of Gerontology, Victoria, B.C.
November 27th, 2004
Canadian Family Medicine Forum, Toronto, Ontario
April 4th, 2005
“Addressing Gaps and Improving Care”
Transforming Dementia Care in B.C.
Vancouver, B.C.
May 14th, 2005
“Delirium, Dementia, Depression”
CABC Caregiver Forum
Vancouver, B.C.
June 6th, 2005
The Collaborative Geriatric Mental Health Toolkit and the Continuous
Enhancement of Quality Measures in Primary Mental Health Care
project at DIC Rounds, GPOT, Vancouver Hospital
June 10th-12th, 2005
“CCMHI Toolkit Project Special Population Seniors Working Group”
6th Nation Conference on Shared Mental Health Care, Ottawa
Bruce Patterson:
September 15th, 2004, October 4th, April 27th and May 25th, 2005
Four lectures to Vancouver City Police covering common presentations
of psychiatric illness in the elderly as they apply to the police.
Richard Monks:
October 16th, 2004
“Diagnosis and Treatment of Dementia”, presented at the North Island
Geriatrics Review, Campbell River, B.C.
April 23rd, 2005
“Vascular Dementia, the ‘Journey through the Aging Brain’”
Educational Day, Comox, B.C.
June 4th, 2005
“The use of the Geriatric psychiatry clinical examination in determining
fitness to drive.” Presented at the CanDRIVE Panel, Annual Meeting of
the BC Psychogeriatric Association, Comox, B.C.
July 13th, 2005
Speaker for Delirium Educational DVD created for Vancouver Island
Health Authority, filmed at Comox, B.C.
Michael Wilkins-Ho:
ECT Update Course: Emerging Directions for Patient Care 2005. Zen and the Art of Maintenance
ECT , University of British Columbia, Vancouver, B.C.
Electroconvulsive Therapy: A One-Day Practical Workshop for Clinicians 2005. In the Jaws of
the Black Dogs, Richmond General Hospital, Department of Psychiatry, Richmond, B.C.
Peter Chan:
Canadian Psychiatric Association Annual Meeting Full Day Course, “ECT In The New
Millennium:(Course Director). “ECT: Indications and Cognition” (Presenter). “ECT Devices”
(Seminar Leader), Montreal, Quebec, October 15th, 2004.
DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
5
Canadian Psychiatric Association Annual Meeting Symposium on Geriatric Anxiety Disorders,
“Diagnostic Issues in Geriatric Anxiety Disorders”(Lecturer), Montreal, Quebec, October 16th,
2004.
Ridge Meadows Hospital, Department of Psychiatry Grand Rounds, “An Update on ECT”, Maple
Ridge, B.C. November 18th, 2004.
VGH Geriatric Psychiatry Rounds, “Undue Influence” December 2004.
Richmond Hospital Department of Psychiatry Workshop, “ECT Indications, Risks, and
Evaluation” February 11th, 2005.
40th Annual Family Medicine Review UBC Division of CME Sponsored “Competency Issues in
Practice”, February 18th, 2005.
UBC Department of Psychiatry ECT Full Day Update Course (lecture and workshop), June 23rd,
2005.
Nirmal Kang:
Grant L. Iverson, Rael T. Lange, Carrie Strangway, Nirmal Kang. Measuring Outcome
from Electroconvulsive Therapy with the Riverview Psychiatric Inventory. Riverview Hospital &
University of British Columbia. Presented at the 66th annual convention of the Canadian
Psychological Association, June 2005, Montreal Quebec.
Karen Oldewening, Rael T. Lange, Sharon Willan, Carrie Strangeway, Nirmal Kang,
& Grant L. Iverson. Accepted for notification in ECT, 2005. Effects of an Education Training
Program on Attitudes to Electroconvulsive Therapy. Presented at the Canadian Psychological
Association annual conference, June 2005, Montreal Quebec
Les Sheldon:
Invited Lecture: Through the Looking Glass: Psychiatry, Delusions and Testamentary Capacity
BC Trial Lawyers Association.
Hem Phaterpekar:
November 3rd, 2005
Stephen Kiraly:
October 1st, 2004
Canadian Academy of Geriatric Psychiatry, poster, “Antidepressant
Induced Hypomania in Dementia Alzheimer’s Type: Case Report
The Healthy Brain Program, Summerhill Open House, North Vancouver.
December 30th, 2004
Brain Health and Mental Activity: The Neurology of Knowledge and
Wisdom. Creativity and Madness Symposium, AIMED, Maui, Hawaii.
February 14th, 2005
Optimizing Brian Health: Clinical Application of the Health Brain
Program. West Vancouver Community Health Retreat.
April 11th, 2005
The Health Brain Program in Clinical Practice: Optimizing Brain
Function. Department of Psychiatry, University of Manitoba, Winnipeg.
May 11th, 2005
Brain Health: Grade 10 Portfolio Day, Brackendale, B.C.
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DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
May 11th, 2005
Healthy Brain Program: Optimization of Brain Health. Cosat Garibaldi
Health, Squamish, B.C.
June 25th, 2005
Healthy Brain Program Seminars: 8 ways to help protect your brain from
aging and disease. Victoria Conference Centre, Victoria, B.C.
Kiran Rabheru:
January 2005
Royal College Exam Preparation Course for all Canadian Final Year
Psychiatry Residents; Geriatric Section – at University of Western
Ontario, London, Ontario: January 2005
March 3-6, 2005
Burhan AM, Rabheru K, Brinker J, Harloff K, Deutsch L: “ Elderly
Depressed on Maintenance Electroconvulsive Therapy (MECT): A Pilot
Study Evaluating Quality of Life and Cognitive Function”: Poster
Presented at American Association of Geriatric Psychiatry Annual
Meeting, San Diego
March 3-6, 2005
Black E, Ross T, Rabheru K, Obar L: “Risk Event Monitoring in a
Geriatric Psychiatry Population: A Four-Year Study”: Poster Presented at
American Association of Geriatric Psychiatry Annual Meeting, San
Diego
April 18th, 2005
Difficult & Interesting Rounds (DIC): “Behavioural Vital Signs”:
May 13th, 2005
The 39th. Annual Mackid Symposium titled “Psychiatric Challenges in
Primary Care: New Concepts Examined”, Calgary, Alberta
May 30th, 2005
(DIC) “Treatment Resistant Depression in the Elderly”
June 23rd, 2005
Mount St. Joseph’s and UBC “Electroconvulsive Therapy (ECT) Update
Course”
D. Fellowships
Michael Passmore:
September 2003 to September 2004
Susan Moore:
September 2003 to September 2004
Kelly French:
August 2004 to August 2005.
3.
RESEARCH
Martha Donnelly:
Granting Agency
Coalition for Health
Environments Research
Subject
$ Per Year
Reducing Nursing Errors
and Increasing Efficiency
Through Environmental
$30,000 US
Year
2005
Principle
Investigator
Habib
Chaudhury
CoInvestigator(s)
ConsultantMartha Donnelly
7
DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
CIHR
International Opportunity
Program
Alzheimer’s
Society/Canadian Nurses
Foundation/Nursing Care
partnerships of the
Canadian Health Services
Research Foundation.
CIHR Institute of Aging
and the CIHR Institute of
Gender and Health
Vancouver Coastal Health
Research
Design in Acute Care
Settings
Researching personhood
in dementia:
investigating
measurement issues
Support services,
personhood and dementia
care: exploring the
interface
Development of a
Resource efficient group
therapy program for older
adults with depression
$21,500
01/03/05 2/28/06
Deb
O’Connor
Co-Investigator Martha Donnelly
$ 50,605
(per year
for a total
of
$101,210)
2005-2007
Deb
O’Connor
Co-Investigator Martha Donnelly
$9,920
2005
Brad Hallam
Consultant Martha Donnelly
Richard Monks:
An outcome study on the impact of Occupational Therapy assessment on diagnostic
categorisation of a cohort of persons with Mild Cognitive Impairment - started in 2005.
Elisabeth Drance:
2004 - Primary Health Care Transition Fund Grant to Providence Health Care
Developing Physician Network for Residential Care.
Kelly French:
Kelly French, Arvind Kang, Rhonda Malyuk, Treatment of Behavioural and Psychiatric
Symptoms of Dementia: Lamotrigine of Little Benefit?
Michael Cooper:
June 20, 2004 - Study No. CL-758007. A Phase III Study of the Efficacy and Safety of Alzhemed
in Patients with Mild to Moderate Alzheimer’s disease. Neurochem Inc.(Sub Investigator)
July 20, 2004 - Trial No. PHE-REM-14. Investigation in a Naturalistic Setting of Patients
Initiated on Reminyl (INSPIRE). Janssen-Ortho Inc.(Principal Investigator)
Sept 9, 2004 - Study No. EFC2946. A randomized, multicenter, double blind, placebo-controlled,
18-month study of the efficacy of xaliproden in patients with mild-to-moderate dementia of the
Alzheimer’s type. Sanofi-Synthelabo. (Principal investigator)
Oct 12, 2004 - Study No. DRI5343. A dose-ranging, placebo-controlled study of SL65.0155-10 at
the doses of 0.5 mg, 2 mg, and 8 mg for 12 weeks in patients with mild-to-moderate Alzheimer
Disease. Sanofi –Synthelabo (Principal investigator)
4.
CLINICAL ACTIVITIES
New Members:
Dr. David Cohen, Richmond
Dr. Darren Thompson, Richmond
Dr. Kiran Rabheru, GPOT, Vancouver Hospital
DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
5.
8
OTHER DEVELOPMENTS
A. Board Activities
Martha Donnelly – Chair of the Board of the Canadian Academy of Geriatric Psychiatry
September 2004 forward.
Liz Drance – Member of the Board of CAGP.
Kiran Rabheru – Member of the Board of CAGP
B. Awards and Distinctions
Stephen Kiraly:
UBC - Excellence in Undergraduate Teaching Aware 2004.
Caroline Choo:
2005 -1st prize and also Best in Show prize: Art exhibit at American Psychiatric Association
Annual Meeting in Atlanta, Georgia for art piece collaboration “transformed by Nature” - On
trust and healing.
6.
PUBLICATIONS
Martha Donnelly:
Donnelly, M., “Behavioural and Psychological Disturbances in Alzheimer’s disease: Assessment
and Treatment” (2005) BC Medical Journal, 47(0):487-493
McGee, P., Tuokko, H., MacCourt, P., & Donnelly, M. (2004). Factors affecting the mental
health of older adults in rural and urban communities: An exploration. Canadian Journal of
Community Mental Health, 23(2), 117-126.
Richard Monks:
Monks, R.C., Somers, S., Schovanek, S., et al, Psychogeriatric Outreach Treatment, Can Psychiat
Assoc Bull, 36:4, 13-15, 2004.
Michael Passmore:
Passmore, M.J., Ingles, J. Fisk, J., Darvesh S. Disconnection of Language and Memory in
Semantic Dementia: A Comparative and Theoretical Analysis. Current Alzheimer Research (2):
435-448. 2005.
Ingles, J., Fisk, J., Passmore, M.J., Darvesh, S. Progressive Anomia without Semantic or
Phonological Impairment. Cortex (In Press).
Kang, N., Passmore, M.J. Successful ECT in a Patient with an Orbital Cavernous Hemangioma.
Journal of ECT, (4): 267-71. 2004.
Passmore, M.J., Devarajan, S., Ghatavi, K., Gardner, D.M., Kutcher, S.P. Serotonin Syndrome
with Prolonged Dysphagia (letter). Canadian Journal of Psychiatry. 49(1): 79-80, 2004
Michael Cooper:
B. Lynn Beattie, MD, FRCPC and Howard Feldman, MD, FRCPC. Treatment Efficacy in
Alzheimer Disease (TREAD) conference. BC Medical Journal. Volume 46, Number 7,
September 2004, page 344-347. I was a conference participant contributing to the data published
in this article.
DIVISION OF GERIATRIC PSYCHIATRY UBC
ANNUAL REPORT July 1st, 2004 - July 1st , 2005
9
Nirmal Kang:
Lange, R.T., Hopp, G., & Kang, N. (2004). Factor Analysis of the Neuropsychiatric InventoryNursing Home version in an Elderly Population. International Journal of Geriatric Psychiatry,
19, 440-448.
Iverson, G., Lange, R.T., Strangeway, C., & Kang, N. (2005). Measuring Outcome from
electroconvulsive Therapy with the Riverview Psychiatric Inventory. Canadian Psychology, 46
(2a), 75.
Lange, R.T., Strangeway, C., Oldewening, K., Willan, S., Kang, N., & Iverson, G. (2005) Effects
of Training and Experience on Attitudes to Electroconvulsive Therapy. Canadian Psychology, 46
(2a), 125.
Iverson, G., Lange, R.T., Strangeway, C., & Kang, N. (2004). A New Method for Monitoring
Outcome from ECT using the Anchored Version of the Brief Psychiatric Rating Scale (BPRS-A).
World Psychiatry, 3(S1), 273-274.
Stephen Kiraly:
Kiraly, M.A., Kiraly, S.J. The Effect of Exercise on Hippocampal Integrity: Review of Recent
Research. Int’l J Psychiatry in Medicine 2005;35:75-89.
Kiran Rabheru:
K. Rabheru: “ Acute Psychosis in the Elderly” – Experts on Call – Can. J. of Diagnosis. January
2005 pp 24.
CPA Position Statement: “ Prescribing Antidepressants for Depression in 2005: Recent Concerns
and Recommendations” by Lam R, & Kennedy S. - K. Rabheru served as an External Reviewer.
Canadian Journal of Psychiatry, 2005: Vol 49, No 12 pp 1-5
7.
FUTURE DIRECTIONS
UBC and the Division of Geriatric Psychiatry were very fortunate this year to have a donor
support a new Chair in Geriatric Psychiatry and Depression. The search will begin in the New
Year. We are very excited about the opportunities this will give us to grow in our research
accomplishments. We look toward to continuing to support excellence in care and teaching, but
also hope to make advances in research within the Division over the next few years.
Finally we wish to actively pursue with the Department membership in the Division around the
province in every region and to create structure will support interregional collaboration.
_____________________________________
Martha L. Donnelly,
Head, Division of Geriatric Psychiatry,
UBC