The American Journal of

Psychiatry
Residents’ Journal
April 2019 Volume 14 Issue 4

Contents EDITOR-IN-CHIEF
2 Strengthening Synapses: A Case for Cross-Discipline Training in Neurology Oliver M. Glass, M.D.
and Psychiatry
Chadrick E. Lane, M.D., and Stanley Lyndon, M.D.
SENIOR DEPUTY EDITOR
Assessing the gap in training Shapir Rosenberg, M.D.
3 The Semicolon Tattoo
Aaron Wolfgang, M.D., and Omin Kwon, B.A. DEPUTY EDITORS
Destigmatizing mental illness in popular culture Matthew Edwards, M.D.
Anna M. Kim, M.D.
4 Topical Triamcinolone-Induced Psychosis
Mihir Upadhyaya, M.D., and Modupe James, M.D. DEPUTY EDITOR/
Emphasizing correct use of medications PODCAST EDITOR
Lindsay Lebin, M.D.
6 Following in the Absence of an Imperfect Light
Theodore V.Z. Longlois
ASSOCIATE EDITORS
Addressing ramifications of addiction
Carol Chan, M.D.
7 The Forgotten Alexander Cole, M.D.
Jason Garner, M.D., J.D.
Reviewed by Carol K. Chan, M.B.B.Ch., M.Sc.
David R. Latov, M.D.
Elon E. Richman, M.D.
8 Residents’ Resources

9 Upcoming Themes CULTURE EDITOR

Erik Bayona, M.D.

CULTURE EDITOR/
SOCIAL MEDIA EDITOR
Somya Abubucker, M.D.
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Angela Moore
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Heidi A. Koch
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EDITOR EMERITA
Rachel Katz, M.D.
COMMENTARY
Strengthening Synapses: A Case for Cross-Discipline
Training in Neurology and Psychiatry
Chadrick E. Lane, M.D., and Stanley Lyndon, M.D.
Neuropsychiatry has a long, illustrious
history, with pioneers such as Pierre Paul
Broca, who fostered the idea of the local-
ization of brain function, and Norman
Geschwind, who introduced the concept
of disconnection syndromes. The healer
of the mind and the brain began as one
and the same. Jean-Martin Charcot, a
neurologist, is perhaps better known for
his interests in hypnosis and conversion
disorders than for being the first person
to describe multiple sclerosis. And one
cannot forget Charcot’s famed pupil, the
neurologist turned father of psychoanal-
ysis, Sigmund Freud, who initially sought
a neurobiological basis of the mind be-
fore ultimately settling on his model of
psychosexual development (1). The dis-
tinction between disorders that are con-
sidered psychiatric versus ones that are
neurologic has become increasingly ar-
bitrary as neuroscience continues to etch
out the biological mechanisms of once
intangible mental phenomena.
The approaches of neurology and
psychiatry have been wedded in com-
bined neurology-psychiatry residencies,
geriatric psychiatry fellowships, and,
more recently, in behavioral neurology
and neuropsychiatry fellowships. Sev-
eral diseases that affect the brain are as-
sociated with cognitive as well as emo-
tional and behavioral symptoms and
therefore are best thought of as neuro-
psychiatric disorders. Alzheimer’s dis-
ease, for example, can cause amnesia,
agnosia, aphasia, and apraxia, although
also can result in depression, agitation,
and psychosis (2).
Neuropsychiatry largely aims to un-
derstand brain-behavior relationships
in the service of diagnosing and treating
patients. However, there is a dearth of
shared learning between neurology and
The American Journal of Psychiatry Residents’ Journal  |  April 2019 2
There is a dearth
of shared learning
between neurology and
psychiatry residents
at most U.S. graduate
training programs.
psychiatry residents at most U.S. gradu-
ate training programs, with many psy-
chiatrists having only 2 months of expe-
rience in neurology across their entire 4
years of general residency. It is even more
dire for trainees in neurology, with the
Accreditation Council for Graduate Med-
ical Education requiring only 1 month on
a psychiatry service. Some have proposed
varying degrees of uniting the two, rang-
ing from increased opportunities for mu-
tual learning to completely reuniting into
a singular specialty (3, 4).
Our concern with complete reunifica-
tion is one of time: expanding beyond the
4 years of residency training will likely
deter applicants at a moment when de-
mand far exceeds supply. However, we
strongly believe there is a need for more
neuroscience within psychiatric curri-
cula and vice versa. We propose a two-
pronged solution: integrating didactic
curricula and building longitudinal clini-
cal experiences. The National Neurosci-
ence Curriculum Initiative, a free online
platform for shared and experiential
learning, has brought clinical neurosci-
ence to a broader audience in graduate
medical training (5). This, and similar
resources, can serve as a foundation for
regular case conferences and problem-
based learning. To further hone bedside
neuropsychiatric skills, trainees will
need a cross-discipline clinical thread
spanning the entirety of residency, em-
bedding themselves within services tai-
lored toward patients with disorders of
cognition, emotion, or behavior.
It has become clear that brain cir-
cuitry does not distinguish between
neurological or psychiatric domains and
neither should practitioners. We hope
further discussion of this gap in train-
ing will persuade residency programs,
as well as professional organizations, to
consider opportunities in clinical neu-
roscience that will enable us to best care
for the millions of people affected by
neuropsychiatric illness.
Dr. Lane is currently a fellow in geriat-
ric psychiatry at Yale University School of
Medicine, New Haven, Conn., and a rising
fellow in behavioral neurology and neu-
ropsychiatry at Boston University School
of Medicine. Dr. Lyndon is a fellow in be-
havioral neurology and neuropsychiatry at
Yale University School of Medicine.
REFERENCES
1. Freud S: A project for a scientific psychology
(1895), in The Standard Edition of the Com-
plete Psychological Works of Sigmund
Freud, London, 1953, 283–397
2. Zhao QF, Tan L, Wang HF, et al: The preva-
lence of neuropsychiatric symptoms in Al-
zheimer’s disease: systematic review and
meta-analysis. J Affect Disord 2016;
190:264–271
3. Price BH, Adams RD, Coyle JT: Neurology
and psychiatry: closing the great divide.
Neurology 2000; 54:8–14
4. Fitzgerald M: Do psychiatry and neurology
need a close partnership or a merger? BJ-
Psych Bull 2015; 39:105–107
5. Arbuckle MR, Travis MJ, Ross DA: Integrat-
ing a neuroscience perspective into clinical
psychiatry today. JAMA Psychiatry 2017;
74:313–314
COMMENTARY
The Semicolon Tattoo
Aaron Wolfgang, M.D., and Omin Kwon, B.A.
For millennia, tattoos have been used to
decorate human skin as an outward sym-
bol of underlying personal and cultural
significance (1). Today, one such symbol
comes in the form of a semicolon inked
not in the fibers of any paper but rather in
the skin of the patient who might be sit-
ting across from you. It is a clinically sig-
nificant clue that providers will need to
understand in order to keep pace with a
generation of patients who are intercon-
nected within digitally driven cultural
movements that are giving voice to those
who may have been previously silent.
Amy Bleuel, a college student inspired
by the loss of her father to suicide and
her own long-standing battle with de-
pression, started Project Semicolon in
2013, primarily in an effort to help destig-
matize mental illness (2). The semicolon
tattoo has since been further popularized
in the Netflix series 13 Reasons Why, and
it is estimated that photos of semicolon
tattoos have now been shared online mil-
lions of times (2). The underlying sym-
bolism behind the semicolon tattoo is
succinctly described in that it “represents
a sentence the author could’ve ended but
chose not to” (3). In more concrete terms,
the semicolon tattoo is a statement indi-
cating that a person once thought of end-
ing his or her life but instead decided to
continue living. Ultimately, it is a symbol
of hope that the wearer is the author of
his or her own life and is empowered to
dictate how to continue his or her story.
The American Journal of Psychiatry Residents’ Journal  |  April 2019 3
The semicolon tattoo
can be
clinically relevant
information.
The semicolon tattoo can be clini-
cally relevant information, hence why it
is important for providers to be aware of
this cultural phenomenon. For example,
if a semicolon tattoo is appreciated in a
patient who denies any history of sui-
cidal ideation, inquiring about the tattoo
could lead to further discussion of sui-
cidality, which may be therapeutically
productive. Perhaps the patient may
have had suicidal ideation in the past but
still harbors substantial shame, prohib-
iting more open discussion of the topic.
Perhaps the tattoo is in support of a
loved one with mental illness, ultimately
shaping underlying schemas regarding
psychiatric disorders in a manner that
may prove to be either instrumental or
possibly counterproductive within the
therapeutic relationship. Regardless, in-
quiring about the tattoo may be a more
acceptable bridge into these areas of ex-
ploration previously veiled in resistance.
In the years since its inception, the
semicolon tattoo has served not only to
help destigmatize mental illness within
popular culture but to bring clarity to
those who wear it as an outward decla-
ration of an ongoing quest to overcome
inner pain. Despite the far-reaching posi-
tive influence that her movement has
created, Amy Bleuel succumbed to her
struggles on March 24, 2018, at the age of
31. Although her story now ends with a
period, her legacy lives on, still punctu-
ated by a semicolon.
Dr. Wolfgang is a third-year resident in
the Department of Behavioral Health, Tri-
pler Army Medical Center, Honolulu. Omin
Kwon is a fourth-year medical student at
the Keck School of Medicine of the Uni-
versity of Southern California, Los Angeles.
The authors thank Dr. Rachel Sullivan for
editorial assistance.
The views expressed in this commentary
are those of the authors and do not reflect
the official policy or position of the De-
partment of the Army, Department of De-
fense, or the U.S. Government.
REFERENCES
1. Lineberry C: Tattoos: the ancient and myste-
rious history. Washington, DC, Smithsonian
Institution, 2007. https://www.smithson-
ianmag.com/history/tattoos-144038580
2. Shield M: Project semicolon—mental health
& suicide prevention—my story isn’t over
yet. Green Bay, Wisc, Project Semicolon,
2018. https://projectsemicolon.com
3. Itkowitz C: ‘And your story will live on’: re-
membering Amy Bleuel, mental health ad-
vocate and founder of Project Semicolon.
Washington Post, March 30, 2017
CASE REPORT
Topical Triamcinolone-Induced Psychosis
Mihir Upadhyaya, M.D., and Modupe James, M.D.
Systemic corticosteroids have long been
associated with adverse psychiatric ef-
fects. Symptoms such as euphoria, insom-
nia, mood swings, personality changes,
severe depression, and psychosis have
been estimated to develop in 5%–18% of
patients treated with corticosteroids (1).
Mania and hypomania are the most com-
monly reported symptoms (35%), fol-
lowed by depressive symptoms (28%)
and psychotic reactions (24%) (2). Psy-
chiatric symptoms typically arise within
1 week of starting corticosteroid therapy,
although it is possible for symptoms to
commence at any time, including after
the corticosteroid is discontinued. Symp-
toms may persist for days or even weeks
after discontinuation.
Corticosteroids are generally cate­gor­
ized as short, intermediate, or long-acting,
based on their half-life. Triamcinolone
is an intermediate-acting glucocorticoid
administered either orally, by injection,
by inhalation, or as a topical ointment or
cream (3). For decades, the topical form
of this corticosteroid, triamcinolone ace-
tonide, has been the standard of care for
treating eczema, a form of atopic derma-
titis that usually develops in early child-
hood (4). Topical triamcinolone is not
typically implicated in the manifestation
or exacerbation of psychiatric symp-
toms. However, it has been theorized
that long-term use of triamcinolone by
an immunocompromised individual may
render such an effect.
We present the case of a patient who
presented to the emergency department
with tactile hallucinations. In efforts to
manage eczema, he misused topical tri-
amcinolone for years. We demonstrate
how corticosteroid overuse in an immu-
nocompromised patient may result in
the development of florid psychosis.
CASE
“Mr. D” is a 26-year-old African Amer-
ican man with a history of HIV and
The American Journal of Psychiatry Residents’ Journal  |  April 2019 4
chronic eczema on his face, neck, torso,
and limbs. He was nonadherent to anti-
retroviral HIV medication. For the past
5 years, he used triamcinolone cream to
treat his eczema.
The patient presented to the emer-
gency department, brought in by an am-
bulance that he summoned. He was anx-
ious, irritable, and restless upon arrival.
He bled from multiple self-inflicted su-
perficial cuts to his left arm, abdomen,
and right leg. He stated, “These cuts won’t
kill me, the bugs under my skin will.” He
further complained that he had not slept
well for days, explaining that he was too
anxious to fall asleep. He declared, “Bugs
are crawling all over my body! Every part,
even my private area. They’re biting me,
so I took a razor and tried to get them off.”
He insisted that he had contracted sca-
bies, and his stated motivation for coming
to the hospital was to obtain a permethrin
prescription to treat the scabies.
His psychiatric history, social history,
and family history were noncontributory
to the acute presentation. His mental
status examination was remarkable for
anxious mood, agitated affect, and ongo-
ing tactile hallucinations. His physical
examination revealed multiple superfi-
cial abrasions. Laboratory studies were
unremarkable.
Out of concern that the patient’s self-
injurious behavior was suggestive of sui-
cidal intent, he was admitted to the psy-
chiatric inpatient unit. The patient was
restarted on antiretroviral medication
for HIV and topical triamcinolone for
chronic eczema. Risperidone was pre-
scribed for psychosis, starting at 1 milli-
gram twice daily.
In the days following admission, he
continued to be agitated and irritable,
often pacing the halls of the inpatient
unit and getting into verbal altercations
with staff and peers. He remained con-
vinced that bugs were crawling under
his skin, and he surreptitiously used
plastic eating utensils to cut his skin in
order to “let the bugs out.”
During the first few days of his hospi-
talization, the patient insisted that twice-
daily triamcinolone administration was
inadequate. On further close question-
ing, he admitted to chronic and intensive
steroid cream use for years as a “beauty
product,” believing that it helped to “re-
plenish” his skin. “I lather it on like sun-
screen, multiple times a day,” he acknowl-
edged. He had reportedly gone to more
than six doctors in the past 6 years to
request a prescription for triamcinolone.
He admitted seeking a new doctor if one
refused to prescribe the medication. He
often went to emergency departments to
obtain a prescription if he was unable to
obtain an office appointment in a timely
manner. In recent months, he purchased
the medication from online pharmacies
in foreign countries and had it shipped
to him.
A dermatologic consultation was re-
quested to determine the appropriate-
ness of further use of triamcinolone. The
consulting team determined that there
was no present sign of eczema, and the
medication was immediately discontin-
ued. The patient required emergent psy-
chiatric medication on an almost daily
basis for nearly a week after triamcino-
lone discontinuation, because his frus-
tration with not receiving the medica-
tion agitated him to the point of physical
aggression toward hospital staff. He ex-
pressed fear that the eczema would re-
turn. However, he noticed that the feel-
ing of bugs crawling under his skin had
gradually resolved.
The patient was continued on risper-
idone, with the dose titrated to 3 milli-
grams twice daily. After 11 days on the
inpatient psychiatric unit, his psychosis
fully resolved. Once triamcinolone’s po-
tential for the induction of psychosis was
explained to him, he agreed to discon-
tinue the drug. He was discharged from
the psychiatric unit with instructions
to continue his antipsychotic medica-
tion and to follow up with an outpatient
psychiatrist, in addition to following up
with a dermatologist to devise a treat-
ment plan for his eczema that avoided
overuse of corticosteroids. The patient
was unfortunately lost to follow-up after
discharge.
DISCUSSION
The hypothalamic-pituitary-adrenal axis,
a neuroendocrine system that regulates
the body’s reaction to stress of a physi-
cal or emotional nature, is the driver of
endogenous glucocorticoid release. Syn-
dromes involving excess or inadequate
cortisol production may have psychiat-
ric manifestations. Cushing’s syndrome,
a relative hypercortisol state, is associ-
ated with anxiety, euphoria, and psy-
chosis. Addison’s disease, a hypocortisol
state, can produce fatigue, low energy,
decreased appetite, and symptoms con-
sistent with neurovegetative symptoms
of depression (5).
Exogenous steroid use may also cause
or exacerbate psychiatric symptoms,
particularly if the steroid dose is high or
the duration of treatment is extended.
Topical corticosteroid induction of psy-
chiatric symptoms is rare. The above
patient applied excessive amounts of tri-
amcinolone even after the onset of for-
mication. It is conceivable that his use of
the medication may have enabled both
topical and more systemic absorption
patterns, with the latter possibly occur-
ring once the medication entered his cir-
culation through self-inflicted cuts.
There is published evidence suggest-
ing that prolonged use (i.e., more than 6
months) of systemic corticosteroid medi-
cation is correlated with a decrease in
hippocampal size, which is then impli-
cated in symptoms such as memory loss,
hallucinations, depression, and vulner-
ability to psychological trauma (6). It is
further believed that discontinuation of
the offending medication would reverse
the damage to the hippocampus, with
the expectation that symptoms would
also resolve. Although neuroimaging
studies were not obtained during our pa-
tient’s hospitalization, it is conceivable
that overuse of topical corticosteroids for
The American Journal of Psychiatry Residents’ Journal  |  April 2019 5
KEY POINTS/CLINICAL PEARLS
• Topical corticosteroids may be implicated in psychosis or mood dysregulation
if used inappropriately.
• A thorough assessment of a patient’s medical history and current medications
is necessary to ensure an accurate psychiatric diagnosis.
• Psychiatrists must educate and caution their patients about medication mis-
use, even common and seemingly innocuous ones.
years might have yielded neuroanatomi-
cal damage, which may then account for
the psychotic features he exhibited.
The definitive solution for corticoste-
roid-induced psychosis is withdrawal of
the agent, either with a gradual tapering
of the medication, or, as with our patient,
immediate discontinuation. Assuming
that the psychosis is entirely attributable
to use of corticosteroids, psychotic symp-
toms should resolve within days, although
the time frame for return to baseline is
partially dependent on the length of time
and dosage in which the medication is
used. Depending on the clinical presenta-
tion, an antipsychotic or mood stabilizer
may be added to assist in restoration to
a nonpsychotic state. The patient in the
above case was started on risperidone be-
cause of its efficacy in patients naive to
psychotropic medication (7).
Patients with steroid-induced psycho-
sis should follow up with an outpatient
psychiatrist. Following the resolution of
psychotic symptoms, the antipsychotic
medication may be tapered and safely
withdrawn.
CONCLUSIONS
The present case illustrates two impor-
tant lessons. First, psychiatrists should
thoroughly assess patients’ medical his-
tories. On the basis of our patient’s self-
injurious behavior and psychotic fea-
tures, it was falsely assumed that he was
motivated by suicidal intent. It was not
until later during his hospital stay that a
multiyear pattern of topical steroid mis-
use became evident. Only then could a
diagnosis of corticosteroid-induced psy-
chosis be considered.
Second, patients must be educated
about the medications they are prescribed
and the harm that may ensue with incor-
rect use. Our patient underestimated the
potency of triamcinolone. It was only
after years of engaging in unscrupulous
activity to obtain the medication and fi-
nally ending up in the hospital for a psy-
chiatric exacerbation that a doctor en-
gaged him in a conversation about the
misuse of triamcinolone. Indeed, good
communication between health care pro-
viders and patients about the correct use
of medications can prevent misuse and
help patients to identify side effects be-
fore they become severe.
Drs. Upadhyaya and James are both sec-
ond-year residents at BronxCare Health
System, Icahn School of Medicine at Mount
Sinai, Bronx, N.Y.
The authors have confirmed that details of
the case have been disguised to protect
patient privacy.
REFERENCES
1. Cerullo MA: Corticosteroid-induced mania:
prepare for the unpredictable. Curr Psychia-
try 2006; 5:43–50
2. Gagliardi JP, Muzyk AJ, Holt S: When
steroids cause psychosis. The Rheu-
matologist. October 1, 2010. https://
w w w.t he-rheumatolog ist.org/a r ticle/
when-steroids-cause-psychosis
3. Zoorob RJ, Cender D: A different look at
corticosteroids. Am Fam Physician 1998;
58:443–450
4. Vickers CFH, Tighe SM: Topical triamcino-
lone in eczema. Br J Dermatology 1960;
72:352–354
5. Brown WA, Johnston R, Mayfield D: The
24-hour dexamethasone suppression test in
a clinical setting: relationship to diagnosis,
symptoms, and response to treatment. Am J
Psychiatry 1979; 136:543–547
6. Brown ES, Woolston DJ, Frol A, et al: Hippo-
campal volume, spectroscopy, cognition, and
mood in patients receiving corticosteroid
therapy. Biol Psychiatry 2004; 55:538–545
7. Bag O, Erdogan I, Onder ZS, et al: Steroid-
induced psychosis in a child: treatment with
risperidone. Gen Hosp Psychiatry 2012;
34:103.e5–103.e6
ARTS AND CULTURE

Following in the Absence of an Imperfect Light

Theodore V.Z. Longlois

Like the three magi,

we come bearing gifts.
But instead of gold, frankincense, and myrrh,
our arms are laden with a casserole, brownies, and a fruit tray.
We are not here to celebrate the heavenly birth of a perfect babe,
but to mourn the death of an imperfect girl,
effervescent, moving, gone,
taken by the all-too-earthly thief
that is addiction.
Though we merely traverse a few city blocks,
mentally we come from afar,
from shock, to grief, to memories,
memories of those once so close to our hearts
who have left but a few paltry reminders of their presence behind.
That familiar sickly sweet smell of funerary flowers,
as powerful as any spirit,
fills our heads with sorrow.
The once-heavenly mother looks tired, worn, but a wisp of a woman,
the father, too broken to carry on.
And the child, the gleaming star,
has returned to the blue yonder,
the world’s precious gift torn out of its clinging, uplifted arms.
We, the physicians, are to play the role of wise men,
but no amount of knowledge can reverse
this ultimate stage of disease.
And we, like the three magi,
have arrived too late.

Theodore Longlois is a medical student at Hackensack

Meridian School of Medicine, Nutley, N.J.

This poem is a modified version of a work previously

published in the Delmar College Siren.

The American Journal of Psychiatry Residents’ Journal  |  April 2019 6

ARTS AND CULTURE
The Forgotten
Carol K. Chan, M.B.B.Ch., M.Sc.
“What sort of witness would I be with-
out my memory?”
The Forgotten, a novel published in
1992 by Elie Wiesel, opens with a prayer
by Elhanan Rosenbaum, an elderly sur-
vivor of the Holocaust, as he pleads to
retain his memories that had begun to
rapidly fade. Fearing that the memories
of all he had experienced would fall into
oblivion owing to an unspecified illness,
he sends his only son Malkiel, a journal-
ist who writes obituaries for The New
York Times, to Romania to retrieve them.
While in Romania, Malkiel discovers
pieces of his father’s past through the
neighborhood’s gravedigger, a grotesque
figure who intertwines stories of the past
with fantastical tales of the dead. Malk-
iel also crosses paths with an elderly
woman who, unlike his father, wished
to discard her own anguished memories
of that time. Unlike Elhanan, who built
his identity as a survivor of war, she had
disassociated from her past as the wife
of a Nazi ally. In retracing his father’s
steps, Malkiel learns not only of his fa-
ther’s past but also that of his grandfa-
ther and others who had perished in the
war. Wiesel revisits the themes of death
and memory many times throughout the
novel through these characters, as he ex-
plores how the passage of memory from
the dead to the living shapes an under-
standing of the present.
The American Journal of Psychiatry Residents’ Journal  |  April 2019 7
by Elie Wiesel. New York, Schocken Books,
1995, pp 320, $16.95.
Although the overarching plot builds
on Wiesel’s other works that bear wit-
ness to the memory of the Holocaust,
The Forgotten also tells the story of an
intimate relationship between a son and
his father and the implications of cogni-
tive decline for an individual and his or
her loved ones. As he battles against time
to pass on what is left of his recollections
to his son, Elhanan slowly loses his iden-
tity, that of a Holocaust survivor. Inter-
estingly, the novel holds many parallels
to the author’s life, as Elie Wiesel himself
was a survivor of the Holocaust. Born
in Romania in 1928, he and his family
were deported to German concentration
camps during World War II. He was lib-
erated in 1945 by Allied troops and was
taken to Paris, where he then worked as
a journalist (1). He later became an au-
thor who dedicated much of his literary
career to the remembrance of the Holo-
caust, for which he was awarded a Nobel
Peace Prize in 1986.
The Forgotten explores the mean-
ing attached to memories and how this
shapes our identity and the subjective in-
terpretation of our experiences. Despite
its grave tone, the novel instills hope that
memories can carry on through genera-
tions and that through these bonds, we
gain not only remembrance but also em-
pathy for the suffering of others.
Dr. Chan is a third-year general adult psy-
chiatry resident in the Department of Psy-
chiatry and Behavioral Sciences, Johns
Hopkins School of Medicine, Baltimore.
REFERENCE
1. Berenbaum M: Elie Wiesel: God, the Holo-
caust, and the Children of Israel. Millburn,
NJ, Behrman House, 1994
Residents’ Resources
Here we highlight upcoming national opportunities for medical students and trainees to be recognized for their hard work, dedi-
cation, and scholarship.
To contribute to the Residents’ Resources feature, contact Matthew L. Edwards, M.D., Deputy Editor (ajpresresource@gmail.com).

Fellowship/Award American College of Neuro Psychopharmacology (ACNP) Travel Award

Organization ACNP
Deadline April 25, 2019
Brief Description This award offers an opportunity to attend a scientific program in clinical and basic research on brain-behavior-
drug interactions and to interact with internationally distinguished researchers and scientists. Benefits include an
ACNP mentor, opportunity to present a poster, and an invitation to attend additional ACNP annual meetings.
Eligibility Medical students and psychiatry residents are eligible. Supporting letters must be written by ACNP members.
Applicants can be no more than 5 years posttraining.
Contact and Website E-mail: ecolladay@acnp.org; Web: https://acnp.org/annual-meeting/travel-awards
Fellowship/Award Transgender Psychiatry Fellowship
Organization Mount Sinai’s Institute for Advanced Medicine
Deadline July 1, 2019
Brief Description This is a paid ($76,148 + conference/travel expenses) 1-year opportunity to work at the Center for Transgender
Medicine and Surgery (CTMS) under the supervision of leading experts in transgender psychiatry. CTMS is located
in the heart of New York City (Chelsea) and is a fully integrated clinic with medical, psychiatric, and surgical
services provided. Available services include pastoral care, social work, and legal aid, all of which are tailored to
transgender and gender nonconforming individuals.
Eligibility Candidates must have completed a general psychiatry residency, have or be able to obtain a New York State license,
and be board-eligible. Competency in LGBT-related mental health is desirable.
Contact and Website Web: http://icahn.mssm.edu/education/residencies-fellowships/list/transgender-psychiatry-fellowship

The American Journal of Psychiatry Residents’ Journal

Annual Meeting Workshop
Date: Saturday, May 18th
Time: 10:00 AM–11:30 AM
Room: TBA

The American Journal of Psychiatry Residents’ Journal  |  April 2019 8

 Information for Authors
Editor-in-Chief
Oliver Glass, M.D.
(Emory University)
Senior Deputy Editor
Shapir Rosenberg, M.D.
(University of Maryland)
Upcoming Themes
Nutritional Psychiatry
Erik Bayona, M.D.
ebayona@salud.unm.edu
Psychiatry and the Visual Arts
Badr Ratnakaran, M.B.B.S.
bratnakaran@carilionclinic.org
If you are interested in serving as
a Guest Editor for the Residents’
Journal, please send your CV,
and include your ideas for
topics, to Anna Kim, M.D.
(annamegkim@gmail.com).
Submissions
The Residents’ Journal considers manu-
scripts authored by medical students, resi-
dent physicians, and fellows in the United
States and Canada; attending physicians
and other members of faculty cannot be
included as authors.
To submit a manuscript, please visit
https://mc.manuscriptcentral.com/appi-
ajp, and select a manuscript type for AJP
Residents’ Journal. See https://ajp.
psychiatryonline.org/residents_journal/
rj_ifora for more detailed instructions.
Article: Reports of novel observations and
research. May include meta-analyses.
Drug Review: A review of a
pharmacological agent that highlights
mechanism of action, efficacy, side-
effects and drug interactions.
Perspectives in Global Mental Health:
Should begin with a representative case
or study on psychiatric health delivery
internationally, rooted in scholarly
projects that involve travel outside of
the United States; a discussion of clinical
issues and future directions for research
or scholarly work should follow.
Case Report: A presentation and
discussion of an unusual clinical
event. All patient information must
be adequately disguised, with written
consent of the patient described.
Commentary: Generally includes
descriptions of recent events, opinion
pieces, or narratives.
History of Psychiatry: Provides a
historical perspective on a topic
relevant to psychiatry.
Arts and Culture: Includes introspective
pieces, poetry, and reviews of books and
films. All submissions must be relevant
to the field of psychiatry.
Letters to the Editor: Comments on
articles published in the Residents’
Journal will be considered for publication
if received within 1 month of publication
of the original article.

Maximum Maximum
Manuscript Type Word Limit Figures and Tables Key Points* References
Article** 1,250 2 Yes 10
Drug Review 1,500 1 Yes 20
Perspectives in Global Mental Health 1,500 0 20
Case Report 1,500 1 Yes 15
Commentary 500 0 5
History of Psychiatry 500 0 5
Arts and Culture 500 0 0
Letters to the Editor 250 0 3
No abstract required for any article type.
*Box with 3–4 key teaching points
**Meta-analyses may be up to 1,500 words with 1 table or figure and 20 references.

The American Journal of Psychiatry Residents’ Journal  |  April 2019 9