Lisa Zakhary - Academia.edu (original) (raw)

Papers by Lisa Zakhary

Research paper thumbnail of Clinical Features, Assessment, and Treatment of Body Dysmorphic Disorder

Oxford Medicine Online

This chapter describes the clinical features of BDD and provides tools for effective assessment a... more This chapter describes the clinical features of BDD and provides tools for effective assessment and diagnosis; in addition, it reviews treatments for BDD, with focus on medication and cognitive behavioral therapy. Body dysmorphic disorder (BDD) is a common and disabling disorder characterized by a preoccupation with an imagined or slight defect in appearance. Its symptomatology and treatment resemble those of OCD in some respects and it is classified in DSM-5 as an OCD-related disorder, but BDD is distinct in a number of key ways. It can lead to significant psychosocial dysfunction, poor quality of life, and suicidality. Although much is known about its clinical presentation and demographic characteristics, large gaps in treatment knowledge remain. Hopefully, research will provide answers to guide more effective treatment of this disabling illness.

Research paper thumbnail of Treating Obsessive-Compulsive Disorder in the Postpartum Period

Harvard Review of Psychiatry

Background and Presentation Mrs. Awas a 31-year-old, married Chinese woman who presented to the e... more Background and Presentation Mrs. Awas a 31-year-old, married Chinese woman who presented to the emergency department with acute suicidal ideation about ending her life by hanging from her ceiling fan, stating “I’d rather kill myself than hurtmy baby.” Shewas admitted to an inpatient psychiatric unit to stabilize her symptoms. Although the patient’s records indicated a history of obsessive-compulsive disorder (OCD), she also had a history of recurrent major depressive episodes and childhood trauma, and this hospitalization came on the heels of being six weeks postpartum of her firstborn, male child. A psychiatry consult with an OCD specialist (AF) was requested on the inpatient service to clarify the diagnosis of OCD or to determine whether another mental disorder (e.g., postpartum depression, postpartum psychosis, posttraumatic stress disorder [PTSD]) could better explain her suicidality. Upon interview, it became clear that the case had cultural aspects. Mrs. A spoke careful English with an accent and had been living in the United States for the past year due to her husband’s fellowship as a visiting scientist at a local hospital. Much of the interview was conducted in Mandarin because she reported that she would feel more comfortable speaking about her intrusive thoughts in her native language. Mrs. A reported that she had not been working during her pregnancy and was planning to return to China soon after her hospitalization. She stated that the months leading up to the delivery were characterized by an increased frequency of constant, unwanted, intrusive harm obsessions about murdering her husband with a kitchen knife. Mrs. A experienced these thoughts as highly distressing and feared that she would act on them;

Research paper thumbnail of A survey assessment of the recognition and treatment of psychocutaneous disorders in the outpatient dermatology setting: How prepared are we?

Journal of the American Academy of Dermatology

Background: Dermatologists provide the bulk of psychocutaneous care; however, recent studies sugg... more Background: Dermatologists provide the bulk of psychocutaneous care; however, recent studies suggest that dermatologists believe they are largely underprepared to treat most psychocutaneous conditions. Objective: We sought to identify gaps in psychodermatologic knowledge among practicing dermatologists in two academic institutions. Methods: An online survey was sent to 59 dermatologists at the Massachusetts General Hospital (Boston, MA) and Brigham and Women's Hospital (Boston, MA) from July 2010 through October 2011. Results: The response rate was 40 of 59 (68%). More than 50% of dermatologists were comfortable making diagnoses for 8 of 10 psychocutaneous disorders. In all, 57% were comfortable making a diagnosis of depression. A total of 11% were comfortable starting antidepressants; 3%, antipsychotics; and 66%, medications for neuropathic pain. In all, 72%, 68%, and 21% of dermatologists never prescribe antidepressants, antipsychotics, or medications for neuropathic pain, respectively. Only 38% believed they were successful treating compulsive skin picking; 15%, body dysmorphic disorder; 27%, delusions of parasitosis; and 24%, depression. Limitations: Limitations include small sample size, data extraction from an academic setting, self-reporting of outcome measures, and response bias. Conclusion: Although the majority of the physicians surveyed believed they were capable of diagnosing psychocutaneous disease, very few were comfortable starting psychotropics or thought they were successful treating such conditions.

Research paper thumbnail of Members of the miRNA-200 family regulate olfactory neurogenesis

Neuron, 2008

MicroRNAs (miRNAs) are highly expressed in vertebrate neural tissues, but the contribution of spe... more MicroRNAs (miRNAs) are highly expressed in vertebrate neural tissues, but the contribution of specific miRNAs to the development and function of different neuronal populations is still largely unknown. We report that miRNAs are required for terminal differentiation of olfactory ...

Research paper thumbnail of Single-cell transcriptional analysis of neuronal progenitors

Neuron, 2003

The extraordinary cellular heterogeneity of the mammalian nervous system has largely hindered the... more The extraordinary cellular heterogeneity of the mammalian nervous system has largely hindered the molecular analysis of neuronal identity and diversity. In order to uncover mechanisms involved in neuronal differentiation and diversification, we have monitored the expression profiles ...

Research paper thumbnail of Clinical Features, Assessment, and Treatment of Body Dysmorphic Disorder

Oxford Medicine Online

This chapter describes the clinical features of BDD and provides tools for effective assessment a... more This chapter describes the clinical features of BDD and provides tools for effective assessment and diagnosis; in addition, it reviews treatments for BDD, with focus on medication and cognitive behavioral therapy. Body dysmorphic disorder (BDD) is a common and disabling disorder characterized by a preoccupation with an imagined or slight defect in appearance. Its symptomatology and treatment resemble those of OCD in some respects and it is classified in DSM-5 as an OCD-related disorder, but BDD is distinct in a number of key ways. It can lead to significant psychosocial dysfunction, poor quality of life, and suicidality. Although much is known about its clinical presentation and demographic characteristics, large gaps in treatment knowledge remain. Hopefully, research will provide answers to guide more effective treatment of this disabling illness.

Research paper thumbnail of Treating Obsessive-Compulsive Disorder in the Postpartum Period

Harvard Review of Psychiatry

Background and Presentation Mrs. Awas a 31-year-old, married Chinese woman who presented to the e... more Background and Presentation Mrs. Awas a 31-year-old, married Chinese woman who presented to the emergency department with acute suicidal ideation about ending her life by hanging from her ceiling fan, stating “I’d rather kill myself than hurtmy baby.” Shewas admitted to an inpatient psychiatric unit to stabilize her symptoms. Although the patient’s records indicated a history of obsessive-compulsive disorder (OCD), she also had a history of recurrent major depressive episodes and childhood trauma, and this hospitalization came on the heels of being six weeks postpartum of her firstborn, male child. A psychiatry consult with an OCD specialist (AF) was requested on the inpatient service to clarify the diagnosis of OCD or to determine whether another mental disorder (e.g., postpartum depression, postpartum psychosis, posttraumatic stress disorder [PTSD]) could better explain her suicidality. Upon interview, it became clear that the case had cultural aspects. Mrs. A spoke careful English with an accent and had been living in the United States for the past year due to her husband’s fellowship as a visiting scientist at a local hospital. Much of the interview was conducted in Mandarin because she reported that she would feel more comfortable speaking about her intrusive thoughts in her native language. Mrs. A reported that she had not been working during her pregnancy and was planning to return to China soon after her hospitalization. She stated that the months leading up to the delivery were characterized by an increased frequency of constant, unwanted, intrusive harm obsessions about murdering her husband with a kitchen knife. Mrs. A experienced these thoughts as highly distressing and feared that she would act on them;

Research paper thumbnail of A survey assessment of the recognition and treatment of psychocutaneous disorders in the outpatient dermatology setting: How prepared are we?

Journal of the American Academy of Dermatology

Background: Dermatologists provide the bulk of psychocutaneous care; however, recent studies sugg... more Background: Dermatologists provide the bulk of psychocutaneous care; however, recent studies suggest that dermatologists believe they are largely underprepared to treat most psychocutaneous conditions. Objective: We sought to identify gaps in psychodermatologic knowledge among practicing dermatologists in two academic institutions. Methods: An online survey was sent to 59 dermatologists at the Massachusetts General Hospital (Boston, MA) and Brigham and Women's Hospital (Boston, MA) from July 2010 through October 2011. Results: The response rate was 40 of 59 (68%). More than 50% of dermatologists were comfortable making diagnoses for 8 of 10 psychocutaneous disorders. In all, 57% were comfortable making a diagnosis of depression. A total of 11% were comfortable starting antidepressants; 3%, antipsychotics; and 66%, medications for neuropathic pain. In all, 72%, 68%, and 21% of dermatologists never prescribe antidepressants, antipsychotics, or medications for neuropathic pain, respectively. Only 38% believed they were successful treating compulsive skin picking; 15%, body dysmorphic disorder; 27%, delusions of parasitosis; and 24%, depression. Limitations: Limitations include small sample size, data extraction from an academic setting, self-reporting of outcome measures, and response bias. Conclusion: Although the majority of the physicians surveyed believed they were capable of diagnosing psychocutaneous disease, very few were comfortable starting psychotropics or thought they were successful treating such conditions.

Research paper thumbnail of Members of the miRNA-200 family regulate olfactory neurogenesis

Neuron, 2008

MicroRNAs (miRNAs) are highly expressed in vertebrate neural tissues, but the contribution of spe... more MicroRNAs (miRNAs) are highly expressed in vertebrate neural tissues, but the contribution of specific miRNAs to the development and function of different neuronal populations is still largely unknown. We report that miRNAs are required for terminal differentiation of olfactory ...

Research paper thumbnail of Single-cell transcriptional analysis of neuronal progenitors

Neuron, 2003

The extraordinary cellular heterogeneity of the mammalian nervous system has largely hindered the... more The extraordinary cellular heterogeneity of the mammalian nervous system has largely hindered the molecular analysis of neuronal identity and diversity. In order to uncover mechanisms involved in neuronal differentiation and diversification, we have monitored the expression profiles ...