Course Description

Course Fee: $170
CME: 2.5 AMA PRA Category 1 Credits™

Join Dr. James Greenblatt as he explores the etiology and pathophysiology of chronic irritability, anger, & aggression, demonstrated by research to be prognostic of treatment outcomes and thus key targets of functional psychiatry interventions.  This two-module course also examines non-suicidal self-injury, serious behavioral presentations often indicative of biochemical imbalances impacting brain function.  Viewers will learn a functional medicine approach to testing and treatment that prioritizes these serious symptoms in order to optimize therapeutic outcomes.

Module 1

  1. Fetal Alcohol Syndrome
  2. Elucidating the Nutrient-Behavior Connection
  3. Hypoglycemia and Aggression: The “Hangry” Phenomenon
    1. Insulin, glucose level, and mood
    2. Toxic hunger
    3. Sugar, neural activation, and addiction
    4. Added sugars in the US diet
    5. Key nutrient depletions
  4. Essential Lipids: Cholesterol
    1. Cholesterol: functions in neuronal health, neurotransmission
    2. Cholesterol deficiency, aggression, and violence
    3. Low cholesterol and drug addiction
    4. Suicidality
  5. Essential Lipids: Fatty Acids
    1. EFA depletion, depression, and suicide
  6. Amino Acids and Protein
    1. Essential amino acids
    2. Acute tryptophan depletion: what it tells. us about amino acids and aggression
    3. Exogenous and endogenous factors in amino acid depletion
  7. Heavy Metal Toxicity
    1. Lead
    2. Copper
    3. The Copper: Zinc Balance
  8. Zinc
    1. Zinc in the central nervous system
    2. Zinc deficiency: behavioral sequelae
  9. Lithium
    1. Neuroprotective effects
    2. Functional lithium deficiency: neurologic and psychiatric ramifications
    3. Lithium for aggression, violence, agitation: the research
    4. Elucidating dosage
  10. CTE & TBI
    1. The new concussion narrative: CTE, aggression, and violence
    2. TBI and suicidality
    3. Clinical indicators of risk: red flags
  11. Disruptive Mood Dysregulation Disorder
  12. Conclusion: Linking Nutrition and Behavior

Module 2

  1. Functional Definitions: What IS irritability and aggression…really
  2. Antidepressants, Antipsychotics, and Aggression
    1. Side-effects of antidepressants
    2. Physical violence and adverse drug reactions
    3. Antidepressants and suicidality
    4. Medication Discontinuation Syndrome (MDS)
      1. Biologic abnormalities to look for
  3. Non-Suicidal Self-injury (NSSI)
    1. Definitions, risk factors
    2. Statistics and epidemiology
    3. Presentations and manifestations
    4. The NSSI cycle
    5. Biological considerations
    6. Robust correlation with future suicidality
  4. Self-Harm and Substance Use
    1. Exploring the research
    2. Keys to prevention
    3. Relationships for prevention
  5. NSSI Treatment
    1. Medication for NSSI: contradicting evidence
    2. Meditation for NSSI
  6. The Adolescent Brain: Implications for NSSI, impulsivity
  7. Risk Factors: Internet Use & Social Media
    1. A mixed bag of effects
    2. Self-harm and internet suicide games
    3. Both problem and solution?
  8. Prevention & Early Intervention: Keys
  9. Conclusion: The Functional Psychiatry Model
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CME Accreditation

DURATION OF ACTIVITY
June 20, 2022 through June 19, 2024

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of MedicusCME and Comprehensive Psychiatric Resources, Inc.  MedicusCME is accredited by the ACCME to provide continuing medical education for physicians.

DESIGNATION STATEMENT
MedicusCME designates this live activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

OVERVIEW
A number of physiological conditions can contribute to irritability, anger, aggression and self-injury. Identifying and addressing problems around diet, blood sugar, nutrient deficiencies, medications and toxicant exposures can often help to reduce these issues.

LEARNING OBJECTIVES

  • Explain the relationship between sugar consumption, blood sugar and irritability
  • Identify potential nutrients, nutritional aspects and toxic exposures related to or associated with irritability and aggression
  • Assess the relationship between medications and irritability, aggression and non-suicidal self injury in adolescents
  • Describe the associations between non-suicidal self injury and mental health
  • Elaborate the functional medicine approach to non-suicidal self injury

HOW TO CLAIM CREDIT
In order to receive AMA PRA Category 1 credit™, participants must do the following:

  • Read the learning objectives and faculty disclosures

  • Participate in the activity, review course content and learning strategies, resources and support materials provided

  • Complete the post-test and activity evaluation

  • Achieve a score of 80% or higher on the post-test

FACULTY CONTENT EXPERT
James Greenblatt, MD
Chief Medical Officer and Vice President of Medical Services
Walden Behavioral Care, Waltham, Massachusetts
Assistant Clinical Professor of Psychiatry
Tufts University School of Medicine
Boston, Massachusetts

DISCLOSURE OF FINANCIAL RELATIONSHIPS
MedicusCME requires instructors, planners, managers, and others in control of educational content to disclose all their financial relationships with ineligible companies over the previous 24 months. All identified financial relationships are thoroughly vetted and mitigated according to MedicusCME policy.

The faculty reported the following relevant financial relationships with Accreditation Council for Continuing Medical Education (ACCME)-defined ineligible entities related to the educational content of this CE activity.

James Greenblatt, MD has disclosed a financial relationship with Pure Encapsulations and Jaymac Pharmaceuticals for his role as consultant.

All other planners and faculty, including MedicusCME planners and managers, have no relevant financial relationships with ineligible companies to disclose. Any relevant financial relationships listed for planners or content contributors have been mitigated according to MedicusCME policies.

ACKNOWLEDGEMENTS
This activity is not supported by funds from an ACCME-defined ineligible company.

HIPPA COMPLIANCE ATTESTATION
In accordance with the Health Insurance Portability and Accountability Act (HIPAA), this educational activity, especially when utilizing patient cases for learning demonstration, will not include individually identifiable health information.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration (FDA). The planners of this activity do not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

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