1. Primary faculty, Department of Psychiatry
The Psychiatric Health Services research group consists of Wayne Katon, MD, Edward Walker, MD and Mark Sullivan, MD. These primary fellowship faculty all work closely clinically with fellows on the psychiatric consultation liaison service and have supervised fellow research projects.
Wayne J. Katon, M.D. Dr. Katon is Professor and Vice Chair in the Department of Psychiatry and Chief of the Division of Psychiatric Epidemiology and Health Services is Director of the NRSA fellowship. Dr. Katon is internationally renowned for his research in three major areas:
|Developing population-based primary care disease management models that potentiate the ability of the primary care medical system to treat major depression;|
|Improving the recognition and treatment of DSM-IV psychiatric disorders in primary care and medical specialty patients with medically unexplained symptoms such as pelvic pain or fatigue|
|Demonstrating the impact of effectively treating major depression in patients with chronic medical illness in reducing amplification of aversive symptoms of chronic medical illness and improving social and vocational functioning|
Dr. Katon has been Principal Investigator on 3 NIMH awards to improve the care of depression, anxiety and somatoform disorders in primary care as well as the principal investigator of the Seattle site for two studies funded by the Hartford and MacArthur Foundations which are randomized controlled trials to study problem solving psychotherapy versus Paroxetine versus Placebo in primary care patients with minor depression. Dr. Katon and his research group are considered one of the preeminent research groups in the United States in studying interventions to improve the care of mental illness in the primary care system of the United States. They have developed an intervention that integrates a range of mental health professionals into primary care and provides enhanced patient education that has been shown in randomized trials to be cost effective compared to usual primary care in improving adherence to antidepressant medications, satisfaction with care and improving depressive outcomes.This leadership in primary care-psychiatry research is evidenced by 3 publications in JAMA by Dr. Katon and his research group in the last 2 years.
Dr. Katon was also a member of the AHCPR Committee that published Guidelines on Recognition and Treatment of Depression in Primary Care and was contracted by NIMH to write a book entitled, Panic Disorder in the Medical Setting, to attempt to improve recognition and treatment of this severe anxiety disorder in primary care. Dr. Katon is a member of NIMH Psychiatric Health Services grant review. Dr. Katon has received two awards for excellence in teaching Psychiatry to primary care physicians. He continues to spend one day a week teaching and consulting on patients at Medalia Family Practice Residency clinic in Seattle.
Edward A. Walker. M.D. Dr. Walker is an Associate Professor of Psychiatry and Obstetrics and Gynecology and an Adjunct Associate Professor in the Department of Family Medicine. He is a nationally recognized researcher who has investigated the relationship of medically unexplained symptoms to psychiatric disorders and childhood physical and sexual abuse. He has completed case-control studies of patients with chronic pelvic pain, irritable bowel syndrome and fibromyalgia and has a 5-year K-Award from NIMH to study in a large HMO population the long-term psychiatric and medical sequelae of childhood physical and sexual abuse. His current research involves the application of collaborative mental health models to rural primary care practices. He has over a decade of direct experience in primary care consultation, and currently works in the University Family Medicine Clinic, and is Chief of the University Hospital Psychiatric Consultation Service. Dr. Walker is a widely sought after lecturer for continuing education programs for family medicine physicians and medical specialists.
Mark Sullivan, M.D., PhD. Dr. Sullivan is an
Associate Professor of Psychiatry and Adjunct Associate Professor of Medical History and
Ethics. He has attended in the Multidisciplinary Pain Clinic and the on Psychiatry
Consultation-Liasion Service as well as working in the Division of Health Services and
Psychiatric Epidemiology for over a decade. His research has focused on the impact of
major depression on
patients with chronic medical illness in terms of decreasing habituation to chronic aversive symptoms such as pain and in causing additive functional disability. Earlier studies of tinnitus and dizziness have been followed by studies of patients with coronary disease and heart failure. His current focus is on quality of life models and their relation to disease pathophysiology. He has had research funding from the National Institute of Aging, the National Institute of Mental Health, and the American Heart Association. He currently has a career development award from NIMH entitled "Health Status and Service Use in Coronary Disease". Dr. Sullivan has a Ph.D. in Philosophy and a long-term interest in medical ethics. He has published papers on the relation between depression and competence and on the relation between pain and disability. He attends on the Ethics Consultation Service at UWMC and directs CME activities for the Department of Psychiatry.
2. Primary Faculty, Department of Family Medicine
Thomas R. Taylor, M.D., Ph.D. Dr. Taylor is Associate Professor in the Department of Family Medicine. He is a graduate of the University of Glasgow in Scotland, is board-certified in both Internal Medicine and Psychiatry and holds a Ph.D. in Biostatistics and Clinical Decision-making from the same institution. His research has focused on many aspects of clinical decision-making from Bayesian inference,linear modeling of physicians clinical policies and computer-assisted cost-conscious selection of investigations in thyroid disease. A secondary theme in his work has been the role of psychosocial issues in clinical practice including the role of psychological problems, (1) in the practices of primary care physicians and (2) in the long-term management of non-insulin dependent diabetes mellitus (NIDDM).He has developed a microcomputer-based measure of functional status in diabetes which was specifically designed for clinical decision-making.
He has been the principal investigator in 3 large-scale nationally funded studies of the management of NIDDM and the role of psychosocial factors in the failure of patients to continue on the insulin pump regimen.These studies were community based involving primary care practices in Montana, Idaho and Washington. From these studies he developed a new model of psychosocially sensitive decision making for management of a chronic disease.
He is currently Director of Research in the Department of Family Medicine at the University of Washington and Co-Director of the National Clinical Policy Program which the American Academy of Family Practice established jointly with the University of Washington after a national search. Dr. Taylor served as Principal Investigator on a contract for AHCPR to produce and test a review instrument based on the Otitis Media with Effusion guideline published in 1994. This instrument was tested in a variety of community practices in the Seattle area. Dr. Taylors recent research has focused on the dissemination of mammography guidelines in 139 practice sites in the state of Washington (funded by AHCPR) and the dissemination of the American College of Physicians Estrogen Replacement Therapy (ERT) guideline (a three state study funded by the Institute on Aging). Current developments of this latter grant focus on a decision support system for women making the ERT decision.
Alfred Berg, M.D., M.P.H. Dr. Berg is board certified in Family Practice and in General Preventative Medicine and Public Health, and is a member of the Institute of Medicine and the National Academy of Sciences. Dr. Bergs research has focused on clinical epidemiology conducted in primary care settings. He has been active on several expert panels using evidence-based methods to develop clinical guidelines, including membership in the US Preventive Services Task Force, co-chair of the Otitis Media panel convened by the Agency for Health Care Policy and Research (AHCPR), chair and moderator of the 1993 CDC STD Treatment Guidelines panel, and member of the AMA/CDC panel producing Guidelines for Adolescent Preventive Services. Dr. Berg is editor of the Year Book of Family Practice and associate editor of the Journal of the American Board of Family Practice. He co-directed the NRSA Fellowship for 5 years with Dr. Katon.
Nancy Stevens, M.D., M.P.H. Dr. Stevens is an Associate Professor in the Department of Family Medicine and Adjunct Associate Professor in the Department of Epidemiology. She has directed the Department of Family Medicine Network Faculty Development Fellowship that focuses on enhancing teaching, clinical and research skills of the junior Family Medicine faculty in the network of residency programs in Washington State. She has published extensively on issues related to medical ethics, reviews of clinical guidelines on treatment of depression and adolescent preventative medicine and the long-term sequelae of childhood abuse and neglect.
3. Affiliated Faculty
Our Psychiatric Health Services researcg group has collaborated with the Center for Health Studies at Group Health Cooperative and has had 3 large NIMH funded grants to improve the care of depression and anxiety in primary care. In addition to Drs Katon, Walker and Sullivan, this group includes Gregory Simon, MD, an internist psychiatrist with Robert Wood Johnson Fellowship Training, Michael Von Korff, Sc.D., a nationally known epidemiologist renowned for his work in pain symptoms and depression in primary care and Elizabeth Lin, M.D., M.P.H., a family physician with Robert Wood Johnson training in the University of Washington Department of Family Medicine. This Group Health affiliation and involvement of Drs. Von Korff, Simon and Lin in the fellowship allows fellows access to Group Healths automated prescription, diagnosis and health utilization records for a population of 400,000 people in Western Washington.
Our most recent NRSA fellows have had research projects with each of these 3 faculty:
Jürgen Unützer, M.D. has worked with Dr. Simon on his Masters thesis entitled, "Depressive Symptoms and Health Cost of Services in HMO Patients Aged 65 Years and Older: A 4 Year Prospective Study" as well as in a more recent research project that has developed a register of bipolar patients treated in Group Health Cooperative, many of whom are managed in primary care.
Charles Engel, M.D., M.P.H., collaborated with Dr. Von Korff on his thesis project, "Predictors of High Cost and Utilization In Primary Care Patients With Back Pain"
Megan Dwight, M.D. is collaborating with Elizabeth Lin, M.D., M.P.H., on a project "Impact of Peripartum Mood Disorder on Primary and Specialty Health Care Utilization and Costs."
Jesse Fann, M.D., M.P.H., has also collaborated with Dr. Simon on his project on, "Minor Head Injury: Psychiatric Sequelae and Medical Costs".
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this page last edited 11/17/98