PSV Fall Meeting Poster Award Winners

Medical Students

1^st place
False Positives, Real Consequences — Psychiatric Destabilization After HIV Misdiagnosis

Janvi Agrawal, MS; Kelly Huynh, MD; Bhavana Madhu; Miles DeLay; Jessica Mees-Campbell, MD
Eastern Virginia Medical School, Department of Psychiatry

This case presentation describes a 54-year-old man with bipolar disorder, PTSD, and alcohol use disorder who experienced acute psychiatric destabilization after receiving a false-positive HIV test result, interrupting his stable recovery from alcohol use disorder. 

Following a reactive 4^th-generation HIV antigen/antibody (Ag/Ab) screening assay, the patient developed paranoia, intense hopelessness, and homicidal ideation, ultimately requiring psychiatric hospitalization. Although confirmatory NAAT testing later proved he was HIV-negative, his fixation on the diagnosis persisted and prolonged his manic episode.

Studies have shown that 4^th-gen HIV screening tests—considered the standard of care—have demonstrated markedly higher false-positive rates since the COVID-19 pandemic, (approximately 11x) from a baseline of 0.16% to as high as 1.8% in those with recent COVID-19 infection or vaccination. This patient had COVID-19 infection three times, which may explain his alternating positive and negative HIV screening results since 2023, discovered on chart review.

This case underscores four key lessons:

1. With the pervasiveness of SARS-CoV-2 infection post-pandemic, the standard-of-care 4^th-gen HIV Ag/Ab assay may yield false-positive results more frequently than originally expected.
2. Clinicians should be cautious when communicating preliminary HIV results, particularly to psychiatrically vulnerable patients.
3. Confirmatory testing must always precede disclosure of a potentially stigmatizing diagnosis.
4. Integrating psychiatric support as part of the CDC’s HIV diagnostic algorithm can help mitigate psychological harm and improve overall patient safety.

2^nd Place
Neuropathic Pruritus as a Precursor to Delusional Parasitosis in Multiple Sclerosis: A Case Report & Proposed Clinical Trajectory

By Shannon Weatherly
Nova Southeastern University, North Chesterfield, VA

My poster explored how an ordinary symptom like itching can unfold into a complex neuropsychiatric condition. Through this case, we proposed a framework linking demyelinating lesions to altered sensory processing, neuropathic pruritus, and the eventual development of fixed somatic delusions. The project illustrates how subtle neurologic changes can manifest as vivid perceptual experiences and highlights the need for collaboration between primary care, psychiatry, and dermatology.

The PSV Fall Meeting was an inspiring reminder of how curiosity-driven clinical observation can reveal new dimensions of the mind-brain connection. Hearing from others who are exploring similar intersections between neurological and psychiatric illness was both validating and motivating for future research.

I was honored to be able to attend and present, and even more thankful to be recognized, especially in the presence of such impressive attendees and leaders in the field of psychiatry. It was a wonderful experience as a fourth-year medical student to connect with residents, residency leadership, and PSV leadership. I am incredibly grateful for the opportunity, learned so much from the speakers, and was so happy to be part of such an inspiring meeting.

3^rd place 
Exploring the Experiences and Impacts on Quality of Life of Caregivers of Children with Autism Use AFEQ:  A Cross-Sectional Study

Jamie Levin
Eastern Virginia Medical School

My poster analyzed how being a caregiver of a child with autism can impact the different domains of parental life through the Autism Family Experience Questionnaire (AFEQ). We looked at demographic data and AFEQ responses of 20 families with a child with Autism. The demographic data showed a diverse sample in terms of age and educational level. The preliminary AFEQ analysis revealed scores in each domain fell within the middle range based on the possible scores that can be achieved on AFEQ, therefore indicating that caring for a child with autism impacts the quality of life of caregivers. However, our study was limited by sample size, and further research with a larger sample size is needed to evaluate the relationship between the different domains of AFEQ and other variables, such as level of education, socioeconomic status and other quality of life outcomes.

Residents

1^st Place 
Gender and Age-Based Demographic Patterns for Drug Induced Movement Disorders at UVA Health

By Yixue “Lily” Wang, MD
University of Virginia 

Our study highlights important demographic trends for antipsychotic-related movement disorders in the UVA Health system. Our findings add support to the hypotheses that sex-linked biological and pharmacologic factors contribute to differential vulnerability. Importantly, these findings highlight the need for early screening, prevention strategies, and targeted prescribing practices. The patterns identified in this cohort may inform clinicians in monitoring different patient populations, ultimately guiding personalized risk–benefit considerations in prescribing.

2^nd Place
Making the Aggression-Impulsive/Reactive (AIR) Diagnosis Using the Reactive Aggression Assessment 16 (RAGA-16)

By Parker Booren, MD 
Virginia Commonwealth University

Aggression is one of the most common reasons for referrals of youth to mental health treatment. Aggression can further be classified into proactive aggression and reactive (or impulsive) aggression. Currently, there are many psychiatric diagnoses that include aggression as phenotypical features, but no diagnosis in the DSM-V or ICD-11 adequately captures the kind of reactive (or impulsive) aggression that can be so impairing to children and their families. This subset of pediatric patients has been described as “diagnostically homeless” so we sought to detect children that meet criteria for Aggression-Impulsive/Reactive (AIR) diagnosis using a novel outcome measure, the Reactive Aggression Assessment 16 (RAGA-16). My poster titled, “Making the Aggression-Impulsive/Reactive (AIR) Diagnosis using the Reactive Aggression Assessment 16 (RAGA-16): A Research Study” sought to demonstrate the current research that is ongoing related to the topic that has further delineated the overlap of AIR symptoms with other conditions, the comparison between AIR to existing DSM-5 diagnoses, and the novel RAGA-16. Further research is needed regarding etiology and development of AIR symptoms as well as treatment options for these youth, but this research has shown that having a clear definition of the clinical phenotype will allow for further investigation of the individual and contextual factors that may contribute to IA and AIR. Fortunately, a robust literature on aggression and its development will facilitate future research in this area.

3^rd place 
Gender Differences in Abilify LAI Prescribing and Implications for Mood Disorders at UVA

By Rajath Kenath MD, Dalynn Kim MD, Kathryn Glayat MD, Harrison Brock
University of Virginia

Discrepancy of administration rates of LAIs based on sex can also be observed at UVAHS in regard to the aripiprazole LAI. This is further highlighted by the higher rates of total aripiprazole (LAI and oral) administration seen in women (LAI and oral).​ At UVA Health Systems, there is a notable discrepancy in the administration rates of aripiprazole long-acting injectable (LAI) based on sex, with women receiving higher rates of both LAI and oral aripiprazole compared to men. These findings highlight the need for further study of potential differences in tolerability and efficacy of LAIs by sex, rather than assuming equal benefit from identical dosing regimens. The observed trend also raises concerns about possible clinician bias and other access barriers affecting LAI utilization. Additional discrepancies were identified, including a lower average age among LAI recipients compared to those on oral formulations, and a notable underrepresentation of Black or African American patients receiving aripiprazole LAI compared to local census data, despite racial parity for White and Asian patients.