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2026 Resident PostersThe Annual Poster Session is a favorite among attendees. Read through 2026 abstracts. Resident PostersBeyond the Black Box: Reconsidering Previously Failed Antipsychotic Trials Through the Lens of Antihistamine Rotation Antipsychotics documented as failed are often permanently excluded from future use, with prior trials treated as fixed contraindications. Yet many failures may reflect modifiable factors such as inadequate duration, subtherapeutic dosing, nonadherence, CYP450 variability, or adverse effects rather than true inefficacy. A parallel exists in antihistamine prescribing, where cycling between agents and returning to discontinued medications is routine. Olanzapine and quetiapine exhibit potent H1 antagonism, with PET imaging showing 61 to 81% cortical H1 occupancy at clinical doses, yet failed antipsychotic trials are treated as permanent while antihistamine rotation is uncontroversial. This review examines whether prior antipsychotic trials warrant reconsideration as clinical context evolves. When Stopping Treatment Becomes the Diagnosis: A Case of Pediatric Amantadine Withdrawal Syndrome Emergency psychiatry frequently evaluates medication-induced neuropsychiatric syndromes, but pediatric cases remain rare and diagnostically challenging. Amantadine withdrawal syndrome is an underrecognized cause of acute neuropsychiatric deterioration and may mimic neurologic emergencies such as neuroleptic malignant syndrome (NMS) or NMDA receptor encephalitis. We present a 16-year-old female with multiple psychiatric comorbidities who developed an acute NMS-like syndrome following abrupt amantadine discontinuation in the setting of recent pimozide dose escalation. Evaluating a Resident-Led Bootcamp Lecture Series to Improve Psychiatry Intern Confidence and Clinical Readiness Preparing incoming interns for early clinical responsibilities is a recurring challenge in residency education. At our institution, PGY-2 residents lead an annual bootcamp series for incoming interns focused on practical issues not typically addressed in standard orientation. PGY-2 resident reflection highlighted reoccurring areas of uncertainty including management of emergencies, documentation practices, and call related responsibilities. Using this feedback, the PGY-2 class updated the intern bootcamp curriculum to better address common early training challenges. The aim of this quality improvement project was to evaluate whether a resident-led bootcamp lecture series improved intern self-reported confidence and readiness across key clinical tasks. Improving Accuracy, Efficiency and Privacy of the Involuntary Commitment Process at ECU Health Medical Center Civil commitment is a widespread practice in psychiatry. In North Carolina, the civil commitment process, known as involuntary commitment (IVC), involves several steps that necessitate extensive documentation and coordination with the legal system. Prior to February 2025, ECU Health Medical Center handled the IVC documentation process using paper records. Over the last two years, alternative electronic medical record (EHR) options were released. This quality improvement project aims to assess changes in the accuracy, efficiency, and privacy of the IVC process after the release of these EHR implementations. Effects of a Single Sub-Anesthetic Dose of Ketamine in Tobacco Use Disorder: An Active-Placebo, Randomized Crossover Study Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has traditionally been utilized as an anesthetic agent, but more recently has gained attention for its potential for use for various psychiatric conditions, including mood and substance use disorders. A sub-anesthetic dose of ketamine has shown promise in reducing craving, withdrawal symptoms, and use of drugs such as alcohol, cocaine, and opioids among individuals with substance use disorders. Ketamine’s therapeutic potential for tobacco use is unknown. Here, we investigated the effect a single sub-anesthetic dose of ketamine among adults with tobacco use disorder who were not interested in changing their smoking behavior. When First-Episode Mania Demands a Deeper Look: Unilateral Cerebral White Matter Disease Following Viral Illness in a Young Adult First-episode mania and psychosis in young adults are commonly attributed to primary psychiatric illness, yet a significant minority harbor underlying neurologic etiologies. A meta-analysis of over 1,600 first-episode psychosis patients found 5.9% had clinically relevant MRI abnormalities, with white matter lesions most prevalent. Autoimmune encephalitis has been identified in approximately 3.5% of these cohorts, and early immunotherapy is associated with improved outcomes. We present a case in which progressive neuropsychiatric symptoms, initially indistinguishable from bipolar I disorder with psychotic features, were linked to striking unilateral cerebral white matter disease following a viral illness. Transcranial Magnetic Stimulation Outcomes in Veterans with Major Depressive Disorder, PTSD, and Prior Civilian or Military Sexual Assault: A Retrospective Cohort Study Patients with PTSD and prior civilian and/or military sexual assault (CMSA) can experience high attrition and poor response to psychotherapy. We hypothesized that patients undergoing transcranial magnetic stimulation (TMS) would have higher dropout rates and lower rates of treatment response and remission than those without CMSA. To date, TMS outcomes for patients with CMSA are unexplored. We conducted a retrospective study to determine treatment acceptability and effectiveness of TMS for patients with major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and CMSA. Improving Psychiatry Resident–Nursing Collaboration Through a Structured Interdisciplinary Workshop: A Quality Improvement Initiative Effective collaboration between psychiatry residents and nursing staff is essential for safe, patient-centered inpatient psychiatric care. Differences in role expectations, communication practices, and workflow may contribute to misunderstandings, workplace friction, and inefficiencies affecting team functioning and patient care. This Quality Improvement project was developed to improve interdisciplinary collaboration through a structured educational workshop and facilitated discussion. Psychiatrists lack knowledge of human crying: A study among NCPA attendees Crying is a fundamental human emotional expression frequently encountered in clinical settings. However, formal medical education rarely addresses the basic, scientific understanding of patient crying. In the past two decades, the knowledge of human crying has exponentially increased which may make knowledge of crying outdated. This study aimed to evaluate practicing psychiatrist’s current knowledge regarding crying. Sublingual Fluoxetine for Depression and PTSD in a Patient with Enteral Malabsorption: A Case Report and Literature Review Patients with gastrointestinal pathology precluding enteral medication absorption face severely limited options for managing depression, anxiety, and PTSD. While parenteral formulations exist for some psychiatric medications such as antipsychotics and benzodiazepines, these are generally not indicated for the treatment of depressive or anxiety disorders. Prior evidence suggests that fluoxetine oral solution may be absorbed sublingually, but clinical data remain sparse. This case highlights the feasibility of sublingual fluoxetine and reviews available non-enteral antidepressant options.
Medical Student PostersThe Quiet Epidemic: Assessing Loneliness in Rural Older Adults Loneliness is a common and harmful social determinant of health linked to depression, cognitive decline, cardiovascular disease, and mortality in older adults. This QI project tested a brief screening-and-response workflow to identify and address loneliness in a rural geriatric primary care clinic. The purpose of this project is to implement and refine a standardized loneliness screening and follow up process for adults ≥65 years between January 1 and June 1, 2026, aiming to screen ≥25 patients and document follow up for those with positive screens. Autism Spectrum Disorder: Diagnostic Challenges in Acute Psychiatric Care The prevalence of autism spectrum disorder (ASD) has substantially increased since the 1990s, at both the national and global level as well as in both children and adults. Given the increasing prevalence of ASD diagnoses, current and future psychiatrists are increasingly likely to encounter patients who have ASD during acute inpatient psychiatric care. Assessment and treatment of these patients is often complicated by the similarity between ASD-related baseline behavior or symptoms and discrete depressive, manic, or psychotic etiologies. Determining whether the symptoms of an acute psychiatric presentation are due to a new diagnosis or attributable to pre-existing ASD is critical in guiding treatment decisions. When Depression Persists During Addiction Treatment: Integrating Transcranial Magnetic Stimulation During Dual-Diagnosis Partial Hospitalization Major depressive disorder frequently co-occurs with substance use disorders (SUDs), complicating diagnostic assessment and long-term recovery. During intensive addiction treatment, clinicians must distinguish depressive symptoms related to intoxication or withdrawal from an independent depressive disorder. Although transcranial magnetic stimulation (TMS) is an established treatment for treatment-resistant depression (TRD), limited literature describes its integration into dual-diagnosis partial hospitalization programs (PHPs). A Descriptive Analysis of GLP-1 Receptor Agonist Prescribing Among Patients With Serious Mental Illness at UNC Patients with serious mental illness (SMI) experience a 20–30 year reduction in life expectancy, largely driven by cardiometabolic disease and psychotropic-associated weight gain. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may improve weight and metabolic outcomes in this population. Expanded NC Medicaid coverage for GLP-1 RAs for weight loss created an opportunity to examine prescribing patterns among patients with SMI receiving psychiatric and primary care at UNC, including integrated models such as STEP Primary Care and REACH. "Hear Me, Doc": Guillain-Barré Syndrome in a Patient with Alcohol Use Disorder and Psychiatric Comorbidity Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy characterized by rapidly progressive weakness, sensory abnormalities, and hyporeflexia or areflexia. Diagnostic challenges may arise in medically and psychiatrically complex patients, particularly when symptoms overlap with alcohol-related neuropathy, nutritional deficiencies, chronic pain syndromes, or functional impairment. CLASP-PC: Adaptation of hospital-based Coping with Long Term Active Suicide Program to suicidality in primary care medicine This study evaluated the adaptation of the evidence-based Coping Long Term with Active Suicide Program for primary care (CLASP-PC) in reducing suicidality, depression, and anxiety among individuals with chronic suicidality.
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