Husain Joins Psychiatry
 

Associate Professor and Interim Chair of UAB's Department of Psychiatry F. Cleveland Kinney, MD, PhD, announces the recent appointment of Zahid Husain, MD, as assistant professor.

A native of Bangladesh, Dr. Husain earned his MD degree at Chittagong Medical College, where he also completed an internship and a year of residency in internal medicine. Before leaving Bangladesh for the United States, Dr. Husain spent 4 years as a medical officer in the Khagrachari Hill District, providing general medical services to the impoverished, rural tribal population.

In 1997, Dr. Husain joined UAB's Department of Psychiatry as a research associate and worked with John Shuster, MD, on a retrospective chart study on end-of-life care provided at University Hospital. Study results prompted the establishment of the Center for Palliative Care and deepened Dr. Husain's interest in clinical medicine. After completing an internship and residency in psychiatry at UAB, Dr. Husain began his current work at the Center for Psychiatric Medicine (CPM).

"Nine beds have recently been added to the CPM's 5th floor step-down unit. I'm caring for those patients, many of whom have serious mental illnesses, such as schizophrenia, schizoaffective disorder, severe depression, or bipolar disorder," Dr. Husain explains. "We also see a significant number of patients who are substance abusers — prolonged, systematic abuse of illegal drugs can often manifest as behavior that mimics psychosis." Dr. Husain's unit covers inpatients from Birmingham's eastern and western catchment areas.

Diagnosis, Treatment Challenges

Treating seriously mentally ill patients poses a number of challenges. "Teasing out a diagnosis can be tricky," Dr. Husain says. "Often, patients have features of more than one disorder. And illegal drug use can compound the complexities of diagnosis; we frequently have to wait until the drugs' effects dissipate before making a clinical judgment."

Selecting appropriate pharmacological therapy is the next hurdle. "Stabilizing seriously mentally ill patients may require a combination of drugs," Dr. Husain notes. "For example, schizophrenic patients, in addition to exhibiting delusional symptoms, often have mood problems. Sometimes, we see what we call 'negative symptoms' — the patient is withdrawn, unwilling to communicate — so we prescribe antidepressants to help bring them back up. We also have patients whose moods are too elevated. They talk excessively and experience racing thoughts. In these cases, in addition to an antipsychotic, a medication such as lithium is indicated."

This "polypharmacy" approach can make pinpointing the most effective medication difficult. "Often, when a patient is taking two or three different drugs, we can't immediately tell which one is causing the improvement," he acknowledges. "And adverse side effects remain a serious issue, complicating treatment and leading to noncompliance. Newer medications for schizophrenia offer better outcomes, and in some cases, fewer side effects, but as many as 40% to 50% of patients do not respond to treatment."

Team Approach

Dr. Husain's treatment team, which typically cares for 8 to 10 patients, includes a clinical nurse specialist, a social worker, and an occupational therapist. "Periodically, a resident, a pharmacist, or medical students rotate through, but those three people, along with myself, form the core of the team," he says. "Observations from each team member are critical for patient evaluation, treatment, and development of a discharge plan. In the case of first-time diagnosis, we schedule a conference with the patient's family to educate them about the disease and let them know what to expect in terms of prognosis and further treatment." Once discharged, patients are followed up at either Eastside Mental Health Center or Western Mental Health Center.

Dr. Husain's personal interests include constructing a Web site that will serve as a resource for Bangladeshi immigrants. "When I first came to the U.S. in 1993, I had to go through a somewhat difficult adjustment period. Now, I'd like to reach out to newly arrived Bangladeshis to share my knowledge and help guide them through the cultural assimilation process," he reveals.

Dr. Husain's articles have been published and accepted for publication in peer-reviewed journals including the Annals of Clinical Psychiatry and Essential Psychopharmacology. His current research interests focus on the role of depression in platelet activation and the genetic basis of schizophrenia.

In addition to his work with the seriously mentally ill at the CPM, Dr. Husain is also available to see outpatients with less severe mental health issues, such as anxiety, depression, and mood disorders. He can be reached at 934-5151.