Hello!
I'm Moukti! Each week, I’ll share updates on projects from Improve Medical Culture and Improve Life PLLC Psychiatry on this page.
By: Edith Sherin Ebenezer Daniel
Posted: 10/21/2025
Journal Article Analysis
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A link to the full article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0268641
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A copy of the abstract(not in the article, so: summary) of the article as written in the article:
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Out of a total of 11 experimental studies, 3 of them, including a total of 116 children and adolescents, found an effect of mobile phone exposure on brain activity and cognition. In contrast, the remaining 8 studies, with a total of 222 children and adolescents, could not identify any effects (Fig 4).
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In general, experimental studies (Human controlled trials) receive a high initial confidence rating according to OHAT [37]. Although one 1st-tier study [88] found a significant change in a cognitive task due to mobile phone-related exposure, 3 other 1st-tier studies and one 2nd-tier study did not find any effect of mobile communication exposure on cognitive function. Due to the inconsistent results across the studies and due to the small study populations (18 to 40 participants) in the studies without effects (allowing for the detection of strong effects only), the evidence was inadequate to conclude (S12 Table).
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Three 2nd-tier studies did not find effects on brain activity. In contrast, one 1st-tier and one 2nd-tier study revealed significant modifications in brain activity due to mobile phone-related exposure. However, similar to the studies on cognitive functions, the evidence was considered inadequate due to inconsistent results across the studies, unclear relevance to human health, the risk of bias in the studies, and the small study populations (17 to 41 participants) in the studies without any effects (S12 Table).
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Although the two 1st-tier studies by Choi et al. (2014) [90] and Lindholm et al. (2011) [91] did not reveal any mobile phone exposure effects on heart rate, respiratory rate, or blood flow, the body of evidence for no effects was considered inadequate due to the small number of studies and the small study populations investigated (n = 26, respectively) (S12 Table).
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Four of the 11 included experimental studies also examined adults [81, 85, 88, 90]. Leung et al. (2011) [88] measured reduced performance during a cognitive task (N-back task) in adolescents only. All other parameters did not show any differences between the 2 age groups. The remaining 3 studies did not find different results for adolescents versus adults.
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Overall, due to the inconsistent evidence in the reviewed experimental studies, and especially in those studies including different age groups, it remains unclear whether children and adolescents are more sensitive to mobile phone exposure compared to adults.
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As the experimental studies included in this review only investigated acute and short-term effects, no conclusion can be drawn regarding potential long-term effects. In summary, the evidence from the included experimental studies is inadequate to conclude mobile phone-related exposure and its effects on cognition, brain activity, and physiological changes in children and adolescents.
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An original summary of the article’s introduction, methods, results, and discussion. Do NOT rewrite/rephrase the abstract. Provide a more nuanced analysis of the study.
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Introduction: The potential health risks from exposure to radiofrequency electromagnetic fields (RF-EMFs) started to concern others as the use of wireless communication devices among children and adolescents increases. This population is particularly vulnerable due to their development and longer lifetime exposure. This study wants to systematically review experimental and epidemiological human studies that examine the physiological and health-related effects of ER-EMFs on individuals aged 0-18. The goal is to evaluate if the scientific evidence proves the concern about health impacts from everyday wireless device exposure.
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Methods: The authors conducted a systematic literature search on major databases PubMed, Embase, and Web of Science until February 2021. They only looked at peer-reviewed experimental or epidemiological studies on ages 0-18 and focused on the RE-EMF exposure from sources like mobil phones, Wi-Fi, and base stations. They used the OHAT (Office of Health Assessment and Translation) approach, organized the evidence, and assessed the quality.
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Results: Out of 3,662 initially identified articles, 42 met and inclusion criteria, and of that, 17 were experimental and 25 epidemiological; the quality was mixed. The quality of evidence was mixed, and most studies did not find a consistent association between RF-EMF exposure and adverse health outcomes. Experimental studies often showed no significant short-term effects, while epidemiological studies suggested an association with behavioral problems or sleep disturbances, though with a high risk of bias. No strong evidence was found for serious health effects, such as cancer or reproductive issues.
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Discussion: The authors conclude that, based on the databases they researched, there is not sufficient evidence for a causal relationship between RE-EMF exposure from wireless devices and adverse health outcomes in children and adolescents. However, many studies suffered from limitations such as small sample sizes, self-reported outcomes, and inconsistent assessments. The authors emphasize the need for more high-quality, longitudinal, and exposure-specific research, especially given the rapid technological changes.
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An assessment of the study in your own opinion. For example, is this study generalizable? Did the investigators choose the right methods for this study? How could the study be strengthened? What gaps remain in the literature?
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Generalizability: The results are cautiously generalized due to the diversity of the study designs, age groups, and outcome measures. Most studies were conducted in specific regions (e.g., Europe), and few included diverse or low-income populations.
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Methods Appropriateness: The OHAT-based baias assessment was a strong choice, providing transparency about limitions of the methods in the included studies. The dual emphasis on both experimental and epidemiological studies was appropriate as well.
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Strengths and Improvements: The major strength lies in the critical evaluation process of the specifically selected works. But, the study could be strengthened by incorporations more recent research past early 2021, including unpublished studies and providing a more quantitative synthesis where appropriate.
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Remaining Gaps: there is a lack of long-term exposure studies, mainly the ones that use objective exposure data rather than self0reported. Moreover, developmental outcomes during adolescence, when brain plasticity is high, are under explored.
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A thesis statement:
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Bodewein et al. (2022) found that current human studies do not provide consistent or causal evidencelinking RE-EMF exposure from wireless devices to adverse health affects in children and adolescents, though method limitation and evolving usage patterns highly the need for more detailed and long-term research.
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By: Eesha Duggireddy
Posted: 10/7/2025
Psychiatry Across the Lifespan
Split (2016) by M. Night Shyamalan focuses on the story of a man with Dissociative Identity Disorder (DID), Kevin Wendell Crumb, who kidnaps three girls, taking over one of his more violent personalities. Although the film was a commercial success and acclaimed as a showcase of the strong performance of James McAvoy, the depiction of DID in the film has received broad criticism from mental health experts and advocacy groups due to its inaccuracy and likelihood of propagating negative stereotypes.
Dissociative Identity Disorder is a complicated mental disorder that is typically associated with extreme childhood trauma. People with DID possess two or more personalities or states of personality that repeatedly assume behavioral control, and there are memory lapses that are too broad to be attributed to simple forgetfulness (American Psychiatric Association,292). Although the movie does show the concept of different identities, such as different mannerisms and speech patterns, the correctness of the movie ends here. The character in Split physically mutates into a superhuman beast, called The Beast, which means that DID may lead to real physiological changes and violent behavior, which are not corroborated by the medical community.
The movie continues the stereotype of psychiatrically ill people as violent and dangerous. It has been found that mentally ill patients are much more likely to be victims rather than perpetrators of violence (Stuart 112). However, Split portrays Kevin's personalities that can commit atrocious acts, which is why the movie follows the trope of a psycho killer that is so common in horror and thriller genres. It not only misleads the general population but may also cause more stigma, which makes it more difficult to find help or be understood by others in the case of DID.
Split, on the other hand, does not question the concept of psychiatric patients as weak or helpless. Kevin is depicted as smart, imaginative, and strong despite the childhood trauma.
Nonetheless, this subtle depiction is shadowed by the exaggerated image of his more violent alter ego. The film audience, which consists of young adults and horror enthusiasts, might get a distorted idea of what DID is all about, as it is regarded as a condition that makes someone unpredictable and frightening, but not traumatized and struggling.
The images of the media, such as Split, have a significant influence on the way people perceive them. Since entertainment can be the main source of information regarding mental health issues, misinformed representation may propagate myths that lead to a lack of empathy and understanding of people with such conditions. The depiction of mental illnesses in pop culture requires critical attention from mental health professionals, filmmakers, and viewers to produce more empathetic and realistic narratives.
Works Cited
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders:
DSM-5. 5th ed., American Psychiatric Publishing, 2013.
Shyamalan, M. Night, director. Split. Universal Pictures, 2016.
Stuart, Heather. “Media Portrayal of Mental Illness and Its Treatments.” CNS Drugs, vol. 20, no.
2, 2006, pp. 99–106.
By: Aryan Garg
Posted: 9/18/2025
Psychiatry Across the Lifespan
PTSD, also known as posttraumatic stress disorder, is a mental health disorder which is seen in a patient who experiences great trauma in their life, where they witness or experience a death, or any other shocking event, ends up with symptoms which affect their thinking, mood, and behavior. These symptoms may arrive randomly, or could be triggered by something with any connection to the traumatic event.
The most common demographic, by age, for the PTSD is younger adults (not seniors). In these adults, we commonly find that PTSD has flashbacks and nightmares, or some sort of avoidance of the reminders of trauma. This could be avoiding something that the person sees as connected to the trauma, or something which can trigger it. For example, a war veteran may associate a certain type of food with the food they ate on the day they saw a friend die, or a certain location with the place they were in combat. They may avoid this in the future. Generally, a large amount of the adult population which actively suffers from PTSD does so because they are combat veterans, survivors of assault, especially sexual assault, or other serious accidents. In terms of treatment, the best known treatment can be cognitive behavioral therapy which is focused on trauma. Recently, EMDR (eye movement desensitization and reprocessing) has also gained traction, but these last two treatments are both non-medicinal. However, medicine such as SSRIs, including paroxetine has been used. The main ethical consideration for adults is to make sure that they have informed consent, and there have been many cases where treatments have been imposed on adults without informed consent.
For children, PTSD is often hard to diagnose as they do not display symptoms as adults do. They also show trauma through emotions, which may be seen as “just being a kid,” however, PTSD can be shown through separation anxiety, aggression outbursts, fear, and many others. With children, the main treatment is not medication, nor CBT, instead it is therapy. There are many psychologists who specialize in children patients and host play therapy and family therapy sessions, both of which are the best ways to improve PTSD in children. Additionally, as a child is a legal minor, the ethical consideration is to make sure parents are always in the loop because the child may not be as developed to understand which treatments work best. The psychologist, in cases of child PTSD, should work closely with parents and avoid using medication as much as possible, as it may have more severe effects on children.
For older adults, PTSD often presents itself as cognitive decline, including memory loss and confusion, but also as depression. That being said, it is often hard to diagnose, as memory loss and confusion are synonymous with Alzheimer’s and a variety of other neurological disorders that happen with aging. There is also a huge overlap in treatment of PTSD in older adults with the treatment of Alzheimer’s, and similar therapy or medication will be recommended by the psychiatrist. The primary ethical considerations are to make sure that older patients feel comfortable expressing their symptoms, especially because there is a greater stigma with these patients, as we often see in the group of combat veterans, and also to make sure that these adults have decision making capacity. If dementia or cognitive decline is a factor, the psychiatrist may want to involve relatives of the patient, but everything should be assessed on a case by case basis.
References
Cook, J. M. (2017, May). Older Adults with PTSD: Brief State of Research and Evidence-Based Psychotherapy Case Illustration. The American Journal of Geriatric Psychiatry, 25(5), 522-530. https://doi.org/10.1016/j.jagp.2016.12.016
Kippert, A. (2019, September 23). Does PTSD Look Different in Adults and Children? Domestic Shelters. Retrieved July 6, 2025, from https://www.domesticshelters.org/articles/after-abuse/does-ptsd-look-different-in-adults-and-children
Mikes, B. A., & Torrico, T. J. (2024, April 20). Posttraumatic Stress Disorder in Children - StatPearls. NCBI. Retrieved July 6, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK559140/
US Department of Veteran Affairs. (2025, April 14). Older Adults and PTSD - PTSD: National Center for PTSD. PTSD: National Center for PTSD. Retrieved July 6, 2025, from https://www.ptsd.va.gov/understand/what/aging_veterans.asp
By: Ashnie Trikha
Posted: 9/11/2025
Independence in Healthcare
The Declaration of Independence states, that "all men are created equal" and that people
have the right to "life, liberty, and the pursuit of happiness", which define the ideals of our
country. However, looking at healthcare in America today, it appears that these rights do not feel
legitimate for everyone.
Not everyone has the same access to healthcare in the US. People from marginalized
communities including low-income families, racial and ethnic minorities, rural communities or
people with disabilities face barriers when seeking help. Some don’t have insurance and others
live far from the nearest doctor or hospital and for many, care is just too expensive in their
situation. Furthermore, individuals face discrimination in access to care because of the inherent
inequities and racial biases of the system. The CDC (2024) says these gaps in care or health
disparities are differences in health that are preventable and related to social determinants of
health such as income, race or where you live.
The inequities in American healthcare are the opposite of the statement “all men are
created equal”. For one of many examples, people with chronic mental illness often can’t get
access to ongoing and affordable treatment. A recent report by the National Alliance on Mental
Illness (2023) showed that between 2019 and 2022, more than half of the people seeking mental
health or substance use care were unable to get those services at least once. Gaps in care can
come from stigma, treatment costs and shortage of providers.
The phrase "life, liberty, and the pursuit of happiness" can also relate to health. Upon
discussion about chronic health or mental conditions, we examined the notion that individuals will experience reductions in both their liberty and pursuit of happiness when they do not have consistent access to medical and mental health services. Untreated conditions may curtail one's ability to work, develop or maintain personal relationships, and even be engaged members of society.
The core values surrounding "life, liberty, and the pursuit of happiness" found in the
Declaration of Independence are still inherently important, but none have been wholly fulfilled
by the current healthcare system. We must work to restore the ideals of the Declaration of
Independence through taking actional steps to fix the inequity of our healthcare system.
References
Centers for Disease Control and Prevention. (2024, June 11). What is health equity?
https://www.cdc.gov/health-equity/what-is/index.html
National Alliance on Mental Illness. (2023, July 18). New report shows remarkable lack
of access to mental health care.
https://www.nami.org/nami-news/new-report-shows-remarkable-lack-of-access-to-mental-health
-care/
By: Ainika Akuthota
Posted: 9/1/2025
Involuntary Hospitalization in Psychiatry
Involuntary hospitalization in psychiatry can refer to admitting a patient into a psychiatric facility contrary to their will due to them being at a serious risk of harm to themselves and/or to others. Involuntary hospitalization is a serious process that is not done unless other suitable options are not working. In order for a patient to be in this situation, they would have to show clear signs of mental illness disorders or substance use disorders and be considered dangerous to the environment.
In Virginia, a patient can be taken into custody by law enforcement or a health professional for evaluation under the ECO (Emergency Custody Order). After this order is in place, a health professional from the Community Service Board or a hospital can evaluate the patient up to 8 hours for adults and 24 hours for minors and decide if they need any further intervention. If the clinician deems that a patient needs further evaluation, then the next step would be to get a Temporary Detention Order from the magistrate to keep a patient in psychiatric hold for up to 72 hours until a hearing. In the hearing, the judge will decide, given the evidence, if a patient needs to stay at a psychiatric facility for further help. During this hearing, the patient is allowed to have an attorney to plead their case and is also allowed to be at the hearing. If they do not agree with the outcome of the hearing, the patient has the right to appeal the decision through the courts.
California is another state that has a process for involuntary hospitalization in psychiatry. Their process is very similar to Virginia’s in which a patient can be taken into hold for up to 72 hours if they are deemed as a danger to themselves and/or others. Though a difference in California than Virginia is that an individual can be placed on hold for 14 extra days if deemed necessary. If more than 14 days is required, a court order needs to be present for the patient to be admitted into a state hospital. All patients have the same rights in California as they do in Virginia.
In many cases, involuntary hospitalization may be required for the safety of the patient and for their surroundings. It gives patients a safe environment to access treatment and stabilize any dangerous and harmful symptoms. This hospitalization also gives patients a longer period for a chance of recovery that they may not have allowed themselves to access or get if not for involuntary hospitalization. Although this concept has many pros, it also has many potential negative aspects. For example, ethical concerns are a major area of conversation within this topic. Some feel that involuntary hospitalization strips patients of rights that they are rightly given and therefore is unethical. It is also a situation that causes much distress for the patient and their family and may cause negative implications in the process.
Citations
California’s protection & advocacy system. (n.d.). Understanding the Lanterman-Petris-Short (LPS) Act. In California’s Protection & Advocacy System (Report Pub. #5608.01). https://www.disabilityrightsca.org/system/files/file-attachments/560801Ch1.pdf
Corderoy, A., Kisely, S., Zirnsak, T., & Ryan, C. J. (2024). The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review. Psychiatry Psychology and Law, 1–48. https://doi.org/10.1080/13218719.2024.2346734
Emergency custody, temporary detention, and involuntary commitment. (n.d.). https://www.arlingtonva.us/Government/Departments/DHS/Behavioral-Healthcare/ECO-TDO-and-Involuntary-Commitment#:~:text=The%20involuntary%20hospitalization%20process%20typically,individual%20will%20be%20involuntarily%20hospitalized.
EXPLANATION OF INVOLUNTARY COMMITMENT PROCESS. (2022). In Commonwealth of Virginia, FORM DC-493. https://www.vacourts.gov/static/forms/district/dc493.pdf
Involuntary Psychiatric Hospitalization of Adults | Community Services Board. (n.d.). https://www.fairfaxcounty.gov/community-services-board/involuntary-psychiatric-hospitalization-adults#:~:text=is%20also%20available.-,Overview,Temporary%20Detention%20Order%20(TDO)?
Specialist, T. (2025, August 5). What is a Voluntary Psychiatric Hold? | Mental Health Hope. Mental Health Hope. https://mentalhealthhope.com/voluntary-psychiatric-hold/#:~:text=A%205150%20hold%20allows%20mental,e.g.%2C%205250%20for%2014%20days)
Stallman, H. M., & Gupta, V. (2025, January 20). Involuntary commitment. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557377/#:~:text=Involuntary%20hospitalization:%20Compulsory%20admission%20to,and%20attendance%20at%20psychotherapy%20sessions.
Sullivan, M., Scherban, B., & Bera, S. (2024). Involuntary commitment: a humanitarian treatment. Psychiatric Services, 75(12), 1281–1283. https://doi.org/10.1176/appi.ps.20240145
Unknown. (2016). Guide to Psychiatric Crisis and civil commitment process in Virginia.
By: Siri Yakkala
Posted: 8/25/2025
A Day in the Life of My Future Self: Dr. Me
A Day in the Life of My Future Self: Dr. Me
It’s 7:03 a.m. and I’m sitting in my car in the parking lot of Improve Life PLLC, sipping a coffee I didn’t have time to finish at home. I like to take a few minutes before going in, just to breathe, center myself, and glance over the day’s schedule. It’s a mix of checkups, one first-time patient, and a couple of chronic care visits. Nothing I haven’t done a hundred times before, but I’ve learned that in medicine, every patient has the potential to surprise you.
Even now, 10 years after I first imagined being a doctor, I still get a weird mix of calm and nerves before walking through those clinic doors.
I Never Thought I’d Choose Family Medicine
If you had asked me in high school what kind of doctor I wanted to be, I probably would have said something like pediatric surgeon or ER doctor. It sounded exciting and intense. But family medicine turned out to be the best fit for me, not just because of the variety, but because of the relationships. I get to know my patients over time. I see them through milestones, challenges, and everything in between.
That’s what I care about the most. Being someone people can rely on, not just for medical answers, but for support and real connection.
A Patient Who Reminded Me Why This Matters
One of the most meaningful visits today was with a teenage girl named Natalie. She came in for abdominal pain, but something felt off. She barely made eye contact, and when I asked about her home life and school, she got quiet. Eventually, she admitted she’d been skipping meals and struggling with body image.
I paused before responding. I didn’t want to sound clinical or judgmental. So I just said, “I’m really glad you told me. That takes a lot of courage.”
We talked more, and by the end of the visit, we had a plan. I referred her to a therapist, a nutritionist, and set up follow-up appointments with me. I told her she wasn't alone and that I’d be here to help however I could.
Those are the moments that matter the most to me. When someone walks in feeling scared or ashamed, and walks out knowing they're seen and supported.
Looking Back at Where It All Started
On my lunch break, I scrolled past an old photo from high school. It was from my pre-med internship at Improve Life PLLC psychiatry, which is the same place I work at now. Back then, I was wearing a borrowed white coat, standing next to one of the doctors who let me shadow her during a busy clinic day. I remember being amazed at how she stayed calm even when things were hectic. She made patients feel heard, and she explained everything so clearly. That summer changed everything for me.
The internship gave me my first real look into what being a doctor was actually like. I helped with intake forms, watched patient visits, and even learned how to take vitals. I realized that being a doctor wasn't just about memorizing science. It was about listening and communicating. That experience helped me understand how to prepare for medical school and what kind of doctor I wanted to be.
My Medical Shadowing Experience
During my junior year, I also shadowed a surgeon at a local hospital. I remember feeling completely out of place. I stood awkwardly in the corner, hoping no one would notice how nervous I was. I didn’t know what to say, so I said almost nothing. But even then, I learned a lot just by watching. I saw how every person in the room had a role, and how much trust was required between patient and provider.
That’s what I tell high school students interested in medicine now. Get in there early, even if it's uncomfortable. Volunteer, shadow someone, ask questions. You learn so much more by being in those spaces than you ever could from a textbook.
Fictional Photo Caption
“Dr. Yakkala between appointments at Improve Life PLLC. Still caffeinated. Still grateful.”
Patient Thank-You Note (Or Google Review, LOL)
Dear Dr. Yakkala,
Thank you for listening to me without judgment. You helped me open up about things I didn’t even know how to talk about. I left your office feeling a little lighter, and more hopeful.
I don’t think I’ve ever felt that comfortable talking to a doctor before.
— Anonymous
3 Tips I’d Give My Younger Self
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Don’t try to impress people. Be honest about who you are and why you care about medicine.
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Take care of your mental health. Burnout doesn’t wait until residency.
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Step out of your comfort zone. Some of the best lessons come from situations that feel awkward at first.
Wrapping Up the Day
By 5:30 p.m., I’m finishing my notes and grabbing my stuff to head out. It’s been a full day, and I’m tired, but I feel good. This job isn’t always easy, and there are definitely tough days. But helping people, even in small ways, is what keeps me going.
Sometimes I think back to that version of myself who was googling pre-med tips and nervously walking into her first shadowing opportunity. If she could see me now, she’d probably be shocked I made it this far, but also proud. Being a doctor turned out to be even more rewarding than I expected.