About

Ira R. Katz is an Emeritus Professor of Psychiatry at the University of Pennsylvania's Perelman School of Medicine. He is affiliated with the Department of Psychiatry and has a contact address at 3535 Market Street, Room 3001, Philadelphia, PA 19104. His educational background includes a B.A. in Chemistry from the University of Chicago (1965), an M.A. and Ph.D. in Chemistry from Columbia University (1969), and an M.D. from Albert Einstein College of Medicine (1973). His research and professional contributions focus on psychiatric disorders, with specific interests in mood disorders, depression, and mental health in elderly populations. He has been involved in various research projects and publications related to geriatric psychiatry, medication effects, and mental health assessment in nursing home residents and dementia patients.

Research topics

• Biology
• Psychiatry
• Clinical psychology
• Medical emergency
• Medicine
• Psychology

Selected publications

• Pharmacological and Somatic Treatments for First-Episode Psychosis and Schizophrenia: Synopsis of the US Department of Veterans Affairs and US Department of Defense Clinical Practice Guidelines

  Schizophrenia Bulletin · 2025-06-21 · 2 citations

  article

  BACKGROUND: The Departments of Veterans Affairs (VA) and Defense (DOD) provide care each year for approximately 75,000 people with first-episode psychoses or schizophrenia, but neither has formal, evidence-based guidance for treating these conditions. Recognition of this gap, together with guidance from Congress, led the Departments to develop clinical practice guidelines for first-episode psychosis and schizophrenia. This synopsis summarizes the psychopharmacological and other somatic treatment recommendations. STUDY DESIGN: An interdisciplinary panel of VA and DOD mental health and primary care providers was created following methods specified by the VA/DOD Evidence-Based Practice Guideline Work Group. The panel formulated key questions that guided a comprehensive search of the intervention literature from November 2011 to December 2021, with evidence limited to findings from randomized clinical trials. Recommendations were based on evaluation of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods. STUDY RESULTS: The VA/DOD guideline panel developed 15 pharmacological and somatic treatment recommendations, including those on antipsychotic medication use for the treatment of first-episode psychosis and schizophrenia, use of clozapine for treatment-resistant schizophrenia, treatment of clozapine non-responders, and side effect management. There was insufficient evidence to provide recommendations for or against the use of non-antipsychotic medications or somatic treatments to treat negative or cognitive symptoms. CONCLUSIONS: The VA/DOD guideline panel developed 15 pharmacological and somatic treatment recommendations to promote optimal, evidence-based care for active service members and Veterans. However, there remain multiple treatment planning decision points for which there is a lack of data and/or effective treatments.

  PublisherDOI

• Synopsis of the 2023 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline for the Management of Bipolar Disorder

  The Journal of Clinical Psychiatry · 2025-01-10

  article

  The US Department of Veterans Affairs (VA) and Department of Defense (DOD) Work Group revised the 2013 VA/DOD Clinical Practice Guideline (CPG) for the Management of Bipolar Disorder (BD). This paper reviews the 2023 CPG and its development process, including how recommendations were made for evidence-based treatment in BD. Subject experts and key stakeholders developed 20 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. Recommendations were based on quality and strength of evidence and informed by other factors, including feasibility, patient perspectives, and the unique needs of people with BD. Peer review by an external group of experts then resulted in completion of the CPG. While the scope of the CPG is broad, this synopsis focuses on clinically relevant recommendations related to the identification and management of BD, including the acute and maintenance phases of illness.

  PublisherDOI

• Psychosocial Management of First-Episode Psychosis and Schizophrenia: Synopsis of the US Department of Veterans Affairs and US Department of Defense Clinical Practice Guidelines

  Schizophrenia Bulletin · 2025-05-11 · 1 citations

  articleOpen access

  BACKGROUND: Despite the large number of people treated for first-episode psychosis and schizophrenia within the Departments of Defense (DOD) and Veterans Affairs (VA), neither the DOD nor VA had established formal recommendations for the treatment of these conditions. This gap led Congress to require the development of clinical practice guidelines (CPG) for the treatment of schizophrenia. This paper reports on the psychosocial and rehabilitative recommendations presented in the VA/DOD Clinical Practice Guidelines for Management of First-Episode Psychosis and Schizophrenia. STUDY DESIGN: The CPG was developed by an interdisciplinary panel of mental health and primary care providers from DOD and VA following methods specified by the VA/DOD Evidence-Based Practice Guideline Work Group. The panel formulated key questions and identified critical outcomes that guided a comprehensive search of the literature published from November 2011 to December 2021. The evidence considered was limited to systematic reviews, meta-analyses, and randomized clinical trials. Recommendations were based on the evaluation of the evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods. STUDY RESULTS: The review process produced 4 psychosocial/rehabilitative treatment recommendations for first-episode psychosis (early intervention services, family interventions, individual placement and support (IPS), and cognitive behavioral therapy for psychosis) and 11 recommendations for schizophrenia (family and caregiver services, assertive community treatment, IPS, smoking cessation, skills training, cognitive training, psychotherapies, aerobic exercise, yoga, weight management, and telephone-based care management). CONCLUSIONS: The VA/DOD CPG reflects the expansion of treatments for first-episode psychosis and schizophrenia and highlights the challenges in developing clinical practice guidelines.

  PublisherOA PDFDOI

• A multilevel investigation of potential inequities in the volume of mental health care received by Black Veterans Health Administration patients.

  Psychological Services · 2025-04-17

  article

  = 1,602,865). Facility-level negative binomial regressions demonstrated that Black patients were disproportionately treated at large, complex, urban facilities in the Southern United States that had higher overall volumes of mental health care and staff but lower mental health staffing ratios and less care for each patient. Though they utilized facilities with lower visits and hours per patient, Black versus non-Black patients had on average more visits and hours per patient. Accounting for these gaps using patient-level Kitagawa-Oaxaca-Blinder (KOB) decomposition analyses, we found (a) negligible and small within-facility effects, (b) between-facility effects that demonstrated that Black patients would have received more treatment than non-Black patients had they utilized facilities in the same proportions as non-Black patients, and (c) excluded variables in unadjusted KOB and excluded variables and covariates (e.g., age, homeless treatment receipt) in adjusted KOB most strongly accounted for gaps. Combining facility-level analyses with novel use of patient-level KOB revealed nuance in the potential inequities experienced by Black VHA mental health patients while demonstrating the need for additional research to examine whether Black patients receive the proper treatments for their mental health conditions and at the optimum dose. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• Impact of Implementation Facilitation on the REACH VET Clinical Program for Veterans at Risk for Suicide

  Psychiatric Services · 2024-03-06 · 2 citations

  articleOpen accessSenior author

  OBJECTIVE: In 2017, the Veterans Health Administration (VHA) implemented a national suicide prevention program, called Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET), that uses a predictive algorithm to identify, attempt to reach, assess, and care for patients at the highest risk for suicide. The authors aimed to evaluate whether facilitation enhanced implementation of REACH VET at VHA facilities not meeting target completion rates. METHODS: In this hybrid effectiveness-implementation type 2 program evaluation, a quasi-experimental pre-post design was used to assess changes in implementation outcome measures evaluated 6 months before and 6 months after onset of facilitation of REACH VET implementation at 23 VHA facilities. Measures included percentages of patients with documented coordinator and provider acknowledgment of receipt, care evaluation, and outreach attempt. Generalized estimating equations were used to compare differences in REACH VET outcome measures before and after facilitation. Qualitative interviews were conducted with personnel and were explored via template analysis. RESULTS: Time had a significant effect in all outcomes models (p<0.001). An effect of facilitation was significant only for the outcome of attempted outreach. Patients identified by REACH VET had significantly higher odds of having a documented outreach attempt after facilitation of REACH VET implementation, compared with before facilitation. Site personnel felt supported and reported that the external facilitators were helpful and responsive. CONCLUSIONS: Facilitation of REACH VET implementation was associated with an improvement in outreach attempts to veterans identified as being at increased risk for suicide. Outreach is critical for engaging veterans in care.

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• High dimensional predictions of suicide risk in 4.2 million US Veterans using ensemble transfer learning

  Scientific Reports · 2024-01-20 · 15 citations

  articleOpen access

  We present an ensemble transfer learning method to predict suicide from Veterans Affairs (VA) electronic medical records (EMR). A diverse set of base models was trained to predict a binary outcome constructed from reported suicide, suicide attempt, and overdose diagnoses with varying choices of study design and prediction methodology. Each model used twenty cross-sectional and 190 longitudinal variables observed in eight time intervals covering 7.5 years prior to the time of prediction. Ensembles of seven base models were created and fine-tuned with ten variables expected to change with study design and outcome definition in order to predict suicide and combined outcome in a prospective cohort. The ensemble models achieved c-statistics of 0.73 on 2-year suicide risk and 0.83 on the combined outcome when predicting on a prospective cohort of [Formula: see text] 4.2 M veterans. The ensembles rely on nonlinear base models trained using a matched retrospective nested case-control (Rcc) study cohort and show good calibration across a diversity of subgroups, including risk strata, age, sex, race, and level of healthcare utilization. In addition, a linear Rcc base model provided a rich set of biological predictors, including indicators of suicide, substance use disorder, mental health diagnoses and treatments, hypoxia and vascular damage, and demographics.

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• Post-traumatic stress disorder: rethinking diagnosis

  The Lancet Psychiatry · 2023-07-24 · 10 citations

  article
  PublisherDOI

• Additional comparisons between PHQ-9 responses from clinical and survey data

  Psychiatry Research · 2023-06-07

  letter1st authorCorresponding
  PublisherDOI

• Outcomes for treatment of depression in the Veterans Health Administration: Rates of response and remission calculated from clinical and survey data

  Psychiatry Research · 2023-04-10 · 4 citations

  articleSenior authorCorresponding
  PublisherDOI

• Estimating the per-protocol effect of lithium on suicidality in a randomized trial of individuals with depression or bipolar disorder

  Journal of Psychopharmacology · 2023-04-11 · 6 citations

  articleOpen access

  BACKGROUND: The CSP590 randomized trial was designed to estimate the effect of lithium on suicidality. After a third of the intended number of participants were enrolled, the hazard ratio of suicidality was 1.10 (95% CI: 0.77, 1.55). Based on this, the trial was stopped for futility. However, only 17% of patients adhered to the specified protocol. AIMS: The objective was to estimate the per-protocol effect of lithium on suicidality, that is, the effect of adhering to the treatment strategies as specified in the protocol. METHODS: We stopped individuals' follow-up if/when they showed evidence of nonadherence. We then conducted the analysis in the restricted sample, adjusting for prognostic factors that predict adherence via inverse probability weighting. The primary outcome was the 12-month risk of suicidality (including death from suicide, suicide attempt, interrupted attempt, hospitalization specifically to prevent suicide). RESULTS: The estimated 12-month risk of suicidality was 18.8% for lithium, and 24.3% for placebo. The risk ratio was 0.78 (95% CI: 0.43, 1.37) and the risk difference -5.5 percentage points (95% CI: -17.5, 5.5). Results were consistent across sensitivity analyses. CONCLUSIONS: With one-third of the targeted sample size, lithium effects (compared with placebo) ranging between a 17.5% reduction and a 5.5% increase in the risk of suicidality were highly compatible with the data. Thus, a protective effect of lithium on suicidality among patients with bipolar disorder or major depressive disorder cannot be ruled out. Trials should incorporate adequate per-protocol analyses into the decision-making processes for stopping trials for futility.

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Recent grants

• NIH Grant R01MH041489

  NIH · $374k · 1990

• NIH Grant R01MH051247

  NIH · $3.0M · 2009

• NIH Grant R37MH051247

  NIH · $4.3M · 2003

• NIH Grant R01MH059380

  NIH · $3.0M · 2005

• NIH Grant R01MH058349

  NIH · $2.3M · 2004

Frequent coauthors

• David W. Oslin

  University of Pennsylvania

  80 shared

• R. O. Anderson

  United States Geological Survey

  75 shared

• Catherine Datto

  68 shared

• Joel E. Streim

  58 shared

• John F. McCarthy

  Central Arkansas Veterans Healthcare System

  55 shared

• Geoffrey P. Kohn

  Cabrini Hospital

  50 shared

• Jessica Campbell

  Georgia Institute of Technology

  50 shared

• J Kennedy

  50 shared