About

Julie Niedermier, MD, is a psychiatrist and professor at Ohio State University Wexner Medical Center, specializing in Psychiatry and Addiction Medicine. She has a particular interest in helping patients develop and achieve wellness goals, addressing barriers to quality life experiences, and empowering patients to cope with chronic illness and find satisfaction in daily life. Dr. Niedermier enjoys caring for patients in diverse settings and working with colleagues at all stages of their professional journeys. She is also actively involved in educational administration and research, with a focus on preparing new psychiatrists for practice and promoting education in addiction. As Program Director for the Department of Psychiatry & Behavioral Health, she has accreditation experience with ACGME and LCME organizations and engages in scholarly activities, including grants to promote education in addiction. Her clinical and academic work is centered at University Hospital – Rhodes Hall, where she provides expertise in addiction medicine, alcoholism, and opioid-related disorders.

Research topics

• Medicine
• Psychiatry
• Psychology
• Nursing
• Psychotherapist
• Internal medicine
• Clinical psychology

Selected publications

• Withdrawal catastrophizing scale: initial psychometric properties and implications for the study of opioid use disorder and hyperkatifeia

  The American Journal of Drug and Alcohol Abuse · 2024-03-19 · 9 citations

  articleOpen access

  as a clinically important phenomenon with implications for the future study and treatment of OUD.

  PublisherOA PDFDOI

• Central sensitization in alcohol use disorder: correlates of pain, addiction and health-related quality of life

  Journal of Addictive Diseases · 2023 · 10 citations

  • Medicine
  • Psychiatry
  • Clinical psychology

  BACKGROUND: Central sensitization is an important mechanism underlying many chronic pain conditions. Chronic pain and alcohol use disorder (AUD) are highly comorbid. Despite great scientific interest in brain mechanisms linking chronic pain and AUD, progress has been impeded by difficulty assessing central sensitization in AUD. OBJECTIVE: The present study is the first to employ a validated surrogate measure to describe central sensitization in a clinical sample with AUD. METHODS: = 99) were recruited from an academic addiction treatment center. A well-established surrogate measure of central sensitization, The American College of Rheumatology Fibromyalgia Survey Criteria (ACRFMS) was administered. Participants also responded to questions about quality of life (RAND-36), and AUD. Descriptive analyses and Spearman's rho correlations were performed. RESULTS: Chronic pain and evidence of central sensitization were prevalent. Greater central sensitization was associated with worse health-related quality of life. Participants higher in central sensitization expressed greater endorsement of pain as a reason for AUD onset, maintenance, escalation, treatment delay, and relapse. CONCLUSION: progressive sensitization of shared brain circuitry. These results may inform future mechanistic research and precision AUD treatment.

  PublisherDOI

• Ornithine Transcarbamylase Deficiency Presenting with Symptoms of Mania in a Young Adult Male

  CNS Spectrums · 2021-04-01

  articleOpen accessSenior author

  Abstract Study Objective The purpose of this case study is to review the clinical presentation and medical workup of a young adult male presenting with acute behavior changes in the setting of undiagnosed ornithine transcarbamylase deficiency (OTCD) Method This case study involves a 19-year-old male with a psychiatric history of depression and one previous suicide attempt, who presented to a large midwestern university hospital emergency department after being found by police naked in a neighbor’s yard. He displayed manic signs and symptoms, including euphoria, lack of sleep for five days, and attempting to purchase a new car and three large screen TVs. Family reported the patient uncharacteristically announced three weeks earlier that he was vegetarian and stopped eating his frequent customary cheeseburgers. Due to increased anxiety and inability to sleep, the patient received lorazepam 2 mg in the emergency department. Upon transfer to the psychiatric unit, therapy was initiated with aripiprazole 5 mg daily and valproate 1000 mg nightly on Day 1 of treatment. The patient refused medications on hospital Day 2, then received this combination again on Day 3. The next morning, the patient complained of lethargy, headache, nausea, and vomiting. Results The patient’s ammonia level was found to be 204 micromol/L with ALT and AST of 714 and 647 IU/L respectively. Tests for infectious hepatitis were negative. Medical consultation recommended discontinuation of current medications, vigorous hydration, and further work up. On further investigation, the patient was found to have low plasma citrulline level of 8 micromol/L, undetectable plasma arginine, and high urinary orotic acid. The laboratory data showed a biochemical phenotype consistent with a diagnosis of partial OTCD, an X-linked urea cycle disorder resulting in toxic hyperammonemia. The patient was treated with a low protein diet modification as well as a combination of sodium benzoate and sodium phenylbutyrate to reduce serum ammonia concentration. With treatment the patient’s laboratory values normalized, and mental status improved. Conclusions In conclusion, partial ornithine transcarbamylase deficiency may manifest with psychiatric symptoms in early adulthood. In young patients with elevated ammonia and mental status change, OTCD is an important diagnosis to consider, as it is the most common inherited cause of hyperammonemia.

  PublisherOA PDFDOI

• Use of Telepsychiatry to Increase Resident Exposure to Forensic Psychiatry During COVID-19

  Academic Psychiatry · 2021-04-20 · 6 citations

  letterOpen access
  PublisherOA PDFDOI

• 120 Laryngeal Dystonia and Buccolingual Crisis: Dystonic Reactions in 2 Patients Receiving Prochlorperazine During Suboxone Therapy

  CNS Spectrums · 2020-04-01 · 1 citations

  articleOpen access

  Abstract: We report two cases of acute dystonia in patients after receiving prochlorperazine to address nausea in the context of buprenorphine/naloxone (Suboxone) therapy. Both were admitted for opioid withdrawal and developed nausea and vomiting refractory to ondansetron on the first hospital day. Within six hours of receiving an intramuscular injection of ten milligrams of prochlorperazine, a 24-year-old Caucasian male developed buccolingual crisis (trismus and dysphagia). His symptoms resolved with repeated intramuscular doses of diphenhydramine, benztropine, and lorazepam. A 31-year-old Caucasian female developed laryngeal dystonia (stridor) and buccolingual crisis (dysphagia, grimacing, and tongue protrusion) within thirty minutes of receiving ten milligrams of prochlorperazine intramuscularly. Given respiratory impairment, emergency airway protection was initiated, and the patient responded to repeated intramuscular doses of benztropine and lorazepam. Although one patient was male and both were relatively young, they did not have other known risk factors for drug induced acute dystonic reactions including history of dystonic reactions, recent cocaine use, or low BMI. Neither patient had a history of exposure to antipsychotic medications and both had medical histories that were otherwise noncontributory. While both patients were at risk for or developing dehydration from nausea and vomiting, their electrolytes were within normal limits on admission, less than twelve hours earlier. We postulate potential etiologies that may possibly explain these events: 1) The patients’ reactions are consistent with the expected number in the general population to have acute dystonia secondary to prochlorperazine use. A small study in 2000 showed that 3.9% of patients receiving prochlorperazine for nausea in an emergency room setting experienced acute dystonia. 2) Could patients receiving intramuscular prochlorperazine during Suboxone therapy have increased risk for severe acute dystonic reactions? According to the European Medicines Agency, hypertonicity is a “common” side effect of Suboxone, occurring in 1% to 10% of patients. 3) Could there be potential interactions between Suboxone and prochlorperazine or between prochlorperazine and substances detected (or undetectable, such as designer drugs) via routine toxicology screening? 4) Could the acute dystonia be unrelated to medication interaction, but instead result from use of prochlorperazine in patients having rapid electrolyte shifts and exhibiting dehydration during acute opioid withdrawal? Given the known risk of opioids, with or without prochlorperazine, to cause respiratory depression and these case reports of acute dystonia with the potential to cause airway impairment due to prochlorperazine administration, we encourage prescribers to exercise caution when utilizing prochlorperazine for the management of nausea and vomiting in patients receiving Suboxone for acute opioid withdrawal.

  PublisherOA PDFDOI

• Dynamic Trainee Support for Residents Involved in COVID-19 Treatment and Response

  Psychiatric Services · 2020 · 5 citations

  • Psychology
  • Nursing
  • Medicine

  Back to table of contents Previous article Frontline ReportsFull AccessDynamic Trainee Support for Residents Involved in COVID-19 Treatment and ResponseAbigail Huff, D.O., Julie Niedermier, M.D., Zachary Kelm, D.O., Adam Jara, D.O., Ph.D., Laura Barnett, D.O.Abigail HuffSearch for more papers by this author, D.O., Julie NiedermierSearch for more papers by this author, M.D., Zachary KelmSearch for more papers by this author, D.O., Adam JaraSearch for more papers by this author, D.O., Ph.D., Laura BarnettSearch for more papers by this author, D.O.Published Online:1 Jul 2020https://doi.org/10.1176/appi.ps.71703AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The COVID-19 pandemic presents a crisis new to the modern era of medicine. Illness acuity and volume of severely ill patients are changing how health care providers perceive care. Residents are providing care in unfamiliar settings, under highly stressful conditions, and with limited training. Confiding in peers is a natural source of support for distressed colleagues, preferred over employee assistance programs or turning to mental health professionals. Medical centers are therefore developing formal trainee support programs to assist individuals as well as treatment teams.Our hospital system has expertise in the support and treatment of traumatized first responders. The Stress, Trauma, and Resilience (STAR) program assesses and treats patients experiencing emotional trauma. In addition, the program serves the needs of health care providers affected by psychological trauma related to their roles as caregivers. The provider-specific team, called the Brief Emotional Support Team (BEST), uses evidence-based training and therapy and has assisted hundreds of first responders and health care professionals over the past 4 years throughout our large academic medical center and within the greater community. Our teams help providers respond effectively in crises while developing skills for resilience and coping with chronic exposure to stress.As an extension of the STAR program, psychiatry residents at our large Midwestern academic medical center self-identified the value of offering support to colleagues in other departments during this crisis. We identified resident volunteers interested in completing a COVID-19 psychiatric response (CPR) elective, which involves integrating the existing therapy curriculum as well as a 1-hour training session into the BEST model, providing daytime support to health care workers through the STAR program phone and to resident peers through a graduate medical education (GME) pager, and providing overnight and weekend support to resident peers through the GME pager. The rotation involves multiple residents to ensure adherence to duty hours. The designated institutional official and intranet announcements helped publicize this service. Faculty of the psychiatry department are available to supervise and oversee the support and assist in the event a distressed trainee or other health care worker expresses ideation to harm self or others.Our early efforts in providing easily accessible, on-demand peer support via multiple modalities have been well received by residents throughout our hospital. The STAR program fields seven to 12 calls every 24 hours, and we have received at least six inquiries from trainees. Confidentiality is ensured; callers requesting to speak with a psychiatry resident are not required to identify themselves. Similarly, resident volunteers do not discuss information with the GME office or programs unless an imminent safety risk arises. As we learn from our experiences, we have developed a tip sheet to share among the group about common concerns and potential helpful responses, including reflective listening and validation phrases, motivational interviewing skills, healthy coping and strength identification, and follow-up opportunities and resources. Here are some examples: “It’s courageous of you to reach out for support and demonstrate your resilience in a very challenging time. What other supports do you have or know of?” “What you’re describing sounds overwhelming. How has this been affecting you when your work ends and you return home?” “It makes sense that you feel anxious and are thinking of not coming to work. It sounds like you are trying to protect yourself. This is a normal reaction. Many people are feeling similarly.”Those seeking support are anxious, fearful, and concerned with the normalcy of their daily experiences. They worry about their own and their families’ well-being, the unknown, and an uncertain future. Resident volunteers respond to immediate concerns but also offer follow-up discussions virtually. Our department’s multidisciplinary clinic, including psychiatry faculty and residents, is used when more formal care is indicated.Our psychiatry residents report finding value in providing this service. Team members have enthusiastically signed up for shifts in this program, eager to leverage training as emerging psychiatrists and identification as medical professionals to support colleagues and friends. In so doing, this program allows us to support the critical services that our hospital continues to provide for victims of the COVID-19 pandemic. We hope to validate residents’ emotional concerns and experiences, promote well-being, and proactively mitigate the traumatic impact of the dire situations our resident colleagues are facing every day.Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center and Ohio State University College of Medicine, Columbus. Francine Cournos, M.D., and Stephen M. Goldfinger, M.D., are editors of this column.Send correspondence to Dr. Huff ([email protected]). FiguresReferencesCited byDetailsCited byProfiles of Burnout and Response to the COVID-19 Pandemic Among General Surgery Residents at a Large Academic Training Program16 August 2022 | Surgical InnovationRebuilding Graduate Medical Education After a Crisis: Perspectives of Medical Residents in the United Arab Emirates1 May 2021 | Advances in Medical Education and Practice, Vol. Volume 12 Volume 71Issue 7 July 01, 2020Pages 753-753 Metrics PDF download History Published online 1 July 2020 Published in print 1 July 2020

  PublisherDOI

• Perceptions of Residents and Their Training Directors Regarding Wellness Education, Program Support, and Access to Depression Treatment: the DEPRESS-Ohio Study

  Academic Psychiatry · 2019-04-29 · 7 citations

  articleOpen access
  PublisherOA PDFDOI

• Maintaining Personal Safety: Understanding and Addressing Aggression and Violence in the Health Care Setting

  MedEdPORTAL · 2018-06-07 · 5 citations

  articleOpen access1st authorCorresponding

  Introduction: A 2-hour introductory lecture-discussion curriculum was developed to provide medical students and residents with education about personal safety in the health care setting. The course focused on providing learners with proactive and practical advice for understanding, recognizing, and responding to difficult patients or others who may pose risks of violence. It was designed for participants to gain knowledge about initial management of often unfamiliar situations before untoward behaviors escalate to violence. Methods: Eight hundred thirty-eight medical students participated in this required element of the third-year psychiatry clerkship experience. Sixty first-year through fourth-year psychiatry residents participated as part of departmental orientation. Instructors provided the same seminar for both learner groups throughout the project's duration. In addition to a PowerPoint presentation, learners participated in discussion about personal safety threats in the health care setting. Evaluations were obtained, and more recent cohorts also completed a postcourse assessment of knowledge. Results: Results suggested that learners from both groups viewed the session favorably, indicating the personal safety curriculum was beneficial and practical and helped increase their knowledge about this important topic. The session received a high number of positive comments from learners, reinforcing its valuable take-home message. Discussion: Given the growing magnitude and understanding of risk of aggression and violence in health care settings, we incorporated a required personal safety session into our psychiatry residency and medical school curricula. The session's emphasis was on preventative and proactive strategies to employ with patients before and during escalation of potentially violent situations.

  PublisherDOI

• Projected Workforce of Psychiatrists in the United States: A Population Analysis

  Psychiatric Services · 2018-03-15 · 234 citations

  article

  OBJECTIVE: This analysis quantified and assessed the projected workforce of psychiatrists in the United States through 2050 on the basis of population data. METHODS: With use of data from the Association of American Medical Colleges (2000-2015), American Board of Psychiatry and Neurology (2000-2015), and U.S. Census Bureau (2000-2050), the psychiatrist workforce was projected through 2050. Two established psychiatrist-to-population ratios were used to determine the estimated demand for psychiatrists and potential shortages. RESULTS: The psychiatrist workforce will contract through 2024 to a projected low of 38,821, which is equal to a shortage of between 14,280 and 31,091 psychiatrists, depending on the psychiatrist-to-population ratio used. A slow expansion will begin in 2025. By 2050, the workforce of psychiatrists will range from a shortage of 17,705 psychiatrists to a surplus of 3,428. CONCLUSIONS: Because of steady population growth and the retirement of more than half the current workforce, the psychiatrist workforce will continue to contract through 2024 if no interventions are implemented, leading to a significant shortage of psychiatrists. Despite an expected workforce expansion beginning in 2025, it is unclear whether the shortage will completely resolve by 2050. Future research should focus on developing strategies to address this quantified shortage in an effort to curb the worsening shortage through 2024 and over the coming decades.

  PublisherDOI

• Understanding Patient Experience: A Course for Residents

  MedEdPORTAL · 2017-03-22 · 5 citations

  articleOpen access1st authorCorresponding

  INTRODUCTION: A 4-hour curriculum was developed to provide residents with information about the concepts of patient satisfaction and experience. The course focuses on the competencies of professionalism and interpersonal and communication skills. It is designed to allow participants to reflect on current knowledge of the patient experience and service principles and to develop a greater appreciation of these concepts' utility and importance to everyday work. METHODS: Thirty-two residents in 2015 and nine incoming residents in 2016 participated in weekly hour-long sessions over 4 weeks. The curriculum also included an optional fifth component, in which patient satisfaction data were provided to the residents. Residents participated in pre- and postcurriculum survey assessments regarding their awareness of concepts involving patient experience. RESULTS: Preliminary results suggested that residents found the curriculum beneficial and that it helped to increase their understanding of the relevance of patient satisfaction and experience education to their practice. Quarterly feedback from patient surveys was provided to residents, identifying strengths and opportunities for improvement. DISCUSSION: Given the growing importance and utilization of patient satisfaction surveys, residents participated in this educational intervention to determine if a novel curriculum and proactive approach to resident understanding and utilization of satisfaction data could result in increased patient satisfaction with resident interactions. The study is ongoing and longitudinal, with initial results encouraging.

  PublisherDOI

Frequent coauthors

• Henry A. Nasrallah

  University of Cincinnati Medical Center

  5 shared

• David Kasick

  The Ohio State University Wexner Medical Center

  2 shared

• Dale Svendsen

  The Ohio State University Wexner Medical Center

  2 shared

• Parker Entrup

  The Ohio State University Wexner Medical Center

  2 shared

• Julie Teater

  The Ohio State University Wexner Medical Center

  2 shared

• Craig J. Bryan

  The Ohio State University

  2 shared

• Anthony King

  2 shared

• Stephanie M. Gorka

  2 shared