About

Robert L. Trestman, PhD, MD, is the Chair of Psychiatry and Behavioral Medicine at Carilion Clinic and joined the Virginia Tech Carilion School of Medicine in April 2017. He is a nationally recognized expert in psychiatry and population health with an extensive background in education and research. Prior to his current role, Dr. Trestman was a tenured professor of Medicine and Psychiatry at the University of Connecticut School of Medicine, with a joint appointment in Nursing. He served as the executive director of Correctional Managed Health Care, overseeing a health system providing comprehensive healthcare to inmates within the Connecticut Department of Correction. His previous academic and leadership roles include positions at the University of Connecticut, Mount Sinai Medical Center, and the Bronx Veterans Affairs Medical Center. Dr. Trestman has lectured and consulted nationally and internationally, authored or coauthored over 180 peer-reviewed articles, book chapters, and commentaries. He is actively involved in professional organizations, serving as Chair of the American Psychiatric Association’s Council on Healthcare Systems and Financing, a Board member of the American Hospital Association, and as a Councilor to the American Association of Chairs of Departments of Psychiatry. Additionally, he chaired the 2023 APA Workgroup on the Future of Psychiatry and sits on various boards and committees related to healthcare and behavioral health. Dr. Trestman enjoys cycling and competes nationally as a saber fencer, and his wife, Dr. Bonnie Hennig-Trestman, competes internationally as a foil fencer.

Research topics

• Clinical psychology
• Psychiatry
• Medicine
• Psychology
• Internal medicine
• Medical emergency

Selected publications

• New-Onset Psychotic Symptoms Following Abrupt Buprenorphine/ Naloxone Discontinuation in a Female Patient with Bipolar Disorder: A Case Report

  Psychopharmacology Bulletin · 2025-08-12 · 4 citations

  articleOpen access

  Buprenorphine and naloxone (Suboxone) is a combination medication-assisted treatment (MAT) for opioid use disorder. MAT withdrawal-induced psychosis is a rare clinical presentation. To our best knowledge, only three reports have summarized the characteristic manifestations of buprenorphine withdrawal psychosis, yet all of them were male. In this case report, we present a 41-year-old female patient with bipolar disorder and comorbid substance use disorder who developed new-onset psychosis and relapse of manic symptoms following abrupt discontinuation of Suboxone. Manic and psychotic symptoms remitted after a short-term hospitalization with the treatment of an antipsychotic and a mood stabilizer. In addition to discussing this case presentation and treatment approach, we review existing literature and discuss possible underlying mechanisms to enhance understanding of this clinical phenomenon.

  PublisherOA PDFDOI

• The prevalence of comorbidities in people with psychogenic non-epileptic seizures (2013–2023)

  Epilepsy & Behavior · 2025-04-17 · 3 citations

  articleOpen access
  PublisherOA PDFDOI

• Psychiatric comorbidities in children with conduct disorder: a descriptive analysis of real‐world data

  General Psychiatry · 2024-04-01 · 6 citations

  articleOpen access
  PublisherOA PDFDOI

• Benzodiazepine use for anxiety disorders is associated with increased long-term risk of mood and substance use disorders: A large-scale retrospective cohort study

  Drug and Alcohol Dependence Reports · 2024-08-13 · 14 citations

  articleOpen accessSenior authorCorresponding

  Background: Benzodiazepines (BZDs) are widely prescribed for anxiety disorders. However, the long-term implications on mental health remain uncertain, especially the potential association between chronic BZD use and subsequent diagnosis of mood and substance use disorders (SUDs). Method: We conducted a 5-year retrospective cohort study by analyzing the TriNetX database, a real-time electronic medical record network. The study population was defined as patients aged 18-65 with anxiety disorders (ICD-10-CM: F40-F48). We employed propensity score matching to pair a BZD-exposed cohort (≥12 BZD prescriptions) with a BZD-unexposed control cohort. The outcomes were defined as depressive disorders, bipolar disorders, and SUDs. We employed Kaplan-Meier analyses to assess the survival probability over five years following diagnosis and BZD exposure; log-rank test to obtain the hazard ratio (HR) with 95 % confidence interval (CI). Results: We identified and matched 76,137 patients in the study and control cohorts. Compared to the control cohort, the BZD-exposed group exhibited significantly higher risks of being diagnosed with depressive disorders (HR, 2.64; 95 % CI, 2.59-2.68), bipolar disorders (HR, 4.39; 95 % CI, 4.15-4.64), overall substance use disorders (HR, 3.00; 95 % CI, 2.92-3.08), alcohol use disorder (HR, 3.38; 95 % CI, 3.20-3.57), stimulant use disorder (HR, 3.24; 95 % CI, 2.95, 3.55), cannabis use disorder (HR, 2.93; 95 % CI, 2.75-3.11), inhalant use disorder (HR, 4.14; 95 % CI, 3.38-5.06), and nicotine use disorder (HR, 2.72; 95 % CI, 2.63-2.81). Conclusion: Our findings demonstrate a concerning association between BZD use and an increased risk of being diagnosed with various mood disorders and SUDs.

  PublisherDOI

• <scp>START NOW</scp> : a cognitive behavioral skills training for adolescent girls with conduct or oppositional defiant disorder – a randomized clinical trial

  Journal of Child Psychology and Psychiatry · 2023 · 12 citations

  • Psychology
  • Clinical psychology
  • Psychiatry

  BACKGROUND: Conduct disorder (CD) and oppositional defiant disorder (ODD) both convey a high risk for maladjustment later in life and are understudied in girls. Here, we aimed at confirming the efficacy of START NOW, a cognitive-behavioral, dialectical behavior therapy-oriented skills training program aiming to enhance emotion regulation skills, interpersonal and psychosocial adjustment, adapted for female adolescents with CD or ODD. METHODS: A total of 127 girls were included in this prospective, cluster randomized, multi-center, parallel group, quasi-randomized, controlled phase III trial, which tested the efficacy of START NOW (n = 72) compared with standard care (treatment as usual, TAU, n = 55). All female adolescents had a clinical diagnosis of CD or ODD, were 15.6 (±1.5) years on average (range: 12-20 years), and were institutionalized in youth welfare institutions. The two primary endpoints were the change in number of CD/ODD symptoms between (1) baseline (T1) and post-treatment (T3), and (2) between T1 and 12-week follow-up (T4). RESULTS: Both treatment groups showed reduced CD/ODD symptoms at T3 compared with T1 (95% CI: START NOW = -4.87, -2.49; TAU = -4.94, -2.30). There was no significant mean difference in CD/ODD symptom reduction from T1 to T3 between START NOW and TAU (-0.056; 95% CI = -1.860, 1.749; Hedge's g = -0.011). However, the START NOW group showed greater mean symptom reduction from T1 to T4 (-2.326; 95% CI = -4.274, -0.378; Hedge's g = -0.563). Additionally, secondary endpoint results revealed a reduction in staff reported aggression and parent-reported irritability at post assessment. CONCLUSIONS: Although START NOW did not result in greater symptom reduction from baseline to post-treatment compared with TAU, the START NOW group showed greater symptom reduction from baseline to follow-up with a medium effect size, which indicates a clinically meaningful delayed treatment effect.

  PublisherOA PDFDOI

• COVID 19: How the Pandemic Changed Psychiatry for Good

  Psychiatric Clinics of North America · 2022-02-23 · 1 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• There’s No Going Back: The Transformation of Psychiatry and Psychiatric Care Postpandemic

  Psychiatric Clinics of North America · 2022-01-31 · 1 citations

  editorialOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Chapter 20. Criminal Justice System and Antisocial Personality Disorder

  American Psychiatric Association Publishing eBooks · 2022-04-27

  book-chapter1st authorCorresponding
  PublisherDOI

• Effect of Care Management or Online Dialectical Behavior Therapy Skills Training vs Usual Care on Self-harm Among Adults With Suicidal Ideation

  JAMA · 2022-06-14

  letterSenior author

  Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal

  PublisherDOI

• START NOW: An Effective Mental Health Intervention

  2021-01-01 · 2 citations

  articleOpen access1st authorCorresponding

  Dr. Robert Trestman, at the Carilion Clinic and Virginia Tech Carilion School of Medicine, has co-developed START NOW, a successful group psychotherapy intervention specifically targeting mental health issues in prisoners. It combines elements of cognitive behavioral therapy to form skills-based learning. Furthermore, START NOW is easily accessible, cost-effective, and designed for use in settings with limited resources. Due to its success within correctional institutions, START NOW is being adapted for use in fields such as adolescent conduct issues and opioid misuse.

  PublisherDOI

Recent grants

• NIH Grant R24MH067030

  NIH · $2.8M · 2010

• NIH Grant R29MH050859

  NIH · $530k · 1998

Frequent coauthors

• Larry J. Siever

  Icahn School of Medicine at Mount Sinai

  33 shared

• Vivian Mitropoulou

  Icahn School of Medicine at Mount Sinai

  28 shared

• L.J. Siever

  Icahn School of Medicine at Mount Sinai

  25 shared

• Emil F. Coccaro

  The Ohio State University Wexner Medical Center

  20 shared

• Deborah Shelton

  20 shared

• Antonia S. New

  Icahn School of Medicine at Mount Sinai

  16 shared

• Julián D. Ford

  UConn Health

  14 shared

• Jayesh Kamath

  UConn Health

  14 shared

Labs

• Communications TeamPI

Education

• M.D.

  University of Virginia

• B.S.

  University of Virginia

Awards & honors

• Chair of the American Psychiatric Association’s Council on H…
• Board member of the American Hospital Association
• Chair of the APA Workgroup on the Future of Psychiatry (2023…
• Chair of the Behavioral Health Committee of the Bradley Free…