Filza Hussain MD, FACLP
Clinical Associate Professor, Psychiatry and Behavioral Sciences - Medical Psychiatry
Bio
Dr. Hussain completed her medical education in Karachi, Pakistan, at the Aga Khan University in 2005 and travelled to the US to pursue her interest in Psychiatry. During residency at the Mayo Clinic, Minnesota she was awarded the Mayo clinic M.J Martin award for excellence in CL psychiatry. It was at Mayo that she solidified her interest and identity as a Consultation Liaison Psychiatrist. Eliminating Mind body dualism while educating others and addressing stigma against psychiatry seemed like an effortless choice and so she pursued a CL fellowship at Columbia University in New York.
Visa obligations took her first to the UK where she utilized her experience in evaluating CL service performance in large teaching hospitals in the NHS. She subsequently moved back to the US to serve as the sole outpatient provider for eleven different counties in Northwest Wisconsin with a panel of over 1500 patients at a Mayo clinic satellite. During this time, she was an active board member of NAMI, taught psychopathology in Crisis Intervention Training for the Eau Claire, and Chippewa Police departments and avidly contributed to international health blogs and newspaper articles with an aim to decrease stigma against psychiatry
In Pursuit of a stimulating academic environment and a return to her true passion, CL psychiatry, she joined Stanford as a Clinical Assistant Professor at Stanford University School of Medicine in 2017. As member of the Education Committee and as of 2022, the CLP Fellowship Associate Program Director, She has been active in helping to restructure the fellowship education experience, initiating several new seminars including the immersion series, the book seminar, and organizing the Chief of service rounds. Her clinical focus is transplant psychiatry, and she serves as the liaison to the Liver and Kidney transplant programs at Stanford. She continues to be engaged with the community and currently participates in the Liver Education and Awareness Program(LEAP) , an endeavor educating patients about Fatty Liver disease. Other areas of clinical/research interests include Personality disorders, Suicidology, Cultural Psychiatry and medical pedagogy. She is also working with Dr. Maldonado in developing the SIPAT-D, a tool for evaluation of live organ donors.
Clinical Focus
- Transplantation
- Psychosomatic Medicine
Academic Appointments
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Clinical Associate Professor, Psychiatry and Behavioral Sciences - Medical Psychiatry
Administrative Appointments
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Associate Program Director- CLP fellowship, Stanford University (2022 - Present)
Professional Education
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Medical Education: Aga Khan University Medical College (2005) Pakistan
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Board Certification: American Board of Psychiatry and Neurology, Psychosomatic Medicine (2013)
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Fellowship: New York Presbyterian Hospital - Columbia University (2012) NY
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Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2011)
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Residency: Mayo Clinic School of Medicine (2011) MN
All Publications
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2023 Academy of Consultation-Liaison Psychiatry guidance statement about depression in solid organ transplant recipients-recommendations for practice and lessons learned from the consensus process
PERGAMON-ELSEVIER SCIENCE LTD. 2024
View details for DOI 10.1016/j.jpsychores.2024.111793
View details for Web of Science ID 001276847900091
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Alcohol Use in Liver Transplant Recipients With Alcohol-related Liver Disease: A Comparative Assessment of Relapse Prediction Models.
Transplantation
2023
Abstract
The selection of liver transplant (LT) candidates with alcohol-related liver disease (ALD) is influenced by the risk of alcohol relapse (AR), yet the ability to predict AR is limited. We evaluate psychosocial factors associated with post-LT AR and compare the performance of high-risk alcoholism risk (HRAR), sustained alcohol use post-LT (SALT), and the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) scores in predicting relapse.A retrospective analysis of ALD patients undergoing LT from 2015 to 2021 at a single US transplant center was performed. Risk factors associated with post-LT AR were evaluated and test characteristics of 3 prediction models were compared.Of 219 ALD LT recipients, 23 (11%) had AR during a median study follow-up of 37.5 mo. On multivariate analysis, comorbid psychiatric illness (odds ratio 5.22) and continued alcohol use after advice from a health care provider (odds ratio 3.8) were found to be significantly associated with post-LT AR. On sensitivity analysis, SIPAT of 30 was optimal on discriminating between ALD LT recipients with and without post-LT AR. SIPAT outperformed both the HRAR and SALT scores (c-statistic 0.67 versus 0.59 and 0.62, respectively) in identifying post-LT AR. However, all scores had poor positive predictive value (<25%).AR after LT is associated with comorbid psychiatric illness and lack of heeding health care provider advice to abstain from alcohol. Although SIPAT outperformed the HRAR and SALT scores in predicting AR, all are poor predictors. The current tools to predict post-LT AR should not be used to exclude LT candidacy.
View details for DOI 10.1097/TP.0000000000004800
View details for PubMedID 37899485
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ACLP Best Practice Guidance: Evaluation and Treatment of Depression in Solid Organ Transplant Recipients.
Journal of the Academy of Consultation-Liaison Psychiatry
2023
Abstract
We present Academy of Consultation Liaison Psychiatry (ACLP) best practice guidance on depression in Solid Organ Transplant (SOT) recipients which resulted from the collaboration of ACLP's Transplant Psychiatry Special Interest Group (SIG) and Guidelines and Evidence-Based Medicine Subcommittee. Depression (which in the transplant setting may designate depressive symptoms or depressive disorders) is a frequent problem among SOT recipients. Following a structured literature review and consensus review process, the ACLP Transplant psychiatry SIG proposes recommendations for practice: all organ transplant recipients should be screened routinely for depression. When applicable, positive screening should prompt communication with the mental health treating provider or a clinical evaluation. If the evaluation leads to a diagnosis of depressive disorder, treatment should be recommended and offered. The recommendation for psychotherapy should consider the physical and cognitive ability of the patient to maximize benefit. First-line antidepressants of choice are escitalopram, sertraline, and mirtazapine. Treating depressive disorders prior to transplantation is recommended to prevent post-transplant depression. Future research should address the mechanism by which transplant patients develop depressive disorders, the efficacy and feasibility of treatment interventions (both pharmacological and psychotherapeutic, in person and via telemedicine), and the resources available to transplant patients for mental health care.
View details for DOI 10.1016/j.jaclp.2023.03.007
View details for PubMedID 37003570
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OUTCOMES OF PATIENTS EVALUATED FOR LIVER TRANSPLANT WITH LESS THAN 6 MONTHS OF ABSTINENCE FROM ALCOHOL
WILEY. 2022: S979-S980
View details for Web of Science ID 000870796603104
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Cannabinoids and solid organ transplantation: Psychiatric perspectives and recommendations.
Transplantation reviews (Orlando, Fla.)
2022; 36 (4): 100715
Abstract
Cannabinoid use in patients seeking solid organ transplantation (SOT) is an important and unsettled matter which all transplantation clinicians regularly encounter. It is also a multifaceted, interprofessional issue, difficult for any specialty alone to adequately address in a research article or during clinical care. Such uncertainty lends itself to bias for or against cannabinoid use accompanied by inconsistent policies and procedures. Scientific literature in SOT regarding cannabinoids often narrowly examines the issue and exists mostly in liver and kidney transplantation. Published recommendations from professional societies are mosaics of vagueness and specificity mirroring the ongoing dilemma. The cannabinoid information SOT clinicians need for clinical care may require data and perspectives from diverse medical literature which are rarely synthesized. SOT teams may not be adequately staffed or trained to address various neuropsychiatric cannabinoid effects and risks in patients. In this article, authors from US transplantation centers conduct a systematized review of the few existing studies regarding clinician perceptions, use rates, and clinical impact of cannabinoid use in SOT patients; collate representative professional society guidance on the topic; draw from diverse medical literature bases to detail facets of cannabinoid use in psychiatry and addiction pertinent to all transplantation clinicians; provide basic clinical and policy recommendations; and indicate areas of future study.
View details for DOI 10.1016/j.trre.2022.100715
View details for PubMedID 35853383
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Substance use screening in transplant populations: Recommendations from a consensus workgroup.
Transplantation reviews (Orlando, Fla.)
2022; 36 (2): 100694
Abstract
Transplant patients are frequently treated with substances that have dependence potential and/or they may have a history of substance use disorders. The Psychosocial and Ethics Community of Practice of the American Society of Transplantation formed a Drug Testing Workgroup with participation from members of the Pharmacy Community of Practice and members of the Academy of Consultation-Liaison Psychiatry. The workgroup reviewed the literature regarding the following issues: the role of drug testing in patients with substance use disorders, for patients prescribed controlled substances, legal, ethical and prescription drug monitoring issues, financial and insurance issues, and which patients should be tested. We also reviewed current laboratory testing for substances. Group discussions to develop a consensus occurred, and summaries of each topic were reviewed. The workgroup recommends that transplant patients be informed of drug testing and be screened for substances prior to transplant to ensure optimal care and implement ongoing testing if warranted by clinical history. While use of certain substances may not result in the exclusion for transplantation, an awareness of the patient's practices and possible risk from substances is necessary, allowing transplant teams to screen for substance use disorders and ensure the patient is able to manage and minimize risks post-transplant.
View details for DOI 10.1016/j.trre.2022.100694
View details for PubMedID 35537285
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PSYCHOSOCIAL PREDICTORS OF ALCOHOL RELAPSE AMONG LIVER TRANSPLANT CANDIDATES WITH ALCOHOL-RELATED LIVER DISEASE
WILEY. 2021: 246A-247A
View details for Web of Science ID 000707188001150
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STANFORD INTEGRATED PSYCHOSOCIAL ASSESSMENT FOR TRANSPLANT (SIPAT) IS SUPERIOR TO SALT AND HRAR IN IDENTIFYING LT CANDIDATES WITH ALD AT LOW RISK OF RELAPSE
WILEY. 2021: 253A-254A
View details for Web of Science ID 000707188001162