Isheeta Zalpuri
Clinical Associate Professor, Psychiatry and Behavioral Sciences - Child & Adolescent Psychiatry and Child Development
Bio
Dr. Isheeta Zalpuri is a child, adolescent and adult psychiatrist. She specializes in the treatment of pediatric anxiety and mood disorders.
Dr. Zalpuri has a special interest in faculty development, professional development of trainees, physician well-being and cultural psychiatry.
Clinical Focus
- Psychiatry
Academic Appointments
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Clinical Associate Professor, Psychiatry and Behavioral Sciences - Child & Adolescent Psychiatry and Child Development
Administrative Appointments
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Assistant Program Director, Stanford Child and Adolescent Psychiatry Fellowship Program (2018 - 2020)
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Acting Co-Director, Stanford Pediatric Mood Disorders Clinic (2020 - 2020)
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Associate Program Director, Stanford Child and Adolescent Psychiatry Fellowship Program (2020 - 2023)
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Co-Director, Stanford Pediatric Mood Disorders Clinic (2021 - 2023)
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Co-Director, Stanford Pediatric Anxiety and Traumatic Stress Clinic (2021 - Present)
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Assistant Director of Education, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine (2022 - Present)
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Acting Program Director, Stanford Child and Adolescent Psychiatry Fellowship Program (2023 - 2024)
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Program Director, Stanford Child and Adolescent Psychiatry Fellowship (2024 - Present)
Honors & Awards
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Faculty Mentorship and Career Development Award, Child and Adolescent Psychiatry Fellowship, Stanford University School of Medicine (2022)
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AAP Early Career Development Award, Association for Academic Psychiatry (2021)
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Annual Chairman's Award in Educational Excellence, Department of Psychiatry and Behavioral Sciences, Stanford University (2021)
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Outstanding Faculty Award, Child and Adolescent Psychiatry Fellowship, Stanford University (2021)
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Excellence in Fellow Advocacy Award, Child and Adolescent Psychiatry Fellowship, Stanford University (2020)
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Outstanding Faculty Award, Child and Adolescent Psychiatry Fellowship, Stanford University (2019)
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Laughlin Fellowship, American College of Psychiatrists (2016)
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Educational Outreach Award for Child and Adolescent Psychiatry, American Academy of Child and Adolescent Psychiatry (2015)
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American Psychiatric Association Substance Abuse and Mental Health Services Administration, SAMHSA Minority Fellowship Awardee (2014-16)
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American Association for Directors of Psychiatry Residency Training, International Medical Graduate Fellowship Awardee (2014)
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American Psychiatric Association, Annual Research Colloquium for Junior Investigators Awardee (2014)
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Resident Psychiatric Educator Award, Association for Academic Psychiatry (2014)
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American Academy of Child and Adolescent Psychiatry, Educational Outreach Award for General Psychiatry Residents (2013)
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American Psychiatric Association, Resident Research Award (2013)
Boards, Advisory Committees, Professional Organizations
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Member, Executive Committee, American Association of Directors of Psychiatric Residency Training (2022 - Present)
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Member, Executive Committee, Association for Academic Psychiatry (2021 - Present)
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Editorial Board Member, Academic Psychiatry (2023 - Present)
Professional Education
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Board Certification: American Board of Psychiatry and Neurology, Child and Adolescent Psychiatry (2016)
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Fellowship: Stanford University Child and Adolescent Psychiatry Fellowship (2016) CA
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Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2014)
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Residency: University of Massachusetts Psychiatry Residency (2014) MA
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Medical Education: Kasturba Medical College (2009) India
2024-25 Courses
- Psychiatry and Behavioral Sciences Subspecialty Areas
PSYC 249 (Win) -
Prior Year Courses
2023-24 Courses
- Psychiatry and Behavioral Sciences Subspecialty Areas
PSYC 249 (Aut)
- Psychiatry and Behavioral Sciences Subspecialty Areas
All Publications
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Workforce Initiatives to Advance Health Equity and Diverse Representation.
Child and adolescent psychiatric clinics of North America
2024; 33 (3): 437-445
Abstract
The persistence of health inequity and the need for workforce diverse representation within child and adolescent psychiatry require systemic solutions. There are recommendations and strategies particularly for the training programs with "all of the above" approach to tackle these complex systemic issues. One of the ways is to think through existing and innovative training pipelines by making them less leaky, enhancing quality, expanding the type and size, and connecting them to reach children and adolescents in need.
View details for DOI 10.1016/j.chc.2024.02.009
View details for PubMedID 38823815
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Advancing Health Equity, Diversity, and Inclusion in Psychiatry Graduate Medical Education.
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2024
View details for DOI 10.1007/s40596-024-01954-2
View details for PubMedID 38443655
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A scoping review of social media in child, adolescents and young adults: research findings in depression, anxiety and other clinical challenges.
BJPsych open
2023; 9 (5): e152
Abstract
BACKGROUND: Social media and other technologies are reshaping communication and health.AIMS: This review addresses the relationship between social media use, behavioural health conditions and psychological well-being for youth aged <25 years.METHOD: A scoping review of 11 literature databases from 2000 to 2020 explored research studies in youth in five areas: clinical depression and anxiety, quantitative use, social media mode, engagement and qualitative dimensions and health and well-being.RESULTS: Out of 2820 potential literature references, 140 met the inclusion criteria. The foci were clinical depression and anxiety disorders (n = 78), clinical challenges (e.g. suicidal ideation, cyberbullying) (n = 34) and psychological well-being (n = 28). Most studies focused on Facebook, Twitter, Instagram and YouTube. Few studies are longitudinal in design (n = 26), had comparison groups (n = 27), were randomised controlled trials (n = 3) or used structured assessments (n = 4). Few focused on different youth and sociodemographic populations, particularly for low-income, equity-seeking and deserving populations. Studies examined association (n = 120; 85.7%), mediating (n = 16; 11.4%) and causal (n = 4; 2.9%) relationships. Prospective, longitudinal studies of depression and anxiety appear to indicate that shorter use (≤3 h/day) and purposeful engagement is associated with better mood and psychological well-being. Depression may predict social media use and reduce perception of support. Findings provide families, teachers and providers ways to engage youth.CONCLUSIONS: Research opportunities include clinical outcomes from functional perspective on a health continuum, diverse youth and sociodemographic populations, methodology, intervention and privacy issues. More longitudinal studies, comparison designs and effectiveness approaches are also needed. Health systems face clinical, training and professional development challenges.
View details for DOI 10.1192/bjo.2023.523
View details for PubMedID 37563766
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Obsessive-Compulsive Disorder.
Pediatrics in review
2023; 44 (5): 297-299
View details for DOI 10.1542/pir.2022-005715
View details for PubMedID 37122041
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The Burden of Leadership: a Survey of Burnout Experiences Among Psychiatry Program Directors.
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2022
Abstract
The objectives of this study were to examine the prevalence of burnout, specify contributors to and protective factors against burnout, and gather suggestions to improve well-being in psychiatry Program Directors.A survey regarding burnout and wellness was distributed to psychiatric Program Directors through the email listserv of the American Association of Directors of Psychiatric Residency Training (AADPRT).The survey response rate was 273 responses out of 880 members surveyed (31%). The majority of respondents were current residency or fellowship Program Directors or Associate Program Directors or had another current educational role (93%, 227/245). Almost half of current Program Directors or Associate Program Directors reported feeling burned out almost daily or once a week (44%, 93/210). These Program Directors reported a desire to resign (77%), experienced discrimination within the past 5 years (66%), and struggled with finding meaning in their job (44%). The most frequently endorsed contributors to burnout were increasing administrative burden and insufficient support.The survey findings confirm that burnout characteristics are common among respondents, associated with a desire to resign and a struggle to find meaning in the highly demanding position of Program Director or Associate Program Director. Advocacy for resources, decreased administrative overload, and increased protected time would enhance well-being in Program Directors. Most striking was the frequency of discrimination reported and its relationship to burnout. Departments may benefit from a careful review of policies, procedures, and training to decrease hostile workplaces for women, international medical graduate, and under-represented in medicine Program Directors.
View details for DOI 10.1007/s40596-022-01675-4
View details for PubMedID 35761064
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Child and Adolescent Psychiatry Fellowship Program Participation in the National Resident Matching Program Match: Trends and Implications for Recruitment.
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2021
Abstract
OBJECTIVE: Recruitment is one of the most important missions for the Child and Adolescent Psychiatry (CAP) Caucus of the American Association of Directors of Psychiatric Residency Training, the American Academy of Child and Adolescent Psychiatry, and the American Association of Directors of Child and Adolescent Psychiatry. A review of the National Resident Matching Program (NRMP) Match data is needed to inform current and future practices.METHODS: The NRMP, Accreditation Council for Graduate Medical Education, and Association of American Medical College databases were queried from 1996 to 2021.RESULTS: The NRMP data show that the number of programs participating in the Match has increased from 87 in 1996 to 106 in 2021 and that the percentage of programs that fill their positions in the Match is increasing and has increased from 41% in 1996 to 67% in 2021. However, each year, a percentage of programs do not fill their positions offered in the Match. The numbers indicate a surplus of positions for the number of applicants that appears to be increasing, and there are currently 49 more positions than applicants.CONCLUSIONS: Trends in the CAP Match are encouraging, and importantly, more programs and applicants are using the Match. One concerning trend is the surplus of positions while there is a great need for child psychiatrists. More research is needed on the incentives for programs and applicants to participate in the Match and how to increase interest in child and adolescent psychiatry.
View details for DOI 10.1007/s40596-021-01546-4
View details for PubMedID 34854071
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Sexual Health in Child and Adolescent Psychiatry: Multi-Site Implementation Through Synchronized Videoconferencing of an Educational Resource Using Standardized Patients
FRONTIERS IN PSYCHIATRY
2020; 11: 593101
Abstract
Objective: Matters of sexuality and sexual health are common in the practice of child and adolescent psychiatry (CAP), yet clinicians can feel ill-equipped to address them with confidence. To address this gap in training and practice, we developed, implemented, and evaluated an educational module enhanced by videotaped depictions of expert clinicians interacting with professional actors performing as standardized patients (SPs). Methods: We developed an educational resource highlighting common issues of sexual health relevant to CAP practice, including sexual development, psychotropic-related side effects, and sexuality in children with autism. We wrote original scripts, based on which two clinicians interacted with three SPs. Digital recordings were edited to yield 5 clips with a cumulative running time of 20 min. The clips were interspersed during a 90-min session comprising didactic and interactive components. Due to the COVID-19 pandemic, we used synchronous videoconferencing, which allowed content dissemination to several training programs across the country. Results: We recruited 125 learners from 16 CAP training programs through the American Academy of CAP's Alliance for Learning and Innovation (AALI). Routine inquiry into adolescent patients' sexual function was uncommon, reported by only 28% of participants, with "awkward" and "uncomfortable" the most common terms mentioned in reference to the clinical task. The didactic intervention led to measurable improvements after 2 weeks in skills and knowledge (p = 0.004) and in attitudes (p < 0.001). The three items with the greatest improvement were: (a) availability of developmentally tailored resources; (b) comfort in addressing sexual development with underage patients; and (c) with parents or guardians of neuroatypical or developmentally disabled patients (p < 0.001 for each). Conclusions: A sexual health curriculum enriched by video-based examples can lead to measurable improvement in outcomes pertinent to the clinical practice of CAP. These educational materials are available for distribution, use and adaptation by local instructors. Our study also provides proof-of-principle for the use of multisite educational initiatives in CAP through synchronized videoconferencing.
View details for DOI 10.3389/fpsyt.2020.593101
View details for Web of Science ID 000595599700001
View details for PubMedID 33329142
View details for PubMedCentralID PMC7716796
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Child and adolescent asynchronous technology competencies for clinical care and training: Scoping review.
Families, systems & health : the journal of collaborative family healthcare
2020
Abstract
Objective: Asynchronous technologies such as mobile health, e-mail, e-consult, and social media are being added to in-person and synchronous service delivery. To ensure quality care, clinicians need skills, knowledge, and attitudes related to technology that can be measured. This study sought out competencies for asynchronous technologies and/or an approach to define them. Methods: This 6-stage scoping review of Pubmed/Medline, APA PsycNET, PsycINFO and other databases was based on a broad research question, "What skills are needed for clinicians and trainees to provide quality care using asynchronous technologies for children and adolescents, and how can they be made measurable to implement, teach and evaluate?" The search focused on key words in 4 concept areas: (a) competencies; (b) asynchronous technology; (c) synchronous telepsychiatry, telebehavioral or telemental health; and (d) clinical. The screeners reviewed the full-text articles based on inclusion (mesh of the key words) and exclusion criteria. Results: From a total of 5,877 potential references, 2 authors found 509 eligible for full text review and found 110 articles directly relevant to the concepts. Clinical studies discuss clinical, technical and administrative workflow rather than competencies, though behavioral health professions' position statements advise on adapting care and training. Existing technology competencies for video, social media, mobile health, and other asynchronous technologies were used to build a framework. Training, faculty development, and organizational suggestions are suggested. Conclusions: Research is needed on how to implement and evaluate asynchronous competencies to ensure quality clinical care and training, which is a paradigm shift for participants. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
View details for DOI 10.1037/fsh0000536
View details for PubMedID 33151726
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Trainees on Technological Terrain: a Video Vignette-Based Tool to Teach E-Professionalism.
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2020
View details for DOI 10.1007/s40596-020-01325-7
View details for PubMedID 33058052
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Clinical Conundrum: How do you treat youth with depression and a family history of bipolar disorder?
BIPOLAR DISORDERS
2019; 21 (4): 383–86
View details for DOI 10.1111/bdi.12788
View details for Web of Science ID 000473072200014
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Pharmacological Approaches for Treating Suicidality in Adolescents
EVIDENCE-BASED TREATMENT APPROACHES FOR SUICIDAL ADOLESCENTS: TRANSLATING SCIENCE INTO PRACTICE
2019: 293–331
View details for Web of Science ID 000550052900011
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Principles of Treatment of Mood Disorders Across Development
CLINICAL HANDBOOK FOR THE DIAGNOSIS AND TREATMENT OF PEDIATRIC MOOD DISORDERS
2019: 83–104
View details for Web of Science ID 000550988100006
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Social Media and Networking Competencies for Psychiatric Education: Skills, Teaching Methods, and Implications.
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2018
View details for PubMedID 30284148
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Therapeutic Assignments: Piloting a Way for Medical Students on the Psychiatry Clerkship to Interact with Patients Beyond the Initial Interview.
Academic psychiatry
2017
View details for DOI 10.1007/s40596-017-0734-0
View details for PubMedID 28589326
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Treatment of psychiatric symptoms among offspring of parents with bipolar disorder.
Current treatment options in psychiatry
2017; 4 (4): 341–56
Abstract
Bipolar disorder is highly familial and has a protracted and diagnostically confusing prodrome. This review critically evaluates recently published literature relevant to the treatment of psychiatric symptoms in high-risk offspring of parents with Bipolar Disorder.Non-pharmacological treatment options including psychotherapy, resilience promotion through good sleep, diet, and exercise hygiene, and omega-3 fatty acid supplementation are important first line interventions for high-risk offspring. There has been some success in treating this population with open-label trials with mood stabilizers and atypical antipsychotics; however, these results have not been replicated in randomized controlled trails.Despite some progress in early identification of symptoms in offspring of parents with Bipolar Disorder, there is scarce evidence supporting the treatment of these high-risk youth to prevent psychiatric symptoms from progressing to threshold bipolar or other psychiatric disorders. There is a need for prospective and randomized trials and research that identifies reliable biomarkers to individualize treatments for these youth.
View details for PubMedID 29503793
View details for PubMedCentralID PMC5831272
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Does psychosis increase the risk of suicide in patients with major depression? A systematic review
JOURNAL OF AFFECTIVE DISORDERS
2016; 198: 23-31
Abstract
Over the years studies have shown conflicting results about the risk of suicide in psychotic depression (MD-psych). To understand this association, we undertook a comprehensive review of the literature to ascertain whether individuals with MD-psych have higher rates of completed suicides, suicide attempts or suicidal ideation compared to those with non-psychotic depression (MD-nonpsych).We searched Pubmed, PsycINFO and Ovid in English language, from 1946-October 2015. Studies were included if suicidal ideation, attempts or completed suicides were assessed.During the acute episode of depression, patients with MD-psych have higher rates of suicide, suicide attempts, and suicidal ideation than patients with MD-nonpsych, especially when the patient is hospitalized on an inpatient psychiatric unit. Studies done after the acute episode has resolved are less likely to show this difference, likely due to patients having received treatment.Diagnostic interviews were not conducted in all studies. Many studies did not report whether psychotic symptoms in MD-psych patients were mood-congruent or mood-incongruent; hence it is unclear whether the type of delusion increases suicide risk. Studies did not describe whether MD-psych patients experienced command hallucinations encouraging them to engage in suicidal behavior. Only 24 studies met inclusion criteria; several of them had small sample size and a quality score of zero, hence impacting validity.This review indicates that the seemingly conflicting data in suicide risk between MD-psych and MD-nonpsych in previous studies appears to be related to whether one looks at differences during the acute episode or over the long-term.
View details for DOI 10.1016/j.jad.2016.03.035
View details for Web of Science ID 000375058100003
View details for PubMedID 26998793
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Relationship between serum uric acid level and cardiometabolic risks in nondiabetic patients with schizophrenia
INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY
2016; 31 (1): 51-56
Abstract
This study examined the relationship between serum levels of uric acid and insulin resistance and metabolic syndrome in nondiabetic patients with schizophrenia. Outpatients diagnosed with schizophrenia or schizoaffective disorder participated in a multicenter, cross-sectional study. Fasting blood samples were obtained to determine serum levels of metabolic measures. A total of 135 patients were recruited for the study. A significant positive relationship was found between serum levels of uric acid and the homeostasis model of assessing insulin resistance (log transformed, r=0.394, P<0.001), and a significant negative relationship was found between serum levels of uric acid and low-density lipoprotein particle size (log transformed, r=-0.306, P=0.001) after controlling for potential confounding variables. Hierarchical multiple regression suggested that serum uric acid level is a significant predictor of insulin resistance (P=0.001) and of low-density lipoprotein particle size (P<0.015). Further, logistic regression showed that serum uric acid levels strongly predicted the condition of metabolic syndrome (odds ratio 0.630, 95% confidence interval 0.463-0.856, P=0.003). This study suggested that uric acid may be a clinically useful biomarker to indicate cardiometabolic risks in nondiabetic patients with schizophrenia.
View details for DOI 10.1097/YIC.0000000000000107
View details for Web of Science ID 000366691200007
View details for PubMedID 26550697
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Decisional Capacity in Pregnancy: A Complex Case of Pregnancy Termination
PSYCHOSOMATICS
2015; 56 (3): 292-297
View details for Web of Science ID 000354405900009
View details for PubMedID 25591494
View details for PubMedCentralID PMC4400254