LAWRENCE McGLYNN
Clinical Professor, Psychiatry and Behavioral Sciences - Medical Psychiatry
Clinical Focus
- Psychiatry
- Amphetamine-Related Disorders
- HIV-Associated Neurocognitive Disorder
- HIV Dementia
- Insomnia Disorder
- Pain Disorder
- Neuropharmacology
- Psychopharmacology
- Encephalopathies, HIV
- AIDS Seroconversion
- AIDS Long Term Survivors
- Hepatitis C
- Transgender
- Acquired Immunodeficiency Syndrome
Administrative Appointments
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Principal Investigator, Stanford-SCC Methamphetamine Task Force (2002 - Present)
Honors & Awards
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Burgiss HIV/AIDS LIfetime Achievement Award, Santa Clara County Board of Supervisors (December 2010)
Professional Education
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Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2015)
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Internship: St Vincent's Hospital (Closed 12/2010) (1997) NY
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Residency, Harvard Medical School - Cambridge Hospital, Psychiatry (2000)
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Medical Education: Harvard Medical School (1996) MA
Community and International Work
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AIDS Education and Training Center
Topic
HIV/AIDS and Comorbidities
Partnering Organization(s)
Community Health Partnership
Populations Served
HIV/AIDS, Community Physicians
Location
California
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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Stanford - Santa Clara Methamphetamine Task Force, Santa Clara County
Topic
Director
Partnering Organization(s)
AIDS Legal Services, The Health Trust
Populations Served
Santa Clara County
Location
Bay Area
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
Current Research and Scholarly Interests
Methamphetamine Abuse
HIV Neuropsychiatry
2024-25 Courses
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Independent Studies (5)
- Directed Reading in Psychiatry
PSYC 299 (Aut, Win, Spr, Sum) - Graduate Research
PSYC 399 (Aut, Win, Spr, Sum) - Medical Scholars Research
PSYC 370 (Aut, Win, Spr, Sum) - Teaching in Psychiatry
PSYC 290 (Aut, Win, Spr, Sum) - Undergraduate Research, Independent Study, or Directed Reading
PSYC 199 (Aut, Win, Spr, Sum)
- Directed Reading in Psychiatry
Graduate and Fellowship Programs
All Publications
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Neurofunctional characteristics of executive control in older people with HIV infection: a comparison with Parkinson's disease.
Brain imaging and behavior
2022
Abstract
Expression of executive dysfunctions is marked by substantial heterogeneity in people living with HIV infection (PLWH) and attributed to neuropathological degradation of frontostriatal circuitry with age and disease. We compared the neurophysiology of executive function in older PLWH and Parkinson's disease (PD), both affecting frontostriatal systems. Thirty-one older PLWH, 35 individuals with PD, and 28 older healthy controls underwent executive task-activated fMRI, neuropsychological testing, and a clinical motor exam. fMRI task conditions distinguished cognitive control operations, invoking a lateral frontoparietal network, and motor control operations, activating a cerebellar-precentral-medial prefrontal network. HIV-specific findings denoted a prominent sensorimotor hypoactivation during cognitive control and striatal hypoactivation during motor control related to CD4+ T cell count and HIV disease duration. Activation deficits overlapped for PLWH and PD, relative to controls, in dorsolateral frontal, medial frontal, and middle cingulate cortices for cognitive control, and in limbic, frontal, parietal, and cerebellar regions for motor control. Thus, despite well-controlled HIV infection, frontostriatal and sensorimotor activation deficits occurred during executive control in older PLWH. Overlapping activation deficits in posterior cingulate and hippocampal regions point toward similarities in mesocorticolimbic system aberrations among older PLWH and PD. The extent of pathophysiology in PLWH was associated with variations in immune system health, neural signature consistent with subclinical parkinsonism, and mild neurocognitive impairment. The failure to adequately engage these pathways could be an early sign for cognitive and motor functional decline in the aging population of PLWH.
View details for DOI 10.1007/s11682-022-00645-6
View details for PubMedID 35294979
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Community Mental Health Supervision Serving the Underserved
SUPERVISION IN PSYCHIATRIC PRACTICE: PRACTICAL APPROACHES ACROSS VENUES AND PROVIDERS
2019: 227–32
View details for Web of Science ID 000550978200026
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Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Students
STUDENT MENTAL HEALTH: A GUIDE FOR PSYCHIATRISTS, PSYCHOLOGISTS, AND LEADERS SERVING IN HIGHER EDUCATION
2018: 411–24
View details for Web of Science ID 000552225100028
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Integrative Treatments
Comprehensive Textbook of AIDS Psychiatry: A Paradigm for Integrated Care
Oxford University Press. 2017; 2nd
View details for DOI 10.1093/med/9780199392742.003.0038
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People Living With HIV/AIDS
CLINICAL GUIDE TO PSYCHIATRIC ETHICS
2016: 147–56
View details for Web of Science ID 000473652900012
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TREATING PSYCHOLOGICAL TRAUMA AMONG RWANDAN ORPHANS IS ASSOCIATED WITH A REDUCTION IN HIV RISK-TAKING BEHAVIORS: A PILOT STUDY
AIDS EDUCATION AND PREVENTION
2013; 25 (6): 468-479
Abstract
The nongovernmental organization, Uyisenga N'Manzi (UNM), provides Rwandan orphans of genocide and HIV/AIDS with education, social, and mental health services. Many orphans in UNM report symptoms of psychological trauma. The primary study objective was to evaluate a multidisciplinary program integrating HIV prevention with an existing package of mental health services. We randomly selected 120 orphans between ages 15-25 years served by UNM and evaluated sexually-transmitted infections, HIV risk-taking behaviors and knowledge, and mental health at baseline, 5, 9, and 12 months. Increased trauma symptoms at baseline were associated with poorer coping skills and social functioning, and increased psychological distress and HIV risk-taking behavior. Following the 12-month intervention, trauma symptoms declined significantly, with those accessing counseling services showing greatest improvement. Orphans with the highest trauma scores benefited most from the intervention. In this at-risk population, addressing mental health issues in the context of HIV prevention is critical.
View details for Web of Science ID 000327416100002
View details for PubMedID 24245594
- HIV/AIDS: Measuring an Evolving Virus Journal of Human Behavior in the Social Environment, 2011; 21 (4): 398:409
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HIV/AIDS: Measuring an Evolving Virus
JOURNAL OF HUMAN BEHAVIOR IN THE SOCIAL ENVIRONMENT
2011; 21 (4): 398–409
View details for DOI 10.1080/10911359.2011.561165
View details for Web of Science ID 000211991600006
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A pilot study investigating the effects of trauma, experiential avoidance, and disease management in HIV-positive MSM using methamphetamine.
Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)
2010; 9 (2): 78-81
Abstract
With high rates of trauma among HIV-positive men who have sex with men (MSM) who use methamphetamine, this preliminary pilot study examined the associations between experiential avoidance, trauma symptoms, and management of a chronic illness. Among a small sample of HIV-positive, methamphetamine-using MSM in a California Bay Area County, greater reported experiential avoidance was significantly related to greater reported trauma and symptoms of traumatic stress. Furthermore, greater reported experiential avoidance was significantly related to reduced self-efficacy of illness management and more frequent methamphetamine use. Although further research is needed, these data suggest that addressing issues of experiential avoidance and trauma could affect behavioral choices and treatment outcomes in this high-risk population.
View details for DOI 10.1177/1545109709360065
View details for PubMedID 20142604
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Personal Values and Meaning in the Use of Methamphetamine Among HIV-Positive Men Who Have Sex With Men
QUALITATIVE HEALTH RESEARCH
2009; 19 (4): 504-518
Abstract
Our aim with this qualitative study was to understand the role of personal values, meaning, and impact of drug use among HIV-positive men who have sex with men (MSM) who struggle with methamphetamine use. Participants were 22 MSM recruited from an ethnically diverse county in the San Francisco Bay area of California. Grounded theory was used to analyze the data collected in individual interviews. Emergent constructs of context, meaning, and perceived impact were identified and are described in a theoretical narrative format. The importance of broadening our understanding of HIV and methamphetamine addiction and their interaction is highlighted. This study contributes to the understanding of the complexity of methamphetamine use within the specific population of MSM living with HIV/ AIDS, and suggests possible directions for addressing important maintaining factors like adaptive use and enhancing factors that could contribute to an individual's ability to make better choices based on meaning and personal values.
View details for DOI 10.1177/1049732309333018
View details for Web of Science ID 000264405400008
View details for PubMedID 19299756
- Psychopharmacology and the HIV Positive Patient American Society of Clinical Psychopharmacology Model Psychopharmacology Curriculum (ASCP) for Training Directors and Teachers of Psychopharmacology in Psychiatric Residency Programs 2009; 5
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HIV-associated cognitive impairment: key issues for providers.
Focus (San Francisco, Calif.)
2008; 23 (3): 5-8
View details for PubMedID 19062783
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IMPACT OF PNEUMOCYSTIS-CARINII AND CYTOMEGALOVIRUS ON THE COURSE AND OUTCOME OF ATYPICAL PNEUMONIA IN ADVANCED HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE
JOURNAL OF INFECTIOUS DISEASES
1992; 165 (1): 93-98
Abstract
Patients undergoing bronchoscopy for possible pneumocystis pneumonia were studied retrospectively to characterize the impact of common viral pathogens on the course of advanced human immunodeficiency virus (HIV) disease and atypical pneumonia. In 327 episodes, Pneumocystis carinii was found in 220 (67%), cytomegalovirus (CMV) in 145 (44%), and herpes simplex virus in 16 (5%). Early deterioration in oxygenation and use of intensive care was less common in CMV-positive patients. Neither CMV nor P. carinii was a predictor of mortality in multivariate analyses. CMV was not associated with an increased prevalence of later CMV disease. Isolation of CMV from the bronchoalveolar lavage fluid of these patients was not an indication for antiviral therapy. Pulmonary shedding of CMV may be associated with a decreased inflammatory response to P. carinii. The outcome of HIV-associated atypical pneumonia where no clear pulmonary pathogen is found on routine evaluation was no better than that of treated P. carinii pneumonia.
View details for Web of Science ID A1992GW58200012
View details for PubMedID 1309375
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The impact of concomitant viral pathogens on the course of Pneumocystis carinii pneumonia.
journal of protozoology
1991; 38 (6): 183S-184S
Abstract
A large retrospective study was conducted to evaluate the impact of culturing cytomegalovirus from the respiratory secretions of AIDS patients with Pneumocystis carinii pneumonia. Pneumocystis carinii was found in 220 (67%) of 327 episodes and cytomegalovirus was found in 106 (48%) of the P. carinii-positive patients. Cytomegalovirus-positive and -negative patients were similar at baseline and had a similar number of hospital days, but had a lower incidence of early deterioration in oxygenation, fewer intensive-care days, were less frequently intubated, and had a higher 30-day survival. The better short-term outcome of cytomegalovirus positive patients observed in this study may relate to the immunosuppressive effects of cytomegalovirus.
View details for PubMedID 1667929