Barbara L. Gracious, MD

Gender:

• Female

Languages Spoken:

• English

Research Center:

• Center for Innovation in Pediatric Practice

Areas of Interest:

• Vitamin D deficiency in populations with mental health disorders Dr. Gracious is exploring the role vitamin D deficiency plays in populations with mental health disorders. Data suggests that vitamin D deficiency is associated with depression, risk for diabetes and that there is a relationship between vitamin D deficiency and bone health, milk intake and food security in adults with major depression. She plans to study whether or not adolescents with vitamin D deficiency who receive vitamin D supplementation when entering treatment will experience better response to depression treatment and metabolic health.
• Bone health in children and adolescents with mental disorders Dr. Gracious is leading a pilot project funded by Nationwide Children’s Hospital examining bone density in children and adolescents who have taken SSRI antidepressants for at least 2 years. Basic science data, epidemiologic studies of late life depression, and clinical reports indicate that SSRIs are associated with increased risk for fracture. We will use this data to apply for NIH funding to explore mechanisms and preventive strategies. She is also examining whether bone biomarkers in adolescent girls might predict who is at risk for bone loss when prescribed an SSRI antidepressant.
• Metabolic health in adolescents Dr. Gracious also plans to examine the use of a low omega-6, high omega-3 dietary intervention in adolescents with elevated lipid profiles who are being treated with second generation antipsychotics to lower their cardiovascular risk for future heart disease. Future work may also prospectively examine the risk for hypertension and related factors in adolescents with major mood disorders.
• The Gracious Lab focuses on metabolic health risk and prevention in adolescents with mood disorders. Overall Dr. Gracious uses a lifespan perspective to unify physical and emotional health of children at risk.

Undergraduate School

• Northwestern University
  Date Completed: 06/30/1979

Medical School

• Northwestern University
  Date Completed: 06/18/1983

Medical School

• Northwestern University Medical School
  Date Completed: 06/30/1983

Residency

• University of Wisconsin
  Date Completed: 06/30/1986

Residency

• Western Psychiatric Institute & Clinic at UPMC
  Date Completed: 03/30/1990

Residency

• Western Psychiatric Institute & Clinic at UPMC
  Date Completed: 06/30/1990

Department:

• Psychiatry

Speciality:

• Child and Adolescent Psychiatry
  
• Internal Medicine
  
• Psychiatry
  

Date of Appointment at Nationwide Children’s Hospital:

• 08/06/2010

2010–present

• Principal Investigator, Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital

2010–present

• Medical Director, TEAMS Program, Ohio State University School of Medicine and Dentistry

2010–present

• Associate Clinical Professor of Psychiatry, Ohio State University

2008–2010

• Associate Professor of Psychiatry, Obstetrics and Gynecology, and Pediatrics, University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital

2008–2009

• Academic Director, Child Psychiatry, University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital

2007–2008

• Director, Child and Adolescent Psychiatry, University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital

2006–2010

• Clinical Volunteer, NIH Clinical Center Sabbatical Program, Emphasis in obesity, diet/nutrition, and CVD

2002–2002

• Director, Child and Adolescent Residency Training and Education Program, Case Western Reserve University School of Medicine, 
  University Hospitals of Cleveland

1999–2002

• Assistant Professor of Psychiatry and Pediatrics, Tenure Track , Division of Child and Adolescent Psychiatry, Case Western Reserve University School of Medicine, University Hospitals of Cleveland

1998–1999

• Associate Program Director, Residency in Child Psychiatry

1996–1998

• Program Director (initiator), Residency in Child Psychiatry
  Scott and White Clinic, Temple, Texas

1993–1998

• Director, Division of Child and Adolescent Mental Health
  Scott and White Clinic, Temple, Texas
  

1992–1999

• Department of Psychiatry and Behavioral Sciences, Assistant Professor of Psychiatry and Pediatrics, Texas A&M University, College Station

1992–1992

• Psychiatric Consultant, Child Services, North Hills MHMR, Wexford, Pennsylvania

1992–1992

• Private Practice, Wexford, Pennsylvania

1992–1992

• Director, Children's Unit (locum tenens), The Meadows Psychiatric Center, State College, Pennsylvania

1992–1992

• Riverview Intermediate Unit (School Consultation), Clarion, Pennsylvania

1990–1991

• Center for Behavioral Medicine, Child and Adult Psychiatry
  Braddock Medical Center, Armstrong County Memorial Hospital

1990–1990

• Assistant Professor of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania

1990–1990

• Program Coordinator, Behavioral Science Outpatient Clinic, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania

• Gracious BL, Llana M, Barton DD. “Lithium and geographic tongue.” J Am Acad Child Adolesc Psychiatry 1999 Sep;38(9):1069-70.
• Findling RL, McNamara NK, Gracious BL, Youngstrom EA, Stansbrey RJ, Reed MD, Demeter CA, Branicky LA, Fisher KE, Calabrese JR. “Combination lithium and divalproex in pediatric bipolarity” J Am Acad Child Adolesc Psychiatry, 2003 Aug;42(8):895-901.
• Gracious BL, Meyer A. “Psychotropic-Induced Weight Gain and Potential Pharmacologic Treatment Strategies.” Psychiatry 2005; (2)1:36-40 (invited manuscript)
• Findling RL, McNamara NK, Youngstrom EA, Stransbrey R, Gracious BL, Reed MD, Shelton M, Calabrese JR. “Double blind 18-month trial of lithium versus divalproex maintenance treatment in children and adolescents with bipolar disorder”. J Am Acad Child Adolesc Psychiatry 2005;44(5):409-17.
• Gracious BL, Youngstrom EA, Findling RL, Calabrese JR. “Discriminative validity of a parent version of the Young Mania Rating Scale.” J Am Acad Child Adolesc Psychiatry, 2002;41(11):1350-9.
• Gracious, BL. “Reproductive endocrine changes in women taking valproate: Part 1.” Int Drug Ther News 2000;35(7):1-2. (peer-reviewed)
• Findling RL, McNamara NK, Gracious BL, O’Riordan MA, Reed MD, Demeter C, Blumer JL. “Quetiapine in Nine Youths with Autistic Disorder” J Child Adolesc Psychopharmacol, 2004 Summer;14(2):287-94.
• Gracious BL, Abe N, Sundberg, J. The Importance of Taking a History of Over-The-Counter Medication Use: A brief review and case illustration of “prn” antihistamine dependence in a hospitalized adolescent. J Child Adolesc Psychopharmacol. 2010 Dec;20(6):521-4.
• Youngstrom EA, Gracious BL, Danielson CK, Findling RL, Calabrese J. “Toward an intergration of parent and clinician report on the Young Mania Rating Scale” J Affect Disord, 2003 Nov;77(2):179-90.
• Findling RL., Gracious BL, McNamara N, Calabrese J. “The rationale, design and progress of two novel maintenance treatment studies in pediatric bipolarity.” Acta Neuropsychiatrica 2000;12: 136-138.
• Gracious, BL. “Elevated TSH in bipolar youth prescribed both lithium and divalproex sodium.” Int Drug Ther News 2001 Oct. (peer-reviewed)
• Campo JV, Stowe R, Slomka G, Byler D, Gracious BL. “Psychosis as a presentation of physical disease in adolescence: a case of Niemann-Pick disease, type C.” Developmental Medicine & Child Neurology 1998;40:126-129.
• Findling RL, Short EJ, McNamara N, Stansbrey RJ, Demeter, CA, Gracious BL, Whipkey R, Manos MJ, Calabrese JR. “Methylphenidate in the treatment of children and adolescents with bipolar disorder and attention-deficit/hyperactivity disorder.” J Am Acad Child Adolesc Psychiatry 2007 (46):11; 1445-1453.
• Gracious BL. Hanusa BH. Wisner KL. Peindl KS. Perel JM. “Weight changes in postpartum women with remitted depression.” Journal of Clinical Psychiatry 2005; 66(3):291-3
• Findling RL, McNamara NK, Gracious, BL. “Pediatric uses of atypical antipsychotics.” Expert Opin Pharmacother 2000 Dec;1(7):1497
• Gracious BL, Chirieac MC, Costescu S, Finucane TL, Youngstrom EA, Hibbeln JR. Randomized, placebo-controlled trial of flax oil in pediatric bipolar disorder. Invited manuscript, Bipolar Disord 2010: 12: 142–154.
• Gracious, B. “Reproductive endocrine changes in women taking valproate: Part 2 – Children & Adolescents.” International Drug Therapy Newsletter.2000;35(8):1-2. (peer-reviewed)
• Gracious, BL. “Atypical antipsychotics and hyperprolactinemia.” International Drug Therapy News 2000;35(1):1-3. (peer-reviewed)
• Findling RL, Gracious BL, Stansbrey RJ. “Antidepressant pharmacotherapy of ADHD – children and adolescents.” Int Drug Ther News 2001, Nov
• Wagner KD, Hirschfeld RM, Emslie GJ, Findling RL, Gracious BL, Reed ML. “Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents.” Journal of Clinical Psychiatry 67(5):827-830, 2006 May.
• Gracious, B. “Reproductive endocrine changes in women taking valproate: Part 3 – Management Strategies.” International Drug Therapy Newsletter, 2000;35(9):1-2. (peer-reviewed)
• Gracious BL, Wisner KL. “Phenelzine use throughout pregnancy and the puerperium: case report, review of the literature, and management recommendations.” Depression Anxiety 1997;6(3):124-8.
• Findling RL, Gracious BL, McNamara NK, Youngstrom EA, Demeter CA, Branicky LA, Calabrese JR. ‘Rapid, continuous cycling and psychiatric co-morbidity in pediatric bipolar I disorder.” Bipolar Disord 2001 Aug;3(4):202-210.
• Youngstrom EA, Danielson CK, Findling RL, Gracious BL, Calabrese JR. “Factor structure of the Young Mania Rating Scale for use with youths ages 5 to 17 years.” J Clin Child and Adolesc Psychol, 2002 Dec;31(4):567-72.
• Findling RL, Frazier TW, Youngstrom EA, McNamara NK, Stansbrey RJ, Gracious BL, Reed MD, Demeter CA. Calabrese JR,; "Double-blind, placebo-controlled trial of divalproex monotherapy in the treatment of symptomatic youth at high risk for developing bipolar disorder". J.Clin.Psychiatry 68 (2007): 781-788.
• Gracious BL, Findling RL. “Antipsychotic medications for children and adolescents.” Pediatric Ann 2001 Mar:30(3);138-145.
• Gracious BL, Cook S, Meyers AE, Chirieac MC, Malhi N, Fischetti A, Ma Y. “Prevalence of overweight in adolescents with severe mental illness.” 2010 May 4 (Epub ahead of print); J Clin Psychiatry
• Youngstrom EA, Findling RL, Calabrese JR, Gracious BL, Demeter C, Bedoya DD, Price M. “Comparing the diagnostic accuracy of six potential screening instruments for bipolar disorder in youths aged 5 to 17 years.” J Am Acad Child Adolesc Psychiatry. 2004 Jul;43(7):847-58.
• Gracious BL, Findling RL, Seman C, Youngstrom EA, Demeter CA, Calabrese JR. “Elevated thyrotropin in bipolar youths prescribed both lithium and divalproex sodium.” J Am Acad Child Adolesc Psychiatry, 2004 Feb;43(2):215-20.
• Gracious BL. “Atrioventricular nodal re-entrant tachycardia associated with stimulant treatment.” J Child Adolesc Psychopharmacol 1999;9(2):125-8.
• Gracious BL, Wisner KL. “Nortriptyline in Chronic Fatigue Syndrome: A Double-Blind, Placebo-Controlled Single Case Study.” Biologic Psychiatry 1991 Aug;30(4):405-8.
• Findling, R, McNamara N, Gracious B. “Central and peripheral nervous systems: Pediatric uses of atypical antipsychotics.” Exp Opin Pharmacother 2000;1(5):935-945.
• Findling RL, McNamara NK, Stansbrey R, Gracious BL, Whipkey RE, Demeter CA, Reed MD, Youngstrom EA, Calabrese JR. “Combination Lithium and Divalproex Sodium in Pediatric Bipolar Symptom Re-stabilization” J AM Academy Child Adolescent Psychiatry 2006; 45(2):142-8.
• Gracious BL, Krysiak TE, Youngstrom EA. “Amantadine treatment of psychotropic-induced weight gain in children and adolescents: case series.” J Child Adolesc Psychopharmacol, 2002 Fall;12(3):249-57.