Memory complaints linked to changes in brain structure in postmenopausal women

Memory complaints in younger postmenopausal women are associated with differences in brain structure and may serve as an early marker for risk of future cognitive decline, according to a study published June 22 in Menopause by Vanderbilt University Medical Center researchers. The study, conducted in collaboration with the University of Vermont, looked at the impact of self-reported memory and attention complaints on brain structure in women ages 50-60 who were in the early years after menopause.

Kristopher Kast, MD

Kristopher
Kast
MD
Associate Professor of Psychiatry and Behavioral Sciences
Associate Program Director
General Psychiatry Residency
Program Director
Addiction Psychiatry Fellowship
Clinical Director
VUH Addiction Consult Service
kristopher.a.kast@vumc.org

Dr. Kast began serving as Associate Program Director for the Vanderbilt general psychiatry residency in 2025, with a focus on outpatient psychiatry and psychotherapy training. He has also served as Program Director for the addiction psychiatry fellowship since 2021, revising the curriculum, expanding program size, and securing grant funding for a research-focused fellowship position. He lectures on substance-related and addictive disorders across medical education contexts at Vanderbilt, and he leads the psychodynamic psychotherapy curriculum for the general psychiatry residency, organizing the didactic series and leading a cadre of faculty and community supervisors.

He served as interim Director for the Division of Addiction Psychiatry for AY2024-25, assisting the Department Chair in a successful national recruitment effort for a permanent Division Director and the recruitment of additional new faculty and staff to VUMC.

From 2020-24, Dr. Kast led the Tennessee State Opioid Response ECHO Tele-Education Hub at Vanderbilt, providing a CME platform for community clinicians caring for individuals with substance use disorders. This work expanded to include an annual regional conference, the Mid-South Addiction Conference, in partnership with the Tennessee Society for Addiction Medicine in 2022, and a quality improvement initiative with community SUD treatment facilities in 2024.

Dr. Kast joined the Vanderbilt faculty in 2020 after fellowship training in addiction psychiatry at Harvard Medical School and Mass General Brigham's hospitals. He trained in general psychiatry at Weill Cornell and New York-Presbyterian Hospital, where he served as chief resident. While in New York, he began psychoanalytic training with the Columbia University Center for Psychoanalytic Training and Research. Since transitioning to Nashville, he has resumed analytic training with the Psychoanalytic Institute of Northern California (PINC), where he is a current candidate. Before this postgraduate work, he completed undergraduate and medical studies at Notre Dame and the Johns Hopkins University School of Medicine, respectively.

Clinical Work

Dr. Kast serves as an attending addiction psychiatrist on the Addiction Consult Service at VUH, where he has been Clinical Director since 2020. He also cares for outpatients with SUD and co-occurring disorders in the Vanderbilt Recovery Clinic. He has previously attended on the inpatient Co-occurring Disorders Unit at VPH and in the Vanderbilt Bridge Clinic for low-barrier, high-acuity outpatient stabilization. He supervises clinical fellows, residents, and medical students across these levels of care. In addition to this work, Dr. Kast maintains a practice focused on psychoanalysis and psychodynamic psychotherapy.

Research

Dr. Kast's scholarly interests include substance-related and addictive disorders, medical education, psychodynamic psychotherapy, and psychoanalysis.

Representative Publications

Ward HB, Blyth SH, Kast K. Rewiring Recovery: Patient-Centered Neuromodulation Interventions for Substance Use Disorders That Meet People Where They Are. Transcranial Magnetic Stimulation 4 (August 1, 2025). doi: 10.1016/j.transm.2025.100179.

Kast KA, Sidelnik SA, Nejad SH, Suzuki J. Management of alcohol withdrawal syndromes in general hospital settings. British Medical Journal. 2025 Jan 8;388:e080461. doi: 10.1136/bmj-2024-080461. PMID: 39778965.

Dockery LM, Kast KA, Smith M, Stewart LS, Reese T, Wiese AD, Shah MV, Marcovitz DE. Nonprescribed Substance Use in the General Hospital: A Retrospective Study. J Acad Consult Liaison Psychiatry. 2025 Jan-Feb;66(1):27-36. doi: 10.1016/j.jaclp.2024.09.006. Epub 2024 Oct 5. PMID: 39370110.

Kast KA, Le TDV, Stewart LS, Wiese AD, Reddy IA, Smith J, Marcovitz DE, Reese TJ. Impact of inpatient addiction psychiatry consultation on opioid use disorder outcomes. Am J Addict. 2024 Mar 28. doi: 10.1111/ajad.13540. Epub ahead of print. PMID: 38546154.

Marcovitz D, Dear ML, Donald R, Edwards DA, Kast KA, Le TDV, Shah MV, Ferrell J, Gatto C, Hennessy C, Buie R, Rice TW, Sullivan W, White KD, Van Winkle G, Wolf R, Lindsell CJ; Vanderbilt Learning Healthcare System Platform Investigators. Effect of a Co-Located Bridging Recovery Initiative on Hospital Length of Stay Among Patients With Opioid Use Disorder: The BRIDGE Randomized Clinical Trial. JAMA Netw Open. 2024 Feb 5;7(2):e2356430.

Fleenor ML, Beavers JR, Tidwell WP, Atchison L, Woo E, Medvecz AJ, Beyene RT, Kast KA, Marcovitz D, Dennis B, Guillamondegui OD, Smith MC. Comparison of phenobarbital monotherapy to a benzodiazepine-based regimen for management of alcohol withdrawal syndrome in trauma patients. J Trauma Acute Care Surg. 2024 Mar 1;96(3):493-498. doi: 10.1097/TA.0000000000004116. Epub 2023 Aug 21. PMID: 37599414.

Marcovitz D, Kast KA. More effective communication during inpatient addiction treatment. Substance Abuse. 2023 Jan-Apr;44(1):12-16. doi: 10.1177/08897077231165064. Epub 2023 May 3. PMID: 37226907.

Audet CM, Pettapiece-Phillips M, Kast KA, White KD, Perkins JM, Marcovitz D. Implementation of a hospital-based intervention for MOUD initiation and referral to a Bridge Clinic for opioid use disorder. Journal of Substance Use and Addiction Treatment. 2023 Mar;146:208961. doi: 10.1016/j.josat.2023.208961. Epub 2023 Jan 24. PMID: 36880904; PMCID: PMC10018480.

Hwang B, Unruh BT, Kast KA. Applying good psychiatric management for borderline personality disorder in hospitalized patients with co-occurring substance use disorders. J Acad Consult Liaison Psychiatry. 2023 Jan-Feb;64(1):83-91. doi: 10.1016/j.jaclp.2022.08.003. Epub 2022 Aug 19. PMID: 35995146.

Kast KA, Rao V, Wilens T. Pharmacotherapy for attention-deficit/hyperactivity disorder and retention in outpatient substance use disorder treatment: a retrospective cohort study. J Clin Psychiatry. 2021; 82(2).

Marcovitz D, Pettapiece-Phillips MJ, Kast KA, White KD, Himelhoch H, Audet CM. Implementation of a hub-and-spoke network for opioid use disorder in middle Tennessee. Psychiatric Services. 2021; Dec 8.

Marcovitz D, Maruti S, Kast KA, Suzuki J. The use of therapeutic metaphor on an addiction consult service. Psychosomatics. 2020; 62(1):102-108.

The Opioid Epidemic and the Therapeutic Community Model: an essential guide. Eds. Jonathan D. Avery, Kristopher A. Kast. Springer Publishing. 2019.

Avery J, Taylor KE, Kast KA, Kattan J, Gordon-Elliott J, Mauer E, Avery J, Penzner JB. Attitudes toward individuals with mental illness and substance use disorders among resident physicians. Prim Care Companion CNS Disord. 2019 Jan 3;21(1).

Avery J, Knoepflmacher D, Mauer E, Kast KA, Greiner M, Penzner J. Improvement in residents' attitudes toward individuals with substance use disorders following an online training module on stigma. HSS Journal. 2018 Nov 1.

Kast KA, Gershengoren L. Cannabinoid hyperemesis syndrome and the consulting psychiatrist: a case study of diagnosis and treatment for an emerging disorder in psychiatric practice. J Psychiatr Pract. 2018 Jan; 24(1): 51-55.

Kathy Gracey, M.Ed.

Kathy
Gracey
M.Ed.
Research Assistant Professor of Psychiatry and Behavioral Sciences
Division of Child and Adolescent Psychiatry
kathy.gracey@vumc.org

Kathy Gracey received her MEd in Counseling Psychology from the University of Mississippi. She has been a member of the Department of Psychiatry and Behavioral Sciences since 1992. She serves as the administrator, responsible for oversight and implementation, of multiple programs serving at-risk children, youth and families.

Ms. Gracey has been the key person with the Vanderbilt Center of Excellence to assist the Department of Children's Services (DCS) with the implementation of a statewide assessment intervention for all children/families in DCS custody along with the implementation of a statewide assessment for non-custody families. She has assisted with the roll-out of the Juvenile Justice Assessment  that has been implemented in approximately 58 juvenile justice courts, training over 300 court staff in Tennessee. This entailed significant collaboration within the Tennessee state system (i.e., Department of Children's Services, Department of Mental Health and Substance Abuse Services along with the Administrative Office of the Courts, which included multi-regional training, networking, and on-going technical assistance. Additional Statewide system improvement initiatives  in collaboration with the TN Department of Mental Health and Substance Abuse Services are projects that support evidence-based practices for our TN System of Care and TN First Episode Psychosis initiative.

Ms. Gracey's research interests include trauma, system improvement, child welfare and juvenile justice.

In 1986, Ms. Gracey moved to Nashville to become Director of a not-for-profit organization that served youth that had experienced sexual trauma. She has been implementing programs at Vanderbilt for at-risk youth and families an youth who have experienced complex trauma for the last 29 years.

Jessica Merritt, MD

Jessica
"Jessie"
Merritt
MD
Assistant Professor
Psychiatry and Behavioral Sciences
Division of Child and Adolescent Psychiatry
Medical Director, PHP/IOP

Youth experiencing homelessness, Psychodynamic Therapy, Trauma Disorders

Representative Publications

Lavender, J., Benningfield, M. M., Merritt, J. A., Gibson, R. L., & Bettis, A. H. (2021). Measurement-based Care in the Adolescent Partial Hospital Setting: Implementation, Challenges, & Future Directions. Evidence-Based Practice in Child and Adolescent Mental Health, 1-13.

Merritt, Jessica A, et al. “Medical Etiologies of Secondary Psychosis in Children and Adolescents.” Child and Adolescent Psychiatric Clinics of North America, 1st ed., vol. 29, Elsevier, 2020, pp. 29–42.

Merritt, J., & Benningfield, M. (2019). Lessons from the street through a homeless youth with depression. Psychiatric Services, 70(6), 526-527.

Merritt, J. & Williamson, E. (2019). Eighth grade [Review of the film Eighth Grade, by B. Burnham]. Journal of the American Academy of Child & Adolescent Psychiatry, 58(1), 142-144.

Merritt, J., Hart, J. C., & LeGrow, T. L. (2017). Autism spectrum disorder in Say-Barber-Biesecker-Young-Simpson syndrome. Case Reports, 2017, 2017:bcr-2017-21993.

jessica.a.merritt@vumc.org

Suzanne Azzazy, DO

Suzanne
Azzazy
DO
Assistant Clinical Professor of Psychiatry and Behavioral Sciences

Dr. Azzazy is an Assistant Clinical Professor of Psychiatry in the Department of Psychiatry and Behavioral Sciences at Vanderbilt University Medical Center and a Staff Psychiatrist at the Tennessee Valley VA Healthcare System. She received her degree from Lincoln Memorial University DeBusk College of Osteopathic Medicine, completed psychiatry residency at East Tennessee State University, and completed a geriatric psychiatry fellowship at Vanderbilt University Medical Center. Dr. Azzazy teaches psychiatry residents, as well as geriatric psychiatry fellows and geriatric medicine fellows. Her areas of interest include Alzheimer’s Disease, Lewy Body Dementia, Frontotemporal Dementia, Parkinson’s Dementia and Psychosis, and caregiver support.

Andrews publishes paper on ICU delirium in American Journal of Critical Care

Patricia S. Andrews, M.D., Assistant Professor of Geriatric Psychiatry within the Department of Psychiatry and Behavioral Sciences, recently published an article titled "Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization" for the American Journal of Critical Care.  Click here to read the article.

Suzanne Cameron, MSW, LCSW

Suzanne
Cameron
MSW, LCSW
Professional Staff
Psychiatry and Behavioral Sciences
suzanne.r.cameron@vumc.org

Suzanne has served the school-based program since 2008 both as a clinician and team leader. She has completed training in RECAP, TF-CBT and the ARC framework. Suzanne helps coordinate student interns in the school-based program. Her prior experience includes teaching parenting classes and providing in-home services to at-risk youth.    

Clinical Description

Suzanne's focus is on providing clinical therapy interventions to elementary school-aged children from underserved, at-risk populations.    

Sheri Dudley, MSW, LCSW

Sheri
Dudley
MSW, LCSW
Professional Staff
Psychiatry and Behavioral Sciences
Division of Child and Adolescent Psychiatry
sheri.l.dudley@vumc.org

Sheri Dudley is a Licensed Clinical Social Worker who joined the school based team in August 2016. Prior to joining Vanderbilt, Ms. Dudley spent 11 years providing assessment, intervention, and crisis response for children and their families in the greater Nashville area.    

Joshua Streicher, M.D.

Joshua
Streicher
M.D.
CHIEF RESIDENT - CONSULTATION / LIAISON SERVICE

Hometown: Cincinnati, Ohio
College: University of Cincinnati
Medical School: University of Cincinnati College of Medicine

Psychiatry Interests: not sure, but possible psychotic disorders and first episode psychosis