Day 1 :
Keynote Forum
Clare Henn-Haase
National University of New York Medical Center, USA / National University of Singapore, Singapore
Keynote: PTSD assessment discrepancies between the PCL screener and the gold standard caps IV/V using DSM-5 and ICD-11 diagnostic criteria in a sample of treatment seeking women in the public sector
Time : 10:20-11:00
Biography:
Clare Henn-Haase has obtained her PsyD in Clinical Psychology from the Illinois School of Professional Psychology, USA. She has worked in the field of trauma for over 15 years. Prior joining NUS, she was involved in clinical research and academia as well as clinical practice where she worked as an Assistant Professor at the University of California, USA and the San Francisco Veterans Affairs for over 10 years and then as Assistant Professor and Clinical Director of the PTSD Research Program at New York University Medical Center, USA for four years. She is a licensed Clinical Psychologist in USA and is certified in several types of trauma treatment including dialectical behavior therapy, cognitive behavior therapy, cognitive processing therapy and prolonged exposure for the treatment of PTSD. She is an active Member of the International Society of Traumatic Stress Studies (ISTSS) and the American Psychological Association. Her research interests include randomized controlled treatment trials for PTSD using evidence based CBT treatment, epidemiological and neuropsychological studies of Post-traumatic Stress Disorder, evidence based treatment trials using cognitive behavioral therapy for the treatment of PTSD and ASD, particularly with women survivors of interpersonal violence, veterans and police officers. She has over 26 peer reviewed publications.
Abstract:
This presentation reports on prevalence rates of DSM-5 and ICD-11 PTSD in a treatment seeking sample of women (n=162) enrolled in an NIMH-funded RCT. Analyses also compared discrepancies between CAPS and PCL ratings. PTSD prevalence and symptom endorsement were measured using clinician ratings (CAPS IV/V) and patient self-report (PCL-IV/V). Although the CAPS is the gold standard for measuring PTSD, the well validated PCL is often used as a comparable measure to screen for or diagnose PTSD. While the CAPS and PCL are highly correlated, there are often discrepancies in reported PTSD symptoms between these measures. In this study, of the patients with DSM-IV PTSD using the CAPS, 96.3% met criteria for DSM-5 and 87.7% met ICD-11 PTSD. Comparing rates of PTSD based on the PCL versus the CAPS, the rate of DSM-5 PTSD was lower on the PCL than the CAPS (78.4% vs. 96.3%) as was that for ICD-11 PTSD (71.0% vs. 87.7%). As expected, the rate of CAPS-based PTSD was lower in ICD-11 than DSM-5. However, there were notable discrepancies between the self-reported and clinician administered measures. Item endorsements indicated that patients self-reported more re-experiencing and fewer symptoms of avoidance of thoughts/feelings, negative emotions, detachment and restricted affect. Implications for measurement development will be discussed.
Keynote Forum
Hesham A El-Beshbishy
Taibah University, Saudi Arabia
Keynote: Targeting synaptic mitochondria and mitochondrial biogenesis for treatment of psychiatric disorders in rat brains
Time : 11:10-11:40
Biography:
Hesham A El-Beshbishy has obtained his PhD in 2001 in the field of Medical Biochemistry and Molecular Biology from Manchester University, UK. He works in the Center for Genetics and Inherited Diseases, Taibah University, Madinah, Saudi Arabia. He is also a Professor in Faculty of Pharmacy at Al-Azhar University, Cairo, Egypt. Previously, he was the Supervisor of the Medical Laboratories Technology Department, Faculty of Applied Medical Sciences at Taibah University in Saudi Arabia. He has published more than 48 papers in reputed journals and has been serving as an Editorial Board Member of several international journals.
Abstract:
Mitochondria play role in depression pathogenesis through mitochondrial dynamin-related protein (Drp-1), fission 1 protein (Fis-1) and brain derived neurotrophic factor (BDNF) through tyrosine kinase B (Trk-B) receptor activation. The precise role of neurotrophins-mitochondrial interaction in depression is unclear. We aimed to study role of mitochondria in pathogenesis and treatment of depression using three different antidepressants. We established animal model of stress-induced depressive behavior named learned helplessness (LH) model. Rats with LH model were treated with fluoxetine FLX (20 mg/kg), imipramine IMP (20 mg/kg) or citalopram CTL (20 mg/kg), i.p. for 2 weeks. The order of decreasing number of LH rats was as follows: CTL>IMP>FLX. Mitochondrial enzymes of brain SDH, MDH, IDH, MAO and SOD enzymes, total antioxidant status, ATP production, BDNF, Drp-1, Trk-B and Fis-1 of depressed (DEP) rats elicited significant declines. Brain lipid peroxides was highly elevated in DEP rats. All these levels were back to normalcy after intake of antidepressants and the protein expression levels of BDNF, Drp-1, Trk-B (full length not truncated) and Fis-1 were enhanced either in prefrontal cortex (PFC) or hippocampus. Electron microscopy of DEP rats exhibited cristae disarrangement, mitochondria with dense matrix surrounded with degenerated cells, mitochondria with increased thickness and remarkably electron dense cristae in degenerated cells. Intake of FLX, CTL or IMP improved mitochondrial damage in brain as well as PFC and hippocampus. We concluded that, use of FLX, IMP and CTL improved depression induced in rats via antioxidant mechanism and through modulation of neurotrophins family in brain PFC and hippocampus.
- Special Session
Session Introduction
Joe Alemkunnapuzha Varghese
Freudian Couch Specialist Clinic, Australia
Title: Our holistic approach to recovery empower our client’s experience and our absolute unwavering commitment to confidentiality allows them to recover in absolute privacy
Biography:
Dr. Joe A. Varghese completed his basic medical education and M. D. in Psychiatry from Bangalore University. He went on to complete his Diploma in Clinical Psychiatry from Leeds University and his Fellowship from the Royal Australian and New Zealand College of Psychiatry. He is the Director of Freudian Couch Specialist Clinic that caters to discerning clients requiring discreet and confidential management of their mental health needs.
Abstract:
Our vast combination of holistic treatments on offer is successfully used to treat drug and alcohol related disorders, anxiety spectrum disorders, depression, grief, trauma, eating disorders and chronic pain, with an individually developed one-on-one program. With access to Australia’s most beautiful beaches and the serene hinterland, our location promotes vitality and a sense of well-being. We work with the client to develop a personalized recovery program based on their unique needs and goals. Our holistic model is fully integrated, meaning our team of professionals work together, taking a proactive approach to their treatment. And you can rely on the highest level of privacy for the care provided. We develop personalized programs to make the transition back home as seamless as possible and reduce the opportunity for relapse. Allow us to be a part of your patient’s journey towards recovery.
- Session on: Psychaitry | Anti Psychaitry | Schizophrenia | Mental Health Disorders
Session Introduction
Peter Norrie
Australian National University, Australia
Title: The place for early use of long acting injectables in managing schizophrenia: An Australian clinician's experience and viewpoint
Biography:
Peter Norrie has held clinical management positions since 2002 and is currently the Chief Psychiatrist and Director of Clinical Services for Mental Health, Justice Health and Alcohol & Drug Services, ACT Health. In addition, he is an Adjunct Associate Professor of Psychiatry at The Australian National University Medical School and is a jurisdictional Member of the Safety and Quality Partnership Standing Committee of the Australian Health Ministers’ Advisory Council. (This committee launched the National Mental Health Recovery Framework in 2013). He is an ACT and bi-national representative on a number of committees for the Royal Australian and New Zealand College of Psychiatrists. He has clinical and research interests in schizophrenia and psychopharmacology. He has also focused on support for international medical graduates and education and training for colleagues, registrars and general practitioners.
Abstract:
Injectable medications have often been viewed as a last resort or when definitive non-adherence is clearly apparent. Debates about treatment resistance or resistance to treatment can delay the pragmatic need to discuss injections as an option. The consideration of injectables early in the course of the illness ensures effective treatment and in many cases a paradoxical opportunity to engage the patient, bring back control of the situation, reduce symptoms and restore/improve cognition. This can then be seen as a positive response to managing a difficult illness instead of the step of failures in moving away from oral medications that have been ineffective for whatever reason. In this presentation, there will be an historical summary of schizophrenia treatments followed by the case for injectables. Case studies will illustrate the options for treatment at a number of illness stages.
Stephanie Cacioppo
The University of Chicago Pritzker Medical School, USA
Title: Dynamic spatiotemporal brain analyses of automatic socio-cognitive processes of the healthy and disordered brain: Empirical evidence from the Chicago electrical neuroimaging analytics (CENA)
Biography:
Stephanie Cacioppo has received her PhD in 2004 from the University Medical School of Geneva & University of Savoy and Postdoctoral studies from Dartmouth College and UC Santa Barbara. She is an Assistant Professor in the Biological Science Division and the Director of the High Performance Electrical Neuroimaging Laboratory at the University of Chicago. She has published more than 80 papers in reputed peer-reviewed journals and has been serving as an Editorial Board Member of repute. She has received several awards including the APS Fellowship (2014), the APS Rising Star nomination (2011), the Annual ESSM Award of Excellence (2011), the Tom Slick Award from the Mind Science Foundation (2010) and the Geneva University Maurice Chalumeau Award (2007).
Abstract:
The rapid growth of large-scale, high-spatial resolution neuroimaging technology has advanced our understanding of the neural underpinnings of various complex cognitive and social processes from the healthy and disordered brain. However, high-spatial resolution neuroimaging techniques such as functional magnetic resonance imaging (fMRI) have been limited in terms of the temporal information they provide in studies of brain function. A key theoretical objective in neuroscience and medicine is not only to specify what brain areas are recruited during a behavioral task but also to specify when and in what specific combinations they are activated. By providing detailed information about the relationship between neuronal activity and the temporal resolution (millisecond by millisecond) of each component information processing operation required for behavioral performance, high-density EEG recordings and event-related potentials (ERPs) have provided a useful additional tool in investigations of brain function. Whereas fMRI analyses are performed in source space, EEG/ERP analyses are performed in sensor space with high-density sensor recordings producing more detailed information about changes in brain activity measured across time and sensor space. Over the years, some have argued that measuring peaks and troughs was sufficient to the temporal processing of the brain, while others argued persuasively that another approach such as a statistical decomposition of the evoked brain states was necessary. In the current talk, I present a new method for identifying non-periodic brain state dynamics for the brain micro segmentation and analysis of averaged high-density ERPs and new research on the chronoarchitecture of brain microstates in health and psychiatric disorders.
Biography:
Aditya Soni has completed his Post graduation in MD Psychiatry from Gujarat University, India. He is currently working at Rajasthan as a Senior Resident in a premier Neuroscience and Deaddiction Centre.
Abstract:
Background: Schizophrenia is outlined as a very early onset schizophrenia when the onset of psychotic symptoms before the age of 13 years. Childhood-onset schizophrenia is rare: Its prevalence is about 50 times lower than the one observed in adulthood. The prevalence of obsessive-compulsive symptoms (OCS) in patients with schizophrenia is relatively high. Antipsychotics have been found to influence OCS. Aim & Objective: The present paper reviews the current knowledge with an emphasis on the clinical presentation, diagnosis and treatment hindrance associated with the very early onset schizophrenia. Case: We report a case of schizophrenia in which risperidone was effective in the treatment of the psychotic symptoms but produced obsessive-compulsive symptoms. Conclusion: The diagnosis of VEOS requires a multidisciplinary approach, a detailed and careful differential diagnosis. The obsessive compulsive symptoms subsided with gradual reduction of risperidone dose
Soumya Sachdeva
New York State Presbyterian Hospital, USA
Title: Pharmacological treatment of opioid dependence in India
Biography:
Soumya Sachdeva has completed her MBBS (Bachelors of Medicine and Surgery) from Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. She is very passionate about medical research and has 7 publications in PubMed and 2 others in peer reviewed journals. She is also the Editor Board of Journal of Young Medical Researchers and is also the Ambassador for International Journal of Medical Students (IJMS). She was a Research Volunteer at Columbia University Medical Center, where she worked on substance abuse.
Abstract:
Introduction: In 2012, it was found that 5.2% of the world population in the age group of 15-64 years had used an illicit drug once in the previous year. The annual prevalence of opiate abuse in Asia is estimated to be at 0.35%. The majority of heroin consumption in Asia occurs in China, Pakistan, Iran and India. Objective: The purpose of this review is to provide evidence based clinical practice guidelines to prescribers and other health practitioners involved in the care of opioid dependent patients with a special reference to Naltrexone. Materials & Methods: Relevant literature was identified through a PubMed literature search for publications and a review was developed. Discussion: Buprenorphine was the earliest drug to be used successfully in India for the treatment of opiate dependence. Its use began as early as in 1993. The regimen of buprenorphine-naloxone treatment has been made available in drug treatment centers since last few years. Methadone has been launched recently as a multi-site study as a pilot project in India. However, there have been no studies on Naltrexone in the SEAR region yet. Several clinical trials from different countries hold evidence that use of Naltrexone has higher efficacy, minimal toxicity and minimal safety concerns. Data also suggest superior efficacy of long acting injectable Naltrexone compared to oral Naltrexone. Conclusion: The use of opioid antagonists for long term treatment of patients with opioid addiction is one of the newer emerging modalities of treatment. It is recommended that trials on both oral and injectable naltrexone should be started to see the efficacy in the SEAR region.
Barbara Pajk
University Psychiatric Clinic Ljubljana, Slovenia
Title: Factors associated with antipsychotic non-adherence in patients with schizophrenia
Biography:
Barbara Pajk has received her Master’s degree in Nursing from Faculty of Health Sciences, University of Maribor, Slovenia. She has worked at University Psychiatric Clinic Ljubljana since 2006. She has performed her professional work at the whole spectrum of psychiatric fields from clinical psychiatry (urgent psychiatry, gerontopsychiatry and community psychiatric treatment), alcohol and medication addiction. She has published articles and proceedings of lectures in the field of dementia and schizophrenia.
Abstract:
Background: Despite the fact that adherence to antipsychotic medications is the cornerstone in the prevention of exacerbation and the relapse of the disease, more than half of patients with schizophrenia are non-adherent to prescribed medications. The purpose of this study was to examine what are the most common factors associated with antipsychotics non-adherence among patients with schizophrenia. Research Methodology: The study included 91 patients (18 to 65 years) with a diagnosis of ICD-10 (F20), hospitalized at the University Psychiatric Clinic in Ljubljana in various forms of treatment. Measures included socio-demographic characteristics, the substance abuse, the number of prescribed medications and daily doses, the knowledge of the prescribed antipsychotic medication, the causes for non-adherence using the Alberta Mental Health Survey questionnaire and attitudes towards drugs using the Drug Attitude Inventory (DAI-10). Adherence was assessed subjectively. Results: 61.5% of patients were non-adherent to antipsychotic medication. There was a negative correlation between medication non-adherence and substance abuse (smoking p=0.013, alcohol p=0.030, drugs p=0.001), negative attitudes towards medication (p=0.012), knowledge of side effects (p=0.009), a higher number of daily doses of antipsychotic medication (p=0.001) and male gender (p=0.003). The most common cause for non-adherence identified was the patient’s belief that they can cure without antipsychotic medications (27.5%) followed by the patient’s subjective feeling that they feel better and therefore the medication would no longer be needed (22.0%), and side effects (16.0%), whereby difficulties with fatigue and weight gain predominated. Subjective feeling that the medication did not help (13.2%); forgetfulness (12.1%) and sexual dysfunction (7.7%) were also identified as a reason for non-adherence. Conclusion: Healthcare professionals should intensely strive to promote adherence among patients with schizophrenia with an emphasis on an individual approach regarding the causes of non-adherence. Special attention should be paid to a vulnerable group of patients.
Ahmad Hussein Rateb Rayan
Zarqa University, Jordan
Title: Stigma of mental illness and attitudes toward psychological help seeking in Jordanian university students
Biography:
Ahmad Hussein Rateb Rayan has completed his PhD from the University of Jordan. He is a Lecturer specialized in Psychiatric and Mental Health Nursing. He has published more than 10 papers in reputed journals and has been serving as a Reviewer in 3 journals.
Abstract:
Background: Avoiding seeking professional help for psychological problems may have a devastating impact on the life of university students. Data about stigma toward mental illness and attitudes toward seeking professional psychological help (ATSPPH) in Arab university students are rare. This study aims to examine the correlates of ATSPPH in Jordanian university students. Method: A cross sectional correlation design was used for this study. Using an online survey, a sample of 519 Jordanian university students completed measures of demographic and clinical variables, stigma toward mental illness and ATSPPH. Stigma toward mental illness was tested as a correlate of ATSPPH using a series of hierarchical multiple regression analyses, controlling for demographic and clinical variables. Results: The results showed that Jordanian students have relatively less favorable ATSPPH than other study groups. Female gender, medically-related specialties, students with a previous history of receiving mental health counseling services and students who reported low scores on measures of stigma toward mental illness were more likely to have favorable ATSPPH. The stigma toward mental illness was the strongest correlate of ATSPPH in students and accounted for 13% additional variance above and beyond the 3% accounted for by all other independent variables. Conclusions: Combating stigma toward mental illness in Arab students is an important step toward promoting their ATSPPH. There is a crucial need to provide professional and culturally competent psychological care for this population in particular.