Psychiatry Congress: today's highlights - 31 May 2011

Psychiatry Congress highlights

Tuesday 31 May 2011 The Royal Australian and New Zealand College of Psychiatrists’ Congress runs until 2 June 2011 at the Darwin Convention Centre. The Congress brings together mental health experts in a diverse range of areas across cultures and age groups. Here are some highlights from today’s program; the full program is available at http://www.ranzcp2011.com/congress-program/.

How childhood trauma changes the brain
The brain structure of children exposed to chronic trauma and neglect develops differently to those children raised in secure, healthy, environments. Drawing from emerging research and clinical experience this presentation will examine how exposure to chronic childhood stress and terror results in a brain hard wired toward a persistently altered stress response. “Children who have suffered early trauma, abuse and neglect commonly have multiple persistent issues including poor emotional regulation, increased anxiety, poor problem solving and impaired social relationships. If left untreated these symptoms can compound to further social and health disadvantage in adulthood,” said author of this review Dr Anja Kriegeskotten. (1.30pm)

Mental health of refugees worse than general population
Mental illness is more prevalent in refugees than the general population according to a study of adult refugees who recently arrived in Western Australia. 11% were found to have probable moderate or severe mental disorder, 12% probable mild mental disorder and 19% probable post traumatic stress disorder in mental health screenings of 300 adult refugees within three months of arrival in Western Australia. “These rates are higher than local population norms and broadly consistent with international studies. The screening program is ongoing and will be used to inform service provision and development for refugees within the WA mental health system,” said study author Dr Jon Laugharne. (1.30pm)

Indian community in Australia does not seek help for mental health problems
Most Indian-Australians with mental health problems do not seek help. A study has found that while the prevalence of self-reported high to very high levels of psychological distress in Indian-Australians was equivalent to the general community, 91% of people with identifiable mental health needs did not seek any mental health consultation. A survey was conducted in a sample of people of Indian background living in Sydney with measures to assess current levels of psychological distress, functional disability, service use and attitudes towards seeking professional psychological help. “General population mental health surveys have failed to capture estimates of needs in individual ethnic migrant communities; this study highlights the need to address this gap,” said study author Dr Raj Maheshwari. (1.30pm)

Characteristics of patients found not guilty on the grounds of mental illness In NSW
There is a higher risk of serious violence in people experiencing first episode psychosis than those with ongoing illness according to a new study. The study compared the past treatment of those found not guilty due to mental illness of violent offences in New South Wales over 17 years. Schizophrenia-related psychosis was the most common diagnosis in this group. 46% were classified as being in their first episode of psychosis, including 52% of the homicide offenders and 39% of the non-lethal violent offenders. The first episode offenders were younger, more likely to be migrants from a non English speaking country and more likely to have used a firearm. “This study confirms that the first episode of psychosis is a period of particular risk for homicide and serious violence among people with psychosis. The rates of violence among people who have received adequate treatment is close to the rate in the wider community,” said researcher Dr Matthew Large. (3.30pm)

Stopping smoking doesn’t make your mental illness worse
There is little evidence to support the common belief that quitting smoking is harmful for people with mental illness. Many people with mental illness who smoke want to quit but are not offered adequate support by health professionals, partly out of the belief that quitting smoking will exacerbate symptoms of mental illness and change medication levels affecting toxicity or effectiveness. A review of the clinical consequences of quitting smoking on people with schizophrenia and those with depression found it wasn’t detrimental to mental health to quit. For people taking clozapine, clinicians should be aware that quitting can lead to increased blood levels and a reduced dose may be possible. “In light of the significant physical and financial benefits of quitting smoking, mental health professionals should advise their patients to quit and provide support to help them do so,” said study author Dr Tanya Ahmed. (11am)

Psychological and social factors and chronic disease in Central Australia
While cardiovascular disease is seen as a primary contributor to the life expectancy gap experienced by Aboriginal and Torres Strait Islander peoples, there has been little research into the potential contribution of disadvantage and its interplay with psychological and social factors. A study of psychosocial factors and chronic disease and its risk factors in Aboriginal communities in central Australia was undertaken with a view to identifying the possible ways in which social disadvantage may lead to illness. “In this sample of Aboriginal men, there was a high level of cardiovascular risk, which was related to a number of psychosocial factors, particularly depression. Approximately 40% demonstrated mild or worse depressive symptoms, which was related to prevalent cardiovascular disease. Men who smoked or who were obese were more likely to have elevated depression. As such, understanding the critical role of psychosocial factors is essential to reducing the burden of chronic disease in Indigenous communities,” said study author Dr Alex Brown. (3.30pm)

Fetal alcohol spectrum disorders
This session explores fetal alcohol spectrum disorder, including fetal alcohol syndrome, alcohol related birth defects and alcohol related neurodevelopment disorder, which can occur in an individual whose mother drank alcohol during pregnancy. “There is limited information available in Australia about the illness. Incidence rates are lower in Australia than those reported in US, France and Sweden, possibility because doctors frequently do not correctly identify the illness in Australia. The growing knowledge of this illness will have implications for health services,” said session presenter Ms Heather D’Antoine. Aboriginal children are 100 times more likely than non Aboriginal children to be diagnosed with fetal alcohol syndrome. (1.30pm)

Mental health and natural disasters
Natural disasters can impact people’s mental health and 2011 has seen a number of natural disasters around the world with large scale loss of life, destruction of property and infrastructure and community disruption. Various Congress sessions will discuss natural disasters and mental health:

Bushfires
A follow up study of adults who as children experienced the 1983 South Australian bushfires has found that subjects exposed to bushfires as children did not have a greater risk of psychosis. Results indicate that exposure to multiple traumas rather than a single major trauma, increases the risk of later psychosis. “Psychotic symptoms were more common in subjects exposed to a greater number of traumas, and were associated with higher rates of childhood adversity, emotional and behavioural disturbance, dysfunctional parenting, and alcohol and cannabis abuse,” said study author Prof Cherrie Galletly. (12pm)

Psychological first aid
After the immediate needs of physical health, nutrition and shelter for disaster victims are addressed, a focus on psychological trauma is paramount. Not all disaster survivors have long term psychological problems, but if not supported immediately some may develop serious outcomes. This session describes scenarios where psychological first aid was used following major disasters in South Asia. After the Boxing Day Tsunami in Sri Lanka in 2004 a group of Australian and New Zealand doctors expert in psychological medicine trained local care givers in psychological first aid. After Cyclone Nargis in Burma in 2008 a group of Burmese doctors from Sydney delivered a similar program to locals. (3.30pm)

Today’s keynote speakers:

Professor Jeremy Holmes, psychiatrist, psychoanalytic psychotherapist and Visiting Professor at Exeter University with expertise in borderline personality disorder and widely published in the field of attachment theory and psychoanalysis.
The psychoanalyst in the mood disorder laboratory: what can we learn, and (what) can we contribute? (9am)

Professor Perminder Sachdev, Scientia Professor of Neuropsychiatry at the University of New South Wales and Clinical Director of the Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, a specialist in neuropsychiatry, specifically in dementia and pre-dementia syndrome in relation to neuroimaging, neuropsychology, biomarkers and risk factors.
How can we protect the brain from age-related decline (9.45am)

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About The Royal Australian and New Zealand College of Psychiatrists
The Royal Australian and New Zealand College of Psychiatrists is the principal organisation representing the medical specialty of psychiatry in Australia and New Zealand and has responsibility for training, examining and awarding the qualification of Fellowship of the College to medical practitioners. www.ranzcp.org.

ENDS

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