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