Psychiatric Professionals Meeting In DC May 1, 2008
Posted by Reginald Johnson in Drugs, Healthcare, International, Mental Health.add a comment
A conference worth attending.
This week the Society of Biological Psychiatry is having their 63rd Annual Scientific Convention here in Washington, D.C. The conference is filled with eager psychiatric professionals. I admit that I am not the best at pharmacology and psychiatry…well, I guess that isn’t true, I do have a masters degree in public policy – specializing in social policy and mental health. But those attending the conference are the best of the best, and the best of the up and coming.
Every year the Society has their conference a few days prior to the American Psychiatric Association – which really is the best of the best. So far, experts in pharmacology and psychiatry have told me of great things that lie ahead for clinicians and patients. There was literally a host of futuristic developments that expands on the past several years of research and advancement in diagnosis and treatment.
The people know what they are talking about.
Something I remember from a few years ago was talking to Richard M. Weinshilboum, MD. He’s in the Department of Pharmacology and Experimental Therapeutics at the Mayo Medical School in Rochester, Minnesota, and he told me of the revolution in developing new therapeutic agents in medicine during the second half of the 20th century. This, he noted, led to the need for maximizing the efficacy of these agents while minimizing their toxicity. Consequently, he said, the need arose to individualize treatment to the differences in the way different people respond to different drugs. This promoted the discipline of pharmacogenetics, the study of the role of inheritance and individual variations in drug response.
Back to the present conference, I spoke to many who said advances in human genomics and new genomic techniques have now made possible the translation of pharmacogenetics into clinical reality. The absolute bottomline in all of this is: ‘What is the best therapy for me?’ — ie, how to individualize treatment with maximum efficacy and minimum toxicity.
I had a chance to talk to a few doctors and researchers at the Clinical Brain Disorders Branch at the National Institute of Mental Health in Bethesda, Maryland. They told me that neuroimaging has been a cornerstone of the revolution in brain science in psychiatry. In the past, neuroimaging has sought to find the patterns associated with mood and anxiety states as well as cognitive dysfunction in psychiatric disorders. With the current advances in genomics the emphasis may now shift to assess genetic conditions that may serve as risk factors for psychiatric disorders.
One area I am interested in looking into is the treatment of psychiatric disorders in general and mood disorders in particular. This is important because the explosive growth of new therapeutic agents. Because of this clinicians have focused on the need for rational treatment (ie, how to sequence the therapeutic agents or combine them if needed). Thus, treatment algorithms started developing in psychiatry after decades of use elsewhere in medicine. Something I’d like to emphasize is the need for empirically based treatment plans as well as the consideration of patient preferences and clinical consensus.
An area that needs a great deal of attention is alcoholism v non-alcoholism. A few years back I listened to a speaker, I forget his name, but he discussed a 20-year longitudinal study of risk factors for alcoholism. The guy reviewed genetics of alcoholism, saying the concordance of alcoholism for monozygotic twins is twice that for dizygotic twins and that adopted children of alcoholics are at a 4-fold greater risk for alcoholism than are the children of nonalcoholics.
Keep in mind that 60% of the variance of risk for alcoholism is associated with genetic factors, while 40% is associated with environmental factors. Genes determine how one metabolizes alcohol and also influence the level of response to alcohol. They also play a role in a person’s being disinhibited or impulsive, which is a risk factor in alcoholism.
This might be boring to some of you, but I was loving this!
The conference runs through to Saturday.
In addition to continuing scientific advances, the next several years may see a movement away from viewing psychiatric disorders as conditions of weak will and lack of motivation but rather as similar to other medical disorders, neurologic diseases, and genetic abnormalities in which individualized treatments promote healthy functioning, productivity, and creativity.
