Bipolar Disorder at the APA Meeting: A Newsmaker Interview With Charles Bowden, MD

May 16, 2003

May 16, 2003 — Editor's Note: At the 156th annual meeting of the American Psychiatric Association (APA), which begins this weekend, an estimated 19,000 attendees are expected. More than 1,000 clinical papers, symposia, new research poster sessions, and workshops will be presented at the meeting, which takes place in San Francisco, California.

To gain perspective on this large meeting, particularly in the area of bipolar disorder, Medscape's Robert Kennedy interviewed Charles Bowden, MD, Karren professor and chairman of the Department of Psychiatry, and chief of the Division of Mood and Anxiety Disorders at the University of Texas Health Science Center in San Antonio, Texas.

Medscape: The APA has so many sessions and symposia. Is the area of bipolar disorders well represented enough for the general psychiatric practitioner to get an update on what is current (as opposed to attending a highly specialized bipolar meeting)?

Dr. Bowden: There is no meeting quite like the APA. The richness and diversity of the program is unequalled, not only in the U.S. but in the world. For any major topic, such as bipolar disorder, there will be more than enough to interest the most bipolar focused psychiatrist. In the main, the APA is easy to negotiate in planning which sessions to attend, because the program allows a delegate to select by subject, as well as by format (symposium, meet the experts session, etc.) and time. This becomes challenging for some mixed programs.

For example, I am presenting on symptomatic dimensions of bipolar disorder at an overall symposium on dimensional symptoms in several psychiatric disorders. The overall symposium title will not specify bipolar disorder, however. There are only two clear downsides. The sheer size of the meeting can make it difficult to get from one location to another, and some meeting rooms are invariably packed. Second, it is not an easy venue to speak with the presenters of the programs.

Medscape: What kind topics in bipolar will attendees find available at the meeting?

Dr. Bowden: A broad array. There will be lectures on diagnosis, especially differentiation from major depression and on comorbid interrelationships. There will be sessions dealing with care of mania, depression, maintenance phase treatments, special issues such as pregnancy, breast-feeding, and substance abuse. Although most treatment presentations will be on drugs, both individually and in combination, there will be presentations on psychotherapies and their more evidence-based benefits. There will be numerous new research posters, dealing with topics such as safety of combination treatment strategies.

Medscape: What presentations in bipolar (or anything else) do you think are exciting and noteworthy at the meeting?

Dr. Bowden: There will be an emphasis on new evidence that combination treatments may be preferable to monotherapy drug treatments in selected conditions. There will be information regarding the predominant role of depression, rather than mania, in both bipolar I and II disorders. Evidence that bipolar disorder can be stabilized from either the manic symptom side or the depressive symptom side will be presented. There will be new evidence on the effectiveness of lamotrigine in depressive components of bipolar disorder. There will be continued evidence that antipsychotics, especially atypical drugs, have an important role to play in certain aspects of bipolar disorder.

Medscape: The understanding and science of bipolar disease is changing quickly, how important is it for psychiatric clinicians to understand the latest treatments and clinical approaches?

Dr. Bowden: If we remain limited to the knowledge we had 20 years ago, or even 10 years ago, we will be simply inadequately addressing the needs of patients with this common, severe disease.

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