Jeffrey A Lieberman, MD


May 13, 2011

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This is Dr. Jeffrey Lieberman of Columbia University talking to you today for Medscape. As you know, the American Psychiatric Association's (APA) Annual Meeting for 2011 is coming up in Honolulu, Hawaii. I've been looking at the program, and I wanted to just mention a few of the activities and presentations that I thought were of particular interest and that you may want to look at on the program and consider attending.

As you know, the APA meeting is enormous. There are parallel activities, over multiple days, going on from morning to night, organized into different formats from distinguished lectureships, to symposia, to workshops, to forums, and to individual presentations. There is no way that anyone can assimilate all of the activities of the program, so it's wise to look at the program in advance, decide what you want to attend, work out a daily schedule, and be fairly disciplined about following it.

I want to bring a few things to your attention that might be of particular interest and which struck me as notable. First, every year there are the "Advances Sessions," a series of activities that are organized into sessions for which there are multiple speakers. Probably the highlight of the Advances Sessions is the Advances in Research, which covers presentations by distinguished researchers in various areas that, over the past year, have been particularly interesting or represent significant advances.

It's chaired, annually, by Herbert Pardes, Former President of the APA, Director of the National Institutes of Mental Health (NIMH), and currently Chief Executive Officer of New York Presbyterian Hospital. This year, this session has a lineup that includes presentations on:

  • "Anxiety Disorders in Children and Adolescents: State-of-the-Art in Assessment and Treatment" by John Walkup of Johns Hopkins;

  • "Posttraumatic Stress Disorder (PTSD), Major Depression and the Risk for Suicidal Behavior" by Marie O'Quendo of Columbia University;

  • "Successful Cognitive Aging and Acquisition of Wisdom" by Dilip Jeste of the University of California San Diego and Elected President-elect of the APA; and

  • "Unhealthy Bedfellows" by Wayne Katon of the University of Washington. This is of particular note.

  • "Advances in Psychotherapy and Pharmacotherapy for Substance Abuse" chaired by Marc Galanter and Herb Kleber;

  • "Intervention Techniques for Initiating Social and Pharmacotherapeutic Treatment" by Laurence Westreich of New York University (NYU),

  • "Motivation Enhancement Combined With Pharmacotherapy" by Ned Nunez of Columbia University;

  • "Cognitive-Behavioral Therapy Combined With Psychopharmacotherapy" by Kathleen Carroll of Yale University;

  • "Therapeutic Treatment Using Buprenorphine Maintenance" by Herb Kleber of Columbia University; and

  • "Treatment Options and Outcomes for Substance-Abusing Physicians" by Marc Galanter of NYU.

There is also a very interesting session called "Advances in the Treatment of Bipolar Disorders." This is chaired by Terry Ketter and Po Wang of Stanford University. This session is largely derived from Stanford faculty and includes:

  • "Advances in the Treatment of Acute Mania" by Terry;

  • "Advances in the Treatment of Bipolar Depression" by Po;

  • "Advances in Maintenance Treatment of Bipolar Disorder" by Terry;

  • "Treatment of Children and Adolescents With Bipolar Disorder" by Kiki Chang (also of Stanford);

  • "Treatment of Pregnant Women With Bipolar Disorder" by Mytilee Vemuri of Stanford; and

  • "Treatment of Older Adults With Bipolar Disorder" by John Brooks of the University of California at Los Angeles.

Another Advances Session is in psychotherapy, chaired by Glenn Gabbard and this includes:

  • "Psychotherapies for Hyperarousal and Dissociative Subtypes of PTSD" by David Spiegel of Stanford University;

  • "Psychotherapy of Suicidal Patients" by Barbara Stanley of Columbia University;

  • "Therapeutic Alliance and Change" by Glenn Gabbard at Baylor College of Medicine; and

  • "Psychotherapy Plus Medication for Addictive Disorders" by Chuck O'Brien from the University of Pennsylvania.

One of the highlights of the meeting, in terms of eminent speakers, is the Distinguished Lecture Series. I want to mention a few of those that I thought were of great interest to me. One is a lecture by Dr. Darrell Kirch, a psychiatrist who is Executive Director and President of the American Association for Medical Colleges, and his lecture is "The Doctor I Need for the Healthcare I Want," and this really talks about the brave new world of 21st century healthcare and personalized medicine.

Another is the Frontiers of Science Lecture, "Rethinking Mental Illness" by Tom Insel of the National Institutes of Mental Health (NIMH), in which he talks about the need to, basically, develop an understanding of the causes of mental illness, in terms of the cognitive and neural science and genetic bases, and it's really portraying the NIMH's view of the future of psychiatric medicine. Another is an international guest lecture by Patrick McGorry at the University of Melbourne on "Early Intervention in Youth, Mental Health Models of Care: 21st-Century Solutions to Strengthen Mental Healthcare in a Modern Society." This is about the early detection and intervention movement, which is really sweeping the globe as a new model of healthcare service delivery.

An interesting presentation is an outside guest lecture by Barry Scheck, the attorney (you may remember him as a consultant in the OJ Simpson case), who will be speaking about "Wrongful Convictions, and Challenges for Psychiatry and Forensic Science." He leads an organization that has identified a lot of individuals incarcerated for faulty or unjust convictions. Another Frontiers of Science Lecture is by Sabine Bahn, from the University of Cambridge on "Disease Biomarkers for Schizophrenia, From Laboratory to Bedside," and this is describing a new technology that she has pioneered using a proteomic analysis of serum to identify a signature profile of analytes characteristic of specific mental illnesses, particularly schizophrenia in this case.

There is a lecture (also in Frontiers of Science) called "Transforming Clinical Outcomes in Addiction" by Nora Volkow, who is Director of the National Institute of Drug Addiction -- for anyone who hasn't heard Nora Volkow speak before, you want to hear her because she is a force to behold and extremely informative and entertaining. There is also a Distinguished Psychiatrist Lecture by Nancy Andreasen from the University of Iowa, "A Journey Into Chaos, Creativity and the Unconscious," which attempts to explain and explore the neuroscience basis of creativity and mental illness.

On genetics, there is a lecture by Michael Owen from the University of Cardiff called "Genomics, Unpicking the Gordian Knot of Psychiatry." There is a series of Presidential Symposia, and regular symposia, and a few more presentations that I think are particularly groundbreaking developments. One is on the "Neuroscience for Informed Strategies for Early Intervention for PTSD -- What To Do in the First Hours of Exposure" by Charles Marmar of NYU. He will talk about what needs to be done after trauma to prevent PTSD from setting in. Another is by Scott Stroup of Columbia University on the randomized trial examining the effectiveness of switching from olanzapine, quetiapine, or risperidone to aripiprazole as a strategy for treating drug-induced obesity or metabolic syndrome.

There is also a presentation in another scientific symposium by George Papakostas from the McClain Harvard group on "Methylfolate Augmentation of SSRI Inhibitors for Major Depressive Disorder." This is another study that has attempted to look at nutraceutical augmentation of antidepressant drugs for the treatment of depression. Folate augmentation is in the same vein as studies of N-acetylcysteine or S-adenosylmethionine (SAMe) as potential nutraceutical adjuncts to antidepressant treatments.

A new treatment is being presented for augmentation in schizophrenia, the glycine transport inhibitor from Roche, RG 1678, as a treatment for negative symptoms and possibly cognitive impairment. This is a treatment being presented by Dan Umbricht of Roche. Lisa Dixon (from the University of Maryland), during another symposium, will be presenting on "The Effectiveness of the National Alliance on Mental Illness' Family- to-Family Education Program, a Randomized Trial." Finally, David Spiegel from Stanford University will be presenting in another symposium on "Decrease in Depression Predicts Longer Survival of Patients With Metastatic Breast Cancer."

These are a few of the things on which I think it is particularly worth considering spending your time, if you are going to the annual meeting. After the meeting, I'll comment on at least some select number of these presentations. This is Dr. Jeffrey Lieberman of Columbia University speaking for Medscape. Thank you.


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