Highlights From the American Psychiatric Association Meeting

Editor's Note: Following the American Psychiatric Association (APA) 2016 Annual Meeting, Medscape spoke with Steve Koh, MD, MPH, MBA, chair of the Scientific Program Committee for APA 2016 and assistant clinical professor at the University of California, San Diego, about highlights from this year's meeting and general trends in the field of psychiatry.

Medscape: What were some of the major themes that stood out at this year's APA meeting?

Dr Koh: I would say that there were three areas that were, generally speaking, the big hot topics.

The first was prodromal symptoms and preventive work that's being done—not only in schizophrenia but also in bipolar disorder, dementia, and Alzheimer disease. The idea is to have psychiatrists screen for and find a subset of patients who are not yet developing symptoms but are about to move into a whole symptom spectrum of the illness and try to prevent it from happening. In general, that's a pretty hot topic in psychiatry right now, and we knew that was going to be well attended.

The second hot topic was drug abuse. There were a lot of discussions about opiate use and different substances like synthetic cannabinoids, marijuana itself, nicotine, GHB, ketamine, and others. Compared with prior meetings, substance abuse has become a bigger part of this meeting. What was different about this year was that people were also talking about how some of these substances might have some benefits despite not being good for our patients. Ketamine is a perfect example. It's a banned substance, but people use it recreationally. There's pretty good evidence coming out that it's quite good for acute suicidality and acute depression, and it works very fast. There's a lot of interest in how to integrate some of these substances in a therapeutic way.

The third hot topic focused on social determinates of health as it relates to mental healthcare. Renée Binder, a forensic psychiatrist, was there, and she's very interested in the tragedy of the fact that a lot of the mentally ill end up being incarcerated and how incarceration itself makes mental illness worse and sometimes even causes it. There were a lot of workshops and symposia on this particular topic and then even more broadly about socioeconomic issues and how those things then drive the worsening of mental health in our patient population. It went beyond just the typical differences between different ethnic and racial groups and went into society itself, how we manage homelessness and poverty level, and how these things affect mental health outcomes.

The one area that we didn't anticipate to be so popular, but were happy to see its popularity, was psychotherapy. What I think was really smart was that the speakers in these sessions linked psychodynamic therapy, analysis, and different types of talk treatments. They were also able to show that these treatments not only work, but you could actually have measurable outcomes and even see brain-imaging changes after a patient goes through this treatment. A lot of our colleagues—myself included—value psychotherapy quite a bit. I think in the media, psychiatry is seen more and more as a medication-oriented profession, and that's certainly not true. The fact that so many folks have shown interest in these therapy-related talks tell us that clearly this is something that still has value.

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