Clinical Update – Schizophrenia
D Castle1, E Chen2, R Howard3
1University of Melbourne, Melbourne, Australia/St Vincent’s Hospital, Melbourne, VIC, Australia
2(Department of Psychiatry,) The University of Hong Kong, Hong Kong
3University College London/King’s College London, UK
Background: This symposium provides an opportunity to update clinicians about recent advances in therapeutic approaches for schizophrenia
Objectives: To provide an overview of new and emerging therapeutic options for schizophrenia, including specialist views from and old age psychiatrist (Prof Howard) and an expert in early intervention (Prof Chen)
Methods: Selective literature review
Findings: A number of potentially exciting new(ish) areas pertinent to the treatment of schizophrenia are evidenced in the literature, encompassing pharmacological and psychosocial domains.
Conclusions: We still have a long way to go in establishing effective and safe treatments for schizophrenia but there are grounds for some degree of optimism in this regard
Clinical Update – Old Age Psychiatry
N Lautenschlanger1, L Lam2
1Department of Psychiatry, NorthWestern Mental Health, University of Melbourne, Melbourne, Australia
2Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
Background: Life expectancy is rising in most countries and therefore population ageing is a global trend. Our societies change dramatically and this leads to significant health care challenges. In mental health this is particular relevant for the field of old age psychiatry.
Objectives: This symposium is part of the new “update” series and aims to provide evidence based updates on central themes within old age psychiatry relevant to clinicians working in settings relevant to mental health of older people.
Methods: Two academic old age psychiatrists who also practice as clinicians will present clinical updates on important old age psychiatry topics with reviewing recent evidence.
Findings: The two presentations in this update will give an update on the topics of depression, anxiety, cognitive decline and non-pharmacological interventions. Following this Congress’ theme the relevance of recent evidence for the Asia-Pacific region will be highlighted.
Conclusions: Clinical activity focusing on mental health in older adults should follow the principles of recovery, independence, dignity and quality of life. To achieve optimal mental health in older people clinicians need to be aware of the complex challenges associated with older age and deliver clinical care in a holistic and culturally appropriate way. Prevention strategies to promote successful ageing or best possible improvement of mental and cognitive health is an increasingly important area of old age psychiatry.
Presenter 1
Clinical Update – Old Age Psychiatry: Depression. Anxiety and cognitive Decline
L Lam1
1Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
Background: Depression is considered as a common problem in old age. It may be a core symptom of major depressive disorder, but could also be part of the dementia syndrome. In both conditions, cognitive impairment is frequently found. Anxiety disorders, on the other hand, has received little attention. Recent studies suggested that late onset anxiety disorders are associated with physical diseases, cognitive deficits and possibly dementia.
Objectives: A clinical update on the assessment of late life depressive and anxiety disorders, and the relationship with cognitive decline and dementia.
Methods: Evidence based findings on the prevalence and symptomatology of these disorders will be presented.
Findings: There are ample evidence to link depressive symptoms with underlying neurodegenerative changes, and anxiety symptoms could also represent a clue to underlying degeneration.
Conclusions: For clinicians who take care of older adults, assessment of depressive and anxiety symptoms should go beyond adjustment reactions to changing psychosocial situations.
Presenter 2
Clinical Update – Old Age Psychiatry: Non-Pharmacological Interventions to Support Mental Health in Older Adults
N Lautenschlanger1
1Department of Psychiatry, NorthWestern Mental Health, University of Melbourne, Melbourne, Australia
Background: Especially since the start of the new millennium increasingly more evidence is emerging in the literature to promote the concept of prevention in relation to mental and cognitive health in older age.
Objectives: This paper will summarise recent evidence arising from non-pharmacological interventions aiming to support mental and cognitive health in older age. The focus of the presentation is to provide information on recent evidence relevant to achieve optimal health promotion and clinical care.
Methods: Recent evidence from the literature will be reviewed with a specific focus on the Asia-Pacific region.
Findings: Non-pharmacological interventions including for example physical, cognitive and social activities are increasingly recognised for the protective potential to support cognitive and mental health in older adults. This applies to healthy people, but also to those with mental illness and cognitive concerns or decline.
Conclusions: More targeted studies are needed to help translate important recent findings from the literature into health promotion activities in the community and clinical programs for older adults with mental illness and cognitive decline. However current evidence is sufficient to encourage communities and health services to include non-pharmacological approaches into their health promotion strategies and care plans.
Clinical Update – Mood Disorders/Depression
G Malhi1,2,3, M Berk4,5,6
1Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia
2Sydney Medical School Northern, University of Sydney, NSW, Australia
3CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
4School of Medicine, Deakin University, Melbourne, VIC, Australia
5IMPACT Strategic Research Centre, Melbourne, VIC, Australia
6Orygen the National Centre of Excellence in Youth Mental Health and the Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
Background: Clinical heterogeneity coupled with a lack of a deeper understanding of mood disorders has meant that both diagnosis and treatment of depression remain diverse and complex. The field provides fertile ground for research and remains a priority area for advancement in psychiatric practice.
Objectives: The presenters will collectively provide the latest research findings pertaining to mood disorders from the fields of neurocognition, neuroimaging, biomarkers and insights into models that underpin mood disorders coupled with advances in treatment. In particular, they will focus on breakthroughs that have occurred in recent years and the conceptual remodeling of mood disorders and treatment implications that are currently occurring as a consequence of these novel insights.
Findings: This clinical update will delve into complex and controversial areas of practice discussing, for example, the emergence of mania due to antidepressants, mixed features, the use of psychostimulants for the treatment of depression, disentangling the neurocognition of mood disorders from that of medications, the mechanisms that underpin the actions of lithium, neurocognitive models providing insight into understanding mood disorders, latest findings from neuroimaging studies worldwide, advances in oxidative and inflammatory neurobiology, novel treatments that impact upon the management of mood disorders and advances in preventative management of mood disorders.
Conclusions: This session will provide an exciting window on a broad array of developments taking place worldwide in the field of mood disorders within psychiatry.
