Five years ago Dr Alan Schatzberg, then APA President, initiated more of a focus on schizophrenia at the APA Annual Meeting, as a way to connect leaders in this field to meeting attendees. The two symposia and the case conference have engaged leading academicians to make thematic presentations - for example neurocognitive remediation and management of non-responders. This year there is a very experienced group of schizophrenia faculty addressing fascinating topics. Here is just a sample of the many great presentations on schizophrenia at this year’s meeting.
The first symposium in the track is titled, “Reduce Duration of Untreated Psychosis (DUP) and then Treat Well.” This is an important topic as the U.S. Government has focused on early psychosis and has asked states and SAMHSA to move this ahead in engaging the young patients as the duration of Untreated Psychosis is longer than a year.
Dr John Kane, Hillside Hospital, will present and illustrate the results of the RAISE Project which was a multicenter study evaluating an integrated program of the management of the First Episode of Schizophrenia. The group of treatments was very successful and the project pointed out the areas for improvement. It is important for the field in engaging these young people with early schizophrenia.
: “Lars and the Real Girl” The Power of Erotomanic Delusions: A Case and Media Study Highlighting the Personal and Social Impacts
Tuesday 7-10 PM (InterContinental)
Symposium: The Schizophrenia Syndrome in 2015: New Facts and Emerging Insights
Sunday 1-4 PM
Symposium: Two-Year Results of a Comprehensive Care Model in First Episode Schizophrenia: The Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP)
Tuesday 2-5 PM431
Workshop: Rethinking the Long-Term Use of Antipsychotics in Schizophrenia: For Everyone, No one or Some?
Monday 9-10:30 AM152
Peter Manu’s workshop: The Challenge of Rechallenge: A Rational Approach to Treating Survivors of Major Adverse Effects of Clozapine
This will be followed by a thoughtful presentation by Dr Oliver Freudenreich, Harvard, who has developed a very thoughtful plan of the initial evaluation of First Episode patients. The strategy evaluates assessment of issues from brain imaging through to blood tests in areas related to psychosis. This is an important assessment as psychosis can be caused by medical issues.
Dr Brian O’Donoghue has an experienced background in Ireland of connecting First Episode treatment with the community – by having a play about psychosis. It is known in other countries that imaginative ways of connecting with the community can really help with the personal connections of young people with psychosis and their families. This will be such a creative and interpersonal presentation.
To conclude the Symposium, Dr Robert Zipursky will review and illustrate the standardized approaches to the young people receiving their first treatment of schizophrenia and other psychotic episodes in the Canadian system. In the U.S. there are reports of some inadequate or incorrect dosing’s for treatment. Further, an estimated 25% of First Episode young patients do not respond to two front-line treatments of atypical antipsychotics so Dr Zipursky will talk about their experience with the next steps. This will be a very informative conclusion for this symposium.
The second Symposium in the Schizophrenia Track will address the controversial topic of the potential of biomarkers and potential clinical application. To lead off this symposium, Sir Robin Murray will present new emerging data on how brain imaging is predicting response to treatment. His work in this area has shown fascinating research findings and as 25% of young patients do not have a full response, this can be very helpful. His new data can be very useful in emerging treatment of young patients with psychosis.
Dr Sabine Bahn has been an investigator exploring proteomics for many years from her initiation of examining proteins across many functions. She moved her work into examining a large number of proteins through a blood test and reported how it separated schizophrenia from controls. Her work has really advanced the potential for diagnostic assessment of patients.
For many years the genetic theories of schizophrenia has led the field to examine how there may be usefulness in practical areas of diagnosis and treatment. Research has been done on genetics of neurotransmitters and medication response. Dr Anil Malhotra, from Hillside Hospital, will review and discuss the potential of genetic factors and treatment response in schizophrenia.
To conclude the symposium on biomarkers, Dr Diana Perkins will introduce the attendees to how biomarker research in those young people with prodromal symptoms may assist clinicians in predicting the progression of this syndrome. This addresses the controversies in this area as was discussed in DSM-5.
The final presentation will be a Case Conference presentation, “Treatment Refractory Schizophrenia . . . A Clinical Conundrum That Is Still Not Going Away,” a case report and then the presentation by Dr Peter Buckley the Dean of the Medical college of Georgia. Over the years the case reports in the Schizophrenia Track provide very specific clinical updates and there is also a section of the session for candid discussion.
This focus on schizophrenia has led to a number of fascinating and contributory presentations. The attendees of the APA can again learn and discuss the forefront of the field.
Dr Schulz is Professor and Executive Medical Director in the department of psychiatry at University of Minnesota.