USPMHC: US Psychiatric and Mental Health Congress

Treating bipolar depression with standard antidepressants has long been controversial, because some patients do not respond and it is believed that the drugs trigger manic episodes. Two physicians outline data on an antipsychotic initially approved for schizophrenia that received an additional indication for bipolar depression.

Treating psychiatric disorders in children and teenagers offers benefits that far outweigh risks, according to Craig Donnelly, MD, of Geisel School of Medicine at Dartmouth. If mental health problems go untreated, the teenager runs the risk of developing a more serious disorder as an adult.

Patients with serious mental illness die 15 to 20 years earlier than those with similar cardiovascular conditions. According to Joseph P. McEvoy, MD, of the Medical College of Georgia, "There's no mystery here." Cognitive deficits, issues, and lack of access can make it hard for these patients to get primary care, and to stick with the instructions they do receive. To help this group, Dr McEvoy believes psychiatrists can gain competency to treat hypertension, diabetes, obesity and to help these patients quit smoking.

The better-known symptoms of schizophrenia are devastating enough: hallucinations, delusions, agitated body movements, the inability to experience pleasure. Yet even when these facets are controlled with antipsychotic drugs, cognitive deficits that make it hard to maintain relationships or hold a job can still consign patients to a life in the shadows, with few friends or little contact with family.

Steven D. Hickman, PsyD, associate clinical professor at the University of California, San Diego, invited a roomful of conference attendees to put down the notes, close their eyes, set an intention, and breathe, gaining an "awareness of the breath." His session, "Mindfulness-Based Stress Reduction for Patients with Chronic or Life-Threatening Illness," highlighted techniques based on 2000-year-old Eastern philosophy that can help patients learn to respond to pain, not react to it.

Evidence of who gets post-traumatic stress disorder, how genetics plays a role, and how to treat it is growing, but much work remains to help the estimated 3.5% of the population who suffer its effects in any given year, according to Murray B. Stein, MD, MPH, professor of Psychiatry and Family and Preventive Medicine, and vice chair for Clinical Research in Psychiatry at the University of California, San Diego.

For more than 70 years, standard care for those addicted to alcohol or drugs has called for the afflicted person to abstain from the substance completely, and to become immersed in a community of fellow sufferers for support. This is particularly true in the early months, when the "phenomenon of craving" remains acute.

Building trust, or a "therapeutic alliance," between the therapist and patient with personality disorder is needed to help the patient work through core beliefs of worthlessness and unlovability that affect behavior, according to Judith S. Beck, PhD, who was the featured speaker Saturday at the US Psychiatric and Mental Health Congress, being held in Orlando, Florida.

If psychiatrists and other mental health professionals don't actively measure their effectiveness, they typically don't know things have gone awry until it's too late, said Mark Zimmerman, MD, director of Outpatient Psychiatry and the Partial Hospital Program at Rhode Island Hospital.