Join Me at the 5th Annual Music For The Hearts Concert

Music For The Hearts Concert

Want to show support toward mental health and make a difference? Interested in a night of live performances and food?

Join me for the 5th Annual Music For The Hearts (MFTH) charity event on Saturday, September 15th. It will be a night of celebrations, with music, great talent, and health advocacy, at the Evergreen Cultural Centre.

MFTH is a non-profit charity dedicated to supporting various causes that benefit health care in Metro Vancouver. They are made up of a group of university students, who have combined their interest in music with their passion for health. Their mission is to organize annual fundraising musical concerts to implement positive changes for our community.

This year, MFTH’s committee members unanimously decided to further contribute to mental health, specifically severe mental illness. All funds raised from ticket sales and further contributions will be donated to BC Schizophrenia Society (BCSS) in order to help families in need.

Schizophrenia is a form of severe mental illness that, for most, is a life-long, debilitating disease. Despite its complexity, it is still manageable. However, the costs associated with seeking treatment and other means of aid are quite expensive. By collaborating with BCSS, all their donations will be used to directly support those coping with schizophrenia, educate the public, and contribute to research and awareness for better medical services.

Don’t miss out on an event that supports an important cause close to my heart!

Buy your tickets today for $15.

12th Annual Pacific Psychopharmacology Conference

12th Annual Pacific Psychopharmacology Conference Banner

Dr. Randall White will be co-chairing the 12th Annual Pacific Psychopharmacology Conference which will will take place on September 21st, 2018 at the Pinnacle Hotel Harbourfront, Vancouver. This popular annual conference features a wide range of topics presented by renowned speakers, with a focus on pharmacological interventions for people with mental health problems.

Key Speakers at the 12th Annual Pacific Psychopharmacology Conference

One of the keynote speakers will be Dr. Don Goff., an expert on schizophrenia from New York University.

12th Annual Pacific Psychopharmacology Conference Dr. Jon Goff

Some of Dr. Goff’s recent publications include:
1) “The Genetics of Endophenotypes of Neurofunction to Understand Schizophrenia (GENUS) consortium: A collaborative cognitive and neuroimaging genetics project.” Read it here.

2) “Association between catechol-O-methyltransferase genetic variation and functional connectivity in patients with first-episode schizophrenia.” Read it here.

3) “Association of Hippocampal Atrophy With Duration of Untreated Psychosis and Molecular Biomarkers During Initial Antipsychotic Treatment of First-Episode Psychosis.” Read it here.

Another highlight of the event will feature Dr. Lakshmi Yatham, the Regional Head of Psychiatry and Regional Program Medical Director for Vancouver Coastal Health and Providence Healthcare. He is also a Professor in the Department of Psychiatry at the University of British Columbia.

12th Annual Pacific Psychopharmacology Conference Dr. Lakshmi Yatham

Dr. Lakshmi Yatham’s presentation will cover the CANMAT & ISBD Guidelines for the Management of Bipolar Disorder. Read and learn more about the recent publication of the CANMAT bipolar disorder treatment guidelines here.

Join Dr. Randall White and many other experts this September for the 12th Annual Pacific Psychopharmacology Conference, and register today! 

Research Study: Health Professional Mothers of Adult Children with Schizophrenia

Research Study

The University of New England School of Health is looking for health professionals to participate in a research study. The health professional must be a mother of an adult child who has been diagnosed with schizophrenia.

The purpose of the research study is to look at these mothers’ stories to see how they have negotiated care for adult children with schizophrenia.

Participation will involve:

  • Answering questions on the phone to see if you meet the inclusion criteria
  • Signing a consent form with your agreement to participate (with the proviso that you can withdraw at any time for any reason)
  • Participating in an interview in which the audio will be taped.

The research is conducted by PhD student Debra Klages from the School of Health at the University of New England.

For more information about participating in this study, please contact Debra Klages by email at dklages@myune.edu.au. The principal investigator Professor Kim Usher may also be contacted by kusher@une.edu.au.

 

Ms. Debra Klages RN, BScN, Cert Case Mgmt., M Adv Nurs Prac (Mental Health), MACN

Study Title: Health Professionals as Mothers of Adult Children with Schizophrenia

This project has been approved by the Human Research Ethics Committee of the University of New England (Approval No HE17-028, Valid to 23/03/2019)

A Family Caregiver Listens to Gerrit van der Leer

Gerrit van der Leer

By Susan Inman

Gerrit van der Leer, BC’s Director of Mental Health and Substance Use, was the closing speaker at the recent sold-out conference at Vancouver General Hospital on Bringing Cognitive Remediation to British Columbia. Van der Leer has decades of experience in developing recovery-oriented programs for people with severe mental illnesses; these include BC’s Early Psychosis Intervention (EPI) programs and Assertive Community Treatment teams.

A ground breaking resource that’s been developed for the EPI programs is the Dealing with Psychosis ToolkitIn the section on “Understanding Cognition,”the Toolkit contains essential information about the common cognitive losses experienced by people with psychotic disorders. These problems include difficulties with attention, learning and memory, critical thinking skills (e.g., planning, organizing, problem solving, abstract thinking) and social cognition. Too rarely do clients, families or many clinicians learn about these cognitive problems.

The Toolkit also contains numerous cognitive adaptation strategies that can help people manage these cognitive problems. Adaptation strategies are a useful component in cognitive remediation (CR) programs, but CR programs have a much broader mandate. Much of the conference described common components of evidence-based CR programs. These components include intensive, supervised computer based work designed to improve cognitive functioning in areas such as processing speed and concentration, and also include professionally facilitated small group discussions. These sessions operate as bridging mechanisms designed to assist clients to bring their new skills to meeting the challenges of daily living, education and work.

Van der Leer expressed his support for incorporating cognitive remediation into BC’s psychosocial rehabilitation services. He discussed the kinds of next steps that need to occur and reminded the audience that these had also been discussed earlier in the conference in a presentation by Dr. John Higenbottam and Dr. Tom Ehmann.   Policy documents need to be developed that address which populations should be included, what kinds of sites should be selected for delivery of services, which remediation programs should be used, how staff should be trained and how programs should be monitored for fidelity and outcomes.

Van der Leer also reminded audiences that cognitive remediation programs are basically inexpensive and relatively easy to implement.

We learned that BC’s new Ministry for Mental Health and Addictions is looking for input in developing a new whole-of-government approach for responding to mental health and substance use. There are vital roles for ministries involved with health, corrections, housing, education, transportation, and children and families to play in developing comprehensive strategies.

As a family caregiver, I’m hoping that certain key issues can be addressed. Here are just three of these issues:

  • BC (and Canada as a whole) needs improved mental illness literacy programs. Inadequate knowledge among the public leads to inadequate responses to psychotic disorders like schizophrenia and bipolar disorder. For instance, delay in treatment of psychosis leads to worse outcomes, and families play a crucial role in getting health care for their family member. Furthermore, inadequate psycho-education programs for clients lead to relapses that are expensive for the health care and criminal justice systems. People are better able to accept and manage their illnesses when they understand them.
  • Many programs training credentialed mental health clinicians do not require any science-based curriculum on psychotic disorders. This is one reason that clients, families and many clinicians have not been learning about the cognitive losses associated with these illnesses; it’s these losses that are considered to be a major factor in ongoing disability.
  • Though contemporary neuroscience and psychiatry no longer blame parents for the development of schizophrenia and bipolar disorder, this blame is still common among other clinical practices. It is an obstacle in creating the kind of cooperative relationships that need to exist between family caregivers and clinicians in order to best help people who develop these illnesses. Standards of training need to be raised. As well, mental health authorities need to provide professional development to help staff learn new ways of interacting with family caregivers.

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BC Hosts the First Canadian Conference on Cognitive Remediation

By Randall White and Susan Inman

An audience of more than 200 people, including mental health professionals, family members and service users, gathered to hear local and visiting experts discuss cognitive remediation. The Bringing Cognitive Remediation to British Columbia conference on Oct. 14th at Vancouver General Hospital was a sold-out event.

Dr. Bill Honer, the Head of UBC’s Department of Psychiatry and the Jack Bell Chair of Schizophrenia Research,, welcomed the conference participants. He explained how cognitive losses in people with schizophrenia are distinct from the cognitive problems impacting people with intellectual disabilities and Alzheimers. For instance, cognitive loss in people with schizophrenia is malleable; a UK study of patients who had suffered severe cognitive impairments found that in most, their cognitive function dramatically improved over a five-year period. Dr. Honer also emphasized the value of medications in treating schizophrenia and their importance in preventing relapses.

Susan Inman, a family caregiver and the conference co-chair along with Dr. John Gray, spoke about “Why and How This Conference Came to Be.” She highlighted, as did others during the day, the lack of awareness among clients, families and many clinicians of the well-researched cognitive losses that frequently accompany schizophrenia. Following a meeting with Dr. Alice Medalia, the Director of Columbia University’s Lieber Recovery Center, Susan had herself become more aware of the extensive progress in developing evidence-based cognitive remediation programs. Through attending the annual Cognitive Remediation in Psychiatry conferences at Columbia University which Dr. Medalia initiated 20 years ago, Susan realized how many countries have received assistance from Dr. Medalia in developing cognitive remediation programs; these include France, Norway, Denmark, Portugal, Japan, and Australia among others. Canada doesn’t yet offer these programs as a part of psychosocial rehabilitation services.

Susan described the two-year collaborative process among representatives from the BC Schizophrenia Society, the BC Psychosis Program, the BC Early Psychosis Intervention program and Psychosocial Rehabilitation BC that led to this first Canadian conference on cognitive remediation.

According to Dr. Chris Bowie, Professor of Psychology at Queen’s University, the cognitive losses in schizophrenia and bipolar disorder are present from the first episode. They affect many domains of cognition such as attention, memory and executive function, and they can be severe to profound, especially in schizophrenia. They predict functional impairment and difficulty in school and employment, and may be manifested by such problems as being slow to complete tasks, being forgetful, an inability to multitask, and appearing socially awkward. Dr. Bowie called these losses “prevalent, pervasive, pernicious and persistent.”

Dr. Chris Bowie

Cognitive remediation is a means to improve these deficits through cognitive activation, strategic monitoring and generalization or bridging to daily life. The latter, according to Dr. Bowie, is crucial and seems to require the presence of an engaged therapist; having a patient do computer training alone is not enough. To this end, he has tested an enhanced form of the therapy called action-based cognitive remediation which involves the clients in activities that are more akin to real-life tasks; preliminary results suggest better retention in treatment and better outcomes compared to more traditional CR including higher likelihood of being employed six months after the end of treatment.

In her presentation on “How to Make Cognitive Health Services a Part of Mental Health Care,” Dr. Alice Medalia explained how cognitive remediation (CR) is an evidence-based, recovery-oriented treatment that helps people become more functional. Among other illness-related cognitive deficits, it addresses working memory, attention, processing speed, problem solving, reasoning, and social skills as well as motivation.

Dr. Alice Medalia

Dr Medalia described the CR programs she has set-up in New York State. They typically involve computer-based activities for 45 minutes and a 15-minute discussion that focuses on bridging skills to the clients’ goals for improved functioning in their community. Although programs usually involve twice weekly sessions for 15 weeks, the duration is adjusted to the clients’ needs. The groups include 6 – 8 people and use rolling admissions so that more experienced clients can help those who are new to the training. Staff, who usually have a master’s degree, are actively involved in both the computer activities and the discussions.

Dr. Medalia trains staff to use a cognitive lens to understand their clients. Usually staff have not previously received training on recognizing and responding to cognitive difficulties. She emphasized that CR training is flexible and can be adjusted to a variety of populations in various settings.

Two panel discussions in the afternoon considered current and future efforts in offering cognitive remediation to British Columbians.

Dr. Tom Ehmann, who helped develop BC’s Dealing with Psychosis toolkit, described the section on “Understanding Cognition.” The toolkit focuses on compensatory and adaptive strategies. Compensatory strategies use existing cognitive strengths by, for instance, identifying and using an individual’s learning preferences. Adaptive strategies use environmental aids such as a day-timer or post-it signs. The areas addressed include attention, learning and memory, critical thinking (e.g., planning, problem-solving, organizing) and social cognition. The toolkit includes a self-assessment checklist which helps individuals identify the kinds of difficulties they may be experiencing.

An overlooked impairment in mental illness is social cognition, the mental processes underlying person-to-person interactions. Dr. Amy Burns said that people with schizophrenia have marked deficits in such domains as

  • Emotion processing
  • Attributional style
  • Social perception
  • Theory of mind

These deficits are related to other symptoms of the disorder including negative and positive symptoms of psychosis, depression and anxiety. Social skills training is a treatment that has shown a strong effect for improving recognition of facial emotions and social perception and significant if lesser effect on other domains.

Drs. Mahesh Menon and Ivan Torres described a pilot project to offer CR to patients at the BC Psychosis Program (BCPP), a residential treatment centre for treatment-resistant schizophrenia (TRS) at UBC Hospital in Vancouver. Two studies have examined cognitive losses in patients with TRS compared to those with more antipsychotic-responsive psychosis and had conflicting results: one study found the cognitive deficits in TRS were more severe whereas the second study did not find a difference. This needs further investigation, but no reason exists why people with TRS should not receive CR.

At the BCPP, CR is based on the software Scientific Brain Training Pro, but the emphasis is on linking the exercises to functional goals such as returning to school or work by using strategies to promote generalization to daily life tasks. The approach is multidisciplinary: the groups are run by a psychologist and an occupational therapist, while nurses and rehabilitation workers remind patients to do homework and prompt them to use the strategies day to day.

According to Dr. Todd Woodward, CR is meant to improve the trait of psychosis related to inefficient use of neural networks that underlie cognitive functions. Metacogntive therapy (MCT), a form of cognitive-behavioral therapy, is intended to target the state of psychosis that underlies cognitive biases that favor development of delusions and hallucinations. MCT is a group-based, interactive program with 8 core modules; the material is presented such that participants can experience cognitive biases during the session that are then discussed in relation to everyday life. These biases include jumping to conclusions and not integrating disconfirming information when trying to understand a situation. Drs. Woodward and Menon, along with a collaborator from Europe, have a clinical trial of CR and MCT underway in Vancouver with mental-health outpatients. Since May, 2014, they have enrolled 320 subjects; more patients will be enrolled during the next 12 months.

The second afternoon panel, “Next Steps in Implementing Cognitive Remediation in BC,” started with a presentation by Dr. John Higenbottam and Dr. Tom Ehmann that emphasized that cognitive remediation is an evidence-based practice. They pointed out that, in fact, most people with schizophrenia do not have access to the full range of evidence-based practices that help manage symptoms and improve psychosocial functioning.

Drs. John Higenbottam, Tom Ehmann, Christopher Bowie, Alice Medalia, and Regina Casey

Drawing on their experiences in establishing various provincial programs, they identified the elements that lead to success. They also raised numerous questions for the panelists to discuss including which populations should be targeted, where services should occur, how fidelity and outcomes should be monitored, and how staff should be trained.

Fellow panelist Dr. Regina Casey led an activity with the audience that encouraged them to identify in their family member or their clients the kinds of cognitive difficulties they witness that are impeding recovery.

The final presentation of the conference was from Gerrit van der Leer, Director of Mental Health and Addiction in the BC Ministry of Health. Director van der Leer sees cognitive remediation as a best practice and he explained the steps necessary to incorporate CR into the mental health system. He spoke of the work he envisions in developing a business plan, standards of practice guidelines, and performance measures. He suggested that each health authority should have an opportunity to learn about cognitive remediation and have regional planning to develop services in their districts.

Over 150 people submitted conference evaluations. The evaluations, which were very positive, included responses to a question about how participants witness cognitive losses impacting people’s abilities to move forward with their lives.

One family member described both the common losses mentioned by many and also wrote poignantly about the impact of the losses. The commenter said their family member’s cognitive losses “affect every area of his life. Money management, daily life – hygiene, food, social interaction. Moving forward with work, school, relationships. The med stabilizes him but he needs help in functioning in daily life. He would be homeless or dead without family help.”

A clinician cited issues described by other professionals: “I work with people with chronic mental illness and could write a book on all the ways this impacts my clients. Isolation, homeless, addiction and alienation are all effects of cognitive decline.”

The videotape of this conference will soon be available on the website of the BC Schizophrenia Society: www.bcss.org

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American Psychiatric Association 2017 Annual Meeting

American Psychiatric Association 2017

Dr Randall White was presenting a research poster at the American Psychiatric Association 2017 Annual Meeting in San Diego, CA.

Session: New Research Posters 1
Date: Monday, May 22
Time: 10:00 AM–12:00 PM
Poster Number: P5-020
Poster Hall: Exhibit Hall A, Ground Level, San Diego Convention Center

Dr White discussing the BCPP findings with Dr. John Kane, who did the first controlled trial of clozapine in North America.

ABSTRACT

Although clozapine is the standard for treatment-resistant psychosis, 40-60% of those treated with clozapine do not have an adequate response as measured by a 20% or greater reduction in the BPRS, PANSS or other assessments. This condition is known as clozapine resistance, ultra-resistance or refractory psychosis. At the publicly funded BC Psychosis Program, at UBC Hospital in Vancouver, Canada, we have developed criteria to identify clozapine resistance (CR) and an algorithmic approach to treatment based on available evidence. This involves assuring adequate clozapine treatment verified by dose and serum level, including addition of fluvoxamine when appropriate; offering ECT to CR patients, and/or antipsychotic augmentation preferably with sulpiride or aripiprazole. All patients admitted since program inception in February 2012 had failed at least 2 antipsychotic trials. A psychiatrist, social worker, pharmacist, nurse, general physician, and neuropsychologist evaluated each patient. All available summaries of previous psychiatric admissions were reviewed, and medical, pharmacological, social and behavioural histories were recorded.

All information is presented at a case conference and a DSM-IV or -5 multiaxial diagnosis reflects agreement among at least 2 psychiatrists and a psychologist. Symptom ratings included the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Psychopathology (GAPS), and the Clinical Global Impression-Severity and Improvement scales (CGI). Clozapine resistance is defined by an adequate trial, that is, at least 500 mg daily dose for ≥60 days; and continued symptoms manifested by PANSS with 2 positive scale items rated ≥ 4 (moderate) OR 1 item ≥ 6 (severe).

Of 114 patients with schizoaffective disorder or schizophrenia on clozapine at admission, 89 had received it for≥ 60 days; 23 were on at least 500 mg; and 20 met criteria for clozapine resistance (i.e., 17 men and 3 women). Of these, 17 had schizophrenia and 3 schizoaffective disorder; the mean age was 39.6 years. The mean PANSS scores at admission were Positive=28.3, Negative=26.2, General=50.0, Total=104.4; the mean CGI-S was 6.3. Of 16 patients with complete data, 8 were offered ECT and 3 accepted a course; the number of ECT treatments ranged 19-46. Of 19 patients discharged to date, 17 remained on clozapine with a mean dose of 463.2 mg; to obtain a therapeutic clozapine level, 6 received fluvoxamine, dose range 37.5-200 mg. Seven patients received adjunctive antipsychotics: 3 sulpiride, 2 aripiprazole, 4 first-generation agents. At discharge, the mean PANSS were Positive=20.8, Negative=22.1, General=40.0, Total=82.9; the mean CGI-S was 5.1.

Find full info on the American Psychiatric Association 2017 Annual Meeting here! 

Join Dr. Randall White at the 11th Annual Family Conference: From Crisis to Hope

11th family conference poster 2016

Dr. Randall White is pleased to be presenting at the 11th Annual Family Conference in mental healthy and substance services. Please join us Saturday, April 23, 2015, 9:00am-4:30pm in the Paetzold Theatre at the Vancouver General Hospital. Admission is $25 per person, and limited financial assistant for admission cost is available –just contact Becky Hynes via email (or call 604-714-3771 ext. 2300 for details.

Keynote Presentations Include:

  • Access & Assessment Centre (AAC): A New Service for Vancouver Residents to Access Mental Health and Substance Use Services in Vancouver
    • Monica McAlduff (Director, Vancouver Mental Health & Substance Use Acute, Tertiary & Urgent Services)
    • George Scotton (Manager, Vancouver Access & Assessment Centre, ACT & AOT)
  • Finding Clarity in Chaos: Principles for Developing Health and Recovery
    • Dr. Diane Fredrikson (Physician Lead, Early Psychosis Intervention Program, Vancouver Coastal Health)
  • When Treatments are Inadequate – New Hope for Patients
    • Dr. Randall F. White (Medical Director, B.C. Psychosis Program, Clinical Associate Professor, UBC)

Panel Discussions:

  • Support for Families in Need
  • Family Panel: How Families Can Advocate for Improved Mental Health Care

For the complete program schedule, click here!

Have questions about 11th Annual Family Conference in Mental Health and Substance Use Services? Contact Annual Family Conference: Family Involvement in Mental Health and Substance Use Services

11th family conference poster 2016

 

 


 

The Canadian Psychiatric Association’s Annual Conference Welcomes Dr. Randall White at its 65th Annual Conference

65th Canadian Psychiatric Association’s Annual Conference banner

Every year, more than 1,200 psychiatrists and other mental health care professionals attend the Canadian Psychiatric Association’s conference to educate themselves on the latest research in the field, exchange ideas, and network with colleagues from across the country. This year, Dr. Randall White is honoured to be presenting a symposium on the diagnostic and therapeutic advances in Schizophrenia along with several of his esteemed colleagues.

As the largest psychiatric professional development program in Canada, the CPA is an invaluable resource. 2015 marks a new direction for its annual conference with several changes to usual programming:

  • Pre-conference courses will be offered Wednesday, September 30
  • Thursday, Friday, and Saturday mornings will each offer an all-delegate keynote plenary
  • The AGM and President’s Gala have been moved to Friday morning and evening, respectively
  • Refreshment stands with coffee and tea will now be available at both venues

The conference will be held October 1st – 3rd at both The Fairmont Hotel Vancouver and the Hyatt Regency Vancouver. For location and room rates, visit fairmont.com/hotel-vancouver and vancouver.hyatt.com/en/hotel/home.html or book online 2015 CPA FHV and 2015 CPA HRV.

Conference Details:

  • Pre-Conference Courses (scheduled on Wednesday, 30 September, 13:00 – 17:00)
    These four-hour sessions were the most highly rated courses from peer reviewers. Space is limited, so register early.
    -Member/Affiliate: $150
    -Non-member: $225
  • Registration Package (CPA Members/Affiliates only)
    Includes three discounted scientific days, admittance to the exhibit hall, daily coffee breaks, admittance to the co-developed symposium, and the option to purchase a ticket(s) to the President’s Gala (all events have limited seating).
    $900
  • Daily Registration
    Each day of registration includes scientific sessions, admittance to the exhibit hall, daily coffee breaks, admittance to the co-developed symposium, and the option to purchase a ticket(s) to the President’s Gala (all events have limited seating).

    Resident & Medical Student Member registrations include all 3 days for $75.

    Thursday
    -Member/Affiliate: $320
    -Non-Member: $550
    -Nurse, Research Assistant, Psychologist, Social Worker: $380

    Friday
    -Member/Affiliate: $320
    -Non-Member: $550
    -Nurse, Research Assistant, Psychologist, Social Worker: $380

    Saturday
    -Member/Affiliate: $320
    -Non-Member: $550
    -Nurse, Research Assistant, Psychologist, Social Worker: $380

Attend the CPA President’s Gala!

Friday October 2, 7:00-11:00pm
The President’s Gala is an exceptional four-course dinner where we honour CPA award winners, congratulate our outgoing president, and conduct the exchange of office. It offers a great opportunity in a beautiful setting for networking with your friends, colleagues, mentors, and may even see you on the dance floor. The dress for this event is business attire.

-Residents: $35
-Members/affiliates: $75
-Non-members: $95

Dr. White’s Symposium Details:

Thursday, October 1 at 4:30pm – 6:00pm
Randall White*, MD, FRCPC; Geoffrey Smith, PhD; William Honer, MD, FRCPC; Marnie MacKay, BScN, PhD (c); Serdar Dursun, MD, PhD, FRCPC; Mahesh Menon, PhD, RPsych; Gary Remington, MD, PhD, FRCPC

 

For a complete schedule of the scientific programming, click here.

For updates, follow @BCPsychosis on twitter & use #cpaconference to follow conference highlights.

Dr. Randall White at the 9th Annual Pacific Psychopharmacology Conference

Dr. Randall White is pleased to be attending the 9th Annual Pacific Psychopharmacology Conference this September where he will be Co-chairing the pre-conference and moderating many of the conference sessions. Join us to learn what’s new in evidence-based research on the pharmacotherapy of psychiatric illness.

This year’s conference theme is: Balancing Risks and Benefits to Improved Adherence

The pre-conference workshop title is: Strategies for Managing Mood and Anxiety Disorders in Primary Care at the workshop. The workshop will also cover the following topics in the format of brief presentations with cases:

  • Incorporating Measurement-Based Care for Mood Disorders into Clinical Practice
  • The BC Practice Support Program Adult Mental Health Module: Implications for Primary Care
  • Use of Antidepressants in Ambulatory Settings

Key speakers for the conference:

Martha Sajatovic, MD
Treatment Adherence in Bipolar Disorder
Dr. Martha Sajotovic, is a professor of Psychiatry and Neurology at Case Western Reserve University. She is also a director of the Geropsychiatry Program, and Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, and a Willard Brown Chair in Neurological Outcomes Research, Cleveland. Her research focus is on treatment adherence in Bipolar Disorder and Improving Outcomes for People with Schizophrenia.

Robert Zipursky, MD, FRCPC
Improving Outcomes for People with Schizophrenia
Dr. Zipursky is a professor, Department of Psychiatry & Behavioural Neurosciences. ‘s research interests have been in investigating the biology of schizophrenia and its treatment using brain imaging techniques (CT, MRI, PET), the treatment of first episode psychosis, prevention of schizophrenia, and clinical outcomes from schizophrenia. He has served on the editorial boards of Schizophrenia Research and Schizophrenia Bulletin. He is a recipient of the John Cleghorn Memorial Award for Excellence and Leadership in Clinical Research from the Canadian Psychiatric Association and the Michael Smith Award from the Schizophrenia Society of Canada.If you are planning to attend, please introduce yourself to Randall! And if you’re coming from out of town, Be sure to ask for the “Annual Pacific Psychopharmacology Conference 2015” rate or quote booking ID #15906 at time of booking.

Pre-conference Workshop Information
September 17, 2015
Time: 1-4pm, lunch provided prior to course at 12:30pm
Cost: $119 for delegates, $69 for residents, apply a $25 discount if you register for the Sept. 18 conference as well

This workshop will be great for nurse practitioners, pharmacy/therapeutics, psychiatrists, registered nurses, residents and students.

Conference Details:
September 18, 2015
Executive Plaza Hotel and Conference Centre

Social Media:
Follow Dr. Randall White @BCPsychosis on Twitter, use #CPDpppc to follow the conference.

Prenatal Tobacco Exposure and Schizophrenia

WIN_20150329_101048

In utero exposure to tobacco, in other words having a mother who smoked during pregnancy, has been associated with several developmental disorders including attention deficit disorder and learning problems. Research from the Finnish Prenatal Study of Schizophrenia, a nationwide cohort of people with schizophrenia, suggests a link between this illness and in utero tobacco exposure. Dr. Alan Brown of Columbia University in New York described 997 Finnish patients with schizophrenia matched with same-sex and same-age controls whose mothers had blood samples taken during pregnancy. The American and Finnish research team examined serum cotinine, a metabolite of nicotine and a reliable biomarker for tobacco use, in the banked blood samples.
 
Among the affected offspring, 20.2% were born to women with serum cotinine greater than 50 ng/ml, considered a sign of high tobacco use, compared with 14.7% of controls; the odds ratio was 1.38 (95% CI, 1.05-1.82, p = 0.02), with adjustment for maternal age, parental psychiatric disorder, and birth province. When serum cotinine was analyzed as a continuous variable, the effect was weaker, with a final odds ratio of 1.06 (CI, 1.004-1.12; p = 0.035) when adjusted for the same factors along with a measure of maternal inflammation, C-reactive protein (CRP), which was also determined in banked serum.
 
The findings, while far from conclusive, suggest a dose-response which is one sign of plausibility. Furthermore, nicotine crosses the placenta and is associated with neurodevelopmental effects including cortical thinning and changes in the P1 auditory evoked response. The physiologic mechanisms of smoking may include reduced placental perfusion, increased carbon monoxide, oxidative stress, and the direct effects of nicotine on nicotinic acetylcholine receptors, which are important regulators of other neurotransmitters, and of neuron migration and cell survival.
 
A. Brown, H. Surcel, S. Niemela, S. Hinkka-Yli-Salomäki, I. W. McKeague, A. Sourander. Epidemiological Evidence for Inflammation and Nicotine Exposure as Prenatal Risk Factors for Schizophrenia. Symposium 1-2, 15th International Congress on Schizophrenia Research, Colorado Springs, Colorado. March 29-April 1, 2015.