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American Psychiatric Association, May 22-26, 2010

American Psychiatric Association Annual Meeting

The American Psychiatric Association's Annual Meeting took place May 22 to 26 in New Orleans and attracted about 10,000 medical professionals and a total of over 15,000 attendees from around the world. The meeting's main theme was "Pride and Promise: Toward a New Psychiatry," and presentations focused on issues such as addiction and development of the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

"One of the themes that's been important to our president is having the best research available, but having research presented in a way that is directly clinically applicable," said co-chair of the Scientific Program Committee, Donald M. Hilty, M.D., of the University of California at Davis. "So they invited some of the best scientists from around the world, and there's been quite a buzz about the high level of science."

"The National Institute on Drug Abuse had many lectures, for example, on how the brain circuits lead a person back to using drugs even when they're seemingly doing well," Hilty said. "That's been one of the key findings, as well as how the brain responds to drug use and creates other problems like depression."

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"A lot of the research findings are being included in our new DSM-5, which will be coming out in a couple of years," said Hilty, explaining that the new edition will more precisely define many mental disorders that are currently ill-defined. "There are people who have symptoms or a set of symptoms that really don't fall in a category. So this will be a nice change and improve access to clinical care."

"DSM plays a pivotal role in both patient care and clinical research, and as the excitement about publication of DSM-5 grows, these meetings grow increasingly valuable in terms of sharing our progress as well as soliciting feedback," David Kupfer, M.D., of the University of Pittsburgh School of Medicine, and chair of the DSM-5 Task Force, said in a statement.

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Significant research included a study by Irene Shyu, of the Massachusetts General Hospital in Boston, and colleagues, who assessed the effectiveness of e-mail to screen college students for depression. They conducted an e-mail survey of 631 students, including 21.7 percent who reported a history of depression, 12.9 percent who endorsed suicidal symptoms, and 14.5 percent who screened positive for major depressive disorder.

Of the 82 students who screened positive for major depressive disorder, 46.3 percent completed the follow-up survey. Only eight of them used the resources provided in the initial survey: depression information and peer counseling groups.

"E-mail appears to be an effective and inexpensive method to screen college students for depression," the authors conclude. "Simply offering online information on depression and available resources had limited effects on students' help-seeking behavior."

Abstract - Shyu

Another study, conducted by Dale D'Mello, M.D., of Michigan State University in Lansing, and colleagues, explored the relationship between population density, suicide rates, and availability of mental health professionals. After assessing data from the National Center for Health Statistics and Bureau of Census Data, the researchers found that the suicide rate was highest in Alaska (23.1 deaths per 100,000 population), which has the nation's lowest population density, and lowest in Washington, D.C. (5.3 deaths per 100,000 population), which has the nation's highest population density.

Nationwide, the researchers found a strong correlation between suicide and low population density, as well as low concentrations of psychiatrists, psychologists, and social workers.

"Complex biopsychosocial, geographic and cultural factors may contribute to the higher rate of suicide in rural populations," the authors conclude. "The present study suggests that access to mental health care may be a relevant factor. The delivery of psychiatric services to rural communities using telehealth may bridge the current gap in available mental health care."

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Partam Manalai, M.D., of the University of Maryland School of Medicine in Baltimore, presented research suggesting that patients with mood disorders and allergen specific immunoglobulin E (IgE) experience a worsening of depressive symptoms during natural peaks of tree and ragweed pollen. The study included 100 participants (average age, 43.8 years), 47 of whom were IgE-positive for tree and/or ragweed pollen.

"Our preliminary findings argue for a 'state' level connection between allergy and worsening of mood disorders," Manalai and colleagues conclude. "Our results also suggest that the link is biologically driven, beyond the mere psychological impact of allergic symptoms, being conducive to research on new preventative and therapeutic targets in the management of mood disorders."

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Robert McLay, M.D., of the Naval Medical Center in San Diego, and colleagues presented results of a study in which 20 active-duty soldiers with post-traumatic stress disorder (PTSD) related to service in Iraq or Afghanistan were randomly assigned to receive either 10 weeks of treatment with virtual reality exposure with arousal control or usual treatment. They found that seven of the 10 intervention patients who returned for post-assessment achieved a 30 percent or greater response on the clinician-administered PTSD scale compared to only one of the nine control patients who returned for post-assessment.

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