A national audience of psychiatrists and psychiatric advanced practitioners is gathering in Chicago April 2-4, 2009 for the continuing medical education (CME) conference “Bipolar Disorder and ADHD: Solving Clinical Challenges, Improving Patient Care” at the Westin Chicago River North.

More than 300 clinicians have registered for the conference, which is being produced by CURRENT PSYCHIATRY publisher Dowden Health Media and the American Academy of Clinical Psychiatrists (AACP). Psychiatrists and advanced practitioners can still register to attend at the meeting’s Web site (www.CurrentPsychiatry.com/AACP). The meeting has been approved for up to 18.5 AMA PRA Category 1 CME credits.

“CURRENT PSYCHIATRY’S expertise in creating peer-reviewed content and managing events dovetails perfectly with the AACP’s mission to provide information-sharing forums for psychiatric practitioners and academicians,” said AACP President Sanjay Gupta, MD. “Together, we have assembled a compelling program.”

The faculty of psychiatric educators and clinicians includes meeting chair Richard Balon, MD, Wayne State University; Kiki Chang, MD, Stanford University; Marlene Freeman, MD, Massachusetts General Hospital; S. Nassir Ghaemi, MD, MPH, Tufts Medical Center; Joseph Goldberg, MD, Mount Sinai School of Medicine; and Frederick Goodwin, MD, George Washington University.

Topics to be discussed at this learning-focused meeting include:

– ADHD in children, adolescents, and adults managing bipolar disorder during pregnancy and the postpartum use of stimulants, antidepressants, antipsychotics, and mood stabilizers in patients with bipolar disorder alcohol abuse in patients with bipolar disorder and ADHD.

*Exhibiting companies include: AstraZeneca, Neuronetics, Prescribing for Better Outcomes (University of North Carolina), Shire Pharmaceuticals and Teva Pharmaceuticals.

Dowden Health Media, a division of Lebhar-Friedman, Inc., publishes CURRENT PSYCHIATRY and other peer-reviewed print and online journals such as OBG MANAGEMENT, THE JOURNAL OF FAMILY PRACTICE, and MAYO CLINIC PROCEEDINGS. Dowden also produces CME conferences such as the Minimally Invasive Surgery Symposium (MISS), promotional education programs for physicians, and health-related consumer newsletters and Web sites.

The American Academy of Clinical Psychiatrists (http://www.AACP.com) brings together clinical practitioners and academicians to enhance care of patients with psychiatric illness by emphasizing practical knowledge. Members keep abreast of scientific developments in the diagnosis, etiology, and treatment of psychiatric disorders through annual conferences, online communications, and the indexed journal, the Annals of Clinical Psychiatry.

Dowden Health Media
http://www.dowdenhealth.com

• New Research Under Way To Study Treatment For Older Adults With Bipolar Disorder

A gene that is arguably the most studied “schizophrenia gene” plays an unanticipated role in the brain: It controls the birth of new neurons in addition to their integration into existing brain circuitry, according to a report in the March 20th issue of the journal Cell, a Cell Press publication. The finding suggests that loss of the gene, as occurs in some cases of schizophrenia as well as bipolar disorder and major depression, may “tip the balance” in the brain, leading to an increased risk of compromised cognition and behavioral abnormalities, the researchers said.

What’s more, the protein encoded by the gene aptly known as Disrupted in Schizophrenia 1 (DISC1) exerts its influence through a well-studied molecular pathway. Specifically, it interacts directly with and blocks the activity of GSK3b, a protein that is the target of the lithium treatments that doctors have used for decades in the treatment of bipolar disorder.

“Lithium is still the most reliable [medication] for bipolar disorder,” said Li-Huei Tsai of the Howard Hughes Medical Institute and the Massachusetts Institute of Technology. “This shows that DISC1 is almost like an endogenous lithium.”

The findings are part of a larger picture of the genetic and developmental causes of psychiatric disorders that has recently begun to emerge and may point the way to new approaches for therapeutic intervention, Tsai said. Although people diagnosed with schizophrenia are typically resistant to treatment with lithium, she added, their observations should encourage scientists to “think creatively” about new and more powerful strategies for targeting GSK3b.

Schizophrenia is a severe brain illness that affects 0.5% of the world population, the researchers said. While its causes are poorly understood, accumulating evidence suggests that neurodevelopmental defects are involved and recent studies have identified many risk genes associated with schizophrenia, DISC1 among them. Studies of a very large Scottish family with a high incidence of schizophrenia, bipolar disorder and major depression over several generations also found that those family members who develop psychiatric disorders carry a mutation in DISC1.

Biochemical evidence later showed that DISC1 interacts with a growing number of binding partners, Tsai said, and functional studies have revealed a role for the gene in the growth and migration of neurons and in the integration of neurons into the brain. Mice with the abnormal version of the gene also develop behaviors that are reminiscent of human psychiatric disorders, including schizophrenia and depression.

Now, Tsai’s team has begun to connect the genetic and biochemical evidence with the behavior in studies of mice.

In addition to the known role of DISC1 in the function of existing neurons, the gene is also highly expressed in neural progenitor cells and is required for their proliferation, they report. This function of DISC1 involves regulation of the so-called b-catenin/GSK3b pathway.

In the adult mouse brain, loss of DISC1 function in the dentate gyrus, a portion of the brain that is important to the formation of new memories, led to reduced neural progenitor proliferation and elicited hyperactive and depressive behaviors in mice. Importantly, they found, those behavioral abnormalities were reversed when the DISC1-deficient animals were treated with a chemical that blocked GSK3b.

“These findings provide compelling evidence that DISC1 is a central player in the GSK3b/b-catenin signaling pathway that impinges on neural progenitor proliferation,” the researchers concluded. Together with earlier findings, the new results suggest that behavioral abnormalities resulting from DISC1 loss of function in the dentate gyrus likely involve a combination of reduced numbers of newly born neurons and their aberrant integration into the existing circuitry, as well as effects on mature neurons.

“In the end, the human lesions may result in subtle functional changes that have an effect on the eventual size of the brain and the progenitor pool,” Tsai said. While those changes might not be sufficient to cause psychiatric disorders on their own, she added, they may leave individuals more vulnerable to getting “pushed over the edge.”

Notes:

The researchers include Yingwei Mao, Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA ; Xuecai Ge, Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA, Harvard Medical School, Boston, MA; Christopher L. Frank, Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA; Jon M. Madison, Massachusetts Institute of Technology, Cambridge, MA; Angela N. Koehler, Massachusetts General Hospital, Boston, MA; Mary Kathryn Doud, Massachusetts General Hospital, Boston, MA; Carlos Tassa, Massachusetts General Hospital, Boston, MA; Erin M. Berry, Massachusetts General Hospital, Boston, MA, Massachusetts Institute of Technology, Cambridge, MA; Takahiro Soda, Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA, Harvard Medical School, Boston, MA; Karun K. Singh, Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA; Travis Biechele, Howard Hughes Medical Institute, University of Washington School of Medicine, Seattle, WA; Tracey L. Petryshen, Massachusetts General Hospital, Boston, MA, Massachusetts Institute of Technology, Cambridge, MA; Randall T. Moon, Howard Hughes Medical Institute, University of Washington School of Medicine, Seattle, WA; Stephen J. Haggarty, Massachusetts General Hospital, Boston, MA, Massachusetts Institute of Technology, Cambridge, MA ; and Li-Huei Tsai, Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA, Massachusetts Institute of Technology, Cambridge, MA.

Source: Cathleen Genova

Cell Press

• National Audience Of Psychiatrists Assembling In Chicago For Conference On Bipolar Disorder And ADHD
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The Kennedy Krieger Institute will commemorate the two-year anniversary of the Interactive Autism Network (IAN), www.IANProject.org, with the much-anticipated launch of its research initiative for adults and the unveiling of a more user-friendly, easily navigated online community. Launched in April 2007 as the first national autism registry, the IAN Project has become the largest pool of autism data in the world, with registration expected to reach 30,000 individuals during Autism Awareness Month.
Having already uncovered new insights and aided hundreds of research studies about children with autism, the IAN Project is now enrolling adults with autism in hopes of using the same proven research model to address the many unanswered questions about this underserved population. Adults with autism can now have their voices heard through the IAN Project in order to help researchers gain a clearer picture of how they are living today. Adult participation meets a significant unmet need - while the number of adults living with autism grows every day, little is known about them. There hasn’t been a comprehensive, national effort to find out what services adults with autism are in need of, or to document the ways they contribute to society. In fact, there is no official estimate of how many adults with autism are living in the U.S. today.
“By expanding the IAN Project beyond children, we will provide much-needed insight that will ultimately enable caregivers, the community, legislators, advocates and researchers to better serve adults with autism,” said Dr. Paul Law, Director of the Interactive Autism Network at the Kennedy Krieger Institute in Baltimore, Maryland. “By surveying and registering adults with autism, the IAN Project will be able to gain a clearer picture of how adults with autism are living today, and connect them with researchers who are working to understand the disorder at all stages of life.”

The IAN Project is also unveiling a new look for its online community, which with its unique model of information exchange and community interaction has facilitated the most comprehensive collection of evidence-based information on autism available to parents on the Web to date. The new design allows users to more easily navigate through the site, and highlights the depth of resources available to the autism community. From the community homepage, users can quickly see the most recent research articles written by prominent autism experts, the latest autism news and what discussions are currently taking place in the community forums.

“We’re proud of the trusted, comprehensive resource we have created for the autism community. Because of the volume of participation in the site it became important to redesign the interface to make the wealth of information available through the IAN Project more accessible. The enhanced site will make it easier for stakeholders in the autism community to locate resources and connect with others affected by autism,” said Dr. Law.

Additionally, the IAN Project continues to generate new insights into autism and shed light on issues of critical importance to the autism community. Research highlights from 2008 include:

• Defining the Spectrum: Having meaningful autism spectrum diagnostic categories is essential to treatments and research. On March 18, 2009, the IAN Project published a paper in the Journal of Autism and Developmental Disorders that described the varied pattern of autism diagnosis across the country and over time (1994-2007). This information is being used by scientists to better define the best way to diagnose autism. Better autism diagnoses will lead to better treatments and more finely tuned research.
  • Parental Depression: More than 44 percent of mothers and 28 percent of fathers of children with autism report they have been professionally diagnosed with either depression or bipolar disorder at some point in their lives, with more than 50 percent reporting diagnosis before the birth of their child(ren) with autism. This statistic is striking when compared to the estimated lifetime prevalence in the U.S. population for major depressive disorder of 16.2 percent and for bipolar disorder of 1 to 2.1 percent.
    • The IAN Project is funded by Autism Speaks, a non-profit organization dedicated to increasing awareness about the growing autism health crisis and raising funds for critical autism research. To register or learn more, visit http://www.IANproject.org.

      Notes:

      
      About Autism

      Autism spectrum disorders (ASD) is the nation’s fastest growing developmental disorder, with current incidence rates estimated at 1 in 150 children. This year more children will be diagnosed with autism than AIDS, diabetes and cancer combined, yet profound gaps remain in our understanding of both the causes and cures of the disorder. Continued research and education about developmental disruptions in individuals with ASD is crucial, as early detection and intervention can lead to improved outcomes in individuals with ASD.

      
      About the Kennedy Krieger Institute

      Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 13,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis.

      
      About Autism Speaks

      Autism Speaks is the nation’s largest autism science and advocacy organization, dedicated to funding research into the causes, prevention, treatments and a cure for autism; increasing awareness of autism spectrum disorders; and advocating for the needs of individuals with autism and their families. Autism Speaks funds more than $30 million each year in new autism research, in addition to supporting the Autism Treatment Network, Autism Genetic Resource Exchange, Autism Clinical Trials Network, Autism Tissue Program and a range of other scientific and medical programs. Notable awareness initiatives include the establishment of the annual United Nations-sanctioned World Autism Awareness Day on April 2 and an award-winning, multi-year national public service advertising campaign with the Ad Council. Autism Speaks’ family services efforts include the Autism Video Glossary, a 100 Day Kit for newly-diagnosed families, a School Community Tool Kit and the distribution of community grants to local service providers. Its government relations department, through its Autism Votes initiative, has played a critical role in securing federal legislation to advance the federal government’s response to autism, and has successfully advocated for insurance reform to require insurers to cover medically-necessary autism therapies. Each year, Autism Speaks Walk Now for Autism fundraising events are held in more than 70 cities across the country, as well as Canada and the United Kingdom.

      Source:
      Megan Lustig
      
      Kennedy Krieger Institute

      • Study Suggests New Treatment Approach May Be Needed For Management Of Depression In Some People With Bipolar Disorder
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