IEPA 2014

Title Poster First Author Abstract or summary Type
Effect of childhood adversity on brain dopamine function in adulthood Alice Egerton

Traumatic experiences during childhood increase the risk of psychosis illness. Abnormal dopamine function is a key feature of psychotic disorders and a plausible mediator of an effect of childhood stressors on risk of later illness. This study investigated whether, in young healthy adults and in those at clinical high risk of psychosis, experience of childhood adversity was associated increased presynaptic dopamine function in the striatum.

Conference Presentations
Dissecting dopamine, salience and the risk of psychosis Toby Winton-Brown

This study unpacks the concept of 'salience as invoked by Kapur and others in linking dopamine dysregulation to psychotic symptoms. Rather than relying on one-dimensional reward based conception of salience that has dominated studies so far it develops a multidimensional view. It sets out to then test this using fMRI and PET scanning in unmedicated subjects at high clinical risk for psychosis (UHR) in the neural setting of the MAM animal model of schizophrenia, that predicts abnormal hippocampal outputs drive striatal dopamine dysfunction in psychosis.

Conference Presentations
Public health significance of bipolar disorder: implications for early intervention and prevention Philippe Conus

Objectives: Early intervention and preventive strategies have become major targets of research and service development in psychiatry over the last few years. Compared to schizophrenia, bipolar disorder (BD) has however received limited attention in this regard. In a review of the available literature, we explored the public health significance of BD and the extent to which this may justify the development of early intervention strategies for this disorder. Methods: The main computerized psychiatric literature databases were accessed.

Conference Presentations
Emerging Mood and Anxiety Disorders: Lost in Transition Swaran P Singh

Background: Many adolescents with mental health problems experience transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). As part of the multisite TRACK study we evaluated the process, outcomes and user and carer experience of transition from CAMHS to AMHS in six large mental health Trusts in England. Method: We identified a cohort of service users (n=154) crossing the CAMHS/AMHS boundary over one year and tracked their transition journey.

Conference Presentations
Pharmacological interventions in early bipolar disorder Matthew J Taylor

Medications prescribed in early bipolar overlap with those commonly employed in early intervention for non-affective psychosis. This talk will review the latest evidence for the most widely employed pharmacological agents in early bipolar disorder including new analyses incorporating the latest data from randomised controlled trials. Of particular interest is the now clear evidence that agents differ substantially in their relative effects on depressive and manic episodes, and this should allow more rational choice of agents particularly for relapse prevention

Conference Presentations
Early Intervention for Bipolar Disorder: The Role of Psychological Interventions Craig A Macneil

For the majority of people who develop bipolar disorder, its onset occurs in late adolescence or early adulthood, a crucial phase in our developmental trajectory. This paper will describe some of the significant challenges and opportunities relating to undertaking psychological interventions with a young bipolar population who are early in the course of the disorder. It will focus particularly on the challenges of engagement and development of insight, while recognising the considerable potential for positive outcomes with this group.

Conference Presentations
Delays to Diagnosis and Treatment of Bipolar Disorder: the UK experience Matthew Taylor

It is common for people with bipolar disorder to experience delays of several years to diagnosis and appropriate treatment. Retrospective studies often report more than ten years between the onset of illness and correct diagnosis being made. Similarly delays of many years before initiation of appropriate medication are described. Growing evidence indicates delayed diagnosis and treatment of bipolar disorder are associated with poorer long term outcomes. Understanding these delays better is key to devising appropriate strategies to remediate them.

Conference Presentations
White matter integrity and cortisol levels in relation to treatment response in first-episode psychosis Tiago Reis Marques

Introduction: Previous studies have suggested that patients with first-episode of psychosis who show poor response to antipsychotic treatment have significantly impaired WM microstructure when compared to Responders. More recently, it as also been showed that baseline cortisol levels could also predict clinical outcome in first-episode psychosis. As the HPA axis is also known to indirectly affect white matter, is it possible to speculate that patient _s ability to respond to treatment is mediated through the effect of cortisol in white matter.

Conference Presentations
Pre-empting social damage through early detection: Long-term negative symptom and vocational function levels Wenche ten Velden Hegelstad

Background: Poor vocational outcome remains a challenge in first episode psychosis (FEP): Only 13-43% of patients have any employment. In the Scandinavian TIPS study, early detection and negative symptoms predicted long-term recovery, of which full time paid employment was part. Little is known about associations over time between negative symptoms, early detection, and employment. Objective: To test the hypothesis that early detection improves vocational outcome through sustained lower levels of negative symptoms, thus improving patients ability to function.

Conference Presentations
Is hedonic capacity a protective factor for the development of stress-induced psychosis? Inez Myin-Germeys

Introduction: The capacity to experience positive emotions and to enjoy the things that happen may protect against the psychosis-inducing effects of stress. We used momentary assessment to investigate the effects of stress on hedonic capacity and to examine whether the experience of positive affect (PA) can protect against the psychosis-inducing effects of stress. Methods: 260 patients with psychotic disorder and 277 healthy controls participated in an ESM study. First, changes in PA and the occurrence of pleasant events (PE) were examined before and following increases in social stress.

Conference Presentations

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