Congress demystifies psychiatric illnesses
By Dewi Anggraeni
MELBOURNE (JP): The public recognition that psychiatric disorders are long-term and chronic illnesses has long been a goal of practitioners of psychiatry. The 20th Collegium Internationale Neuro-Psychopharmacologicum (CINP) Congress, held in Melbourne recently, may help psychiatrists bring about this recognition sooner. Ninety symposiums, held concurrently in four days, from June 23 to June 27, cover numerous topics such as schizophrenia, depression, drug addiction and other compulsive behavior disorders.
The congress, attended by 400 participants from 55 countries, including Indonesia, helps demystify psychiatric illnesses and bring them into the open for public discussion. Professor Graeme Burrows, the chairman of the local organizing committee, says that 8 to 12 percent of the world population suffer from depression at any given time. One in a hundred suffers from schizophrenia, 8 percent suffer from various social phobia, and 2 percent from panic disorders. "A total of 20 percent of the world population suffer from a degree of psychiatric disorders, and 10 percent of these are major illnesses," he says.
Recent technological advances also play a crucial role in bringing psychiatric disorders out the shadows of social stigma and suspicion. The link between neurological sciences and psychiatry was strengthened when brain-scanning and brain imaging technology became available. Professor Lewis Judd, the current CINP President, says this technology is one of the most important bridging sciences. He explains that brain imaging is now capable of measuring the functions of the brain down to several milliliters. While it is still an extremely costly method, the brain mapping has been able to confirm theories, hitherto established by post-mortem investigation, that people with psychiatric disorders do have particular abnormalities in their brains. A glitch in their neurological structure, it seems, is responsible for their psychiatric condition, often manifesting itself in psychotic behavior.
Abnormality
Brain imaging also allows early discovery of a person's genetic predisposition towards a particular psychiatric abnormality. Early medical intervention may be able to minimize or suppress the onset of symptoms.
These social costs of psychiatric disorders are shocking; some are obvious, others less so. Massacres, deliberate food poisoning and environment contamination perpetrated by psychotic individuals are common all over the world. Another resultant social phenomenon is suicide, which is one of the topics focussed on in the congress.
Professor John Mann of Colombia University, reveals that 15 percent of people suffering from depression attempt or commit suicide in their lives. In the United States alone, suicide is the eighth leading cause of death: 30 thousand die at their own hands every year. "Every two years, suicide kills more than the whole Vietnam War," he emphasizes. Professor Mann explains that people with suicidal predisposition in their genes are more prone to reach that threshold. Studies conducted in Western countries show that over 90 percent of suicides suffered from psychological illnesses. They were able to establish these findings by careful interviews with the doctors, families and friends of suicides. Now with brain mapping techniques early intervention is possible. One of the focuses of treatment is a neuro-transmitter called serotonin, which is known to check impulsive behavior. In some predisposed individuals, the serotonin system is very much reduced in function. If genetic markers can be made in that reduction in function, it will be possible to treat the sufferers with a drug that is designed to increase the function. Genetic markers, however, are not easy to establish, because serotonin is present peripherally as well as in the brain, and the level necessary in each individuals is unique.
Professor Paul Plotzky of Atlanta University reveals that genetic predisposition may be aggravated by early or prenatal stresses. Research on animals indicate that stresses such as maternal deprivation and other adverse physical experiences in animals with genetic predisposition increase the likelihood of psychiatric behavior later in life.
The congress also saw good news for sufferers and their families in regards to treatment. New drug screening techniques are increasingly helping to develop more effective drugs, especially for schizophrenia and Alzheimer's. Screening drugs used to be a very expensive, labor-intensive and slow process. Now with technology using sophisticated robotic components, the refining of drugs has been made easier.
US$12 billion is spent worldwide on the treatment of schizophrenia alone. Professor David Copolov, the Australian Chairman of CINP, says that one third of schizophrenics are treatment resistant. The drug Clozopine, traditionally used for these people, is known to cause side effects such as stiffness, shaking and inner restlessness. However, thanks to advanced technology, various drugs mimicking Clozopine have been produced, with the promise of fewer side effects. Professor Copolov emphasizes, however, that pharmacological treatment of schizophrenia and Alzheimer's disease should not be conducted in isolation of socio-psycho therapy.
The CINP congress is held biennially, and the next one is being in Glasgow, Scotland.