P. Brambilla, ItalyUniversity of Milan Pathophysiology and transplantation
Moderator Of 3 Sessions
Proposed by the EPA section on Neuroimaging -Brain subregional shrinkage is commonly reported in major affective and non -affective psychosis, but its role in the illness is still poorly understood. In particular, it is unclear how clinical and psychosocial variables relate to brain volumes across the life span. In particular, longitudinal studies have reported a correlation between larger ventricles, decreased prefrontal volumes and worse outcome in psychoses. This would potentially allow to isolate subtypes of schizophrenia patients with a worse prognosis and more evident biological impairments, ultimately helping in designing specific cognitive rehabilitation. This symposium will focus on the correlations between environmental variables and psychotic and affective disorders. Four international recognised speakers in the field will represent countries from Europe, UK and USA. Prof. Kirkbride will describe whether environmental factors (e.g. urbanicity, migrancy, residential stability) may relate to increased risk of affective and non-affective psychosis. Prof. Fiorillo will delineate the impact of adversities during adolescence on the development of psychosocial disability and mental disorders, and how these can influence their long-term trajectory. Prof. Brambilla will show the impact of disability and social functioning on brain anatomy in schizophrenia and bipolar disorder. Prof. Frangou will present data from a nationally representative cohort of 10,000 children aged 9-10 years in the US, quantifying the effect of being raised in a psychosocially disadvantage environment and delineating the separate and cumulative effect of risk and protective factors. It has finally to be noted that this is an official proposal from the EPA Neuroimaging Section.
Proposed by the EPA Section on Neuroimaging and Epidemiology and Social Psychiatry -Refining our understanding of developmental trajectories of mental disorders will allow us to identify early those patients most likely to develop persistence impairment in mental health as well as those patients which will benefit most from treatment. Because of the limited viability of treating all cases, it is particularly important to find out individual determinants predisposing to worst outcome or to a better response to treatment. The key role of social and environmental risk factors, within a gene-environment interplay framework, in precipitating and maintaining specific trajectories in mental disorders will be pointed out in different representative samples. In the same way, alterations in neurobiology and neuroimaging biomarkers which have been associated to developmental patterns leading to different mental health outcome will be critically revised in the light of recent evidence-based results.
Proposed by the EPA Section on Neuroimaging -Converging evidence suggests that patients with major psychoses such as schizophrenia, bipolar disorder or major depression suffer from deficits in brain anatomy and neurocognitive functioning. Also, enhancing neuroprotective mechanisms and anti-inflammation mediators has recently been shown to be beneficial in these disorders. In this context we will present findings from proof of concept studies with aspirin and N-acetyl aspartate in the treatment of depression in bipolar disorder patients. The potential neuroprotective role of long-term antipsychotic therapy on brain anatomy and myelination in psychotic patients will also be debated. Moreover, we will show distinct and shared contributions of diagnosis and symptoms to neurocognition in severe mental illness in the Paisa population in Colombia. In particular, Bipolar-I and schizophrenia displayed nearly identical impairments in accuracy and speed, across cognitive domains, whereas bipolar-II and major depressive disorder performed similarly to controls, with subtle deficits in executive and social cognition. Finally, we will describe the impact of specific hippocampal subfields on negative symptoms and verbal learning in first-episode and drug-naïve schizophrenia patients. This symposium will be extremely innovative, trying to disentangle the complex inter-relationships between treatment, neuroanatomy, psychopathology and cognition in major psychoses, with the long-term goal of improving response in this patient group along with their quality of life. Finally, the data presented in this symposium we will also be crucial for testing novel interventions in this important area of drug development for the treatment of schizophrenia bipolar disorders, and major depression.