Royal College of Psychiatrists: Faculty of Neuropsychiatry Annual Conference

Posted in Courses & Conferences on 8th Jan 2018

 

Conference details: September 14-15, 2017, Stoke-on-Trent, UK.
Report by: Dr George El-Nimr, Consultant Neuropsychiatrist and Academic Secretary to the Faculty of Neuropsychiatry.
Conflict of interest statement: None declared.
Published online: 8/1/18


With a host of distinguished international speakers, adopting various session formats, the Faculty’s conference covered important clinical and research topics that have contributed to its continued success over recent years. As in previous years, the event was heavily subscribed, having earned its place in the diary of many colleagues.

Towards the end of the two-day conference, it was refreshing to witness such a lively debate around how far services should investigate patients with mild cognitive impairment. The conference also presented an inspiring exploration of what the humanities can teach today’s clinicians when it comes to contemporary understanding of the mind.

The conference delegates also heard about the impact of neuropsychiatric disorders on carers and families and how this can potentially be an enriching and fulfilling experience rather than a devastating one.

In addition to keynote talks, the conference offered a host of interactive seminars covering various clinical, legal and research topics. These sessions have addressed a wide range of educational needs in a format that has always proven to be highly valued by colleagues from around the UK and other countries. The international and transcultural perspective of the conference has certainly added further educational value to the event.

Following introductions from Professor Eileen Joyce, Faculty Chair, the conference opened with an update from Professor Wendy Burn, our newly appointed President of the Royal College of Psychiatrists. Professor Burn talked about neuropsychiatry within the College and the College’s plans in relation to training in neurosciences.

Chaired by Dr George El-Nimr, Academic Secretary, the rst plenary addressed issues around image, imagery and the imagination. First, Adam Zeman, Professor of Cognitive and Behavioural Neurology at the University of Exeter gave a detailed account on phantasia and discussed the neurology of visual imagery. Professor Zeman gave a fascinating account on how the “mind’s eye” can be impaired in certain individuals. Professor Giacomo Rizzolatti then discussed the contribution of his group in discovering the mirror mechanism and its social and clinical implications. He described the functions of the mirror mechanism located in the parieto-frontal network of monkeys and humans and how this mechanism enables one to understand others in an immediate, phenomenological way without recourse to cognitive inferential processing. He also discussed the role of the mirror mechanism in understanding basic Darwinian emotions, focusing on disgust, fear and joy. His talk was followed by another interesting talk from Professor Velakoulis who gave a presentation on the neuropsychiatry of younger onset neurodegenerative disorders.

In the context of the following plenary session, mild traumatic brain injury and post-concussion syndrome were addressed from the neurological perspective and bio-markers by Professor David Sharp. The neuropsychological aspect, chronicity and treatment were then addressed by Dr King, Consultant Clinical Neuropsychologist. His presentation reviewed the neuropsychology of mild head injury and post-concussion symptoms, in both the early stages after injury and when problems are chronic. His talk also addressed the factors which contribute to persisting symptoms and the evidence base for psychological interventions for post-concussion symptoms. Neuropsychiatric perspective and medico-legal dilemmas were subsequently discussed by Dr Robin Jacobson who highlighted the non-specificity of the post-concussional syndrome along with the predominant model suggesting early physiogenesis and perpetuation of symptoms on a predominantly psychological basis. The medico-legal aspects of mild traumatic brain injury was also reviewed, including the assessment of the duration of post-traumatic amnesia and the use of effort tests in neuropsychological examination.

The afternoon of the first day of the conference featured a number of seminars that were very well received by the conference delegates. These included discussing the auto-antibodies in psychosis, smart technology and epilepsy management, updates on the neurobiology of obsessive compulsive disorder and the role of expert witness in acquired brain injury claims.

The last plenary of the day was an exciting session that addressed epilepsy and the mind. It talked about how the humanities can inform our contemporary practice. Professor Steve Brown talked about music, epilepsy and the brain. Professor Brown highlighted how the subject of human language and communication encompasses a spectrum from verbal language, music, dance, movement and gesture, as well as the visual arts. He explained how music contributes to internalised thought and external social interactions, as do other art and language forms. It was interesting to hear how scientific approaches have emphasised the crucial importance of music and music related skills in general cognitive development. Conference delegates had the opportunity to learn how music can also induce particular mood states which in turn may modify behaviour and cognitive functions. The example of musicogenic epilepsy was discussed, highlighting how music is one of a large number of sensory experiences that may evoke seizures in predisposed individuals. Studies of such specific seizure evocation help inform not only the mechanisms of epilepsy but also the neural pathways and interactions that play a part in music. It was also fascinating to hear how music has also been postulated as an anti-epileptic tool, although it is not entirely clear how this relates to specific pieces of music. The potential influence of music on intelligence was also highlighted. Similarly, the potential positive impact of exposure to music and music education on basic cognitive and emotional development has an impressive evidence base.

Dr Maria Vaccarella, Lecturer in Medical Humanities at the University of Bristol, then talked to the conference attendees about epilepsy in contemporary fiction and its relevance to clinicians. Literary authors have long used epilepsy as a characterisation or plot device, but usually in a stereotypical way. More recent epilepsy narratives, instead, provide compelling insight into the stigma and difficulties associated with this condition. In her talk, Dr Vaccarella highlighted a selection of such narratives to demonstrate how literary texts can help us better understand patients’ views on controversial issues, such as poor compliance with anti-epileptic medications. Examples from her own research on literary presentations of epilepsy surgery were discussed along with their application in a clinical context.
On the final day, the programme launched

in poetic vein, with Mr Peter Maeck’s moving presentation entitled “Remembrance of Things Present – Making Peace with Dementia”. This presentation combined Mr Maeck’s poetry, prose and photographs to celebrate his father’s brave, good humoured struggle with Alzheimer’s disease. The presentation highlighted how initial feelings of depression yield ultimately to a realisation that dementia’s grip is loosened by the power of poetry, pictures, music and love, which can break down cognitive boundaries by freezing time initially then melting it, enabling a coming-together in a lyrical middle realm between what has gone before and what is yet to be. This session stimulated significant audience engagement through the Q and A session.

Offering a global perspective, a plenary session on cardiovascular disease and brain ageing highlighted specific transcultural lessons. Professor Ingmar Skoog first explored the role of vascular factors in neuropsychiatric conditions. This was followed by another impressive presentation by Professor Krishnamoorthy. This presentation covered a novel integrative model of care that blends psychological approaches with complementary and alternative medicine in India. The talk specifically addressed how behavioural and psychological dysfunction can be managed in a specific clinical setting.

In addition to poster presentations that were entered into a trainees’ competition, the conference also hosted a session dedicated to oral presentations delivered by trainees and again, culminating in a prize-giving at the end of the conference. There were a number of high quality research presentations, including potential neural correlates in imaging studies

in relation to functional weakness, the psychiatric phenotype of anti-NMDA receptor encephalitis, quantitative EEG findings as a potential prognostic biomarker in anti-NMDA encephalitis and chemokines in depression in health and in inflammatory illness.

Similarly, a selection of seminars were well attended by conference delegates. These included ECT in neuropsychiatric disorders, new and future drugs in sleep medicine, neuropsychiatry on the shop floor: discussing difficult clinical cases and neurological assessment and investigations: what do psychiatrists need to know?

Before announcing the best presentation and prize giving, the conference concluded with a lively debate chaired by Dr Peter Byrne. The debate had the title of “This house believes that the investigation of patients with Mild Cognitive Impairment is clinically unhelpful and economically unjustified”.

The controversy of this topic was highlighted right from the beginning when votes were taken. Many of the attendees were unable to express strong views either way. The two positions were presented by Dr Jeremy Isaacs, who proposed the motion, and Dr Jonathan Schott, who argued against it. The debate was helpful in informing clinicians’ views on the threshold and the details of assessments for which patients with Mild Cognitive Impairment should be considered.

The Faculty’s business meeting took place on day two of the conference, when the membership was updated on the work of the Faculty and ideas for next year’s conference were invited.

It was agreed that next year’s conference will also be held at the Royal College of Psychiatrists in London on the 13th and 14th September 2018.

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