Psychiatric Institute Annual Scientific Conference

Two months after the World Trade Center attacks, Dr. Oldham opened the Arden House Retreat with a sobering statistic: there could be as many as 90,000 new cases of post-traumatic stress disorder as a result of the attacks. This number is based on a preliminary report by the New York Academy of Medicine’s random-dial phone survey of Manhattan residents below W. 110th Street. In addition, the results of a study conducted during the weekend after the attacks and reported in the November 15, 2001 issue of the New England Journal of Medicine found that 44% of adults around the country reported “substantial symptoms of stress.”

While this mounting evidence as to the cumulative effects of the attacks on September 11 has demanded a lot of our attention, a great deal of much-needed work continues in other areas of psychiatry. Symposium chair Dr. Myron Hofer set the stage for the first day’s presentations on early development, a subject which has received much attention lately in the scientific realm. Why the interest now? Recent evidence, said Dr. Hofer, has pointed to specific vulnerable periods in early development as the catalyst for many psychiatric disorders like schizophrenia.

Dr. Arnold Kriegstein presented on his work in neurobiology and behavior on the early stages of neocortical development. His studies are focused on the major excitatory and inhibitory transmitter systems in the cortex. Dr. Susan Brunelli, who is collaborating with Dr. Hofer, presented her work with infant rats as an animal model for the development of human anxiety disorders. Looking at premature infants, Dr. Bradley Peterson, Chief of Pediatric Neuropsychiatry in the Department of Child Psychiatry, is currently carrying out research assessing the long-term brain development of pre-term babies. His findings have so far revealed that among eight year olds, preemies have more abnormal motor regions and a lower IQ than babies who were born at term. The question remains as to what point in the course of development abnormalities surface.

Using the monkey as a model, Dr. Michael Goldberg, Professor of Neurology (in Psychiatry) in the Center for Neurobiology and Behavior and the featured plenary speaker, discussed research on the attention process. How does the brain accomplish visual attention, spatial perception, and decision-making?

Among the five workshop presentations were an update on clinical trials focused on research to inform efforts to curb PTSD, depression and other “fallouts” of the attacks on the World Trade Center, and the progress in and obstacles to conducting research in psychotherapy.


Mini-retreats
What Should the Department of Psychiatry be Doing in Clinical Trials and Clinical Psychopharmacology? To address the need for more clinical trials at PI, Dr. Jack Gorman proposed the establishment of an advisory board including the Washington Heights Community Service at PI and the Presbyterian Service at the Presbyterian Hospital site of New York Presbyterian Hospital.

Behavioral Medicine and Behavioral Treatment at Columbia By early next year, a web-based system of delivering psychotherapy, which is funded by the American Legacy Foundation, will be up and running. The program, reported Dr. Richard Sloan, is “as close as anything to actually duplicating what happens in a one-on-one intervention.” Users of this system will have lifetime access to the program.

Technological Interventions in Psychiatry ECT research conducted in Dr. Harold Sackeim’s lab has helped resolve one of the most longstanding debates regarding the efficacy of unilateral vs. bilateral applications of ECT. Studies show that high intensity unilateral ECT is as effective as the bilateral application. Dr. Holly Lisanby’s TMS (transcranial magnetic stimulation) work has shown it to be a remarkably focal technique because it may provide better control over what areas of the brain are stimulated.