Event Programme

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  • Day 1 Friday 22 October 2021
  • Day 2 Saturday 23 October 2021
  • Virtual Auditorium 1
  • Virtual Auditorium 2
08:15 - 08:30Opening of Conference By Gavin Dawe / Roger Ho Chun Man / Tan Chay HoonLocal Organising Committee

Welcome and Opening Ceremony

08:30 - 09:30Plenary Session 1 By Lakshmi Yatham, University of British ColumbiaProfessor

“Challenges in the Treatment of Bipolar Disorders: Looking Ahead”

Bipolar disorder is a complex psychiatric condition with pleomorphic presentations, varied course and high comorbidity. While several options are available for treating mania and preventing mania, many challenges remain in providing optimal outcomes for patients with bipolar disorder. For instance, treatment options continue to be limited for treating acute depressive symptoms in patients with bipolar I and bipolar II disorder and few proven strategies are available for preventing relapse of depressive episodes. Similarly, while cognitive impairment is common and impacts functioning in patients with BD, no proven treatments exist for improving cognition in BD. Comorbidities are common in bipolar disorder, and there is limited data to guide management of such patients. Finally, prevention of mood episodes in patients at high risk for BD remain unexplored. This presentation will review these challenges and suggest some strategies to advance the field.

09:30 - 11:00Meet the Experts 1 By John Kane, Zucker Hillside Hospital, The Donald and Barbara Zucker School of Medicine Professor

“Advances in the Understanding and Management of Treatment Resistance in Schizophrenia: Practical Considerations”

Schizophrenia continues to present a major public health problem associated with enormous personal suffering, diminished functioning, family burden and societal costs. Although current treatments (ideally combinations of medication and psychosocial modalities) can substantially improve outcome for many affected individuals, a substantial subgroup qualifies as having “treatment resistant schizophrenia (TRS).” Estimates suggest that 15-20% of patients at their very first episode of psychosis do not derive expected/sufficient benefit from antipsychotic medications. Over time this proportion increase to greater than 30%. In recent decades considerable research has been done evaluating the efficacy of a variety of treatment for these individuals. At the same time there has been insufficient consensus on how to define treatment resistance and many clinical trials employed different criteria for inclusion of subjects. The TRIPP guidelines, published in 2017, were an attempt to provide a consensus of international experts on how to define TRS.

Clozapine remains the only specific medication that has received regulatory approval in many countries for the treatment of TRS. At the same time, however, it remains markedly underutilized. Although there remains some debate regarding clozapine’s unique qualities, a good deal of research supports its role in the management of TRS. Research also suggests that clozapine’s efficacy is greater if it is administered within one to two years after the emergence of TRS.

We still lack good biomarkers to identify those individuals likely to experience TRS and those most likely to benefit from clozapine; however, promising leads have emerged in prospective clinical assessment as well as the use of resting state MRI, PET and EEG perspectives.

Recent research has also suggested that psychotic relapse is associated with poorer response to standard treatment than that observed in prior episodes, suggesting that repeated relapse might also be part of the trajectory towards TRS.

11:00 - 12:30Symposium 1 By Symposium SpeakersProf / A/Prof / Dr
12:30 - 13:30Poster Viewing By Poster Presenters and JudgesLunch and Posters

Lunch break and poster viewing

13:30 - 15:00Symposium 2 By Symposium PresentersProf / A/Prof / Dr
15:00 - 16:30Meet the Experts 2 By Eduard Vieta, University of BarcelonaProfessor

Advances in the understanding and management of treatment resistance in bipolar disorder

“Treatment resistance” is a definition that does not belong to the classification system, because it depends on the availability of suitable therapies at a given point in history. However, it has regulatory implications, and it may be useful for clinical practice. Treatment resistance is quite well defined in the field of depression, but not so much in the field of bipolar disorder: hence, concepts such as “treatment resistent mania”, “treatment resistent bipolar depression” and “treatment resistent bipolar disorder” await standardized definitions that may guide clinical practice. This presentation will review this concepts and provide hints for optimal treatment of all those clinical scenarios, with a sight to the future.

16:30 - 17:30Plenary Session 2 By Andrea Cipriani, University of OxfordProfessor

“Evidence Based Mental Health in the Real World: Promises, Challenges and Future Directions”

An evidence-based decision about a specific intervention (either pharmacological or not) is not determined only by its demonstrated efficacy and tolerability; it may vary from one patient to another depending on individual clinical circumstances (sex, age, clinical history, etc) and personal preferences. However, ‘evidence’ is not necessarily ‘evident’. Evidence is anything presented in support of an assertion. This support may be strong or weak, but it is the closest that we can get to the truth itself and the only objective starting point we can use for our clinical reasoning. We need all good quality, available data to justify our rational choice; otherwise patients will be treated according to mere opinion. This is the reason why I strongly disagree with opponents of Evidence Based Mental Health who say that it is the wrong paradigm to answer our routine clinical questions. On the contrary, given the inevitability of biases and inaccuracies in the scientific literature, we have a simple choice: we can either make the best use of the available evidence or dismiss and ignore it. Clinicians (and patients and carers) should favour the former approach and reject nihilism. Valid conclusions can be drawn from a critical and cautious use of the best available, if flawed, evidence. Also ‘the best available evidence’ implies the continuous update and progress of scientific knowledge, doubting, testing and retesting previous findings. Scientific knowledge in medicine can develop and increase only if there are researchers, clinicians, patients and public who strive to see things from a different perspective, always pursuing the truth (which almost always means avoiding easy answers). Evidence Based Mental Health should be seen as a tool to engage new generations of psychiatrists and psychologists to develop and implement the evidence-based approach into daily clinical practice.

09:30 - 11:00Oral Presentations 1 By Oral PresentersDr

Best of US/Canada/Americas/Asia-Pacific

11:00 - 12:30Oral Presentations 2 By Oral PresentersDr

Best of US/Canada/Americas/Asia-Pacific

12:30 - 13:30Poster Viewing By Poster Presenters and JudgesLunch and Posters

Lunch break and poster viewing

13:30 - 15:00Oral Presentations 3 By Oral PresentersDr

Best of Asia

15:00 - 16:30Oral Presentations 4 By Oral PresentersDr

Best of Europe/Africa/Asia

  • Virtual Auditorium 1
  • Virtual Auditorium 2
08:30 - 09:30Plenary Session 3 By Roger S. McIntyre, University of TorontoProfessor

“Artificial Intelligence in the Pharmacological Treatment of Psychiatric Conditions”

Depression is a complex and often chronic illness. Improving health outcomes in depression begins with improving characterization of the illness in those affected. Ecological momentary assessment (EMA) provides opportunity for passive and ambient collection of data that EMA devices suggest can determine whether a patient is depressed or not. Notwithstanding the availability of multiple app-based technologies, most require patient direct entry of some sort which the literature indicates will be insufficient from the point of view of adherence. Passive collection of data does not require any direct entry by the end user and has the ability to inform not only the person living with the illness but also their healthcare providers whether their illness is active and requires treatment. It may also be able to determine whether persons at greater risk of suicide which is being looked at with future research. This presentation will discuss the role of technology in the detection, treatment and management of mental disorders with a focus on depression and the role of artificial intelligence (AI) in treatment discovery and clinical care.

09:30 - 11:00Symposium 3 By Symposium PresentersProf / A/Prof / Dr
11:00 - 12:30Meet the Experts 3 By Toshi A. Furukawa, Kyoto University Graduate School of Medicine / School of Public HealthProfessor

“Building evidence for sequenced depression treatment”

In 2009 we published one of the earlier network meta-analyses (NMA) of 12 new generation antidepressants in the acute phase treatment of depression 1. In 2018 we expanded and updated this NMA by including five more new generation antidepressants and four old antidepressants (522 trials, 116 477 participants) 2. The major difficulty in these endeavors was to identify unpublished trials, as publication bias has unfortunately been the pervasive practice not only in psychopharmacology but in biology and science at large 3. Through extensive collaboration with some industry and regulatory agencies, we were able to identify 86 unpublished trials and find unpublished information for 188 additional trials. The results challenged the old clinical wisdom that there are no major differences in efficacy among antidepressants.

Examination of the response rates on placebo among the included studies in the past four decades cast serious doubts on the decade-long superstition that the placebo response rate was increasing over the years in antidepressant trials. There was a structural break in 1991, and since then, the average placebo response rates in antidepressant trials have remained constant in the range between 35% and 40% 4.

The comprehensive dataset has also enabled us to conduct the dose-response meta-analysis of SSRIs, venlafaxine and mirtazapine based on a sizable number of fixed-dose trials. The results suggested a dose-response up to doses between 20 mg and 40 mg of fluoxetine equivalents, and a flat to decreasing trend through the higher licensed doses. Dropouts due to adverse effects increased steeply through the examined range. Taken together, for these commonly used second-generation antidepressants, the lower range of the licensed dose achieved the optimal balance between efficacy, tolerability, and acceptability 5. Using the flexible adjustment in accordance with the patient’s response did not confer any benefit over prescribing at the minimum licensed dose 6.

A large pragmatic trial comparing the minimum vs maximum dose of sertraline as the first step treatment for hitherto untreated episodes of major depression and comparing second-line strategies of continuation vs switching to mirtazapine vs augmentation with mirtazapine if the patients do not remit by week 3 confirmed the above findings 7.

The exiting psychopharmacology guidelines should be rewritten: (1) Start with one of the more efficacious and acceptable antidepressants, (2) Aim at the minimum licensed dose; do not titrate to the maximum, (3) Switch or augment if the patients do not show early response.

1.         Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009;373:746-758.

2.         Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391(10128):1357-1366.

3.         Ioannidis JP. Acknowledging and Overcoming Nonreproducibility in Basic and Preclinical Research. JAMA. 2017.

4.         Furukawa TA, Cipriani A, Atkinson LZ, et al. Placebo response rates in antidepressant trials: a systematic review of published and unpublished double-blind randomised controlled studies. Lancet Psychiatry. 2016;3(11):1059-1066.

5.         Furukawa TA, Cipriani A, Cowen PJ, Leucht S, Egger M, Salanti G. Optimal dose of selective serotonin reuptake inhibitors, venlafaxine, and mirtazapine in major depression: a systematic review and dose-response meta-analysis. Lancet Psychiatry. 2019;6(7):601-609.

6.         Furukawa TA, Salanti G, Cowen PJ, Leucht S, Cipriani A. No benefit from flexible titration above minimum licensed dose in prescribing antidepressants for major depression: systematic review. Acta Psychiatr Scand. 2020;141(5):401-409.

7.         Kato T, Furukawa TA, Mantani A, et al. Optimising first- and second-line treatment strategies for untreated major depressive disorder – the SUN☺D study: a pragmatic, multi-centre, assessor-blinded randomised controlled trial. BMC Med. 2018;16(1):103.

12:30 - 13:30Poster Viewing By Poster Presenters and JudgesLunch and Posters

Lunch break and poster viewing

13:30 - 15:00Symposium 4 By Symposium SpeakersProf / A/Prof / Dr
15:00 - 16:30Symposium 5 By Symposium SpeakersProf / A/Prof / Dr
16:30 - 17:00Closing Ceremony By Gavin Dawe / Roger Ho / Tan Chay HoonLocal Organizing Committee

Closing Remarks and Announcement of Prize Presentations

09:30 - 11:00Oral Presentations 1 By Oral PresentersDr

Best of US/Canada/Americas/Asia-Pacific

11:00 - 12:30Oral Presentations 2 By Oral PresentersDr

Best of US/Canada/Americas/Asia-Pacific

12:30 - 13:30Poster Viewing By Poster Presenters and JudgesLunch and Posters

Lunch break and poster viewing

13:30 - 15:00Oral Presentations 3 By Oral PresentersDr

Best of Asia

15:00 - 16:30Oral Presentations 4 By Oral PresentersDr

Best of Europe/Africa/Asia

Submit an Abstract Now

Abstract submission deadline: 5 pm May 31, 2021 (Singapore time)