Day 1 :
Chinese University of Hong Kong
Professor WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong
Background and objectives:
The objectives of this study were to ascertain the pattern of grey and white matter volume reduction and regional metabolic and activation abnormalities in chronic ketamine users, and to evaluate the correlations between these brain abnormalities and cognitive impairments in chronic ketamine users in Hong Kong.
Cross-sectional observational study.
Counselling Centre for Psychotropic Substance Abusers in Hong Kong.
One hundred and thirty-six participants were recruited from October 2011 to April 2014. The participants were divided into two groups: ketamine users (79) and healthy controls (57).
Main outcome measures:
Psychiatric assessments included screening with self-rating questionnaires and face-to-face interviews. All of the participants completed a detailed cognitive battery that covered general intelligence, verbal and visual memory, executive functions, motor speed and language. All of the participants underwent magnetic resonance imaging of the brain.
Many of the participants in the ketamine group also frequently used cocaine and cannabis. Among the ketamine users, 12.6% were diagnosed with a mood disorder and 8.9% with an anxiety disorder. The participants in the ketamine group had worse performance than the healthy controls on tests of general intelligence, verbal, visual and working memory and executive functioning.
In terms of grey matter volumes, the right orbitofrontal cortex, right medial prefrontal cortex, left and right hippocampus and possibly the left orbitofrontal cortex were smaller in the ketamine group. In contrast, the volumes of the left basal ganglia, left putamen and possibly the left caudate were higher in the ketamine group. In terms of white matter volumes, the ketamine group had a lower periventricular white matter volume in the right hemisphere. The grey matter volumes of the left and right orbitofrontal cortex, right medial prefrontal cortex, left basal ganglia and left putamen, and right periventricular white matter volume were negatively correlated with the severity of ketamine dependence. The hippocampal volumes were correlated with performance on the arithmetic, information and digit span tests. The periventricular white matter volume also correlated with the information score.
A functional connectivity examination of the default mode network revealed significantly decreased connectivity in the medial part of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral gyrus rectus, left superior temporal pole, left inferior temporal gyrus, bilateral angular gyrus and bilateral cerebellum crus II in the ketamine group. This group also displayed increased connectivity in the bilateral precuneus and right inferior occipital gyrus.
The results provide imaging evidence of brain damage in chronic ketamine users. Chronic ketamine use was associated with reduced grey and white matter volumes in certain regions of the brain. Chronic ketamine use was also associated with altered functional connectivity with the default mode network. Abnormal brain structures and altered functional organisation of the brain network may underlie the hypersensitivity towards drug related cues but weakened cognitive control in those with ketamine addiction. Longitudinal or prospective studies would help to strengthen the evidence on the reversibility of the structural and functional brain damage caused by ketamine.
Community College of Aurora, USA
Charles W. Graham has completed his PsyD from The Chicago School of Professional Psychology and graduate work at The University of North Texas. He is the Vice President of Clinical Operations of CoreVision Network, a premier dual diagnosis treatment organization based in Colorado Springs, CO. He is one of the leading professionals in the field of recovery and co-occurring disorders. He was the Program Director at Sober Living by the Sea, one of the premier treatment centers in America, for five years, and for the past five years he has been the Executive and Clinical Director at Behavioral Health Synergy where he has started up numerous sober living homes, treatment centers, and counseling centers. He has been a speaker at state and national conferences on such topics as Domestic Violence and Substance Abuse, and Co-Occurring Bipolar Disorder and Substance Abuse. He is currently an Adjunct Professor of Psychology at The Community College of Aurora.
Today the necessity to better understand the complex world of emotional regulation is evident in the process of screening, assessment, case formulation, and treatment of patients with co-occurring disorders. This presentation will bring theory into the arena of evidenced-based treatment to one of the most difficult populations, co-occurring disorders. It explores the nature of emotional regulation, the predominant underlying theories, client resilience and resistance, and the interaction between the autonomic nervous system, the physiology of emotion, and application in diagnosis, assessment, treatment, and remediation. This presentation covers the foundation for, and process of controlling emotions, some potentially damaging myths about emotions, and the key habits of emotionally resilient people. This study takes emotion out of the theoretical labroatory and into the practical application of fostering emotional maturity and resilience in the care and treatment of patients with co-occurring disorders including case study analysis.
Association of Integrative Aesthetic Medicine, Hong Kong
Dr Chan Kam Tim Michael is a practicing private Dermatologist in Hong Kong. He received his fellowship from Hong Kong Academy of Medicine (FHKAM)(Medicine) as a registered Dermatologist since 1998. He received his post- doctoral training in University of California, Los Angeles (UCLA) in 1997. He is now the Vice President of the Association of Integrative Aesthetic Medicine (AIAM) in Hong Kong. He is the Editor of Hong Kong Journal of Dermatology and Venereology from 2002 to 2007. Honorary Clinical Assistant Professor of the Faculty of Medicine in The University of Hong Kong From July 2007 to June 2009.
Acne Scarrings and Papulopustular Rosacea (PPR) are well documented cutaneous condition associated with major psychosocial morbidity: social isolation, depression and suicidal ideation. The disease burden to the family and society is significant. A positive family history is a predictor. Emerging data revealed early retinoid used, positive life-style modifications may prevent scarrings. Energy device like Radiofrequency Microneedling, Fractional Laser and Superficial Radiotherapy, Intralesional Cryotherapy are recognized new attempts to treat atrophic scars and painful severe hypertrophic Keloid scars in Asian dark skin types respectively. The lectures will discuss these new strategies and examined its potential advantages and drawbacks. PPR are increasing in prevalence as seen in local skin clinics due to increasing non-judicious topical steroids use; propensity of topical Cosmeceuticals in Asian markets and the use of Epidermal Growth Factor Receptor (EGFR) Inhibitors in treating metastatic lung cancer. Recent investigations highlighted the importance of the Demodex mites, Vascular Epidermal Growth Factor (VEGF), dermal inflammation and impaired epidermal barrier dysfunction in its pathogenesis. New promising treatments are emerging. The dysmorphic acne excoriee and Acneiform eruption associated with antipsychotics including recreational drugs abuse will also be discussed.
- Drug Addiction
University of Malayasia
Dr Anne Yee completed her Postgraduate training in Psychiatry in University Malaya (UM) in 2011 and is conferred the Fellowship in Addiction Medicine by UM Centre of Addiction Science in 2012. She is now the senior lecturer in Universtiy Malaya. She is also the President of the Malaysian Mental Health Association (MMHA) Depression Support Group and scientific head of UM Centre of Addiction Science. She has been regularly invited as keynote speaker at various national level plenaries and public symposiums; and she pioneers the use of Taiwan Tzu Chi University drug rehabilitation program in Malaysia. Dr Anne has published her work in many international academic journals and contributed in local mental health guideline books, besides collaborating projects with high impact researchers from Yale University. Her special interest includes areas in addiction, dual diagnosis, psychosexual and palliative care.
Objective: Although methadone maintenance therapy has benefited individuals with opioid dependence, a substantial proportion of patients still experience psychiatric symptoms which may affect treatment outcome. As the methadone maintenance therapy reaches its first decade in Malaysia since its implementation in 2005, this study aims to examine the association between psychiatric comorbidity and quality of life.
Method: A total of 225 male patients who were on methadone maintenance therapy completed the study underwent the Mini International Neuropsychiatric Interview, Opiate Treatment Index, and World Health Organization Quality of Life-BREF Scale. The association between different variables and quality of life scores was tested using t-test for categorical variables and Pearson’s correlation for continuous variables. Multiple regression analysis was then performed for the significant variables.
Results: 14.2% and 15.6% of patients on methadone maintenance therapy had a current and lifetime non-substance use Axis I psychiatric disorder respectively, with major depressive disorder being the most prevalent Axis I disorder. The analysis showed that patients with a non-substance use Axis I psychiatric disorder were significantly more likely to use psychiatric medications (OR = 11.92, 95% CI 3.42-41.51, p < 0.001), have an antisocial personality disorder (OR = 5.07, 95% CI 1.83-14.10, p = 0.002) and had higher scores for physical health on OTI, indicating poorer physical health (OR = 1.41, 95% CI 1.02-1.96, p=0.041). In multiple linear regression analysis, having a non-substance Axis I disorder was the only factor which significantly predicted the quality of life in all 4 domains and in the combined quality of life and general health.
Conclusions: Patients on methadone maintenance therapy with a non-substance use Axis I comorbidity have a poorer quality of life in all domains than those without the comorbidity. The impact of psychiatric comorbidity on quality of life calls for attention to detect psychiatric comorbidity and provide adequate treatment to patients on methadone maintenance therapy to improve their quality of life.
Suicide Prevention Resource Center, USA
Adam D. Swanson is a nationally awarded public speaker dedicated to equity in public and health care systems. He assists state governments, universities and other organizations improve quality of care for people in crisis at the Suicide Prevention Resource Center in Washington, DC. Adam has served on national and international exprt panels to advise organizations in addressing minority health disparities. He previously led LGBTQ initiatives and oversaw national efforts to implement innovative first-episode psychosis treatment services at the National Council for Behavioral Health. In the U.S. Senate, he helped advance anti-bullying legislation and Ryan White HIV/AIDS Care Act reforms. Adam is a former Mental Health America fellow.
For more than a decade, studies have shown that Americans of minority status face remarkable disparities when it comes to preventable illnesses, mental health and addicition conditions, and overall mortality. The statistics speak for themselves: Black babies are almost 5 times more likely to die before reaching their first birthday than white babies; suicide attempts for high school-aged Hispanic girls are 70 percent higher than for white girls in the same age group; lesbian, gay and bisexual (LGB) adults are about 5 times more likely than heterosexual men and women to have a mental illness in their lifetime such as those related to mood, anxiety or substance use; and nearly 40 percent of all transgender people report that they have faced harassment or discrimination when seeking routine health care. Explainations of this phenomna from researchers and policymakers varies across issues of access, poverty, and biology. But the less talked about root cause of health dispairities—discriminiation—is all too often glossed over. Adam D. Swanson, a nationally awarded public speaker and health equity advocate, will share his harrowing life story about crisis health care interactions to help demostrate the impact of discrimination as a major root cause of systemic health disparities within clinical care settings. His story and supporting data about the vulnerablities facing minority populations will help providers of all levels and researchers think more broadly about how to improve health outcomes, eliminate health disparities, and achieve health equity.
- Addiction & Brain
MOSC College of Nursing, India
Mrs Renju Sussan Baby is a graduate and post graduate of college of Nursing, AIIMS, New Delhi, currently pursuing PhD in nursing from National PhD consortium in nursing by INC. She is guiding undergraduate and post graduate nursing research projects. She has written research articles which is published in national and international journals. Her research area of interest is Addition psychiatry. She has presented scientific papers in national and international conferences and has organized state level workshops and conferences.
Aims and objectives: The study aimed to assess the high risk factors, precipitants and predictors of relapse among SUD subjects with and without co-morbid psychiatric illness post de-addiction treatment. It also aimed at assessing the outcome parameters such as de-addiction treatment outcome and quality of life of SUD subjects with and without co-morbid psychiatric illness followed up for one year post de-addiction treatment. The study also compared the quality of life among sober SUD subjects and subjects relapsed to their substance use, also to identify the predictors of quality of life of SUD subjects with and without co-morbid psychiatric illness.
Materials and methods: Quantitative approach, prospective cohort design was adopted for the study. After obtaining ethical clearance, establishing validity and reliability of tools and conducting feasibility assesment by pilot study, hundred SUD subjects with co-morbid psychiatric illness and hundred SUD subjects without co-morbid psychiatric illness admitted for 31days inpatient de-addiction treatment in MMM de-addiction and research centre of MOSC Medical College Hospital, Kolenchery, Kerala during February to December 2014 were enrolled using total enumeration method and were followed up monthly upto twelve months post de-addiction treatment. The subjects were assessed for the demographic details, substance use related details, severity of addiction using addiction severity index and quality of life using WHO QOL BREF on 29th day of admission .Monthly assessment for their substance use status and reassessment of quality of life was done at third, six and twelve months post de-addiction treatment. Data collected was analysed using SPSS version 20 using appropriate descriptive inferential statistical test after assessing the normality of the data.
Results: Fifty two SUD subjects with co-morbid psychiatric illness and 37 SUD subjects without co-m-morbid psychiatric illness relapsed to their substance use at 12 months post de-addiction treatment. Survival analysis revealed that SUD subjects without co-morbid psychiatric illness had higher survival time/ duration of abstinence. Maximum relapses use were observed within first six months in the SUD subjects without co-morbid psychiatric illness, whereas more SUD subjects with co-morbid psychiatric illness relapsed after six months post de-addiction treatment.
Quality of life scores remained low for the two groups of subjects during the de-addiction treatment, significant improvement in the quality of life score were observed in the SUD subjects in both the groups at three months post de-addiction treatment, thereafter no significant improvement in the QOL score noticed till 12 months post de-addiction treatment period in both the groups. SUD subjects without co-morbid psychiatric illness had better quality of life than those SUD subjects with psychiatric illness both among sober as well as subjects who relapsed to their substance use. Relapse to substance use, psychiatric symptom severity, follow up and medication non-compliance were the most significant predictors of quality of life in four QOL domains.
Conclusion: The results were consistent with much of the de-addiction treatment outcome literature related to relapse and quality of life among SUD subjects. Clinical implications of the research are explored and it is concluded that, aggressive interventional strategy should be initiated at the time of discharge which focus on constant push for follow up, motivating SUD subjects for regular participation in AA self-help groups, strengthening therapeutic alliance and enhancing family support to be formulated in an individualised basis with special focus to the management of comorbid psychiatric illness. Ultimate aim of de-addiction treatment should focus on enhancement of quality of life of the SUD subjects focussing on complete recovery. Directions for future research are suggested and final conclusions made.
Alfalfa Clinic, Pavilion Center, & Global Welfare Organization, Pakistan
My name is Adeela Saba. I am clinical psychologist. I did my M.S.C from B.Z.U.and A.D.C.P from Sargodha Uni. Now a days i did my practice in ALFALFA CLINIC and PAVILION Center and GLOBAL WELFARE ORGANIZATION. I send you the abstract my research. my research related to drug users. I won to times best international award of my research from OMICS research center U.S.A.
The present study explored the effectiveness the Rational Emotive Behavior Therapy in disputing the irrational beliefs persons with substance use disorder. It was hypothesized that there is likely a negative relationship between rational emotive behavior therapy exposures and the irrational beliefs in person with substance use disorder. Repeated measure research design was employed. Purposive sampling was used to draw a sample of 12 patients who had undergone treatment for substance use disorder from addiction ward. PIMH and Fountain House, Lahore (Demographic information sheet, history take examination), and MSE were used to rule out others psychiatric illness. After the careful examination, diagnosis of the substance disorder’s irrational beliefs was measured by shortened general attitude and belief scale. The new and personal invention of the study is that pictorial presentation of REBT techniques gives a better understanding and significant result. All the pictures were hand made and mind invention. The present study was able to find out the effectiveness of REBT in disputing irrational beliefs in substance use disorder. The finding of the study indicated a significant difference in irrational beliefs of persons with the substance use disorder before and after the treatment. Based on the finding, it can be concluded that present research provides justification for irrational beliefs in persons with the substance use disorder.