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Invited speakers

• Professor Gavin Andrews
• Professor Michael Berk
• Professor Richard Bryant
• Professor Graham D. Burrows
• Professor David Jonathan Castle
• Professor Ian Hickie
• Associate Professor Malcolm Hopwood
• Professor Stuart Montgomery
• Emeritus Professor Eugene Paykel
• Dr Roger Pinder
• Professor John Tiller
• Professor Kay Wilhelm AM

Professor Gavin Andrews

Gavin Andrews AO MD is Scientia Professor of Psychiatry at UNSW at St Vincent's Hospital, Sydney. He is interested in the problems of the elderly and in the diagnosis and treatment of anxiety and depression, both in the clinic and over the web.

Professor Andrews directs a WHO Collaborating Centre to further the revision of ICD-10. He is a member of the International Steering Committee for ICD-11. He is also heavily involved in work towards revising DSM-IV towards DSM-V; he was a member of the first meeting to plan the research agenda, chaired the group on Trauma and Fear Circuitry Disorders, was a member of the Dimensionality group, and is a member of the Anxiety Disorders and of the Disability Workgroups. He has argued that both classifications are unnecessarily complex. Invited by both WHO and the APA, both he and David Goldberg are working to produce a simplified classification that will be robust in clinical use.

As part of the aim to simply classification Professor Andrews was the originator of an organizing scheme to group all mental disorders into five clusters largely based on causal factors. The evidence for each cluster is outlined in seven articles that have been presented at the DSM-V and ICD meetings and have now been solicited by Psychological Medicine as invited reviews.

Professor Michael Berk

Professor Michael Berk is currently appointed to the Chair of Psychiatry for Barwon Health and The Geelong Clinic at The University of Melbourne, is an Honorary Professorial Research fellow at the Mental Health Research Institute, and leads the first episode Bipolar program at Orygen Youth Health. He has published over 200 papers on mood and psychotic disorders, particularly bipolar disorder. He has completed 15 self-initiated randomised controlled trials, predominantly in mood disorders. These include the first two published randomised controlled trials of the atypical antipsychotics and lamotrigine in bipolar disorder, as well as the first positive trials of N-acetyl cysteine in both schizophrenia and Bipolar Disorder. He is the recipient of a number of grants, including Stanley Medical Research Foundation and National Health and Medical Research Council, awards and is Chairman of the International Society of Bipolar Disorders.

Professor Richard Bryant

Richard Bryant is Scientia Professor of Psychology, University of New South Wales and Director of the Traumatic Stress Clinic at Westmead Hospital, Sydney. He has published over 250 peer-reviewed journal articles on trauma, anxiety, and treatment. He has co-authored the leading text on acute stress disorder. His work has focused on the assessment and treatment of initial trauma reactions, as well as the cognitive and biological mechanisms underpinning traumatic stress. His assessment and treatment protocols are currently being employed by many civilian and military agencies around the world, including agencies coordinating mental health projects following terrorism, natural disasters, and war. He is currently coordinating major research programs addressing the neurobiology of anxiety disorders, mental health in Indigenous Australians, novel early interventions following trauma, and evidence-based approaches for complex trauma populations.

Professor Graham D. Burrows

Graham Burrows is a Professorial Fellow with the title of Professor in the Department of Psychiatry of the University of Melbourne and Consultant Psychiatrist at The Melbourne Clinic, Richmond.

Professor Burrows has published more than 665 scientific articles in peer-reviewed journals. He is the author or editor of more than 103 books, and has contributed chapters to approximately 180 other scientific books. He serves on the editorial boards of 30 International and Australian journals.

Professor Burrows serves on a number of advisory boards to Australia, International, Governmental and Scientific Organisations, including the World Psychiatric Association and the World Health Organisation. He was President of the First and Second World Congress on Stress, Chairman of the International Congress in Melbourne Collegium International Neuropschopharmacologicum (CINP), Chairman of the Mental Health Foundation of Australia.

Professor Burrows has been honoured with the following awards for distinguished service to medicine - the Order of Australia (AO) in 1989; Knight of The Order of Saint John of Jerusalem (KSJ) in 1996; the Paul Harris Fellowship, Rotary International in 1997; Benjamin Franklin Gold Medal - International Society of Hypnosis in 2000; Knight Commander of Grace of The Order of Saint John of Jerusalem (KCSJ) 2001; Honorary Member, The Royal Society of St George in 2003, and Honorary Fellow, World Federation of Societies in Biological Society, in 2004.

Professor David Jonathan Castle

David is Chair of Psychiatry at St Vincent's Health and The University of Melbourne. His clinical and research interests include schizophrenia and related disorders, cannabis abuse, and bipolar disorder. A specific area of interest is the medical care of people with a mental illness. He is also pursuing his work on OCD spectrum disorders, notably body dysmorphic disorder.

David has published widely in prestigious journals, including around 300 papers and chapters; and has co-authored or co-edited 15 books. He has been successful in attracting substantial grant funding from a variety of different sources, and has strong local, national, and international research links. He is on a number of advisory boards and editorial boards, and is a regular reviewer for over 30 national and international scientific journals.

David speaks regularly at local, national, and international scientific meetings about his research, and also teaches at undergraduate and postgraduate levels.

Professor Ian Hickie

In October 2006, the Australian Financial Review included Professor Hickie in its list of the top 10 cultural influences. The specific comments noted his role as a "long-term campaigner", "the person who orchestrated the campaign" that led to the COAG announcements ($4 billion dollars over five years. In October 2000 he was appointed as the inaugural CEO of beyondblue: the national depression initiative and from 2003-06 served as its Clinical Advisor. In 2003, he was appointed as the inaugural executive director of the flagship Brain and Mind Research Institute at the University of Sydney. In 2006, Professor Hickie received the Australian Honours Award of Member (AM) in the General Division; for services to medicine in the development of key national mental health initiatives and general practice services in both the public and non-government sectors. In 2007, he was appointed to the Prime Minister's Australian National Council on Drugs and has led the BMRI as a founding member of the new National Youth Mental Health Foundation ('headspace'). In 2007, Professor Hickie was elected as a Fellow of the Academy of the Social Sciences in Australia. From 2008-13, Professor Hickie is one of the first round of new NHMRC 2008 Australian Fellows; recognising excellence in Australian Medical Research. His research, clinical and health services development work focuses on expansion of population-based mental health research and development of international mental health strategies. In July 2008 he was appointed to the Federal Health's Minister's new National Advisory Council on Mental Health.

Associate Professor Malcolm Hopwood

Associate Professor Malcolm Hopwood completed and received his MBBS and later his MD at the University of Melbourne and also completed a Masters of Psychological Medicine at Monash University. He received his fellowship of RANZCP in 1993.

Associate Professor Malcolm Hopwood is the Director of the Veterans' Psychiatry Unit and the Brain Disorders Program at Austin Health in Melbourne Australia. He is also a Senior Fellow in the Department of Psychiatry at the University of Melbourne. He holds several senior positions within the Royal Australian and New Zealand College of Psychiatrists including Chair Board of Research, membership of the General Council and previously Vice Chairmanship of the Section of Neuropsychiatry. His research interests include psychopharmacology, mood and anxiety disorders within a focus on depression and PTSD and a range of neuropsychiatric areas including psychiatric aspects of acquired brain injury and Parkinson's disease. He has published over 80 book chapters, referred journal articles or abstracts. He has received research funding from a range of sources including the Australian National Health and Medical Research Council, the Australian Department of Veterans' Affairs, Alzheimer's Association and the Weary Dunlop Foundation.

Professor Stuart Montgomery

Stuart Montgomery is Emeritus Professor of Psychiatry at the Imperial College of Medicine, University of London, UK. He was President of the European College of Neuropsychopharmacology (ECNP) from 1992 to 1995 and President of the British Association of Psychopharmacology from 1990 to 1992. He has been a member of the Committee on Safety of Medicine. Dr Montgomery is Editor of European Neuropsychopharmacology and of International Clinical Psychopharmacology. Early in his career he developed the widely used MADRS and he is well known for his research into the treatment of schizophrenia, bipolar disorder, depression and the anxiety disorders. He has published more than 400 scientific papers and book chapters and 26 books.

Emeritus Professor Eugene Paykel

Eugene Paykel is Emeritus Professor of Psychiatry, University of Cambridge, and Emeritus Fellow, Gonville and Caius College. He was born in Auckland, New Zealand and graduated in Medicine from the University of Otago in 1956. He trained in psychiatry at the Maudsley Hospital, London. He worked at Yale University, USA as Assistant Professor, as Assistant Professor and Co-Director, later Director, Depression Research Unit, and later at St George's Hospital London, as Professor, from which he moved in 1985 to Cambridge as Professor and Head of Dept. His main research field has been depression, including evaluation of antidepressants and of psychological treatments, life events. In the last 15 years this has particularly focussed on longer term outcome and treatments to improve it. He was joint founding editor of the Journal of Affective Disorders, later editor of Psychological Medicine. He has published more than 400 papers and chapters, and 8 books, including the Handbook of Affective Disorders. He is a Distinguished Fellow of ISAD.

Dr Roger Pinder

Dr. Pinder is an independent pharma consultant based in the city of York in the UK. Educated in the UK and the USA at the universities of Hull and Virginia, Dr. Pinder holds doctoral degrees in medicinal chemistry (Ph.D.) and neuropsychopharmacology (D.Sc.). During his industrial career he held several senior positions in Akzo Nobel, principally with the human pharmaceuticals business unit Organon in both the Netherlands and the USA. Dr. Pinder is President, and was previously Secretary, of the International Society for Affective Disorders (ISAD). He has also served as Treasurer and Councillor of the International College of Neuropsychopharmacology (CINP). He is the Founding Editor of Neuropsychiatric Disease and Treatment, the official journal of the International Neuropsychiatric Association (INA), and of the International Journal of Wine Research.

Professor John Tiller

John W.G. Tiller, MD, is Professor of Psychiatry, The University of Melbourne, and Director of the Professorial Psychiatry Unit at Albert Road Clinic, an 80-bed private psychiatric facility in Melbourne and part of the Ramsay Health Care group. He is currently Head of Department of the Department of Psychiatry at The University of Melbourne.

Dr. Tiller qualified in medicine and science in New Zealand, holds a Doctorate of Medicine with his thesis on anxiety disorders from The University of Melbourne, is a Fellow of the Royal Australasian College of Physicians, a Fellow of the Royal Australian and New Zealand College of Psychiatrists, and has a certificate of completion of specialist training in child psychiatry.

His primary research interests have been in the assessment and treatment of depressive disorders, anxiety disorders, psychoses including bipolar disorder, and the development and improvement of training and knowledge about electroconvulsive therapy. He is a recognized expert in psychopharmacology and has more than 300 scientific publications.

Professor Kay Wilhelm AM

Professor Kay Wilhelm AM is Head of Consultation-Liaison Psychiatry at St Vincent's Hospital. She was previously the Clinical Director of Prince Henry Hospital.

She is a Conjoint Professor in the School of Psychiatry at the University of New South Wales.

She has also had a long interest in the mental health of doctors is a member of the New South Wales Medical Board, chairing the Board's Doctors' Health Committee.

She has published about 200 papers, book chapters and educational workshops for the NSW Institute of Psychiatry and the Black Dog Institute on aspects of depression and its management. Her main interests are depression, especially psychosocial and genetic risk factors to depression; deliberate self harm; smoking cessation; brief interventions to assist coping and general hospital psychiatry and the mental health of doctors and teachers. She is responsible for programs targeting deliberate self harm, including the Green Card Clinic and Mood Mapping.

She has been involved in a series of studies related to smoking and depression, especially targeting underprivileged groups and is Co-Chair of the NSW Smokefree Mental Health Taskforce.

She awarded the Founders' Medal of the Australasian Society of Psychiatric Research, 2005; became a Member, Order of Australia in 2006, and in 2008, she was awarded a College Citation from the Royal Australian and New Zealand College of Psychiatrists.

Sponsored Symposia

Pfizer Australia

Chronobiology and sleep physiology in bipolar disorder

• Naomi L. Rogers, Bradley G. Whitwell, Elizabeth Scott, Ian B. Hickie Brain & Mind Research Institute, University of Sydney

The circadian system is a homeostatic system that ensures appropriate co-ordination of nearly all the body's physiological and behavioural activities. In humans, one of the most well recognised activities that displays circadian rhythmicity is the sleep-wake cycle. Under normally entrained conditions, humans are designed to be awake during the day and asleep at night. This ensures optimal cognitive, endocrine, mood and immune functioning, and high sleep quality and consolidation. Disruption to the circadian system produces disruption to the physiological and behavioural systems under its control, resulting in deficits in many aspects including cognition, mood, metabolic function and sleep. Circadian disruption occurs in shiftworkers and overseas travelers, and is also common in a range of circadian, medical and psychiatric disorders. In addition, sleep disturbance is typically comorbid with circadian disruption, which can then have further negative effects on a range of health and cognitive outcomes.
Changes in the circadian timing system and in sleep-wake behaviour are well documented in many psychiatric disorders, including bipolar disorder and depression. It is often reported that changes in these systems precede initial presentation of depressive or manic symptoms, as well as preceding relapse in patients with stable symptoms. This suggests that changes in sleep-wake timing and quality may potentially be used as a biomarker of symptom stability and onset of some disorders, which would allow for early intervention to better manage these psychiatric disorders. In addition, targeting the sleep-wake and circadian systems concurrently with the treatment of the depression or bipolar disorder may provide an enhanced method of symptom management.

AstraZeneca

Chronobiological abnormalities in Bipolar disorder: A framework and approach to management

• Speaker 1 - Prof Ian Hickie "Role of the circadian and sleep systems in the management of Bipolar Disorder."
• Speaker 2 - Prof Bernhard Baune " Circadian Rhythms in Bipolar Disorder: Clinical Application of Quetiapine"
• Speaker 3 - Dr Peter Farnbach - "Case examples : the practical use of Quetiapine in BPD"

Bipolar disorder is characterised by repeated episodes of significantly disturbed mood and activity levels. Even with appropriate pharmacological and psychological management, the occurrence of relapse in patients with bipolar disorder is high. The underlying mechanisms that lead to relapse in bipolar disorder are not known, and represent an important area of investigation for the development of additional management strategies and interventions to reduce the rate of relapse in these patients. Both circadian disruption and sleep-wake disturbance have been widely reported to occur in bipolar disorder, in all phases. Despite this, few studies have carefully evaluated alterations in these systems, nor the role that these two systems may play in the occurrence of subsequent relapses.

Sleep is important for quality of life and optimal affect regulation. Sleep disturbances predict episodes of bipolar disorder and are among the most prominent correlates of mood episodes, and inadequate recovery in bipolar disorder. Sleep disturbance and circadian dysregulation are regarded as critical pathophysiological elements in bipolar disorder. Although the circadian system and the sleep system are potentially separable, they are interconnected. The serotonin and dopamine systems are implicated as the critical links between abnormalities in the sleep and circadian systems and affective functioning in bipolar disorder. Therefore, the effective treatment of sleep disturbances in bipolar disorder is a major clinical challenge.

Combining pharmacological and/or behavioural treatments for BPD with treatments to manage circadian and sleep-wake disturbance may represent a new management strategy for bipolar disorder, and ultimately reduce the incidence of relapse in many patients.

Wyeth

Letting an antidepressant into the wild of clinical practice, with a focus on desvenlafaxine.

• Associate Professor Trevor Norman
• Associate Professor Chee Ng
• Associate Professor Chris Alderman
• Professor David Castle

Desvenlafaxine is a new SNRI antidepressant approved for the treatment of major depression, including prevention of relapse. This symposium will review the pharmacokinetic profile of desvenlafaxine, and results from pivotal clinical studies. Consideration will then be given to the relevance of the pharmacokinetic and clinical profile of antidepressants to their use in everyday practice, where patients frequently have comorbid psychiatric and medical conditions, and may be taking multiple medications. Much of the inter-individual variability in drug response has been attributed to variations in genetic factors; in particular genetic variations in the CYP450 system have been much studied. With the understanding of the genetic variations underlying clinical response to drugs steadily emerging, there has been significant focus over the past decade on understanding differences in the rate of CYP450 mediated drug metabolism. Cytochrome P450 2D6 has received special attention as many drugs, including many antidepressants, are metabolised by this isoenzyme. Specific attention will be given to the practical application of an understanding of genetic variations in drug metabolism to the use of antidepressants 'in the wild'. In particular, issues relating to 'real world' patients being treated with multiple medications, such as adverse events and drug interactions, will be reviewed.

Servier

Circadian Rhythms and Depression

• Dr Naomi Rogers: "The Circadian System"
• Prof Michael Berk: "Rhythm and blues"
• Prof Ian Hickie: "Depression and the sleep-wake"
• Conclusion: Prof Graham Burrows

This symposium aims to investigate the relationship between disturbed circadian rhythms and depression. The presentations will examine the important role of circadian rhythms in maintaining health and the impact disrupted circadian rhythms can have on mental health and depression. Depression is most often characterized by abnormal patterns of circadian rhythms and these rhythms may be important in the etiology and treatment of depression. The implications for the treatment of depression and the influence of correcting various circadian rhythms in facilitating recovery will be discussed.

Positive Futures program - Disability Services Queensland

Truth, Politics and Intellectual Disability

• Dr Paul White, Senior Staff Specialist (Psychiatry), Specialist Response Service, Disability Services Queensland

Demand is increasing for evidence-based policy and services. Implementation of the recommendations of the 2006 judicial inquiry into human rights abuses of adults with an intellectual disability constitutes an example of policy and service development and reform which is underpinned by research.

Significant physical and psychological morbidity exists within the estimated 1300 people within this cohort. Greater than 60% of individuals already reviewed have had previously undetected mood disorders. Research evidence indicates these disorders may be treated efficiently and effectively.

Disability Services Queensland's (DSQ) Specialist Response Service (SRS) part of the Positive Futures initiative has used this research to develop an evidence based approach to people with intellectual disability, mood disorders and challenging behaviour. In doing so the disability sector seeks to engage with support and advocacy organizations for people with mood disorders and to advance the cause of doubly marginalised people - adults with intellectual disability and mood disorders.