Over the years the focus of psychiatry has moved from concepts based on psychology of the human mind, to genes, molecules and dynamic cellular level interactions leading to visible behavioral changes. For advancement of research in biological psychiatry, the development of “systems biology of neuron” (construction of a cell based on mathematical computer model) is vital. Computational psychiatry offers to bridge this gap. The classical psychoanalytic theory of Freud dominated psychiatry duringfirst half of the 20th century. However the discovery of drugs like chlorpromazine, iproniazid and imipramine laid the foundation of a biological model in psychiatry. Biological psychiatry aims to understand various mental disorders based on an underlying biological basis. Though biological abnormalities are evident in various psychiatric disorders, none have been significant and consistent enough to be used as diagnostic tests of clinical utility. Thus a “biological gold standard” definition of a psychiatric disorder could not be established. An alternative to this could be looking for biologically homogenous subtypes (biomarker based subtypes) which may traverse different phenotypic presentations of the illness.
Stress leads to the release of glucocorticoids from adrenal glands (through hypothalamic-pituitary-adrenal axis) and increased sympathetic nervous system outflow. These lead to increased inflammation through NFKB. The inflammatory cytokines access the brain through leaky areas in blood brain barrier / sensory vagus and activate pathways which lead to depression. Increased inflammation in prenatal and perinatal period influences brain development and function and significantly increases the chances of developing schizophrenia in adulthood. Increase in Tumor Necrosis Factor(TNF)-α and Interleukin (IL)-12, unbalanced Th1/Th2 cytokine production and reduced activation of NK/ T-cells has been noted in autism. Genetic studies (association and linkage studies) in autism have progressed consistently (when compared to other disorders like schizophrenia, major depression and bipolar disorder). This has been possible in autism due to high heritability, availability of large sample sizes and consistent findings.
ANCIPS 2018 at Ranchi marks 100 years of CIP (Central Institute of Psychiatry) which has been witness to this journey of psychiatry from morals to molecules. The conference includes a number of award papers like Marfatia Award, Bhagawat Award, Bombay Psychiatric Society Silver Jubilee Award, Dr. DLN Murti Rao Oration Award, Dr. JK Trivedi Life Time Achievement Award, Tilak Venkoba Rao Oration Award and Poona Psychiatric Association I and II awards etc. Symposia and Posters would include topics based on the theme and off-theme topics of relevance to the practice of clinical psychiatry. Some major social controversies which have been plaguing the Anglo-American psychiatry will be covered. This will be followed by current research trends and critical analysis of bipolar spectrum disorders. Evolutionary Psychiatry is likely to give new insights into the genesis of mental illnesses. Evolution creates vulnerability to a disorder, where in selection operates to benefit reproduction and not health. Evolutionary theories of psychopathology can give various phylogenetic and proximate etiological factors and guide the treatment. Epigenetics promises new biomarkers and future treatments in psychiatry. Molecular mechanisms involved in environment- behavior interaction is likely to provide novel therapies for treatment.
Childhood psychiatry -particularly psychosis, medically unexplained symptoms, prescription writing in mental health and use of statistics in research are important areas of discussion. Even after specialist consultation one third to half of the patients with medically unexplained symptoms remain undiagnosed. Even after long term follow up, these symptoms remain unexplained. Pre-pregnancy counselling in women with pre-existing mental illness is an area often overlooked. This will include the effect of mental illness and psychotropic drugs on the foetus and postpartum risks involved. The three primary areas affected by chronic exposure to drugs of abuse include: the dopaminergic system in brain, extra-hypothalamic actions of Corticotropin Releasing Factor (CRF), and frontal brain leading to hypofrontality. Newer insights into the genetics of addictive disorders will be refreshed. Discussion on the new Mental Health Act, National Mental Act Policy and human rights of mentally ill in 21st century in India, is currently the most talked about topic with IPS (Indian Psychiatric Society) putting in its best effort to modify certain sections which are likely to be counter-productive in the future. New gene editing techniques, tele-psychiatry, epilepsy related to psychiatry and “Rights of Persons with Disabilities Act, 2016” will be discussed. Also there will be a number of workshops on practically relevant topics. For thefirst time School sex education is in focus. Clinical Practice Guidelines (CPG) for management of various psychiatric disorders among elderly will be addressed. Child sexual abuse, forensic and military psychiatry will be covered.
At the outset we are very happy with the release of this abstract book of ANCIPS 2018 and we wish the conference all the success.
Long live IPS! Long live IJP!