Day 2 :
Keynote Forum
Wai Kwong TANG
The Chinese University of Hong Kong, Hong Kong
Keynote: Structural and functional MRI correlates of Poststroke Depression
Biography:
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, including Health and Medical Research Fund, reference number: 02130726. Health and Medical Research Fund, reference number: 01120376. National Natural Science Foundation of China, reference number: 81371460. General Research Fund, reference number: 474513. General Research Fund, reference number: 473712. 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.
Abstract:
Many stroke survivors suffer from depression. Poststroke Depression (PSD) adversely effects on the recovery and rehabilitation of stroke survivors. The frequency of PSD remained high in both acute and chronic stroke patients. Possible structural correlates of PSD include cerebral microbleeds, lacunar infarcts, and white matter changes. Functional changes in several brain networks, such as the default mode network and the affective network have been reported in PSD. Latest findings on the link between structural and functional brain changes and PSD will be discussed. This project is supported by the following grants: Health and Medical Research Fund, reference number: 02130726; Health and Medical Research Fund, reference number: 01120376; National Natural Science Foundation of China, reference number: 81371460; General Research Fund, reference number: 474513; General Research Fund, reference number: 473712.
Keynote Forum
Pawan Rajpal
10 Harley Street London, UK
Keynote: Executive Function deficits in Neuro developmental disorders and Chronic Mental illness
Time : 10:40-11:20
Biography:
Dr. Pawan Rajpal completed his bachelors in medicine from Mumbai in India and followed this by a Post Grad diploma in Psychological Medicine. He further trained in London finishing his Membership of the Royal college Of Psychiatrists and further specialised in Psychiatry of Intellectual disability. He has been practising for last decade in prestigious Harley Street in London and at Priory group, working with people with Neuro developmental disorders, specialising in diagnosing and managing complex cases.
Abstract:
Neuro Developmental disorders, (NDD) including Autism/Asperger’s (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), have deficits described either in Social communication/interaction/imagination, or in attention/concentration/hyperactivity/impulsivity. There is significant co morbidity, from 30% to 50%. The common symptoms occur in almost all, however in about â…“ to ½ cases fulfil criteria for more than one diagnosis.
Mental illnesses like Depression, Anxiety, psychosis, which could be part of Schizophrenia or Bipolar, can become chronic, in about more than half the cases even with best treatment and best compliance.
These complex cases are often associated with Executive function deficits. It is these that continue to cause morbidity for life long. It is also these that are given least attention or support, leaving our patients with burden that they continue to carry.
EFD is a term used to describe cognitive processes that help individual regulate, control and manage out thoughts and actions. It includes planning, working memory, attention, problem solving, verbal reasoning, inhibition, cognitive flexibility, initiation of actions and monitoring of actions. Though the EFD are not a part of diagnostic criteria, in NDD diagnosis or count as diagnostic issues when diagnosing mental illness chronicity, it’s these deficits that cause the most morbidity in day-to-day living.
The lack of behaviour flexibility, poor emotional control, decreased ability of self-monitoring, can the basis of either initial presentation, or the cause of relapse. For clients who eventually get a diagnosis of NDD, Environment adaptations are advised, of the need for routine, structure and predictability, however little is provided for supporting the EFD’s, that a person is struggling with.
Just focusing on core deficits in ASD or ADHD, or mood variations, and psychotic symptoms of mental illness, does not enhance the quality of life or the the outcomes. Identifying the exact set of EFD’s, will allow for developing specific adaptations, to enhance the quality of life, for children, students and adults.
- Behavioral Neurology
Session Introduction
Philip Anthony McMillan
Hull and East Yorkshire Hospitals NHS Trust, UK
Title: Integrated biochemical theory of delirium and experience with Pharmacological reversal
Biography:
Dr Philip McMillan is a Consultant in the NHS with over 23 years of medical expertise. His primary focus has been around Geriatrics and Neurological Rehabilitation and has developed unique perspectives on the capacity of the brain to recover from injuries and disease. Through international collaboration he has proposed a nutritional protocol for dementia reversal and has recently had a breakthrough theory on the pathology of dementia. His current aim is to lead the field of dementia to a new direction of research and treatment of this devastating disease.
Abstract:
Delirium is a significant problem in older hospital admissions, with worse clinical outcomes, prolonged hospital stay and functional disability. This presentation will cover the clinical experience of managing these complex patients during their hospital stay. The basis of this theory is with hepatic encephalopathy and the fact that all forms of delirium are clinically consistent. Looking to explain the integrated theory of delirium based on brain glutamate and ammonia management. This will demonstrate the biochemical aspects of delirium and how it is related to other conditions and most significantly how there is a higher incidence of delirium in dementia. Anecdotal experience of reversing delirium using this biochemical framework and use of simple medication in hospital has been very successful with up to 70% of patients demonstrating clinical improvement. This theory has the potential to revolutionize our care of older patients and give insight into the links between delirium and dementia.
Amani Osman Hassan
CWM Taf University Health Board, UK
Title: The STOMP in children and adolescents with learning disabilities in South Wales, UK
Biography:
Abstract:
Fawad Kaiser
Shifa Tameer–e-Millat University, Pakistan
Title: Relationship between violence and mental health in the Afghan Refugees; Plight of the Internally Displaced Person (IDP)
Biography:
Fawad Kaiser is an Associate Professor Psychiatry and Head of Department of Behavioural Sciences Shifa Tameer–e-Millat University Islamabad Pakistan. Also Director Quality Enhancement Cell, STMU and Consultant Forensic /Adult General Psychiatrist at Shifa International Hospital. Visiting Consultant Forensic Psychiatrist Jeesal Group UK. Also Managing Editor Journal of STMU and Member Scientific Advisory Board and Reviewer for Rawal Medical Journal and EC Forensic Science journal E Cronicon. As a hobby He is a Columnist with newspaper Daily Times Pakistan, Hilal, Turkey Tribune, The Morning Mail and have also published widely in research e.g. medical education, genetics, law, stress disorders, politics, economics, crime, psychology and terrorism.
Abstract:
Statement of the Problem: Inside Afghanistan, tens of thousands have become internally displaced1. Internally Displaced Person IDP are at a greater risk for physical and mental health problems. Pakistan, home to 1.3 million registered Afghan refugees and some 700,000 undocumented Afghans, resulting in significant personal, social and economic cost and the impact of all three may have on their mental health.
Additionally, and importantly, studies have investigated relationship factors between mental health of displaced person and refugee person2, 3, 4, 5, 6.. Relationships might include relationships between individuals, groups and communities. In a study7 with a 30-month follow-up, PTSD, depression, and somatic complaints reduced with time in internally displaced and non-displaced children, but psychosocial adaptation did not improve in displaced children and remained worst with time. The relationships between violence and health need further investigation, might it be the impact of war on mental health8 or the impact of family relationships, physical abuse and early adversities. The purpose of this study is to describe the experience of IDP Afghan Refugees seeking help for mental health disorders. Methodology: A review of individual, family, community, and societal risk and protective factors for mental health among Afghan refugees who are settled as Internally Displaced Person in Pakistan. Findings: Exposure to violence was found to be a key risk factor, whereas stable settlement and social support in the host country have a positive effect on the mental health and well-being. Conclusion & Significance: Timely, but fair and thorough, assessment and resolution of refugee status had positive effect on mental health. Early intervention access for mental and physical health, and provision to good housing and schooling were central to adjusting and positive mental health. Further research is needed to enquire into the effects of prolonged uncertainty about refugee status which seems to have a negative effect on mental health. Since mental health problems originating among refugees in forced migration are often long lasting, recommendations are made that host countries must implement immigration, health-care, and social policies that support IDP family units and keep deleterious consequences for mental health to a minimum.