International Congress this year. Remember this conference is for psychiatrists and what their interests are. The top three are:-
(1) Neurostimulation: Current evidence for the management of depression. The evidence base for transcranial magnetic stimulation (rTMS) (see previous post), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS) will be described. rTMS uses a magnet to stimulate the brain, tDCS passes electrical current through two electrodes placed over the head, and in DBS a pair of electrodes is implanted in the brain and controlled by a generator placed in the chest. The idea seems to be that stimulation of the brain, however crude, will stop it causing depression. And, there's no need to cause an epileptic fit, as with ECT. Exciting stuff apparently!
(2) Disorders at the interface of neurology and psychiatry. A day course on neuropsychiatry - this must be proper medical psychiatry. Better learn about new disorders such as autoimmune encephalitis and c9orf72 gene mutation, in case they are relevant to mainstream psychiatry. Huntington's Disease features in a session and is probably only regarded historically as a psychiatric disorder, rather than neurological disorder, because some of these people ended up in asylums. I'm not quite sure why factitious disorder features so prominently in another session, as I would have thought whether symptoms are functional or feigned is a psychiatric rather than neurological problem. As I said in a previous post, "Psychiatry, unlike neurology, is not based on treating a physical lesion". Trouble is psychiatrists are attracted to neuropsychiatry because they want to believe there's no difference between neurological and psychiatric disorders. That's a specialist way of avoiding having to deal with mainstream psychiatric problems, and apparently popular and far more interesting.
(3) Immune pathogenesis of psychosis. Surely there's no evidence that schizophrenia is an immunological disorder. This sessions sets out to suggest otherwise. The MRC has even funded the PiPP study to look at the prevalence of neuronal cell surface antibodies in patients with psychotic illness. There is even a hypothesis that cytokine-mediated events are the key pathogenic event in schizophrenia. Immune based treatment studies are considered a realistic option. I suppose it's fun that such speculations are followed up, and it keeps researchers in a job. I guess they just shrug off their disillusion when they don't make progress.
Academic psychiatry seems to have been well and truly remedicalised, in the sense that it focuses on what it thinks is the expertise of psychiatrists as medical doctors. I find it sad that psychiatry has so narrowed itself to a physicalist perspective and now presents this as an exciting advance.
Critical psychiatry doesn't get any space in RCPsych congresses. In fact, submitted proposals have been turned down. It's a shame that mainstream psychiatry can't be more broadminded.