Physical health and early intervention key focus at SIRS 2018

The 6^th Schizophrenia International Research Society Conference (SIRS) was held in Florence from 4 – 8 April 2018.

This conference brings together scientists and clinicians working in all areas of psychotic disorders. Reflected in the plenary sessions and symposiums, a variety of topics were covered from cell biology to novel clinical treatments.

The conference was opened by Alastair Campbell, a past press secretary for former UK Prime Minister Tony Blair. Alastair is now a vocal advocate for increased resources for mental health research and services.  During his plenary speech Alastair spoke of his brother, Donald. Donald was a talented bagpipes player living with a diagnosis of schizophrenia since early adulthood, who sadly died at the age of 62 from complications of cardiovascular and respiratory disease. The talk set the scene for the conference and reminded us why we had all gathered at the conference; to improve the lives of those affected by psychotic disorders, and their families.

Professor Gail Daumit’s plenary talk the following the day couldn’t have been timed better. She demonstrated the improvements that thoughtfully planned out interventions can have in reducing the risk factors which contribute to cardiovascular morbidity (smoking, diet, exercise) for people affected by psychotic disorders. She also highlighted that these improvements can be maintained for long periods of time.

Addressing physical health as a potential treatment for mental health disorders was a theme that ran throughout the conference. During a symposium on physical health interventions, Professor David Kimhy demonstrated that people with psychotic disorders could be engaged in physical activity by using commercially available motion sensor video games. This novel intervention resulted in an improvement in both fitness and cognition. A further plenary session by Professor Asya Rolls addressed the association between mental and physical health by examining mechanisms that involved the immune system.

A number of symposiums were dedicated to how cannabidiol may be effective for psychotic disorders. Antipsychotic medications causing dopamine blockade have been first line treatment for psychotic disorders since the 1950s, and any potential alternative is usually met with great excitement.

Dr Sagnik Bhattacharyya presented preliminary findings from a randomized controlled trial (RCT) involving young people who were identified as being at clinical high risk for psychosis. It demonstrated that short term treatment with cannabidiol resulted in a reduction in the level of anxiety and distress associated with psychotic symptoms, and there was a trend towards a reduction in psychotic symptoms.

In a cross-over RCT, Associate Professor Mohini Ranganathan presented interim results that found cannabidiol did not have an effect on positive psychotic symptoms in individuals with a full threshold psychotic disorder, although the sample size was small. When looking at a RCT involving individuals with a more enduring illness, Professor Phillip McGuire demonstrated that adjunctive treatment with cannabidiol resulted in an improvement in positive psychotic symptoms.

The conference had a number of symposia dedicated to the prevention and delay of psychotic disorders, a common goal of many researchers. In a symposium on detection of the at-risk mental state, Associate Professor Jai Shah identified that the majority of individuals exhibited at least one early sub-threshold psychotic symptom prior to the onset of their first episode of psychosis. Professor Fusar-Poli utilised a large patient register (>90,000) and found that only 5% of transitions to psychosis came from people who were designated to have an at-risk mental state. These findings indicated the need for transdiagnostic prediction of psychosis in secondary mental health care.

In the addition to the plenary, symposia and oral presentations, the poster sessions were a highly sociable event, with great opportunities for researchers across the world to discuss ideas and collaborate. While some people may wish for variety in the cities where a conference is held, I would argue that when a conference has found its home in one of the most stunning and historic cities in the world, there is no reason to move. The picture below is not a postcard, but rather a photo from my last morning in Florence as the sun was rising. It’s hard to take a bad photo in Florence!

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