Review of ISBD Regional Group
Meeting in Sydney Australia

Intro and Summary | Day 1 Scientific Program |
Day 1 Social Program |Day 2 Scientific Program |
Conclusion

The inaugural International Society for Bipolar Disorders Regional Group Conference was held at the Sydney Convention and Exhibition Centre from the 5 - 7 February 2004. This highly significant event marked the first stand-alone ISBD meeting. The theme for this Pacific Rim Regional Group Conference was "Improving Patient Outcomes." This meeting may have catalysed a pattern for the ISBD, of having regional meetings in the interval years between the biennial International Conference on Bipolar Disorder held in Pittsburgh. The next regional meeting is planned for Edinburgh in 2006.

By all standards this was a highly successful meeting with almost 450 delegates from over 20 countries attending. It was the largest meeting on Bipolar Disorder held in Australasia and perhaps the largest meeting on the topic held outside the US. The meeting was well supported by industry with a number of the major companies involved. The informal feedback from delegates on the general organization of the meeting and the scientific program was uniformly favourable. The venue, which has a harbourside location, was excellent, placing the exhibition area adjacent to the meeting rooms and auditorium and providing a suitable informal setting for delegates, speakers and sponsors to mix and renew or build further contacts both nationally and internationally.

The chairman of the organising Committee was Professor Gordon Johnson of Sydney, assisted by Prof Michael Berk, Dr Russel D'Souza, Prof Peter Joyce, Prof Ken Kirkby, Dr Natalie Krapivensky, Dr Bill Lyndon, Prof Phillip Mitchell, Prof Isaac Schweitzer and Prof John Tiller. The organisers were most grateful for the assistance of the ISBD secretariat in Pittsburgh, and wish to thank Dr Samuel Gershon, the Chair of the ISBD, Vice President, Dr Lakshmi Yatham, and Founding President, Dr David Kupfer, as well as Ms. Donna Carothers, ISBD Executive Director.

The program for the ISBD Regional Group Conference highlighted new developments in bipolar disorders, presented by a panel of internationally distinguished speakers. The scientific program, which was based around the theme of improving patient outcomes, also addressed areas of current interest in bipolar disorder with a particular emphasis on aspects of clinical management, including both pharmacological and non pharmacological treatments. The panel of plenary speakers presenting during the morning sessions on Friday and Saturday provided a critical analysis of the evidence base of treatment across the differing phases of the illness.

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Day 1

The sessions held on day one of the conference began with Professor Guy Goodwin, University of Oxford, United Kingdom delivered a keynote address highlighting the Neurobiology of Bipolar Disorder. He focussed on key new findings in areas of genetics, neuropsychology, imaging and neuropharmacology. These findings were interfaced with clinical issues including the role of environmental factors and functional issues in recovery. Dr. Goodwin's session was followed by Dr Lakshmi Yatham of the University of British Columbia, Vancouver, Canada, who spoke on Monotherapy or Combination Therapy for Bipolar Disorder. Recent clinical trial data examining mania, maintenance and depression was presented, suggesting increased efficacy for all phases of the disorder with a number of combination strategies. The third session was led by Dr Terence Ketter from Stanford University School of Medicine who discussed new treatments for bipolar disorders and reviewed a number of the emerging therapies for the disorder and its comorbidities.

In the afternoon, both Professor Philip Mitchell and Dr David Kupfer addressed the issue of Bipolar Depression. Professor Mitchell focussed on the clinical characteristics of bipolar depression, and Dr Kupfer on data on the use of antidepressants in the disorder.

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Social Program

The social program that followed Friday's sessions included a champagne cruise across Sydney's famous harbour, providing the spectacle of a stunning sunset behind the Harbour Bridge and the Opera House which I am sure will be a long lasting reminder for those who came to the meeting. The evening concluded with the conference dinner in the Taronga Park centre overlooking the Harbour and the City and was very much enjoyed by the delegates.

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Day 2

On day two, Dr Gary Sachs of Harvard Medical School spoke on using a collaborative care model and its role in developing practical management strategies for bipolar disorder. This approach aimed at increasing concordance in clinical care, focusing on clinical skills, a specific model of interaction, the use of standardised practice procedures and the development of a written collaborative care plan. This was followed by Dr Ellen Frank of the University of Pittsburgh, who examined the active ingredients of adjunctive psychotherapies for bipolar disorder. Data on recent trials of psychotherapy were presented, and the common themes were identified. The last plenary speaker was Professor Eduard Vieta of the University of Barcelona, Spain, who spoke on the mechanism of action of psychoeducation in bipolar disorder. While psychoeducation clearly increased compliance, evidence was presented that it has efficacy over and above its effects on adherence. All plenary speakers stimulated wide spread interest with all topics generating questions and discussion that was limited by time constraints.

The plenary symposia that followed covered a range of diverse topical and clinically relevant areas including neuroimaging, functional disability, first episode illness, consumers and carers, psychosocial interventions, ECT and TMS, advocacy, pediatric bipolarity and the role of the internet. In general, issues raised in the plenary sessions were revisited in the symposia and workshops and were addressed from the patient perspective in the consumer care workshop mentioned above. Friday's symposium on Functionality created considerable interest, and a small but vigorous workshop held on Saturday addressed the issues surrounding advocacy and was led by Rodney Elgie from the Global Alliance for the Mentally Ill (GAMIAN). The strong advocacy movement in Australia was represented by Barbara Hocking from SANE and Ian Hickey from The Beyond Blue depression network. Interest in ECT and TMS and their role in Bipolar Disorder was high with standing room only throughout Saturday's symposia.

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Conclusion

A meeting on bipolar disorder would not be complete without a mention of John Cade. Delegates had the opportunity to attend a powerfully and poignantly presented play on John Cade and the story of Lithium. This was a new drama entitled "Dr Cade" by Neil Cole was supported by Beyond Blue, the national depression initiative mentioned earlier, as well as Ramsay Healthcare and the Black Dog Institute. The play dramatised but remained faithful to the historic events in Cade's life, including his experience as a prisoner of war in Changi, and detailed key aspects of the clinical and research work of the man who first discovered the therapeutic effects of lithium in manic-depressive illness over 50 years ago in Melbourne. This was extremely well received by the audience, and closed the circle both on the programme and its historical context.

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