Today, I have been at the British Mecca for Psychiatrists, the annual conference of the Royal College of Psychiatrists. We have taken over the ICC in Birmingham where the entrails of the Tory party conference are still being tidied away. I did have a double take moment of “Lord, I’m at the wrong conference” when I was greeted with the “A Country That Works For Everyone” signage which dwarfed our college’s diminutive logo. The juxtaposition being even greater because within the medical profession, the psychiatrists are probably the most left leaning, our life’s work being in the care of some of the most discriminated and disadvantaged in society who are not usually the Conservative party faithful.
I’m not really a “conference” person. Brown-nosing and networking brings me out in hives, but I have been around long enough to know just enough people to make small talk to. At shrink-fest this usually involves grumbling about:
- Lack of in-patient beds
- Being mistaken for a psychologist
- Not being recognised as “proper doctors”
- Lack of medical students wanting to train in our wonderful specialty
Mostly, I am robust enough to endure colleagues darting-off mid conversation to talk to someone else of greater importance. Occasionally, I bump into old supervisors and I have to admit to them that I’ve chucked in my research and pretend to be blissfully happy about this decision. Other times I catch sight of another female ex-researcher and we indulge in metaphorical hand-holding and sighs of “it’s so hard with children”. If it gets too much, I hide out in the loos checking social media. People post me pictures of dead animals (anti-hunting friends – don’t ask).
It might sound awfully depressing, but I also learnt these amazing nuggets:
From the wonderful Dr Andrea Danese, an Italian contemporary who heads up the Stress Lab at the Institute of Psychiatry. He once gave me a good recipe for pesto and today, he taught me this:
- If you get a nasty cut that gets infected, the skin gets red and “inflamed”. If we took a sample of your blood, we would find raised levels of proteins e.g. C-Reactive Proteins which are called inflammatory markers.
- Stress can cause an inflammatory response, just like an infection in quality but milder. This is to prepare the body to fight stress, in the same way that your body prepares itself to fight an infection.
- Children and adults with depression have raised inflammatory markers.
- These markers are even more raised if there was evidence of early life stress such as childhood maltreatment.
- Adults with raised baseline inflammatory markers are more likely to have recurrent and chronic depression which does not respond to traditional anti-depressant treatments.
- Anti-inflammatory agents usually used as pain killers after surgery (COX-2 inhibitors) have been successful in treating depression, particularly in people with high baseline inflammatory markers.
I know, this sounds dull to you, but to shrinks this is like: Yay! Another drug (cheap too) – maybe they won’t confuse us with psychologists anymore?
I also learnt from Professor Ian Goodyear (Head of Child Psychiatry at Cambridge University) that in his longitudinal studies of depression he divides us parents into the following groups which form a measure of “suboptimal family environment”:
- Optimal (that’s me of course)
- Aberrant (well-meaning but missing in action or clueless)
- Discordant (bickering and self-interested)
- Hazardous (deliberately cruel and abusive)
- Not surprisingly, the majority of children raised by “hazardous” parents end up with all kinds of mental health problems.
And from Professor Eric Taylor, the grand don of my field neuropsychiatry:
- 20-70% of children with ADHD continue to have symptoms into adulthood.
- 50% have another psychiatric diagnosis by age 27 years (mainly anti-social behaviour, drug misuse or depression).
- Children with ADHD with no friends and unsupportive, hostile parents at age 7 years are more likely to develop conduct problems and antisocial behaviour.
- If a child with ADHD lasts to age 17 years without engaging in anti-social behaviour, their parents can heave a large sigh of relief because they will very unlikely ever engage in this type of behaviour (they may still be susceptible to depression unfortunately).
The best part of conference?
The hotel to retire to overnight. Totally kid-free: gym, luxuriating bath, telly, bed and totally guilt-free and legitimate because “I’m working!”.
Roll on day 2!