'Mental As': the week that was, & what's to come

The media profile for mental health and illness for the 2015 awareness week has been high and the Mental Health Foundation of Australia lists over 100 events in Victoria alone for October. Yet structural reform through government funding and policy is not sufficient to power the twin engines of mental health treatment and care - that is, research into the causes of conditions, and provision of primary health care services. The result is inadequate and fragmented mental health care services for the 1 in 5 adults who will suffer from a mental disorder in any given year.

Photo of the Week: Women’s Mental Health Team (MAPrc)

March 2015 The Women's Mental Health team. L-R: Ms Lucinda Miller, Ms Vivian Monitto, Mr Gayan de Mel, Ms Marija Ugrcic, Dr Shainal Nathoo, Professor Jayashri Kulkarni, Ms Caitlin Bleeker, Ms Heather Gilbert, Dr Jasmin Grigg, Dr Roisin Worsley, Ms Emmy Gavrilidis.

Mental illness has many gender-specific characteristics that clinical practice has historically overlooked. The Women’s Mental Health Team at MAPrc is evaluating several promising new treatment approaches with specific focus on the hormonal (endocrine) system, for mental illnesses in women.

Their world first study looking at how oestrogen can help treat schizophrenia in previously treatment-resistant women has recently been published in Molecular Psychiatry.

There are a number of new treatment trials currently underway for schizophrenia, postmenopausal depression, treatment-resistant depression, and borderline personality disorder.

• Enquiries: Team Leader Emmy Gavrilidis on (03) 9076 6913 or emmy.gavrilidis@monash.edu
• MAPrc Women's Mental Health www.maprc.org.au/womens-mental-health
• Reference: Kulkarni J, Gavrilidis E, Wang W, Worsley R, Fitzgerald PB, Gurvich C, Van Rheenen T, Berk M, Burger H. Estradiol for treatment-resistant schizophrenia: a large-scale randomized-controlled trial in women of child-bearing age. Mol Psychiatry. 2015 Jun;20(6):695-702. doi: 10.1038/mp.2014.33. Epub 2014 Apr 15.

Forthcoming CCS events: Seminars, public events, general notices

Sree Malakar (Gastroenterology)
presenting at the 2014 postgraduate
symposium.

Central Clinical School has regular seminar series and postgraduate presentations. All event notices are maintained on the CCS Events calendar.
CCS staff & students can see details of both public and local events (including professional development courses, trade fairs and Graduate Research Student calendars) and deadlines, at the Intranet's Announcements page.

Various departments have their own calendars. See CCS seminar index: www.med.monash.edu.au/cecs/events/seminars.html

What's on for this coming week: 12 - 16 Oct 2015

Mon	►	10/12/2015	12:30	Psychiatry Professorial Grand Round
Tue	►	10/13/2015	13:00	PhD Pre-submission review - Ms Sreepurna Malakar
			14:00	PhD Pre-Submission Seminar : Ms Simone Peters
Wed	►	10/14/2015	11:30	PhD Mid-candidature review seminar - Ms Kirsty Wilson
			11:30	PhD Pre-Submission Seminar : Ms Sacha Filia

In the Future

• 18 Nov Postgraduate symposium

CCS Public lecture on women's mental health fully subscribed!

Oct 2013: Professor Jayashri Kulkarni & then Governor-General

Dame Quentin Bryce, at the MAPrc launch.

Central Clinical School's public lecture is this year being given by Professor Jayashri Kulkarni, Director of the Monash Alfred Psychiatry research centre, and Dame Quentin Bryce, former Governor-General of Australia, who has had a longstanding interest in women's mental health.

The lecture is fully subscribed, but if you would like to receive notification of the video link for the lecture, which will be 2-3 weeks later, please register here.

See more about MAPrc's research.

Mental health week 2015: Meditation for mindfulness vs meditation in religion or spiritual practice

What effect does the type of meditation have
on your brain?

Dr Neil Bailey from MAPrc has co-authored a study which explores whether mindfulness meditation has the same effect on the brain as meditation in spiritual practice.

According to the study, individuals who practise meditation religiously or spiritually and those who practise mindfulness meditation often report a greater sense of compassion, wellbeing, feeling of wholeness, decreased anxiety, and faster recovery from mental illness.

The report examines neuroimaging research that has focused on groups of meditating individuals, groups who engage in religious/spiritual practices, and research that has examined groups who perform both practices together, in an attempt to assess whether the effects on people's mindfulness are the same.

Supporting pregnant women and new mothers with mental illness

Ms Heather Gilbert

Heather Gilbert co-ordinates The National Register of Antipsychotic Medication in Pregnancy (NRAMP), which is now in its 10th year.

She is undertaking a PhD at MAPrc, part time, supervised by Professor Jayashri Kulkarni and Dr Caroline Gurvich. Her PhD is embedded within NRAMP,  and is planned to add to this important work.

Heather's PhD topic is 'Developing a new model of support for pregnant women and new mothers with mental illness'. Her first paper has been published, and is about the special issues facing pregnant women with mental illnesses, increasing clinical awareness, encouraging risk assessment and promoting management planning, by using an integrated model of care in support of women during pregnancy and in early motherhood.

Reference: Gilbert H, Gurvich C, Kulkarni J (2015) Special Issues for Pregnant Women with Mental Illness. J Nurs Care 4:280. doi: 10.4172/2167-1168.1000280

Mental health in the media with MAPrc

Prof Paul Fitzgerald explaining about

Transcranial Magnetic Stimulation

ABC Catalyst: Brain stimulation, broadcast 6 October 2015

Dr Maryanne Demasi explores magnetic transcranial stimulation or TMS with Professor Paul Fitzgerald. In the case of treating depression, the magnetic field is applied to the left prefrontal cortex, the part of the brain most responsible for happiness. Paul  says, "We tend to find about 45% of the patients we treat get a really substantial antidepressant response. Another 20% or so get benefit without it perhaps being life-changing. And about 35%, the patients don't respond at all."

Radio 3AW Talking health 4 October 2015: Professor Jayashri Kulkarni on 'borderline personality disorder' with Dr Sally Cockburn, how the term was invented 80 years ago and doesn't really help or explain the disorder (they don't quite have psychosis, they don't have depression, so it must be 'personality'!). Prof Kulkarni says that 85% of individuals diagnosed with the disorder had an early life trauma. They don't have a good internal sense of who they are. The major and most dangerous symptom is self harm.

Schizophrenia and working memory

Researchers at MAPrc have published a pair of research papers providing crucial proof-of-principle for a new treatment for cognitive impairment in schizophrenia.  Cognitive impairment is a core symptom of schizophrenia, occurring in greater than 80% of patients, and results in considerable functional disability. Despite the prevalence and significant burden associated with these symptoms, treatment options are few and of limited effectiveness.

Novel form of brain stimulation enhances working memory

Dr Kate Hoy, lead researcher on the TBS study

MAPrc researchers have recently published a world first finding in Cerebral Cortex.

The paper, lead authored by Dr Kate Hoy, investigated the use of a novel form of brain stimulation to enhance working memory.  Impairments in cognition, such as difficulties in attention and memory, are core symptoms of a number of psychiatric and neurological conditions. These difficulties greatly affect patient’s ability to engage in day-to-day life and there are currently no effective treatments.

Mental health week 2015: Schizophrenia and mirror system function

MAPrc student Dr Sophie Andrews supervised by Dr Kate Hoy, Professor Paul Fitzgerald, and Dr Richard Thomson recently authored a study which looked at patients with schizophrenia and whether their mirror neuron systems are impaired.

Dysfunctional mirror neuron systems have been proposed to contribute to the social cognitive deficits observed in schizophrenia. A few studies have explored mirror systems in schizophrenia using various techniques such as TMS (levels of motor resonance) or EEG (levels of mu suppression), with mixed results.

This study used a novel multimodal approach (eg: concurrent TMS and EEG) to further investigate mirror systems and social cognition in schizophrenia. Nineteen individuals with schizophrenia or schizoaffective disorder and 19 healthy controls participated.

The study found that the schizophrenia group showed significant deficits in facial affect recognition and higher level theory of mind, compared to healthy controls. A significant positive relationship was revealed between mu suppression and motor resonance for the overall sample, indicating concurrent validity of these measures. Levels of mu suppression and motor resonance were not significantly different between groups.

These findings indicate that in stable outpatients with schizophrenia, mirror system functioning is intact. Therefore, their social cognitive difficulties may be caused by alternative pathophysiology.

Reference (full study): Andrews SC, Enticott PG, Hoy KE, Thomson RH, Fitzgerald PB. No evidence for mirror system dysfunction in schizophrenia from a multimodal TMS/EEG study. Psychiatry Research 228:3,pp.431–440, 30 Aug 2015.

Congratulations to MAPrc students on completing their PhDs

Congratulations to Melissa Kirkovski and Eric Tan from Monash Alfred Psychiatry research centre who have both recently completed their PhDs.

Melissa, who was supervised by Professor Paul Fitzgerald and Associate Professor Peter Enticott, completed her thesis which looked at gender differences in the brain basis of Autism Spectrum Disorders. She enjoyed working with a great research team and being exposed to a variety of different types of research in mental health.

Eric's research explored the origins, causes and impacts of speech problems in schizophrenia and was particularly interested in how these speech problems impact a patient’s quality of life. Eric was supervised by Dr Susan Rossell and Dr Gregory Yelland. His other research interests include other language disorders, memory, cognition, quality of life and early/pre-psychosis phenomena.

Participants sought: Can brain stimulation improve memory and attention?

A study participant engages in a memory task

Dr Kate Hoy's team at MAPrc is currently conducting a number of projects looking at the use of brain stimulation for the treatment of cognitive impairment in people with head injuries or with schizophrenia. 

Participants sought: Do you have problems with your memory?

A new study being conducted by the Monash Alfred Psychiatry Research Centre is investigating whether brain stimulation can improve cognitive performance in older adults who report memory problems.

Previous research has demonstrated the efficacy of non-invasive brain stimulation in improving cognitive functioning in a variety of populations. This study is looking at whether the response to stimulation is different between younger adults, older adults and adults who identify as having a memory problem (beyond what would be expected from normal ageing). Understanding the brain activity changes occurring across the lifespan, and how this relates to cognitive functioning and neural plasticity, can help in developing treatments for disorders of cognitive decline such as dementia.

Participants will be asked to attend the centre for a single session that will take approximately 3.5 hours. Participants will complete cognitive tasks and receive two forms of non-invasive brain stimulation: transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS). Recording of brain activity will be completed through electroencephalography (EEG).

If you are interested in taking part of would like more information, please contact Ms Melanie Emonson: melanie.emonson@monash.edu or 03 9076 9823.

Participants sought: Non-invasive medical treatment for reducing symptoms of fibromyalgia

Participants are sought for a unique double-blind study, ‘Repetitive transcranial magnetic stimulation for the treatment of fibromyalgia’. The Monash Alfred Psychiatry Research Centre (MAPrc) is investigating the clinical potential of repetitive Transcranial Magnetic Stimulation (rTMS), a non-invasive treatment that uses magnetic fields to stimulate neurons in the brain, for the treatment of fibromyalgia.

Participants sought: Are you interested in a non-medication treatment for depression?

Does concurrent transcranial direct current stimulation augment the antidepressant efficacy of cognitive control training for major depression?

This study is looking at whether cognitive control training can help alleviate the symptoms of depression. It is also investigating whether a mild form of brain stimulation called transcranial electrical stimulation can be used to boost the impact of cognitive control training. Transcranial electrical stimulation is a safe, mild and non-invasive means of stimulating nerves cells in the brain.

Participants sought: Hearing voices (auditory verbal hallucinations)

Participants are sought for study on auditory verbal hallucinations in relation to mood in bipolar disorder and major depressive disorder.

Have you heard voices when no one else was nearby? To the person hearing the voice, it seems like someone is talking to them, but others around them do not actually hear the voice. These experiences tend to be more common amongst people with a mental illness, but also affect a proportion of people without a mental illness. Please find out more from the study coordinator, Dr Wei Lin Toh:

• Contact email:  wei.lin.toh@monash.edu
• Contact phone number:  (03) 9076 5172
• Website link: www.maprc.org.au/cognitive-neuropsychiatry

Translational Research Symposium success

A passion for research drove the young Barry Firkin (right) to
establish the Australian Society for Medical Research. Barry
was the Alfred Department of Medicine's Foundation Chair

The Central Clinical School hosted Monash University's inaugural Translational Research Symposium last week.

With over 200 people attending the event throughout the day, the symposium showcased some of the country's top medical researchers in translational research. Early Career and graduate student researchers participated in the symposium's Translational Research Young Investigator Poster competition. It was won by MAPrc's Dr Rebecca Segrave.