Clinical Updates to Explore Hoarding, Lithium Underuse, and More

This year’s Annual Meeting will once again feature the popular Clinical Updates Track: 18 sessions on clinically relevant topics presented by some of the leading minds in the psychiatry field. As with previous iterations, the Clinical Updates Track provides ready-to-use guidance on a range of common challenges a practicing clinician often encounters, said Ronald Winchel, M.D., chair of the Clinical Updates Track Subcommittee.

Winchel is excited about what he calls “an all-star lineup of speakers, including many world-class psychiatry scholar-teachers, including Charles Nemeroff, Stephen Stahl, Kim Yonkers, Roger McIntyre, Katherine Phillips, John Kane, Maurizio Fava, Lenard Adler, and many more.” Winchel believes all 18 are excellent and worth attending, but he shared some thoughts on a few noteworthy ones:

• Technological Addictions: The New Frontier in Addiction Psychiatry: While a presentation by the current APA president might be reason enough to attend, Winchel said this talk by Petros Levounis, M.D., M.A., is extremely timely. “This may be the topic of 2024, if not the decade,” he said, noting the deluge of stories about almost unstoppable tech overuse and overload, “stealing our time and our attention and possibly sabotaging our kids’ development.”

• Rethinking Lithium: One of the goals of this year’s Clinical Updates is to reinvigorate awareness, understanding, and use of lithium. Lithium is “an extraordinary medication that has been shockingly underused—and possibly misunderstood—in recent years,” said Winchel. Stephen Stahl, M.D., and Jonathan Meyer, M.D., “will address the myths that surround the drug and update us on state-of-the-art clinical use of lithium.”

• Hoarding Disorder: A Comprehensive Clinical Overview and New Research Directions: “We all have patients who hoard, and often we may not even know years into treatment. It can be a source of enormous shame,” Winchel said. “Given that many individuals may find it hard to acknowledge either to their doctors or themselves that their habits constitute a hoarding condition, and given the therapeutic nihilism that clinicians feel about hoarding, many psychiatrists may not have experience in talking to patients about hoarding.” Carolyn Rodriguez, M.D., Ph.D., and Randy Frost, Ph.D., who co-authored a book on the subject last year, together with Michael Wheaton, Ph.D., will address the subject.

• Overweight and Obesity in Persons Living With Mental Illness: Given the recent surge of interest in medication-assisted weight loss, the ubiquity of weight gain associated with many psychotropic medications, and the growing awareness of a relationship between excess weight and vulnerability to psychiatric morbidity, everyone wants to know “what’s the skinny on fat?” said Winchel. Roger McIntyre, M.D., who recently received an award from the Brain and Behavior Research Foundation for his research into the links between obesity and mood disorders, and Joseph Goldberg, M.D., both stellar teachers, will review the evolving science and clinical application of our emerging knowledge.

• Worry, Worry, Worry: Treatment of Anxiety Disorders and PTSD: “Anxiety symptoms and disorders are enormously common but often minimized or dismissed as a secondary disorder in comparison to depression or other diagnoses,” Winchel said. But disorders such as generalized anxiety disorder and social anxiety disorder can be the sources of considerable—even life compromising—distress and functional impairment; they are also among the most challenging to bring to full, or near, remission. The always engaging Charles Nemeroff, M.D., Ph.D., will draw on his breadth of experience and discuss how psychiatrists can optimize their anxiety treatment.

• Overview of Antipsychotics: “Old, new, typical, atypical, first generation, second generation, third generation. The range in this oldest of psychotropic classes is sometimes beyond perplexing.” Winchel said. He pointed out that the large number of choices, complicated by variabilities in neurotransmitter effects, costs, indications, and side effects “can generate a psychiatric crisis in the doctor who is trying to make the best choice for a particular patient.” John Kane, M.D., will make use of his outstanding expertise and experience in the field to bring order and clarity to these medications and their application to both mood and psychotic disorders.

Additional sessions and presenters include the following:

• Suicide Across the Board: Risk Factors, Assessments, and Interventions: Karen Wagner, M.D., Doug Jacobs, M.D.

• Irritability and Disruptive Behaviors in Children and Adolescents: Janet Wozniak, M.D.

• Clinical Update on Personality Disorders: Diagnosis and Treatment: Kaz Nelson, M.D., Carla Sharp, M.D.

• Cardiac Issues in Psychiatry: Margo Funk, M.D.

• Autism and Neurodivergent Individuals Across the Lifespan: Eric Hollander, M.D.

• Obsessive-Compulsive Spectrum Disorders: Clinical Presentation and Treatments: Jon Grant, M.D., M.P.H., Katherine Phillips, M.D., Christopher Pittenger, M.D., Ph.D.

• Psychiatric Update on Reproductive Mood Disorders: Kim Yonkers, M.D., Gina Savella, M.D.

• Pharmacological Approaches to Treatment-Resistant Depression: Maurizio Fava, M.D.

• Emerging Concepts in Difficult-to-Treat Late-Life Depression: Jordan Karp, M.D., Eric Lenze, M.D., Olusola Ajilore, M.D., Ph.D., Meryl Butters, Ph.D.

• Real-World Strategies for BP 2: Recognition and Management Under Conditions of Uncertainty: Gary Sachs, M.D.

• Neuromodulation: Andrew Leuchter, M.D., Linda Carpenter, M.D.

• Diagnosis, Assessment, and Treatment of ADHD Through the Lifespan: Leonard Adler, M.D. ■