5/17/11 Honolulu, HI

NOTE: This draft of the 2011 12th HAPA Annual Meeting Minutes was approved by the HAPA executive committee. The Minutes are posted on the HAPA website and will be ratified at the 13th HAPA  Annual Meeting in May 2012 in Philadelphia, PA

Members Present:

Drs. Petrides, Kanellopoulou, Papastrat, Mavromatis, Dagadakis, Lymberis

Guest:  Mrs. Eleni Kanellopoulou

Members Absent:

Drs Cassimatis.  Candilis, Matthews-Ferrari, Christodoulou, Fouras, Vidalis

Dr. Lymberis opened the meeting, welcomed all and noted that due to other demands a number of HAPA officers have been unable to attend.

This meeting would have been headed by incoming HAPA president, Dr. Matthews-Ferrari, who had to cancel due to death of her ailing father.  We all send to her & her family our condolences.  While her father’s health has been poor for sometime, death is still a “shock”, even when expected.

Minutes of the 11th HAPA Annual Meeting were distributed, reviewed and approved as written.

President’s Report: Dr. Lymberis read Dr. Cassimatis’ message to the members.

Treasurer’s Report: Dr. Fouras was also unable to attend. Dr. Lymberis presented his report: HAPA is running on a deficit because of lack of timely dues collection. A minimum of 20 full paying members is necessary for HAPA to stay in business. He urged that all should participate on a membership drive.

The future of HAPA was discussed.  Members present expressed their appreciation and affirmed the value of HAPA but the recent problem of membership and poor attendance to our meetings was again noted.

There have been on-going efforts for HAPA recruitment over the last five to six years.  Dr. Petrides noted this is a very difficult time economically.  Dr. Lymberis noted that all organizations have trouble with membership.

Dr. Lymberis noted that for several years now all HAPA business is by email only. HAPA has never had any staff. HAPA executive committee members have kept the organization alive by volunteering their services and personally contributing to fund its functions and by loaning funds to cover costs on an as needed basis.

Dr. Lymberis personally has been financing the HAPA website since 1999 and funded the recent website upgrade, valued at $1,600.00. Our current Treasurer has noted that this practice is not sustainable.

In 2010 it was discovered that HAPA had lost its legal status due to failure to register on a yearly basis. The decision was made to correct the problem and make HAPA legal by registering as an organization and establishing a HAPA Foundation as a non-profit within the state of California. This required legal services at a cost of $2,400. This amount was funded by the current HAPA Executive committee members.

A letter soliciting contributions was send out to all current and past HAPA members but the response was very minimal. This request will be repeated with every HAPA dues requests for the next few years.

While the commitment to HAPA’s future survival by all members present at this meeting in Hawaii was just as strong as that of the HAPA Executive committee members still the future of HAPA continues to be uncertain.  Everyone present was urged to recruit at least one HAPA member between now and our 13th HAPA meeting in Philadelphia in 2012. It is hoped that many East Coast members will be able to attend our 13th Annual meeting which will greatly improve our fiscal situation.

Reports from Greece: Dr. Christodoulou, Vidalis, Zervas and other Greek psychiatrists are no longer able to travel as in the past, due to cut backs in funding.  Dr. Christodoulou invited HAPA members to participate at the meeting of the Hellenic Psychiatric Association’s 21st Pan Hellenic Congress that was held in Athens, May 5th through May 8th.  No one from HAPA was able to participate.

The following are reports from the two key HAPA members who have been essential in the growth of HAPA serving to link the Hellenic Psychiatric Association with HAPA and promote close cooperation.

1)   Report form Professor George Christodoulou dated 9/28/2011:

I am back from the World Congress of Psychiatry that took place in Buenos Aires, Argentina, 15.000 participants ! Buenos Aires has always been a very attractive place in spite of the economic crisis which is still continuing there.
The Hellenic Psychiatric Association had the initiative to produce a book entitled “Anthology of Greek Psychiatric Texts” from the classical period up to the era of Psychopharmacology in the ‘50s. We decided to translate this book, insert three Introductory articles by Christodoulou, Ploumpidis and Karavatos and produced a WPA book. It took us three years to complete the book in English but we thought it would be worth it, not only for scientific reasons but also for reasons associated with the upgrading of the damaged image of our country internationally. The production of the book was funded by the Lilian Voudouri Foundation of Greece. We produced the book in 10.000 copies, shipped it to Argentina and had it distributed free of charge to the participants of the World Congress . The Embassy of Greece and the Ambassador Mr Michael Christides helped a lot with the customs and by organizing a reception funded by the Hellenic Psychiatric Association, at the impressive residence of the Ambassador, for the promotion of the book. All important people of International Psychiatry were there. The reception of the book was enthusiastic and we are naturally very pleased with its impact.
Please do not ask me for copies because all of them have been distributed in Buenos Aires. BUT you can download the book if you go to www.paeeb.com <http://www.paeeb.com> and click “editions”.
Other news from Greece:
On 10th October there is the World Mental Health Day. On this occasion, the Hellenic Psychiatric Association along with the World Federation for Mental Health and the two Departments of Psychiatry of the University of Athens are organizing a Press Conference on current pressing issues of Mental Health on the 6th October and the Hellenic Psychiatric Association is organizing. two round-table discussions at the Psychiatric Hospital at Daphni on the 10th October. As you know, in periods of economic crisis, psychopathology and especially suicide, which is closely associated with unemployment, increases. Additionally, mental health services are the first to suffer cuts internationally in periods of economic crisis and we want to prevent this, if we can.
I will have the great pleasure of seeing Arthur Papas and perhaps also Tina to-morrow. Arthur is in Athens at the moment and I spoke to him this morning.

2)   Report from Athanasios A. Vidalis, MD, PhD

The following is my edit of his emails from 8/11, 9/11 and 10/11:

Dr Vidalis is the President of the “International Society of Quality Medicine: A scientific international society of multi-medical specialties”. This organization was established in 2011 in Bulgaria <http://www.is-qm.eu>. Dr Vidalis has provided the leadership and inspiration for the formation of this group since 2002 when he helped initiate a series of World Congress meetings on “Quality in Clinical Practice” in Europe. He offered a warm welcome for any member of HAPA to join.

Dr Vidalis noted in his email of 8/24/11:

I also miss the USA. However as you know, things have changed. The pharmaceutical companies have difficulties in supporting us in order to come to the HAPA conferences. I’m sure it is not an uncommon problem, because American HAPA members didn’t have the chance to attend any meetings of the Pan-Hellenic Hospital Psychiatry Society <http://www.4sp.gr> either in Greece or abroad. I also share your worries about (the difficulties in fostering) the close collaboration of Greek and American psychiatrists. We did try to push the idea of HAPA to Greek fellows but without a lot of success unfortunately as you pointed out.  Apart from that, there were unfortunately no submissions to the Hellenic General Hospital Journal from any HAPA members. To conclude, it is true that USA and Greece are far away from each other, but I think that it is not a problem we can’t solve. It would be great if we could find a chance to meet and discuss all these issues in person.

HAPA Nominations: Dr. Lymberis presented the nominations in the absence of Dr. Matthews-Ferrari. There were no nominations from those in attendance.  There was discussion about the office of HAPA councilor and the Greek HAPA members (Drs Zervas & Siouti) that were recommended by Dr. Christodoulou.

Dr. Petrides moved acceptance of the nomination of Dr. Zervas as the candidate for the HAPA Councilor opening for 2011-2014.  The motion passed unanimously.

Scientific Presentation:

Neuroprotection and Neurogenesis:

The Added Promise of Psychotropic Medications

Paul Barkopoulos, M.D., M.P.H.

Summary:

Psychopharmacology clearly benefits patients by providing symptom reduction. However, there is no clear evidence that this treatment can modify the underlying disease process, or that all of these medications have disease modifying qualities. There is clear evidence supporting the disease modifying capacities of medications for multiple sclerosis, ALS, Parkinson’s disease, epilepsy, and possibly Alzheimer’s. These disorders are considered neurological. For conditions that are considered psychiatric such as schizophrenia, bipolar, depression, and PTSD, no disease modifying therapy has been confirmed. This is perplexing in that the psychiatric disorders mentioned above are both neurological and psychiatric and have some potential commonalities in regards to their neurologic underpinnings, including deficits in neuroplasticity and glutamergic dysfunction.

Similarly, with respect to neuroplasticity, processes like “sensitization” and “kindling” may play a role in a number of the disease states. Further evidence supporting the potential for disease modifying potential by psychopharmacologic agents, is the fact that many of the medications which work for both groups of disorders may be the same, or at least

similar in their psychopharmacologic actions, i.e. enhancing neurotrophic factors.  These actions can include activity at glutamergic pathways, scavenging free radicals, or decreasing the impact of inflammatory processes. All of these may protect neurons, or promote their growth, and thus are potentially disease modifying.

In this talk the following were generally discussed:

1)   Review the fundamentals of neurogenesis and neuroplasticity,

2) Investigate some of the contemporary understanding regarding

alterations in neuroplasticity in psychiatric disorders such as bipolar illness, depression, PTSD, and Alzheimer’s disease, which are presently considered to be progressive and neurodegenerative in nature.

3) Review the evidence supporting the concept that various psychopharmacologic agents act in a neuroprotective fashion.

4) Discuss how this accumulated data lays a foundation for cogent theories regarding potential disease modifying properties of currently used pharmacotherapeutic agents

5) Summarize findings, along with some notations in regard to future directions.

6) Conclude with the potentially inspiring message for all psychiatrists, that not only are we capable of alleviating the symptoms of our patients, but we may become powerful agents in preventing, slowing, or halting the progression of their illnesses.

Paul Barkopoulos, M.D

Attending Medical Staff

Cedars-Sinai Medical Center, Los Angeles, California

Assistant Clinical Professor, Psychiatry, UCLA Geffen School of Medicine

Instructor, UCLA-Sepulveda V.A. Olive View Psychiatry Residency

There was a lively discussion during & following this very stimulating presentation.

Adjournment: Dr Lymberis closed the meeting at 8:15PM

A group of five HAPA members met for the Dutch treat dinner at the local restaurant at the conclusion of the meeting.

The 13th HAPA Annual meeting will be in Philadelphia in connection with the APA Annual meeting in Philadelphia, Penn. Details will be on the HAPA website soon

Respectfully Submitted

Maria T. Lymberis, MD

HAPA Founder & Past President”