Young residents and psychiatric patients have a lot in common. A paranoid attitute towards their colleague, repetitive patterns, obsessive checking behaviours, intrusive thoughts (will my patient survive?!) and they both spend the summer near their usual hospital. Sometimes practically inside it. So I was particularly glad to leave my Department for a few days and attend the annual BAP summer meeting thanks (thanks!) to the University of Southampton. The BAP meeting was in Harrogate, a place with the right atmosphere for a novel by one of the Brontë sisters. I had never been that far north.

The conference gave me a chance to get away from my usual work

The British Association of Psychopharmacology support various educational programs so not surprisingly there were many researchers under 35 attending, among them some other EUSARNAD exchangees such as Ben Ainsworth and Andy Crawford. It’s a great opportunity to make friends and meet like-minded young researchers as well as gaining  wisdom from some of the more experienced members. One of my personal highlights of the meeting was the Blogging service, managed by Suzi Gage, a  PhD student from the University of Bristol whose blog appears in the Guardian website.

It’s impossible to attend all of the sessions, but I gave it my best go, including an introduction to computational modelling in psychiatry that left me pretty interested and with many doubts at the same time (and also a little dazed!). A session of particular interest to me anxiety disorders session was chaired by David Baldwin and David Nutt, hosting one of the EUSARNAD mentors as a speaker, Nick Van der Wee, with a talk on possible improvements in drug treatment in anxiety disorders. The whole symposium focused on experimental medicine with Gerry Dawson illustrating the P1vital programme and Sally Adams from Bristol showing the results of her group’s studies on cognition and face-processing.

The University of Southampton’s Matt Garner revealed the results on his development of an experimental model of GAD – I had the chance to see the CO2 model while in Southampton last summer and I was surprised about this efficient way to provoke an anxious state in healthy controls, which is useful for better understanding of GAD. The poster sessions were pretty crowded and someone even had an interest in my work (!) on the duration of untreated illnesses.

The Southampton University BAP Delegation, including EUSARNAD members Carlotta Palazzo, Ben Ainsworth and Professor David Baldwin (as well as some members-to-be)

During the last evening, a formal dinner was held in Harrogate theatre where many young researchers, both undergraduate and postgraduate, received awards and recognition for their achievements over the last couple of years. Later on, the Lifetime Achievement Award was  this year dedicated to Charles Marsden, who gave a great speech covering his impressive and eclectic career. Overall, it was a really interesting conference and I felt pretty lucky to have the chance to attend, and meet so many people who were previously just named authors on journal articles I read! And, let’s say it: how many of you guys have a photo taken by David Nutt?

– Lotte

At the BAP meeting my friend and colleague Ben Ainsworth kindly reminded me that I haven’t posted anything on the EUSARNAD blog yet. I love British people because they are so polite and proactive that you can only feel guilty and try to accomplish what they ask you to do, even in this really hot midsummer afternoon in Milano. So I will try to let you have a glimpse of my EUSARNAD experience.

I had a great time meeting and working with fellow EUSARNAD researchers (and friends!) Natalie Cuzen and Christiane Nday

I was really lucky as I heard about the research network directly from Professor David Baldwin whilst at a conference in Roma. I already had an interest in anxiety disorders so I (actually pretty bluntly) asked Professor Baldwin to join his team in Southampton. While in the UK  I met Natalie Cuzen, a South African psychologist involved in the scheme. Natalie and me, well, we became good friends while preparing our talk for the ICOCS congress in Vienna (nothing like your first talk at an international meeting can teach you what anxiety really is…Natalie fixed her presentation all the morning before while I had a candy apple overdose at the Prater…but this is another story I’ll tell you in the future).

So when I flew to Cape Town I already had some friends to help me settle. While there I was given the opportunity to work on something completely new for me: epidemiology and statistics. I was a bit skeptical at the beginning. I was so used to medical tools like proteins, cytokines, molecules that I kind of lost the perspective on our job: to understand and create solutions to help people enjoy a fullfilling life.

While trying to find my way with a literature search on “mental health literacy in anxiety” I had a great help from Katherine Sorsdahl that was my mentor while in Groote Schuur. Katherine was a great source of informations on South Africa populations, on their attitude related to alcohol and substance consumption, and on the actual access that people can have to health care. This is the good and bad about South Africa: it give you the feeling of a place where the future is happening and still have to face a troublesome past.

The townships in South Africa (this is a photo of Khayelitsha) have disproportionate levels of crime, alcoholism and mental health problems. But they are also full of a liveliness and vibrancy like nowhere else.

All this raised in me a lot of huge questions: what’s the point in having new treatments, knowledges and really detailed information about every little piece of the brain if a large part of the world population can’t access this, doesn’t want to or doesn’t trust health care at all? Numbers have the power to show you in which direction you are going more efficiently than experience itself. But an experience can give you a new perspective.

That’s what happen to me during a trip with Katherine and Ben in the township of Khayelitsha. Katherine was invited by an NGO to teach brief psychological interventions in the field of alcool abuse to people having some kind of social role in the township. Policemen, teachers, social workers, were there to learn the administration of the AUDIT questionnaire and how to provide a first line help to people facing an addiction.   This is just one of the strategies studied to work with few resources on a large scale. This is what health literacy does.

We were lucky enough to attend a small talk in Khayelitsha for locals who want to help reduce the impact of the high levels of alchohol abuse in the township

So, despite feeling much more comfortable while dealing with patients or protein expression (!),the work in EUSARNAD in Cape Town reminded me to look at the big picture of mental disorders. And that big answers to big questions come from big networks.

😉

– Lotte

After spending 4 weeks in Cape Town in January as a EUSARNAD-exchangee, followed by another 2.5 weeks of traveling, I had completely fallen in love with South Africa and, in particular, with the Mother City (that’s Cape Town!).

In the course of my 4 week stay at the Department of Psychiatry of the Groote Schuur hospital it became clear that the project I had been working on with Jean-Paul Fouché for over a year (starting with his visit to Leiden a year earlier), was not progressing as quickly as we would like. Setting up an international database of Social Anxiety Disorder MRI data comes with politics, logistics, analysis plans, quite a few renowned research centres worldwide, and requires a fair amount of patience. I soon realised that this ‘mega-analysis’ project would benefit from fulltime attention. Fortunately, the supervisors agreed and I left Cape Town feeling hopeful to return some time. Mind you, I had to come back, since I had not even been to Robben Island yet!

And I was lucky… A mere day after setting foot on Dutch soil, I got the green light to continue working on the mega-analysis in Cape Town, where all Social Anxiety Disorder MRI data was transferred. Fast-forward 4 months including a visit from Ben Ainsworth to Leiden, and here I am again, in one of the most exquisite cities in the world, feeling like the luckiest girl in the world. True, Europe is currently in a massive heat wave and after a cold and wet spring, my timing of leaving The Netherlands could have been better. Especially since it is winter in South Africa, which means I have gone straight back to the cold and rain… But who can say that when they walk out their door en look left they see the ocean, look right see Table Mountain and the Twelve Apostles, and look ahead to see Lion’s Head?! And, rather importantly, I am thrilled to work on the social anxiety mega-analysis because to me, it is simply one the most interesting projects on the planet.

I was very excited to see my colleagues at the Groote Schuur again, with whom I got along very well during my previous visit. These included some other EUSARNAD researchers such as Sonja Pasche, Jean-Paul Fouché, Anne Uhlmann, Sarah Heany, and Coenie Hattingh. All of the colleagues were very welcoming and it was almost as if I had never left. Meetings with the department allowed me to get an idea of the exciting studies that the groups are doing here – many of which involve anxiety, and I can’t wait to learn more. But most importantly, JP and I are about to sink our teeth in the social anxiety mega-analysis, which will undoubtedly prove to be challenging as well as interesting.

Although I am only a few weeks into my 6-month stay in Cape Town it felt like home from the very beginning. The experience so far is already wonderful, and I can only look forward to what is yet to come!

– Nienke

From the natty acronym ‘EUSARNAD’ it’s pretty apparent that most of the collaborative programs are cross-continental, between the European Union (that’s the ‘EU’ part) and South Africa (you might have guessed, the ‘SA’). But the idea behind it is not just to allow researchers to complete current research in environments, using techniques and tools they wouldn’t usually have access to, but also to allow those researchers to build links and create communicative networks that might yield future collaboration.

It took a while before I was able to manage to cycle around on the bike I was kindly leant without reducing the people around me to breathless laughter at my incompetence…

A case in point was my trip to Leiden University Medical Centre. At Southampton, we have a number of projects that EUSARNAD takes an interest in, from developing new experimental models of anxiety (the ‘7.5% CO2 model’) to using these models to evaluate various psychological and pharmacological anxiety treatments.

One aspect of our department that we are currently developing is the use of neuroimaging to further evaluate models/treatments. Neuroimaging, using Magnetic Resonance Imagining (MRI) is much touted as a way to ‘look inside a living brain’.  While, as with any scientific tool, there are certain caveats to it’s usefulness, it’s certain that it’s an extremely powerful tool which will, as methods are refined, become more and more useful over the coming decades. I learnt some MRI techniques under the tutelage of JP Fouche at the CUBIC institute, and when I came back to Southampton I was determined to create an opportunity to use these skills.

I didn’t realize it at the time, but the EUSARNAD scheme had already given me everything I needed. I met Nienke Pannekoek and Steven van der Werff at the University of Cape Town while I was there, and it was immediately obvious that we shared a lot of beliefs about the future of anxiety research. We kept in touch, and when Nienke suggested that I spend some time at the LUMC, I jumped at the chance. She offered me the opportunity to meet the rest of her department, learn some of the MRI analysis methods they were familiar with, and observe some of their experimental techniques.

This picture was actually one I took to use as navigation – (un)fortunately Leiden is so full of historical sites and striking architecture that it wasn’t that helpful!

Although I was only working in the LUMC for two weeks, I really was given an insight into a busy clinical facility that makes the most of its excellent neuroimaging facilities.  I observed and took part in studies, I attended presentations, and I was given ample opportunity to poke my nose into anywhere I fancied.  Furthermore, the LUMC researchers were interested in the work we’re doing in Southampton, and the different cognitive, clinical and experimental methods we employ. This mutual interest really does bode well for future work together, and is a perfect example of the EUSARNAD scheme achieving its goals.

(Even this post was a collaborative effort between me (Ben) and Nienke Pannekoek).