What's really bugging you? - The role of the gut microbiome in modulating psychiatric disease in the C/L setting

Thursday, November 7, 2024

1:30 PM – 2:45 PM EST

Location: Brickell

Speaker(s)

James N. Kimball, MD, FACLP, DFAPA

Clinical Professor
Atrium Health Wake Forest Baptist Medical Center
Winston Salem, North Carolina

PDF
DK

Drew Kiraly, MD, PhD

Associate Professor
Wake Forest University School of Medicine
Winston-Salem, North Carolina

Lead Speaker(s)

MC

Molly Cinderella, MD (she/her/hers)

Associate Program Director, Cone Health Psychiatry Residency Program. General C-L Psychiatrist.
Cone Health
Winston-Salem, North Carolina

PDF

Speaker(s)

NN

Nona Nichols, MD

Staff
Cleveland Clinic
Cleveland, Ohio

PDF

Abstract:

The growing mental health crisis has put additional pressure on an overstressed and underfunded mental health system. Patients frustrated by lack of access to psychiatric care or insufficient results with traditional psychotropic medications are looking towards complementary and alternative treatments. From autism to addiction to Alzheimer’s disease, dysfunction in the gut microbiome is implicated in a wide range of psychiatric illnesses (1,2).

The bidirectional communication between the central nervous system and gut microbiota is of significant pop culture and research interest. It is challenging for clinicians to sort through the glut of literature on the gut microbiome and determine what is both clinically relevant and scientifically sound. The gut microbiome as a whole is capable of synthesizing not only serotonin, but also endocannabinoids, neuropeptides, short-chain fatty acids and biogenic amines (3). All of these compounds have the potential to effect measurable changes in mood and cognition. Current research suggests a robust but short-lived response to “microbiome transplants” for depression and anxiety (3). Similar patterns are seen in patients taking probiotics, with ongoing use needed for continued benefit. The gut microbiome exists in delicate equilibrium with an individual’s genetics, diet, and lifestyle and returns toward its set point in the absence of ongoing change.

In this workshop sponsored by the integrative medicine SIG, we will present an overview of the gut microbiome within the context of the gut-brain axis as well as deviations commonly seen in a C-L psychiatrist’s daily practice. We will use question-and-answer technology throughout all four presentations; Drs. Nichols and Cinderella will use a case-based approach to foster a highly interactive learning experience. Participants will leave the workshop with the vocabulary to be able to assess the current literature in the field and apply cutting edge research to day-to-day practice.

Dr. Kimball will present an overview of the gut-brain axis and a brief overview of necessary terminology for the rest of the workshop. (15 minutes)

Dr. Nichols will discuss the known impact of alterations in microbial diversity on a range of psychiatric diseases. (15 minutes)

Dr. Cinderella will discuss best practices in how to take a “nutritional history” and incorporate discussion of lifestyle changes that promote a healthy microbiome in everyday practice. (15 minutes)

Dr. Kiraly will discuss his lab’s translational research on the microbiome’s role in addiction and discuss future directions in microbiome research. (20 minutes)

We will close with a 10 minute Q&A session.
Learning Objectives:
1. Participants will be familiar with literature and current research on the gut microbiome and mental health across the lifespan
2. Participants will be able to incorporate evidence-based recommendations to influencing the microbiome into their clinical practice
3. Participants will be familiar with current and future directions in gut microbiome research.