Meeting Minutes

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 13^th 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 13^th 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”

Minutes of the 11th HAPA Annual Meeting were distributed, reviewed and approved with the addition of the following section that was previously omitted:

HAPA Elections: The nominating committee presented the following nominations for the term 2011-2012

President Elect: Philip J. Candilis, M.D
Treasurer: George Fouras, MD
Secretary: Philip J. Candilis, M.D
Councilor for the term 2010-2013: Arthur N. Papas, MD

5/25/10 New Orleans, LA
NOTE: This draft of the 2010 11th HAPA Annual Meeting Minutes was approved by the HAPA executive committee. The Minutes were posted on the HAPA website and will be ratified at the 12th HAPA
Annual Meeting in May 2011 in Hawaii, HA

Members Present: Drs: Cassimatis, Candilis, Kaliore, Matthews-Ferrari, Levounis, Lymberis, Petrides, Zaphiropoulos.

Members Unable to attend: Drs: Agalianos, Alexopoulos, Bouras, Cardasis, Christodoulou, Emmanouel, Kanellopoulou, Latoussakis, Lyketsos, Papas, Stratas, Papadimitriou, Papakostas, Zervas, Latoussakis, Vidalis.

Invited Guest: Bruce Hershfield, MD, APA Assembly Speaker

I) Introductions

HAPA President Dr. Cassimates opened the meeting at 7:15PM welcoming all present and noted our special guest Dr. Hershfield. He thanked the members of the executive committee for their dedication, hard work and personal contributions which has helped keep the organization going thru these difficult times.

II) President’s Report

Dr. Cassimatis asked for a moment of silence in memory of our founding member and HAPA past officer Michael Kalogerakis, MD who died suddenly on March 10th 2010 while on vacation with his wife, Kay, in Florida. He was 83. Among his many accomplishments, he was also Past-President of International Society for Adolescent Psychiatry & Psychology, and a recipient of American Society of Adolescent Psychiatry’s Schonfeld Award.

Dr. Cassimates then announced that there are several changes in the HAPA leadership because of the resignations of the HAPA President Elect and HAPA Treasurer. He made several appointments to fill their terms of office: Dr. Mathews-Ferrari accepted the appointment as HAPA President-Elect, Dr.Fouras accepted the appointment as HAPA Treasurer and Dr Candilis accepted the appointment as HAPA Secretary. He will fill out the last year of Dr. Mathews-Ferrari’s term as Secretary now that she is the President Elect. All three are expected to be re nominated to these offices at the 2011 HAPA Annual meeting and elected to a full three year term. Dr Papadimitriou has finished his term of office as HAPA Councilor. A note of appreciation will be send to him. Dr. Papas was nominated and elected as HAPA Councilor. His term of office is 2010 to 2013.

III) HAPA 10th Annual Meeting Minutes

Dr Lymberis presented the Minutes of the 2009 HAPA annual meeting, the 10th year HAPA Anniversary meeting, which took place in San Francisco, CA. The Minutes were posted on the HAPA Website and copies were provided at this meeting. They were approved as written.

IV) HAPA Treasurer’s Report

In the absence of Dr. Papas, Dr. Lymberis presented the financial report. She noted that during the first 5 to 6 years HAPA had a yearly dues income was around $3,000.00 to $4,000 a year. Thus the dues collected covered the cost of the HAPA annual meeting ($3,000.00 to $4,000.00 per meeting). However, starting in 2006 there was a decrease in attendance at our annual meetings with a corresponding decrease in dues collection.

Dues income 2007: $2,006.00 & Annual meeting expenses: $3,493.55
Dues income 2008: $525.55 & Annual meeting expenses: $2,693.70
Dues income 2009: $850.00 & Annual meeting expenses: $2,675.00

Starting in 2007 HAPA began to run a deficit. Dr. Lymberis paid the cost of the dinners for 2008 and 2009. The HAPA executive committee urged that each member of the executive committee consider making a contribution of $150.00. This was done starting in 2007. The deficits in 2007, 2008 and 2009 were covered by contributions from the members of the executive committee. All HAPA bills were paid in full as of the end of 2009.

After 2008 as the global recession took hold,attendance at HAPA meetings and dues collection became an even bigger problem. In late 2009 the HAPA Executive committee voted to change the format of the HAPA annual meetings starting with this the 2010 HAPA annual meeting. HAPA meetings will continue to be on the Tuesday of the APA’s meeting but the time of the meeting changed to 6:00-8:00PM with a Dutch Treat dinner at 8:30PM at a local restaurant for those who wish to join in after the meeting. This year, 2010, all members in attendance had a very successful, intimate, highly enjoyable dinner in a private room of the hotel restaurant. This helped with bonding as HAPA members got a chance to better know each other. The success of this first meeting with the new time and the Dutch treat dinner reassured everyone that this new HAPA format will be very good for all our future meetings.

As of the time of the 2010 meeting in New Orleans HAPA had no deficit:
Dues income 2010: $225.00 & Annual meeting expenses: $122.17.

During 2010 HAPA also received a special contribution from Stella Lymberis, MD. The HAPA contribution of $250.00 is seed money for the establishment of a fund: “for a Greek American Scholarship Award in Psychiatry in memory of (her grand mother) Styliani Orologa Lymberis to be presented at a HAPA Annual meeting to a deserving female resident for exceptional work during residency”. She and other family members will be contributing to this fund over time.

Dr. Lymberis announced that she is funding the cost of $1,500.00 for the update of the HAPA website. The update has already started and should be completed by the end of 2010.

V) Updates on Psychiatry from Greece

A) Report from Professor Christodoulou by email dated 4/25/10

“One of the main reasons that I will not be coming to New Orleans is that on the same month I have been invited by WHO to give a course on “”Advanced Psychiatry”” to Palestinian physicians. I thought it was politically and substantially correct to accept this challenge and organize a course with the assistance of Prof. Yiannis Giouzepas, Prof. Dimitris Ploumpidis and Prof. Ilias Angelopoulos who will accompany me to Palestine. The Hellenic Psychiatric Association, HAPA, will be the co-organizer with WHO of this event.

You may remember that some years ago, when Lebanon and Israel were almost at war, a group of us visited Tel Aviv and Beirut and managed to persuade the two psychiatric associations to produce anti-war statements. The Palestinian Psychiatric Association received this initiative enthusiastically. This initiative was carried out on behalf of the Institutional Programs on Disasters and on Violence of the WPA but the Hellenic Psychiatric Association played a major role in it. On that occasion I remember Viveca Hashbun, a Palestinian child psychiatrist who took part in the Tel-Aviv conference organized for the above purpose, who spoke and said that she was originally hesitant to come to a scientific meeting in Israel and that what made her decide was that the event was organized by the Greeks.

I am mentioning these activities because they may give you some ideas on how the activities of the HAPA may be shaped in the future. Do you want me to negotiate anything on behalf of HAPA? Would HAPA be interested in undertaking something similar in the future? My opinion has always been that national politics is carried out more efficiently by NGOs rather than the Ministry of Foreign Affairs. This is added value to the scientific benefit that is expected to be derived from this course for the Palestinian colleagues

In the above context, our collaboration with the Cyprus Psychiatric Association and with the Psychiatric Associations of the Balkan countries and especially Serbia are worth considering. With reference to Cyprus, as you may know, the Cyprus Psychiatric Association is organizing its congress from 9 to 12 September this year (2010). How about organizing a symposium there? If you decide to do this, you have to move quickly by writing to Dr Neophytos Papaneophytou, the Cyprus Association President.

B) Report from Professor Vidalis by email dated 5/10/10

“Maria, unfortunately, due to many scientific and executive committments here in Greece I will be unable to participate in the New Orleans HAPAs meeting”. Dr. Vidalis noted that his meeting The 4 Seasons of Psychiatry that took place in Dubronvic . (www.4sp.gr) was a big success: “I had the chance to receive very positive comments about this event and as an example I will share the comments of Professor P. Udomratn, the Vice Chairman of the Federation of Asian Psychiatrists:

“”Dear Prof.Vidalis ,Dr.Bras, and all of speakers,
It was my great pleasure to meet all of you in Dubrovnik last week.
The 4 Seasons of Psychiatry is a meeting that I can not find in any place of the world.
It expands the horizon of my knowledge of psychiatry to neuroradiology, neurology, nanomedicine, complex theory of mathmatics, magnetic encephlography,etc.””

VI) HAPA Scientific Program

Dr Lymberis noted that Dr Zervas send his regrets because he was not able to come to the US. Hopefully he will be able to give his presentation at a future HAPA meeting. Petros Levounis, MD, MA was then introduced. He is the Director of the Addiction Institute of New York and Chief of the Division of Addiction Psychiatry at St. Luke’s & Roosevelt Hospitals. He is an Associate Clinical Professor of Psychiatry at Columbia University College of Physicians & Surgeons.

Dr Levounis gave a very scholarly and comprehensive presentation on his work with addictions. He noted that addiction is “the archetypical bio-psycho-social-brain disease”. Starting with a fascinating discussion on the history of addictions as illnesses he moved on to the evidence base stemming from 20 years experience in treating addictions. After focusing on the neurobiological, socio-cultural and treatment aspects, he presented his main work on motivation and change. Those who are interested can check out his just published book: “Motivation & Change”. His book is a major contribution. It is especially focused for clinicians interested in helping patients overcome the ravages of their additions. However, his insights and treatment approach is applicable not only to addictions but to a wide spectrum of psychiatric patients. The book is available on and

VII) Adjournment

Dr. Cassimatis closed the meeting at 8:00PM. The next HAPA Annual will be in Hawaii in connection with the APA meeting in May 2011

Respectfully Submitted
Maria T. Lymberis, MD
HAPA Founder & Past President

It is with GREAT Pride & Pleasure that we, in HAPA, announce the publication of two very timely and important psychiatric books
1) “”MOTIVATION & CHANGE”” by one of HAPA’s Founding members: Petros Levounis, MD

Director, The Addiction Institute of New York; Chief, Division of Addiction Psychiatry, The St. Luke’s & Roosevelt Hospitals and Associate Clinical Professor of Psychiatry, Columbia University College of Physicians & Surgeons
Dr Levounis gave a terrific presentation at the just complicated 11th HAPA Annual meeting on these topics in New Orleans on 5/25/10. His presentation was very scholarly, comprehensive, informative and clinically relevant. His book which is a major contribution especially for clinicians interested in helping patients overcome the ravages of their additions. His treatment approach is applicable not only to addictions but to a wide spectrum of psychiatric patients.
The book is available on amazon.com and appi.org.

Tuesday May 19th 2009,  San Francisco, CA

NOTE: This draft of the 2009 10^th HAPA Annual Meeting Minutes was approved by the HAPA executive committee and were ratified at the 11th HAPA Annual Meeting on May 25th 2010 in New Orleans, LA

Members Present: Drs. Cassimatis, Cardasis, Markos Emmanouel, Katina Matthews-Ferrarri, Fouras, Isabella Kanellopoulou, Lymberis, Papas, Petrides, Vidalis,  Zaphiropoulos as well as Mrs. Stella Kaliora and Athena Papas.

Members Unable to attend: Drs. Georgopoulos, Stratas, Latoussakis Alexopoulos, Agalianos, Christodoulou (Immediate Past President HPA), Lyketsos, Cardasis, Kalogerakis, Papastrat, Papakostas and Zervas.

Invited Guests: HAPA appreciates the presence of APA President Nada Stotland, MD and Drs. Leah Dickstein, Carol Bernstein who were able to briefly come to our meeting.

Invited Guest Professor J.K.Trivedi of India send his regrets as he was unable to attend.

(1) Introductions

HAPA President Dr Cassimatis opened the meeting at 7:10 PM. He welcomed our members, our guests and our speaker Professor Nemeroff. He noted that this is his first meeting as HAPA President. He noted that we are celebrating our organization’s ten year birthday. HAPA is a small all volunteer organization but it has made considerable contribution by bridging the gap between Hellenic psychiatrists of the US with our colleagues in Greece and in the Diaspora. This anniversary meeting was hoped to be very well attended but the scare about the “swine flu” coupled with more recent global terrorist attacks has made flying to the US problematic for many in Greece and elsewhere. He stressed that HAPA will continue thru these hard times thanks to the committed work of the dedicated members of the HAPA executive committee and expressed his appreciation for their service to HAPA. Among the goals of his presidency  membership development is central.

Dr. Cassimatis announced that he had accepted, with regret, the resignation, for personal reasons, of HAPA President-Elect Vassilios Latoussakis, MD, effective at the conclusion of this meeting. He noted that Dr Latoussakis is a founding member of HAPA who served HAPA in a leadership position with devotion and distinction. He will continue as a HAPA member.

(2) HAPA 2008 Annual Meeting Minutes

Dr Lymberis presented the minutes of the 2008 HAPA Annual Meeting. The meeting was  in San Diego, CA. The Minutes were posted on the HAPA Website and copies were provided at the meeting. They were approved as written.

(3) HAPA Treasurer’s Report

Dr Papas will submit his report for the 2008 and 2009 annual meeting expenses and the dues income for 2008 and 2009.

Dr. Lymberis noted that since 2002 HAPA has had no outside financial support. HAPA is a small APA Affiliate member organization that is entirely supported by member dues and by the generosity of all the HAPA members who made and continue to make voluntary contributions. Specifically, HAPA gratefully acknowledges the generous contributions of Drs. Nicolas Stratas and Katina Matthews-Ferrari. Each has contributed $500.00 to HAPA.

Dr. Lymberis noted that since 2007 the cost for dinner meetings has increased dramatically because there is a requirement for a minimum of 25 dinners for a dinner meeting reservation. Since there is no way to predict that we will have 25 or more members attending, HAPA ends up having to pay the full cost of the reservation. Clearly our dues of $50.00 cannot cover our expenses. HAPA had a deficit in 2008. That deficit was covered by a special contribution of $100.00 by each of your HAPA officers. It is anticipated that HAPA will again have a deficit in 2009.

All HAPA work is done by email. HAPA conference calls are at no cost to HAPA because of the generocity of our HAPA Presidents. Special THANKS go to both Drs. Petrides and Cassimatis who personally are arranging the monthly HAPA executive committee conference calls.

Currently, the HAPA Annual dinner meeting is the main expense of HAPA. The publication of the HAPA Newsletter was discontinued in 2005 due to luck of a funding source. In addition we had to discontinue the offering of CME credits because of the costs involved. Given our deficits the cost of the dinners at the Annual meetings will be re evaluated and a decision will be made about continuing this in the future.

The updating of the HAPA website is an essential future project because all HAPA correspondence is by email.  An updated website will help us further improve communications and dues collection. The website was originally donated by Dr. Lymberis in 1999 at the time of the founding of HAPA. Clearly, it now needs to be updated. Hopefully it will be updated by the 2010 HAPA Annual meeting. Finally, we are minimizing mailing costs, trying to keep them to a bare minimum, by moving all communications to the web with an updated HAPA website. Please make sure you give us your email.

(4) Updates on Psychiatry from Greece

I) Report by Professor Christodoulou

Professor Christodoulou is one of the founding members of HAPA. He has been devoted to the growth of HAPA and been present at all of the past HAPA meetings. He and his lovely wife Gabriella were not able to attend this year. He remains a very active member of the HAPA leadership serving as a crucial link for HAPA with both Greek and Europian psychiatric organizations as well as the WPA thru his various leadership positions in national and international psychiatric organizations.

Professor Christodoulou was the Chair of the Program Committee of the highly successful 20th Pan-Hellenic Psychiatric Congress that took place in Crete on 5/14/08 to 5/18/08. HAPA actively participated as cosponsor in this as well as in past Pan Hellenic Congresses.  Our President Dr. Cassimatis as well as Drs. Petrides and Lymberis gave individual presentations and participated in the  HAPA sponsored panel on “Post Graduate Psychiatric Education in the US”. The next Congress is scheduled for 2011. HAPA hopes again be an active participant

Professor Christodoulou has organized several meetings in Greece for the rest of 2009: a) the World Congress of Mental Health which is sponsored by the World Federation of Mental Health. This meeting will be held in Athens in September 2009 (9/02-9/06) For more information check their website: www.wmhc2009.com, b) the Second Congress of Eastern Europe will be held in Moscow, Russia in October 2009 (10/27 –10/30)

For more information check their website:  www.paeeb2009moscow.ru. These are very interesting meetings. HAPA is a cosponsor and members are encouraged to attend.

II) Report by Dr. Vidalis

Dr. Vidalis has also been a devoted, founding member of HAPA. He is HAPA’s link with the psychiatrists in Thessaloniki and the north of Greece.  His presence at our Anniversary meeting was especially appreciated since he was the only HAPA member who was able to come from Greece this year.

Dr. Vidalis is a distinguished leader in the Pan Hellenic Hospital Psychiatry organization. He is the organizer of many highly successful meetings for this group and the editor of the Journal. This year their meeting is taking place in the island of Corfu in late May 2009. HAPA is a cosponsor of that meeting as well of his yearly “Seasons of Psychiatry” psychiatric meetings. These meetings usually take place in beautiful areas in Greece or in other Mediterranean countries. For more detailed information on current and future meetings see their website: www.4sp.gr.

At the 2008 HAPA Annual meeting, Dr. Vidalis had proposed the establishment of the office of HAPA Co-Chair from Greece or VP from Greece. In his view such an office is needed to help promote interest in HAPA among Greek psychiatrists by providing a more direct leadership stake in the organization. It was pointed out that presently all three of the HAPA Councilors are from Greece and that all offices of the HAPA leadership (including President Elect) are open to all HAPA members including Greek psychiatrists.

The HAPA Executive committee reviewed the HAPA By-Laws and drafted, in consultation with Dr. Vidalis, an Amendment. That amendment was presented at this meeting. However, given the absence of any other members from Greece the issue was tabled for a future meeting when more Greek HAPA members would be present.

(5) HAPA Scientific Program

Dr Papas introduced our presenter Charles B. Nemeroff, MD  Professor of Psychiatry at Emory. He made a very scholarly detailed presentation on Neuroscience and psychopharmacology under the title: “Psychopharmacology in the 21^st Century: Towards Personalized Medicine in Psychiatry”.  An open active discussion followed his presentation.

(6) Other Business:

There was no new business

(7) Adjournment

Dr Cassimatis thanked our speaker and all members for their participation. He invited all to the 2010 HAPA meeting. He adjourned the meeting at 10:15PM

The next HAPA Annual Meeting will take place in New Orleans, LA in May 2010 in connection with the APA 2010 Annual Meeting.

Respectfully Submitted

Maria T. Lymberis, MD

HAPA Founder & Past President

“NOTE: This draft of the 2008 9th 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 10th HAPA Annual Meeting in May 2009 in San Francisco, CA

Honorary Guests Present: Juan Enrique Mezzich, MD President of the World Psychiatric Association; Roy Abraham Kallivayalil, MD President, Indian Association for Social Psychiatry, Professor & Head, Dept of Psychiatry, Medical College, Kottayam, India; George Bartzokis, MD HAPA presenter.

Members Present: Drs. Alexopoulos, Agalianos, Christodoulou (Immediate Past President HPA) and Mrs Christodoulou, Cassimatis, Lymberis, Stratas, Latoussakis, Petrides, Papas and Mrs Papas, Papastrat.

Members Unable to attend: Drs. Lyketsos, Cardasis, Kalogerakis, Zaphiropoulos, Georgopoulos, Papakostas.

(1) Introductions

HAPA President Dr Petrides opened the meeting at 7:10 PM. He welcomed our members and our special honorary guests. He noted that this is his last meeting as HAPA President and noted that while our

organization has made it to age 9 years, which is a considerable achievement for our small all volunteer organization, there is still a lot of work that needs to be done primarily in membership recruitment and retention of members in the USA. He promised to continue to actively participate as the immediate Past President in the years ahead and thanked all members of the Executive committee for their dedication and hard work.

(2) HAPA 2006 Annual Meeting Minutes

Dr Lymberis presented the minutes of the 2007 HAPA Annual Meeting which took place in San Diego, CA. The Minutes were posted on the HAPA Website and copies were provided at the meeting. They were approved as written.

(3) Treasurer’s Report Dr Latoussakis presented his report:

HAPA Balance from 2006: $1,734.86 (expenses of 2006 meeting)

HAPA Dues Income during 2007: $2,006.00 HAPA balance as of 5/15/07 $ 2,094.86

HAPA Expenses in 2007: $3,493.55 (expenses of 2007 meeting)

HAPA Dues collected in 2008: $525 .00

Dr. Lymberis noted that since 2002 HAPA has had no outside financial support. HAPA is now a member organization entirely supported by member dues. She urged that we all become involved in recruiting new members. She noted that HAPA provides a valuable service by linking psychiatrists in the US with those in Greece and the rest of the world. HAPA members can support our organization by letting fellow Greek psychiatrists and others know of our programs. HAPA is promoting and has cosponsored some of the recent meetings in Greece of the Hellenic Psychiatric Association and other Greek psychiatric organizations such as the Pan-Hellenic Society of General Hospital Psychiatry.

Dr. Lymberis noted that for the second time this year the HAPA executive committee voted to charge for the cost of the dinner, in addition to HAPA dues. The costs of the HAPA meetings have gone up dramatically. Our dues of $50.00 are no longer sufficient to cover our expenses. HAPA is anticipating a deficit in 2009. The HAPA dues of $50.00/per year have remained the same since our founding in 1999, while our costs for the annual meeting now about $2,000.00 to $3,000.00 per meeting, without any staff or honoraria. All of the work of HAPA is done by the HAPA officers by email and conference calls that are of no cost to HAPA. Our only costs are our annual meeting and our website. All of our communications are by email. We keep mailing costs to a bare minimum.

(4) Updates on Psychiatry in Greece

Professor George Christodoulou, a vital supporter since the founding of HAPA, was introduced and addressed the meeting. He is currently running for President of the WPA. We are very proud of his work. He is the President of the Hellenic Centre for Mental Health and Research, the Immediate Past President of HPA and the President of the Psychiatric Association for Eastern Europe and the Balkans. He is also chairing the Committee on Ethics of WPA as well as chairing the European Division of the Royal College of Psychiatrists.

Professor Christodoulou noted that the upcoming 20th Pan-Hellenic Psychiatric Congress in Crete, May 14 to May 18 2008, features several HAPA presenters and a panel on Post Graduate Psychiatric Education with HAPA and HPA presenters. For 2009 he is organizing two very interesting meetings: the World Congress of Mental Health is meeting in Athens. Dates: September 2-6 2009. Contact them directly by their web-site: www.wmhc2009.com The Second meeting is the Congress of Eastern Europe in Moscow Russia in October 27-30th 2009. Contact them directly by their website: <www.paeeb2009moscow.ru>.

Drs Vidalis and WPA President Dr. Mezzich also briefly addressed our meeting with news about their organizations and upcoming meetings.

Dr. Vidalis proposed the establishment in HAPA of the office of HAPA Co-Chair for Greece. His proposal was accepted for consideration. The HAPA Executive committee will review the HAPA By-Laws and draft a proposal, in consultation with Dr. Vidalis, for discussion at the next HAPA Annual meeting. Furthermore, Dr. Vidalis noted that he is organizing several meetings in Greece including the meeting of the General Hospital Psychiatry Conference, in Corfu during May 2009, and four other meetings for the program “”The Four Seasons of Psychiatry”” details as to location and time to be announced in the future.

(5) HAPA Scientific Program

Dr Lymberis introduced our presenter George Bartzokis, MD Professor of Neurology & Psychiatry at the UCLA Brain Research Institute. He made a very fascinating and informative presentation on “Brain aging and age-related risk factors for prevalent neurodegenerative disorders: Implications for treatment and prevention”. His talk focused on myelination. He noted that myelination has markedly expanded the timeline of what is considered normal human brain development. He discussed the unique process of human myelination and its role in producing the cortical environment that triggers the Alzheimer’s disease. He concluded with a discussion of the impact of genetic and non-genetic risk factors on the age of onset of Alzheimer’s disease.

An open lively discussion followed. He further explained that “myelination of the cortex (necessary to become adults) sets up the necessary environment to develop the Alzheimer’s pathology. As we get older the myelin breaks down. The actual pathology (plaques and tangles) develops as a result of the myelin breakdown and continual repair attempts that follow. That is why Alzheimer’s disease does not occur in 10 year olds even when they have familial Alzheimer’s disease genes – the myelination of the cortex must occur first. It is a permissive step. The myelin breakdown is what gives us the functional deficits – long before the pathology starts killing neurons. Also, the reasons I call it “”myelin breakdown”” as opposed to “”de-myelination”” is 1) to differentiate this from the MS process where white blood cells, phagocytes, remove the myelin, 2) the fact that the myelin is still there contributes to the process that produces the lesions, and 3) the breakdown can impact the function of myelin and therefore have symptoms appear before the loss of neurons and the appearance of permanent disability”

Dr Bartzokis presentation was clearly outstanding. His talk received very high marks for both content and delivery by all in attendance.

(6) HAPA Elections

Dr. Cassimatis chair of the HAPA Nominating committee presented the nominations for HAPA Officers for 2008-2011

President Elect: Vassilis Latoussakis, MD

Treasurer: Arthur Papas, MD Secretary: Athanasios Vidalis, MD Councilor: open for nomination from the floor

There was an extensive discussion regarding the office of Secretary. Dr. Vidalis expressed his preference to continue as a councilor for another term. Katina Mathews-Ferrari, MD was nominated for the office of HAPA Secretary and Athanasios Vidalis, MD was nominated for HAPA Councilor for another term. Both accepted their nominations and were unanimously elected.

Dr Petrides congratulated all for their election. He then passed the office of the President to Dr. Cassimatis who thanked Dr Petrides for his service to HAPA. Dr Cassimatis briefly outlined the goals of his presidency and stressed his determination to achieve an increased HAPA membership and improve HAPA’s financial position.

(7) Adjournment

Dr Cassimatis adjourned the meeting at 10:10PM The next HAPA Annual Meeting will take place in San Francisco, CA in May 2009 in connection with the APA 2009 Annual Meeting.

Respectfully Submitted Maria T. Lymberis, MD HAPA Founder & Past President”

5/22/07 SAN DIEGO, CALIFORNIA

NOTE: This draft of the 2007 HAPA Annual Meeting Minutes was approved by the HAPA executive committee. The Minutes were posted on the HAPA website and were ratified as written during the 9th HAPA Annual Meeting in May 2008 in Washington DC

Honorary Guests Present: Governor & Mrs. Dukakis, Larry Tye, Konstantinos Roditis, Juan Enrique Mezzich MD (WPA President), Marcia Goin, MD (Past APA President), Drew Clemens, MD, Richard Shadoan & Mrs Shadoan,  Thomas Ciesla, MD (APA Trustee Area VI).

Members Present: Drs. Agalianos, Christodoulou (Immediate Past President HPA) and Mrs Christodoulou, Cassimatis, Lymberis, Samolis, Gatos, Pantelis (Professor from Melbourne Australia), Petrides, Roditis, Gross (SCPS President), Kader, Tsapakis, Locateli, Mariari, Galton, Kaliora, Vidalis, Mawhinney (President of CPA) and Mrs Mawhinney as well as Mrs Mary Thurrell (Past President of APAA).

Members Unable to attend: Drs. Lyketsos, Cardasis, Kalogerakis, Kentros, Stratas, Kanellopoulou, Kachoris, Zaphiropoulos, Georgopoulos, Papakostas, Latousssakis, Papastrat.

(1) Introductions

HAPA President Dr Petrides opened the meeting at 7:15PM.
He welcomed our members and our special honorary guests
He noted that this is an unusual occasion for two reasons. First, in having the honor of hearing first hand the experiences of a patient who was successfully treated with modern ECT but especially in having such a prominent Greek American family go public about psychiatric illness and its treatment. He noted that we will hold an abbreviated members meeting to leave maximum time for the presenters.

(2) HAPA 2006 Annual Meeting Minutes

Dr Lymberis presented the minutes of the 2005 HAPA Annual Meeting which took place in Toronto Canada. The Minutes were posted on the HAPA Website and copies were provided at the meeting. They were approved as written.

(3) Treasurer’s Report

Dr Latoussakis was unable to attend.
Dr Lymberis presented his report:

HAPA Balance from 2005: $4,110.30
(after expenses for the 2005 meeting)

HAPA Dues Income during 2006: $1,523.59

HAPA Expenses in 2006: $3,899.03
(expenses 2006 meeting)

HAPA Dues collected in 2006: $360.00

HAPA balance as of 5/15/07 $ 2,094.86

Dr. Lymberis noted that since 2002 HAPA has had no outside financial support. HAPA is now a member organization entirely supported by member dues. She urged that we all become involved in recruiting new members. She noted that HAPA’s mission is vital in this world of interconnections. HAPA provides a valuable service by linking psychiatrists in the US with those in Greece and the rest of the world. HAPA members can support our organization by letting fellow Greek psychiatrists and others know of our programs and by helping to promote the various programs offered by HPA and the Pan-Hellenic Society of General Hospital Psychiatry in Greece.

Dr. Lymberis noted that for the first time the HAPA executive committee asked that members pay an additional charge of $15.00 to cover the cost of the dinner for today’s meeting. Up until this time the member annual dues of $50.00 have covered the dinner. However, our dues have not been raised since our founding in 1999 while our costs connected to the annual meeting have gone up.
It should be noted that HAPA has no paid staff and that the work is done by the HAPA officers mostly by email and thru our HAPA website

(4) Updates on Psychiatry in Greece

Dr. Christodoulou gave a comprehensive report on the various activities of organized psychiatry in Greece. Specifically that under the umbrella of the World Psychiatric Association, the WPA Institutional Program on Disasters under his leadership, in collaboration with the Hellenic Psychiatric Association was able to get the three national Psychiatric Associations of the three warring Middle East nations (Lebanon, Israel and Palestine) to independently produce a Declaration Against War. This is a small but impressive step in the right direction. Psychiatry was able to bring together all three on an agreement on the need for prevention of the catastrophic personal and psychiatric damages that the ongoing war is inflicting on countless innocent civilians on all sides in that region.
Dr Christodoulou note that there are excellent meetings of psychiatric interest coming up in Greece: The 20th Pan-Hellenic Psychiatric Congress will take place in Crete from May 14 to May 18 2008. More details will be posted on the HAPA Website when available. In 2009 he will be the organizer of the World Congress of Mental Health. This meeting is sponsored by the World Federation of Mental Health. It will be held in Athens in September 2009 (9/16-9/20). If you plan to attend, check the HAPA website in 2008 for more information.

Drs Vidalis and WPA President Dr. Mezzich also briefly addressed our meeting with news about their organizations and upcoming meetings.

(5) HAPA Scientific Program

Dr. Petrides introduced our three presenters. Mrs. Kitty Dukakis spoke first. She gave a very moving account of her personal battle with depression and how, finally, reluctantly, she agreed to ECT.
That treatment has changed her life.
Governor Dukakis spoke second. He gave the inside story of being the spouse who was witnessing the ravages of depression that were transforming his vibrant wife and her dramatic return to her usual self with ECT. Larry Tye as the co author with Kitty Dukakis of the much acclaimed book “”Shock: The Healing Power of Electroconvulsive Therapy”” detailed his involvement in the project of writing this book.
Dr. Petrides who is intimately involved in research on ECT and a member of the national multicenter CATE study on ECT was the discussant. He presented the history, the stigma associated with this treatment modality and the data as to its efficacy.
An open discussion followed with members actively interacting with the presenters.

(6) Adjournment

The meeting was adjourned at 10:00PM
The next HAPA Annual Meeting will take place in Washington, DC in connection with the APA 2008 Annual Meeting.

Respectfully Submitted
Maria T. Lymberis, MD
HAPA Founder & Past President”