bluuebunny/crossref_metadata_2025_split huggingface dataset:
The trainee perspective
Authors: Phanasathit M. 
Published: May 2016

In Asia, while the postgraduate training in psychiatry employs the World Psychiatric Association (WPA) core training curriculum for psychiatry as a standard course, some adjustment to the course is required for the unique demographic and sociocultural characteristics of its region.From the small group work in the 14th course for the academic development of psychiatrists (CAD), organized by the Japan Young Psychiatrists Organization (JYPO) in 2015, young psychiatrists form Indonesia, Japan, Philippines, South Korea, Taiwan and Thailand agreed that the core psychiatric curriculum must include both general and psychiatric knowledge which are fundamental to clinical practice and continuous learning. General knowledge consists of knowledge management, academic skills, epidemiology, research methodology and statistics, evidence-based medicine, bio-ethic and medicolegal issues, professionalism, and medical anthropology, while psychiatric knowledge incorporates basic science, diagnostic assessment skills, etiopathogenesis, pharmacological and non-pharmacological treatments, disease prognosis, and mental health promotion and prevention. Moreover, the curriculum for junior psychiatric residents has to be composed of courses from various departments that encourage them practice in holistic care and multidisciplinary approach including emergency medicine, internal medicine, neurology, pediatrics, community based medicine, anesthesiology, radiology and palliative care. For senior psychiatric residents, the training program should consist of in-depth psychiatric knowledge, general psychotherapy concept and basic skills, and free elective subjects.Since Asia is different from Europe in terms of large population, shortage of psychiatrists, aging society, racial and cultural diversity, and high risk of natural disasters; the postgraduate training in psychiatry in Asia should focus on the subjects regarding health economy, geriatric psychiatry, cultural and trans-cultural psychiatry, ethnopsychopharmacology, disaster psychiatry and mental health. Furthermore, the cooperation among Asian countries should be promoted in order to initiate knowledge exchange and research collaboration. These could contribute to the sustainable advancement of Asian psychiatry and mental health in the future.Disclosure of interestThe author has not supplied his declaration of competing interest.
Psychiatric trainees’ view on a European curriculum of psychiatry
Authors: Pinto da Costa M. 
Published: May 2016

The European Federation of Psychiatric Trainees (EFPT) represents the consensus of psychiatry trainees associations across more than 30 European countries, advocating for the improvement and harmonization of psychiatry training across Europe. This federation has as priority to get direct feedback from psychiatry trainees, analyzing the concerns related to psychiatry and training in Europe, collaborating with other national and international partners to translate trainees’ views into action, while offering trainees several opportunities.Surveys of psychiatry trainees show that the main concerns around Europe revolve around differences of duration of training in the different countries, the discrepancies between the European training standards, the national programmes and the real experience of trainees. Likewise, levels of recruitment into psychiatry and inadequate working conditions also concern trainees, especially at the current times of economic challenge, where the choice to migrate abroad is quite frequent. Nevertheless, the involvement of psychiatry trainees in the development of national programmes and in the quality assurance of training varies significantly around Europe.This presentation will highlight the current differences observed in the structure, content and duration of psychiatry training programs in Europe, reporting trainees’ views on a European curriculum of psychiatry, and exploring mechanisms to evaluate and harmonize the postgraduate training in Europe.Disclosure of interestThe author has not supplied his declaration of competing interest.
Can alcohol-dependent patients really reduce their alcohol consumption over time?
Authors: Mann K. 
Published: May 2016

IntroductionTreatment of alcohol dependent patients is moderately successful but it only reaches about 10% of the population in need. A new harm reduction strategy aims at abstinence in the long run but claims to benefit patients already early on by reducing their alcohol consumption.ObjectivesA brief outline of the debate on abstinence versus controlled drinking will be followed reporting several RCTs striving for reduced drinking in alcohol dependent patients.AimsThe participant will find guidance whether and how to treat patients following this new approach.ResultsStudies testing behavioural treatments and counselling (MATCH, UKATT) indicate that a reduction over time is possible. Using nalmefene (a mu and delta opioid antagonist and a partial agonist) RCTs with more than 2500 patients were performed showing a benefit over placebo. On this basis the EMA approved this drug for the reduction of alcohol consumption in alcohol dependent patients. Other compounds such as naltrexone showed similar effects in smaller trials but are not approved for reduction. More studies testing further compounds are underway.ConclusionsThis new approach has the potential to lower the barriers which to date prevent many patients from accepting treatment for their alcohol problems. Two research questions warrant further study: (1) does the reduction in alcohol consumption translate into health and other benefits, and (2) are there specific subgroups of patients who benefit more than others. Preliminary answers will be given in the lecture.Disclosure of interestThe author has not supplied his declaration of competing interest.
Should all psychiatrists be skilled to practice psychotherapy?
Authors: Sönmez E. , Gargot T. 
Published: May 2016

Psychiatrists have a unique place in the spectrum of mental health services, as being able to integrate psychotherapy and pharmacotherapy in clinical practice. It is through psychotherapy training that a trainee gains optimal communicative skills and competence in establishing therapeutic alliance with a patient. It helps developing empathic understanding, which is very important for a good collaboration and enable understanding, diagnostic and treatment. It improves trainees’ own insight. All are these fundamental aspects of a biopsychosocial approach of psychiatry.In many countries psychiatry trainees have a positive attitude towards psychotherapy during their training. Moreover, patients often prefer and adhere to combined psychotherapy and medication than split-care treatments. Research in psychotherapy provides ample evidence that these treatments are effective. The UEMS considers psychotherapy education as mandatory. EFPT advocates that all trainees must gain competence in at least one recognised form of psychotherapy and have a basic knowledge for other forms. Altogether, there is a consensus among all actors of mental health services that psychotherapy training is essential and should be improved. Yet, it is still far from being a priority in psychiatric training and is subdued by biological training and research, which is easier, faster and prevailing in training institutions. Also, psychotherapy training is found less affordable by trainees.With collaboration from other organizations, EFPT aims to improve standards of psychiatry training, including psychotherapy. We present some initiatives led by UEMS, EPA, WPA and ECNP. Today's technology allows trainees to reach various psychotherapeutic training availabilities, including online tools (Webinar, MOOCs, online guidebooks) and international courses. It is advisable that training institutions devote more time on psychotherapy training and supervision, associations provide costly training availabilities or scholarships, encourage more scientific research on psychotherapeutics and take into account the progress of research in psychology and neuroscience [1–5].Disclosure of interestThe authors have not supplied their declaration of competing interest.
Involving people with intellectual disabilities in the formal assessment of psychiatrists’ skills
Authors: Soni S. , Hall I. , Doulton P. , Bowie P. 
Published: May 2016

PurposeIt is widely recognised that people with intellectual disabilities receive a poorer quality of healthcare than their non-disabled counterparts. Training for healthcare professionals in intellectual disability is often scant or non-existent. The purpose of this work is to explore the usefulness of employing actors with intellectual disabilities as simulated patients in the assessment of trainee psychiatrists.Design/methodology/approachThe development of a structured clinical exam “station” designed to assess the ability of trainee psychiatrists to communicate with a simulated patient played by an actor with an intellectual disability is described. The paper also assesses the potential benefits of this kind of assessment and the experience of actors and examiners taking part in this process.FindingsThe station was found to perform well in discriminating between candidates of various abilities and was well received by actors, examiners and observers. The station is now routinely used in the formal assessment of trainee psychiatrists in the UK.Practical implicationsThe use of people with intellectual disabilities in training and assessment appears to be advantageous in terms of improving knowledge, attitudes and skills amongst healthcare professionals and gives increased opportunities for people with intellectual disabilities to undertake valued social roles.Originality/valueFew institutions currently employ actors with intellectual disabilities as simulated patients as part of their training programmes and as a result there is little in the way of literature on this subject. This paper describes an alternative approach to teaching and assessment which falls in line with recommendations from the UK Department of Health to involve service users in the training of healthcare professionals.Disclosure of interestThe authors have not supplied their declaration of competing interest.
GRIN2B mediates susceptibility to affective problems in children and adolescents
Authors: Nobile M. 
Published: May 2016

ObjectivesAssociation studies have implicated the N-methyl-D-aspartate receptor 2B subunit gene (GRIN2B) as candidate for different brain illnesses, also including both internalizing and externalizing disorders. Here, we explored the association between selected SNPs of GRIN2B (rs5796555-/A; rs1012586C/G; rs2268119A/T; rs2216128A/G; rs11609779C/T; rs2192973G/A) and attention problems in children an adolescents as assessed by CBCL 6/18 (Achenbach and Rescorla, 2001).MethodsIn a large cohort of 320 Italian nuclear families selected from an ongoing comprehensive project on child and adolescent psychopathology performed at two sites of our Institutes (BP and UD), we performed a family-based association study to determine whether the GRIN2B gene influence and/or mediates susceptibility to attention problems through time. Genetic association was investigated by the quantitative transmission disequilibrium test (QTDT, version 2.5.1; Abecasis et al., 2000). Quantitative traits were analyzed using the ‘-wega’ and the ‘-ao’ options. Empirical P-values were computed from 10,000 Monte-Carlo permutations, and the significance levels were adjusted by the false discovery rate method (Storey, 2002) applied to the tests performed for each marker (i.e., 8 phenotypes) at two different point times. Latent profile analysis was performed to assess the effect of gene on different trajectories over time. The effect of environmental determinants was also evaluated.ResultsEvidence for significant association of GRIN2B-rs5796555-/A was found with attention problems both at first and second evaluation. Latent profile analysis suggested significant association with specific trajectories and specific environmental factors.ConclusionsThese results provide preliminary evidence of an association between the GRIN2B polymorphism and continuity of attention problems throughout adolescence within an Italian population of referred children and adolescents, suggesting that the GRIN2B genes could play a role in susceptibility to attention problems during developmental age.Disclosure of interestThe author has not supplied his declaration of competing interest.
Brain glutamate levels and antipsychotic response in schizophrenia
Authors: Egerton A. 
Published: May 2016

There is considerable interest in identifying biomarkers of antipsychotic response in schizophrenia. Glutamate is one key candidate. The development of brain imaging techniques for measuring brain glutamate levels has allowed this hypothesis to be tested directly in patients. This talk will present our ongoing research examining the relationship between brain glutamate levels and antipsychotic response in first-episode psychosis and in treatment-resistant schizophrenia. I will summarise our results from both our completed and ongoing studies, to consider whether glutamate imaging might be useful in the future to identify patients who would benefit from non-dopaminergic antipsychotic drugs and inform novel, glutamate-based, treatment strategies.Disclosure of interestThe author has not supplied his declaration of competing interest.
Hikikomori and modern-type depression in Japan
Authors: Kato T. 
Published: May 2016

Maladaptive social interaction and its related-psychopathology have been highlighted in psychiatry especially among younger generations. “Hikikomori” defined as a syndrome with six months or longer of severe social withdrawal was initially reported in Japan, and the prevalence rate has been reported as 1.2% in Japanese population. The majority of hikikomori patients are adolescents and young adults who become recluses in their parents’ homes for months or years. They withdraw from contact with family, rarely have friends, and do not attend school or hold a job. An international vignette-used questionnaire survey indicates the spread of hikikomori in many other countries (Kato et al. Lancet, 2011; Kato et al. Soc Psychiatry Psychiatr Epidemiol, 2012). In addition, our international clinical studies have revealed the prevalence of hikikomori outside Japan (Teo et al., 2015). On the other hand, a novel form of maladaptive psychopathology, called modern-type depression has emerged in Japan (Kato et al. J Affect Disord, 2011; Kato et al. Psychiatry Clin Neurosci, 2016).In this presentation, I will introduce “Hikikomori” and “modern-type depression” in Japan, and also propose novel diagnostic/therapeutic approach against them.Disclosure of interestThe author has not supplied his declaration of competing interest.
After all, is E-Mental Health capable of making a paradigm shift?
Authors: Krausz M. 
Published: May 2016

Only a very small percentage of adolescents and young adults with mental challenges is able to access specialized care. Access is limited due to a lack of capacity but also internal hurdles and stigma especially among young males. The web creates a new environment for them, which is defining a new culture of communication and interaction. The majority is using smart phones to access the Internet and make that their main communication device.Walkalong is a web-based platform, which aims to provide a range of opportunities and tools for youth with especially mood challenges. These tools include screening and assessment, online resources and all kind of orientation and interaction for informed decision-making.We are working on that to develop a framework for better online-based mental health care including useful tools beyond crisis based on the principles of empowerment and strength based approaches.Disclosure of interestThe author has not supplied his declaration of competing interest.
Digital healthcare: Fools gold or a promised land?
Authors: Wise M. 
Published: May 2016

Digital healthcare is the use of technology to deliver healthcare. There are many facets of it. The paradigm of care at a distance e.g. a live interface is the most understood, whether it is the old fashioned analog phone call or that of todays Millenial who ‘get’ Skype or see video calling as a day to day reality.This has moved to non-live uses, asynchronous, the modern version of written communication, email, videomessage, Instagram, twitter or any one of a multitude of social media.It has progressed beyond that though to a plethora of devices, apps and cross breeds that promise to maximise your patients health, and often your practice income! Grand claims, if not ones supported by the evidence.They have broadened the range of providers from the plain vanilla (group) therapist to the Cyber support groups; from patient information sheets, to sophisticated hyperlinked, video embedded ‘hope box’, or manual on your phone. They have changed in vivo exposure from what was limited by travel time, to what is limited by the programmers imagination.Telemdecine can connect patients and providers worldwide – how can that not be an amazing promise, today's truly outstanding goal – tomorrow commonplace event.The promise of near infinite data; if only we can measure enough, we can treat better, may hold true for a physical paradigm such as mobile ECG or BP monitoring, but is it true for mental health?Science is not a door to infinite wisdom, but a rescue from unending ignorance. The evidence is that technological innovations are not a magic solution but tools widening access, they are to travel what the motorway is to the dust track. They are an equaliser in that more people can be reached than ever before–but they do not replace human skill and ability.By December 2015, 500 million smartphone users worldwide will be estimated to be using a health care application. Yet, there is no evidence of a systematic evaluation of a fraction of these apps. They may not be snake oil salesman, but has the placebo effect graduated from molecules to ones and zero's?We will explore the evidence to understand some of the promises and the realities of what was once Tomorrows World, here today.Disclosure of interestThe author has not supplied his declaration of competing interest.
Medical students choice of psychiatry – an international survey
Authors: Bhugra D. 
Published: May 2016

The appeal of psychiatry as a speciality varies around the globe for a number of reasons. In a majority of countries, medical students are reluctant to choose psychiatry and this has become a much more evident matter of concern in the past three decades. The factors, which affect the choice of psychiatry as a specialty by medical students include external and internal stigma, quality of teaching of the subject as well as research exposure and clinical experience during placements. In many countries, a placement may last only two weeks and the exposure is to patients in asylums, whereas a majority of psychiatric conditions are treated in primary care. In addition, personal factors such as the ability to deal with openness and ambiguity play a role in the choice of speciality. A study in 19 countries to explore factors prior to entering medical school, experiences in medical school and postgraduate in the choice of the subject showed that those medical students who are likely to choose psychiatry fall into three major categories:– those who had decided prior to joining medical school that they wanted to choose psychiatry;– those who decide during medical school placements and, finally;– those who select the specialty after having finished their medical school training.The latter group has two further subgroups: one, which falls passively into psychiatry and another who make an active choice to take it up. Among 2198 students who participated, 4.5% of the sample planned to become psychiatrists, with a further 15% considering it as a possible career. Women (21%) were more likely to consider psychiatry than men (16%). Key factors associated with choosing psychiatry were personal as well as based on teaching/learning experiences. In order to recruit into psychiatry, better teaching, exposure to common mental disorders and small research projects may prove to be helpful.Disclosure of interestThe author has not supplied his declaration of competing interest.
Methylome modifications in monozygotic twins and in depression
Authors: Fañanás L. , Córdova-Palomera A. 
Published: May 2016

Epigenetics is the study of gene expression changes that are produced by heritable, though potentially reversible, modifications of chromatin structure or DNA methylation. DNA methylation is interesting in epidemiological studies, due to its accessibility and since previous evidence indicates that large inter-individual differences in methylation levels at some loci may correlate with phenotypic plasticity in changing environments.Prior genome-wide methylomic research on depression has suggested that, together with differential DNA methylation changes, affected co-twins of monozygotic twin pairs have increased DNA methylation variability, probably in line with theories of epigenetic stochasticity. However, the putative biological roots of this variability remain largely unexplored.This study evaluate whether DNA methylation differences within MZ twin pairs were related to differences in their depressive status. Genome-wide DNA methylation levels were measured in peripheral blood of 34 twins (17 MZ pairs) using Illumina Infinium Human Methylation450 Beadchip. Two analytical strategies were used to identify differentially methylated probes (DMPs) and variably methylated probes (VMPs).The majority of the DMPs were located in genes previously related to neuropsychiatric phenotypes, such as WDR26, a GWAS hit for MDD whose expression levels have been found altered in blood of depressed individuals.VMPs were located in genes such as CACNA1C, IGF2 and the p38 MAP kinase MAPK11, showing enrichment for biological processes such as glucocorticoid signaling.The findings expand on previous research to indicate that both differential and variable methylation may play a role in the etiopathology of depression, and suggest specific genomic loci of potential interest in the epigenetics of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.