Education and Training in Addiction Medicine and Psychology across Europe: A EUFAS Survey

Introduction: Training in addiction medicine and addiction psychology is essential to ensure the quality of treatment for patients with substance use disorders. Some earlier research has shown varying training between countries, but no comprehensive study of addiction training across Europe has been performed. The present study by the European Federation for Addiction Societies (EUFAS) aimed to fill this gap. Methods: A Delphi process was used to develop a questionnaire on specialist training in addiction treatment in 24 European countries. The final questionnaire consisted of 14 questions on either addiction medicine or addiction psychology, covering the nature and content of the training and institutional approval, the number of academic professorial positions, and the estimated number of specialists in each country. Results: Information was not received from all countries, but six (Belgium, Denmark, Ireland, Italy, Poland, and Romania) reported no specialized addiction medicine training, while 17 countries did. Seven countries (Belgium, France, Ireland, Italy, Russia, Switzerland, and the Netherlands) reported no specialized addiction psychology training, while 14 countries did. Training content and evaluation methods varied. Approval was given either by governments, universities, or professional societies. Eighteen countries reported having professorships in addiction medicine and 12 in addiction psychology. The number of specialists in addiction medicine or psychology varied considerably across the countries. Discussion: The survey revealed a large heterogeneity in training in addiction medicine and addiction psychology across Europe. Several countries lacked formal training, and where formal training was present, there was a large variation in the length of the training. Harmonization of training, as is currently the case for other medical and psychology specializations, is warranted to ensure optimal treatment for this under-served patient group

Alcohol Abuse in Pregnant Women: Effects on the Fetus and Newborn, Mode of Action and Maternal Treatment

Offspring of mothers using ethanol during pregnancy are known to suffer from developmental delays and/or a variety of behavioral changes. Ethanol, may affect the developing fetus in a dose dependent manner. With very high repetitive doses there is a 6–10% chance of the fetus developing the fetal alcoholic syndrome manifested by prenatal and postnatal growth deficiency, specific craniofacial dysmorphic features, mental retardation, behavioral changes and a variety of major anomalies. With lower repetitive doses there is a risk of “alcoholic effects” mainly manifested by slight intellectual impairment, growth disturbances and behavioral changes. Binge drinking may impose some danger of slight intellectual deficiency. It is advised to offer maternal abstinence programs prior to pregnancy, but they may also be initiated during pregnancy with accompanying close medical care. The long term intellectual outcome of children born to ethanol dependent mothers is influenced to a large extent by the environment in which the exposed child is raised

A clinical review of the treatment of catatonia

Catatonia is a severe motor syndrome with an estimated prevalence among psychiatric inpatients of about 10%. At times, it is life-threatening especially in its malignant form when complicated by fever and autonomic disturbances. Catatonia can accompany many different psychiatric illnesses and somatic diseases. In order to recognize the catatonic syndrome, apart from thorough and repeated observation, a clinical examination is needed. A screening instrument, such as the Bush-Francis Catatonia Rating Scale, can guide the clinician through the neuropsychiatric examination. Although severe and life-threatening, catatonia has a good prognosis. Research on the treatment of catatonia is scarce, but there is overwhelming clinical evidence of the efficacy of benzodiazepines, such as lorazepam, and electroconvulsive therapy

De la contrainte à l'observance thérapeutique

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Tabagisme et co-morbidités psychiatriques

Contexte : La prévalence du tabagisme est, en moyenne, deux fois plus importante parmi les sujets souffrant de pathologies psychiatriques par rapport à la population générale. Souvent banalisée et vécue par les soignants avec un certain fatalisme au sein des institutions psychiatriques, cette association soulève par ailleurs des interrogations. Méthode : Au moyen d une revue de littérature, nous proposons d exposer les données actuelles concernant les liens entre le tabagisme, la psychopathologie et les principales pathologies psychiatriques, afin de pouvoir dégager des facteurs limitants à l arrêt du tabac. Résultats : Ces données laissent apparaître toute la complexité des interactions entre les pathologies psychiatriques et les conduites tabagiques. Loin de pouvoir se réduire à un sens de causalité unidirectionnel, la compréhension de ce phénomène de co-occurrence prend son sens dans une approche bio-psycho-sociale permettant d appréhender les freins à l arrêt du tabac multiples au sein de cette population. La place du tabac au sein du fonctionnement psychique du patient permet de nous interroger sur nos pratiques de soins, tant dans les services de psychiatrie qu en psychiatrie de liaison, afin de sortir de ce déterminisme.LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Stimulations magnétiques transcrâniennes et conversion (à propos d'un cas de pseudo Parkinson)

Contexte: Le concept d hystérie a beaucoup évolué au cours du temps. Actuellement, la clinique de l hystérie est découpée en trois grands types de troubles: la conversion somatique ou trouble de conversion, la conversion psychique ou troubles dissociatifs, et le trouble de la personnalité. Il s agit ici d un cas clinique de trouble de conversion à type de syndrome parkinsonien atypique pris en charge par stimulation magnétique transcrânienne (ou TMS). Méthode: Une stimulation du cortex moteur a été réalisée chez cette patiente, au cours d une seule séance, à basses fréquences (1 stimulation toutes les 3 secondes), à 80 % du seuil moteur. Résultats: A la fin de cette séance, le syndrome Parkinsonien s est levé, sans rechute rapide. Discussion/Conclusion: Cette patiente a donc été guérie par ce traitement. Au delà des effets de la suggestion et des réaménagements psychiques que cette technique permet, il semblerait exister une action au niveau neuronal participant également de la guérison de cette patiente. Cependant, des études solides manquent encore.LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

LES FACTEURS FAMILIAUX DE L'ANOREXIE MENTALE

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Utilisation du langage hypnotique dans le traitement de la douleur, quelques outils communicationnels à l'intention des médecins généralistes

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF