Interventions for posttraumatic stress disorder in psychiatric practice across Europe: a trainees' perspective

BACKGROUND: With an annual prevalence of 0.9-2.6%, posttraumatic stress disorder (PTSD) is very common in clinical practice across Europe. Despite the fact that evidence-based interventions have been developed, there is no evidence on their implementation in clinical practice and in national psychiatric training programmes. ----- OBJECTIVE AND METHOD: The Early Career Psychiatrists Committee of the European Psychiatric Association conducted a survey in 23 European countries to explore implementation of evidence-based interventions for PTSD and training options. ----- RESULTS: The findings indicate that pharmacotherapy was available in the majority of the participating countries (n=19, 82.8%). However, psychological interventions were much less widespread. For example, psychoeducation was widely available in 52% of the countries (n=12), cognitive-behavioural therapy in 26.2% (n=6), and specific trauma-focused techniques were rarely available. Training on PTSD was part of the official training in 13 countries (56.5%), predominantly in the form of theoretical seminars. ----- CONCLUSIONS: Overall, this survey indicates that the treatment for PTSD is largely focused on pharmacotherapy, with psychological evidence-based interventions poorly available, especially outside specialized centres. Poor implementation is linked to the lack of official training in evidence-based interventions for psychiatric trainees across Europe

TRAINING IN SLEEP MEDICINE AMONG EUROPEAN EARLY CAREER PSYCHIATRISTS: A PROJECT FROM THE EUROPEAN PSYCHIATRIC ASSOCIATION – EARLY CAREER PSYCHIATRISTS COMMITTEE

Introduction: Sleep disorders have a proven association with psychiatric illness. Therefore, psychiatrists require appropriate training in diagnosing and treating sleep disorders. To date, there is no data available in Europe on training in sleep medicine for early career psychiatrists (ECP). Aims: To identify the availability of training in sleep medicine for psychiatric trainees across Europe and to establish how confident doctors feel in treating these conditions. Methods: European-wide survey carried out by the European Psychiatric Association (EPA)-Early Career Psychiatrists Committees. Representatives of ECPs from each participating European country filled in a questionnaire about availability of training in sleep medicine in their country. ECPs were also invited to fill out a questionnaire at the EPA congress in Nice in 2013. Results: 55 participants from 27 European countries responded. Only 24% had sleep medicine training mandatorily included in their national training curriculum. A majority (60%) felt that the quality of the training they received was either average or below average. 88% felt either very or fairly confident in treating insomnia. However, when asked to select the correct management options for insomnia from a provided list of six, only 19% and 33% of respondents chose the two correct options. Conclusions: There is a clear gap between the level of confidence and the clinical judgements being made to treat insomnia among European ECPs. There is a definite need to improve the availability and structure of sleep medicine training for psychiatric trainees in Europe

THE PsyLOG MOBILE APPLICATION: DEVELOPMENT OF A TOOL FOR THE ASSESSMENT AND MONITORING OF SIDE EFFECTS OF PSYCHOTROPIC MEDICATION

Mobile health interventions are regarded as affordable and accessible tools that can enhance standard psychiatric care. As part of the mHealth Psycho-Educational Intervention Versus Antipsychotic-Induced Side Effects (mPIVAS) project (www.psylog.eu), we developed the mobile application "PsyLOG" based on mobile "smartphone" technology to monitor antipsychotic-induced side effects. The aim of this paper is to describe the rationale and development of the PsyLOG and its clinical use. The PsyLOG application runs on smartphones with Android operating system. The application is currently available in seven languages (Croatian, Czech, English, French, German, Japanese and Serbian). It consists of several categories: "My Drug Effects", "My Life Styles", "My Charts", "My Medication", "My Strategies", "My Supporters", "Settings" and "About". The main category "My Drug Effects" includes a list of 30 side effects with the possibility to add three additional side effects. Side effects are each accompanied by an appropriate description and the possibility to rate its severity on a visual analogue scale from 0-100%. The PsyLOG application is intended to enhance the link between patients and mental health professionals, serving as a tool that more objectively monitors side-effects over certain periods of time. To the best of our knowledge, no such applications have so far been developed for patients taking antipsychotic medication or for their therapists

Barriers and facilitators to conducting research by early career psychiatrists: a literature review

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Clinical, electroencephalographic and biological parameters to optimise narcolepsy diagnostic criteria

La narcolepsie est une maladie rare, touchant une personne sur 2000. Elle se caractérise par l'association d'une somnolence diurne excessive, d'épisodes de cataplexie, de paralysies du sommeil, d'hallucinations hypnagogiques. et d'une fragmentation du sommeil. La narcolepsie sans cataplexie constitue un sous-type hétérogène. Le diagnostic de narcolepsie peut être clinique, mais bien souvent un Test Itératif de Latence d'Endormissement (T1LE), précédé d'une polysomnographie nocturne (NPSG). sont utilisés pour porter le diagnostic.La cause de la plupart des cas de narcolepsie avec cataplexie a été découverte au début des années 2000: la destruction, probablement d'origine auto-immune. des neurones à hypocrétine de l'hypothalamus. Un déficit en hypocrétine à la ponction lombaire constitue désormais un test de référence pour établir le diagnostic, ce qui offre l'opportunité d'optimiser les critères actuels et de tester de nouvelles hypothèses diagnostiques en regard de ce test de référence. Peu d'études ont à ce jour spécifiquement porté sur la narcolepsie sans cataplexie et son diagnostic. Nous avons donc cherché à identifier les prédicteurs du déficit en hypocrétine dans la narcolepsie sans cataplexie. De plus, dans la narcolepsie-cataplexie, l'utilisation comme critère diagnostique d'une latence courte d'apparition du sommeil paradoxal à la NPSG n'a jamais été évaluée en utilisant comme test de référence le déficit en hypocrétine, et nous avons donc cherché à en déterminer l'utilité diagnostic et la valeur-seuil optimale.Afin de mener à bien ces projets de recherche, nous avons initié et participé au développement du logiciel d'analyse ROC (Receiver Operating Characteristic) SoftROC. Dans la narcolepsie sans cataplexie. nous avons montré que les paramètres électrophysiologiques, plus que cliniques, différaient entre les patients avec un taux bas d'hypocrétine et ceux avec un taux normal. Dans la narcolepsie avec cataplexie. nous avons établi qu'une latence courte (< 15 minutes) d'apparition du sommeil paradoxal à la NPSG était un test diagnostique spécifique, mais peu sensible, pour la narcolepsie avec déficit en hypocrétine. Nos résultats ont contribué à la révision des classifications internationales des troubles du sommeil.Narcolepsy is characterised by excessive diurnal sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations andsleep fragmentation. Narcolepsy without cataplexy is a heterogeneous subtype. Diagnosis can be established clinically,but a Mulitple Sleep Latency Test (MSLT) following a Nocturnal PolySomnoGraphy (NPSG), is used most of the time.Auto-immune loss of hypocretin cells is responsible for narcolepsy with cataplexy. Hypocretin deficiency at lumbarpuncture is a gold standard for diagnosis.Few studies have focused specifically on narcolepsy without cataplexy. Our aim was to identify predictors of hypocretindeficiency in this condition. Moreover, in narcolepsy with cataplexy, a short REM sleep latency at NPSG has never beenevaluated as a diagnostic test using hypocretin deficiency as a gold standard, and we therefore have aimed at assessing itsdiagnostic utility and optimal cut-off.In order to conduct our research, we have contributed to developing a ROC analysis software (SoftROC).In narcolepsy without cataplexy- objective (NPSG and MSLT) more than clinical parameters were predictors ofhypocretin-deficiency. In narcolepsy-cataplexy, a short (< 15 mins) REM latency at NPSG was a specific, but notsensitive. diagnostic test. Our results contributed to the revision of international diagnostic classifications

Relations entre humeur et sommeil

International audienc

Etude du concept de qualité de vie chez les patients souffrant de schizophrénie

BESANCON-BU Médecine pharmacie (250562102) / SudocSudocFranceF