EPA Courses

Time of the course: Saturday, 10 April 2021, 14:00-16:00 (CET)

Course Director: Barbara Franke, The Netherlands

Course Co-director: Joseph Antoni Ramos-Quiroga, Spain

Course Co-director: Sarah Kittel- Schneider, Germany

Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic neurodevelopmental disorder that is characterized by attentional problems, deficient impulse control, hyperactivity and often also by emotional dysregulation. ADHD has its onset in childhood and affects approximately 5% of children. In over half of the individuals with ADHD, symptoms persist into adulthood and even old age. World-wide, ADHD in adulthood is under-recognised and under-treated. Undiagnosed or untreated ADHD in adulthood is problematic, because it often co-occurs with other psychiatric and somatic illnesses. Among the most prevalent ones are major depression, anxiety, substance use and obesity. These comorbid conditions considerably contribute to the disease burden of individuals, as well as to healthcare costs. In many instances, individuals with ADHD drop out of psychiatric healthcare in the transition from childhood to adult services. Later in life, they often return with symptoms of comorbid conditions; their ADHD often is not recognised at that point and there is a danger that they might receive treatments for their comorbid problems without awareness and adequate care for the underlying ADHD. Providing care throughout the lifespan, but especially in young adults, may therefore be pivotal to reducing this negative developmental trajectory later in life. In this course, experts in adult ADHD will inform clinical psychiatrists about the prevalence and characteristics of ADHD in adulthood and its most common comorbid conditions across the lifespan. Using real life examples of cases, participants will practice how to diagnose ADHD in the context of comorbidity, and discuss different (pharmacological and non-pharmacological) treatment and psychotherapy options.

The course material is available only to registered participants via the following link.

Time of the course: Saturday, 10 April 2021, 14:00-16:00 (CET)

Course Director: Peter Handest, Denmark

Course Co-director: Andrea Raballo, Italy

The diagnostic interview remains at the heart of clinical psychiatric practice. It consist of a dialogue between two subjects with the common goal of clarifying symptoms and diagnosis. It is precisely within such dialogic setting that the manifold diversity of psychopathological phenomena emerges, often beyond the descriptive boundaries of diagnostic glossaries. Indeed, the interview is a vital prerequisite to treatment and invariably sets the tone for the therapeutic alliance. The course, which capitalises on the personal experience as a service user of one of the co-directors, is built upon a combination of live patient interview, discussions and short lectures. It will address foundational aspects of the psychiatric interview, focusing on strategic-technical aspects and relational-emphatic skills; and also provide concrete advice, tips and tricks from experienced interviewers and patients. Key learning points will be: 1. how to establish an atmosphere of interpersonal trust and to initiate the diagnostic process, 2. how to ask “the right questions”, 3. how to explore the meaning behind common language phrases like “I feel depressed” or “I have had a nervous breakdown”, 4. how to discriminate between normal”, morbid and psychotic; and between subjective experience, notions and expressed behaviour. 5. how to choose the best diagnostic tools and instruments.

The course material is available only to registered participants via the following link.

Time of the course: Saturday, 10 April 2021, 14:00-16:00 (CET)

Course Director: Cecile Hanon, France

Course Co-director: Renaud David, France

Proposed by the EPA section on Old Age Psychiatry

Prescribing Psychotropics can often be challenging in old age because of several aging-specific parameters (changes in pharmacokinetics/pharmacodynamics, frequent polypharmacy increasing the risk of drug interactions and iatrogeny, higher sensitivity to side effects, frequent comorbidities). In addition, clinical presentations of psychiatric disorders differ in old age. Moreover, psychiatric symptoms in old age can be more easily misidentified because of the importance of psycho-somatic comorbidities as well as the neurocognitive disorders that could likely lead to anosognosia, lack of insight and difficulties in verbal expression. The course will present the following aspects: -presentation of the main psychiatric domains and diseases in old age and their specificities compared to younger adults (recent classifications and diagnostic criteria) -presentation of behavioural and psychologic symptoms associated to neurocognitive disorders and psycho-somatic comorbidities -specificities and indications of psychotropics in old age: pharmacokinetics/pharmacodynamics, drug interactions, dosage, side effects, prescribing duration, indications, managing with the lack of international guidelines in the daily practice -presentation of non pharmacological therapeutic: Information and Communication Technologies (serious gaming, virtual reality, connected devices), other therapies (CBT, music therapy, olfactotherapy..).

The course material is available only to registered participants via the following link.

Time of the course: Saturday, 10 April 2021, 14:00-16:00 (CET)

Course Director: Thomas Gargot, France

Course Co-director: Jesper N. Kjaer, Denmark

The methodology of scientific method can be sometimes difficult to understand and implement in psychiatry. Different tools exist to help this process by collecting and interpreting data but they can sometimes be quite expensive. Here we will present free and open source software that help to communicate but also randomise, collect, interpret and publish data. These tools can be easily reused and shared. That could improve validity and reproducibility of scientific research. In order to be interactive, we will involve the participants in the collection of the data of a prototypical scientific study, an international cake testing database! (http://bit.ly/cakereport) We will see a study protocol and how we can register this protocol defining the primary outcome. Here what is the best cookie from 2 different brands? We will discuss the issue of sample selection. Who will taste the cookies? Randomizer.org will help us to attribute a condition (cookie A or B) to each subject. Lime survey helps to run easy online surveys. What did you think about each characteristic of your cookie? R helps to analyse and plot the data. What the mean score? How to plot the results? Is the difference significant? GitHub helps to publish publicly or not our data and analysis script. ArXiv systems helps to publish early works and manuscripts before publication. Equator-network.org can give guidelines that could help to write scientific articles. We can promote our work then on Wikipedia and discuss what are the advantages and issues to promote your own work on Wikipedia.

The course material is available only to registered participants via the following link.

Time of the course: Saturday, 10 April 2021, 16:30-18:30 (CET)

Course Director: Lionel Cailhol, Canada

Course Co-director: Rémy Klein, France

Guidelines emphasise on psychotherapeutic treatment as they are the most studied and successful type of treatment. However, a large proportion of BPD patients do not have access to psychotherapy for different reasons (i.e.: this kind of treatment does not exist in their area, patient is not motivated). In this course, we will review clinically useful strategies to improve the outcome for these patients, which can be used whether the patient has access to psychotherapy or not. First, we will present ways to review diagnosis and efficient ways to offer psychoeducation to the client. Then we will consider treating clinical comorbidities such as addiction, PTSD, depressive disorder, ADHD. Furthermore, we will present the common medical disorders in this population and some tools to improve their medical management (screening, follow-up). We will highlight the potential of lifestyle medicine (improving nutrition, sleep, physical activity). We will discuss the strengths and weaknesses of psychiatric hospitalisation and emergency services and offer guidelines for efficient case management. Considerations related to the usefulness of psychometric tools (screening and outcome measures) will be discussed. Lastly, we will introduce some new kinds of treatments and discuss prevention.

The course material is available only to registered participants via the following link.

Time of the course: Saturday, 10 April 2021, 16:30-18:30 (CET)

Course Director: Kris Goethals, Belgium

Course Co-director: Kolja Schiltz, Germany

Proposed by the EPA section on Forensic Psychiatry

The course will provide the knowledge and research results about the risk of psychiatric patients of becoming violent and of becoming offenders with violent crimes. It will focus on the indicators of risk for violence and delinquency but also on the indicators of immediate threat and imminent aggression on wards and in outpatient settings. It will teach on how to develop a structure in the assessment and to come to a professional judgment on the severity and on the imminence of risk. It will also teach on risk formulation and risk communication among staff and outside of the clinicians’ surroundings (relatives, police, courts, caretakers).It will address risk management, when to intervene and how, the methods of prevention and the long term guidance of risky patients.

The course material is available for registered participants only via the following link. 

Time of the course: Saturday, 10 April 2021, 16:30-18:30 (CET)

Course Director: Andriy Samokhvalov, Canada

In medical schools we always hear that we are supposed to treat the patient, not the disease, but somehow by the time we graduate and become specialists we learn to focus on select aspects of our patient’s conditions and stop seeing the big picture, which includes a variety of health indicators and the determinants of health. We study guidelines and use evidence-based medicine to address symptoms by prescribing medications, using psychotherapeutic approaches, and too often we overlook endocrine disorders, nutrition, lack of exercise, sedentary lifestyle, obesity, sleep disturbances, smoking and substance use. All these factors are underrecognised in current treatment models and this course is intended to bridge this gap and to provide our colleagues with all the tools necessary to provide truly integrated treatments to their patients, which will include nutritional and metabolic assessments, exercise and weight loss prescription, time management and sleep hygiene, behavioural activation and substance use treatments when necessary. We will focus on affective disorders, primarily on depression, but also on anxiety and fibromyalgia as the most prevalent conditions in which lifestyle modification was shown to be effective in scientific literature.

The course material is available only to registered participants via the following link. 

Time of the course: Saturday, 10 April 2021, 16:30-18:30 (CET)

Course Director: Wendy Burn, United Kingdom

Course Co-director: Sophia Frangou, USA

Course Co-director: Derek Tracy, United Kingdom

In the era of personalised and integrated mental health care, neuroscience will play an increasing role in psychiatry. New, and better, diagnostic and therapeutic models will be developed by incorporating and integrating the individual’s neurobiological and psychosocial characteristics into clinical decision making. To take advantage of this, clinicians need a robust foundation in neuroscience. Most psychiatrists are not experts in neuroscience, but in this new era they need to be knowledgeable enough and confident enough to effectively integrate into patient care the advances that will be made during their working lives. Early Career Psychiatrists and more established clinicians need to be prepared to model this integration for psychiatrists in training, because the next generation of psychiatrists, more than any before, will need to be able to understand, critically evaluate and translate new research findings into improved clinical care for their patients. This course will present an immersive experience of this new era of integrated neuroscience. We will emphasise the relevance of advances in brain research to psychiatric practice by referring to selected examples from cutting-edge neuroscience that is already making an impact on clinical psychiatry. Participants will take part in facilitated group work and interact with speakers to exchange ideas and experiences, and to obtain inspiration. Participants will also gain experience of innovative strategies for learning and for teaching in the broadest of contexts, including patient education. We require one additional co-Director, Dr Derek Tracy (KCL, London), with specific and complementary expertise in facilitating the role-play activities.

The course material is available only to registered participants via the following link.

Time of the course: Sunday, 11 April 2021, 8:00-10:00 (CET)

Course Director: Gabriela Stoppe, Switzerland

Course Co-director: Filip Bouckaert, Belgium

Proposed by the EPA section on Old Age Psychiatry

Depression is the most frequent mental disorder also in the elderly population and it is soften unrecognised and untreated. Compared to other age groups, there are differences in risk factors, symptomatology, comorbidity, differential diagnosis and management. In the course epidemiology and risk factors will be presented. Diagnosis will be discussed with special focus on the differential diagnosis to grief, dementia and anxiety disorders. Sleep problems and suicidality will deserve special attention. Regarding therapy relevant modifications of drug therapy and psychological therapies will be presented. The different types of psychotherapy for elderly (schema based therapy, psychodynamic psychotherapy, cognitive behavioural therapy) will be discussed. We also discuss neuromodulation therapies, ECT, and exercise. The management in the presence of physical disability or in special settings requires tailored interventions. Case vignettes regarding diagnosis and therapy are discussed.

The course material is available only to registered participants only via the following link.

Time of the course: Sunday, 11 April 2021, 8:00-10:00 (CET)

Course Director: Merete Nordentoft, Denmark

Mental illness is associated with high burden of disease and it has severe individual and societal consequences. It will be of immense value to be able to intervene in risk groups identified before onset of psychosis and other severe psychiatric disorders. In first episode psychosis, early Intervention services with team-based intensive case management and family involvement are superior to standard treatment in reducing psychotic and negative symptoms and comorbid substance abuse and improving social functioning and user satisfaction. As an introduction, the results of the OPUS-trial will be presented together with meta-analyses based on similar trials. The basic principles for working in an early intervention team will be presented and discussed. Involving families is a cornerstone in early intervention. Family involvement can be in many different formats, depending on the needs and preferences of the patients and the relatives. The multifamily group approach will be presented with vignettes and tried out in role plays. The implementation of OPUS all over Denmark will be presented together with the Danish OPUS-fidelity study.

Time of the course: Sunday, 11 April 2021, 15:00-17:00 (CET)

Course Director: Rutger Jan van der Gaag, The Netherlands

Course Co-director: Jan Wise, United Kingdom

Ethics (from the Greek ‘εiks: the best way to behave”) is, according to the Oxford dictionary “the branch of knowledge that deals with moral principals”. Moral principles govern a person’s behaviour. Aristotle held “virtues” as the guiding principal, Kant “duty”, whereas utilitarianism stipulates that the “guiding principal” should be “the greatest happiness or benefit of the greatest number”. In medicine ethics are based on the Hippocratic oath, nowadays expressed in the “Declaration of Geneva” (2017). Two moral principles in this medical oath are crucial: – respect for the autonomy of the patient and their safety (in a broad sense: both physical and intellectual (privacy). In clinical practice, medical doctors struggle, on daily basis, with dilemmas around these themes. What to do, if there are appropriate treatments but the patient declines them or cannot express his will? When a patient expresses a wish to die or asks their doctor to refrain from treatment this is particularly challenging. In cases of cancer, few will doubt that the doctor should abide by the patient’s wishes. In psychiatry the doctor will struggle with the dilemma of whether the patient understands what they ask for and its consequences, particularly if it appears to be suicidal ideation? In other words, does the patient have capacity to oversee the consequences of his ideas, are they an autonomous agent? These themes will be explored and discussed in the groups or subgroups, using case vignettes.

The course material is available only to registered participants via the following link.

Time of the course: Sunday, 11 April 2021, 15:00-17:00 (CET)

Course Director: Peter Schulte, The Netherlands

Course Co-director: Dan Cohen, The Netherlands

Clozapine is a much underused drug, due to lack of promotion by pharmaceutical companies and patient and prescriber fears of clozapine-related risks. The course fills this lacuna and teaches indication of patients for clozapine treatment (treatment refractory schizophrenia and off-label use), motivating patients for clozapine, preparation of the treatment, titration of clozapine, monitoring of clozapine plasmalevel and granulocyte counts, assessment and treatment of frequent and rare side effects, and weighing arguments for and against compulsory treatment and stopping granulocyte controls. Brief powerpoint presentations and video’s will be alternated with discussions. Course director Schulte proposes to include a third course director: Dr. J. Bogers, M.D., who is a board member of the Dutch Collaboration Group too, and has been involved in many educational and scientific activities of the collaboration group.

The course material is available only to registered participants via the following link.

Time of the course: Monday, 12 April 2021, 8:00-10:00 (CET)

Course Director: Samuel Bulteau, France

Proposed by the EPA section on Old Age Psychiatry

Despite advances in psychopharmacology, up to 30% of patients with psychiatric condition continue to experience disabling symptoms despite being on medication. Thanks to their ability to modulate cerebral networks, non-invasive brain stimulation methods have been proposed as an alternative method to alleviate symptoms in patients with treatment resistant psychiatric conditions, especially depression, schizophrenia and substance use disorders. Non-invasive brain stimulation methods cover a broad range of approaches including electroconvulsivotherapy (ECT), repetitive transcranial magnetic stimulation (rTMS), transcranial electrical stimulation (tES: tDCS, tRNS, tACS, tSOS,…). The course will have four sections: 1) Overview of rTMS and tDCS methods -Brief presentations of their main indications in psychiatry (depression, schizophrenia and substance use disorders) and their place in the treatment algorithm, with a focus on the elderly 2) Practice exercises with the devices 3)General Discussion about strengths, weaknesses and gaps in adult as well as elderly population The goals of this course are to: 1) Review recent non-invasive brain stimulation approaches (rTMS and tDCS) for the treatment of psychiatric symptoms and question their relevance in late-life psychiatric disorders. 2) Practice with available brain stimulation devices approved as medical device by health authorities. 3) Discuss the strengths, weaknesses and gaps of the various approaches in each indication.

The course material is available only to registered participants via the following link.

Time of the course: Monday, 12 April 2021, 15:00-17:00 (CET)

Course Director: Birgit Völlm, Germany

Course Co-director: Peggy Walde, Germany

Course Co-director: Jack Tomlin, Germany

Peer support work is an important part of mental health care. This is a particularly useful approach in inpatient settings where patients’ interactions with family, friends and others outside the care setting may be limited. Peer support work is beneficial for both patients and peer supporters themselves, as this bridges staff-patient gaps. Peer supporters are able to share positive experiences with patients and patients might find it helpful to receive support from someone they feel they can relate to. Peer support has a long tradition but is still novel in many mental health settings. This course will guide participants through the process of involving peer support workers within an inpatient care setting. It will present factors that may help or hinder this process. Special attention will be paid to organisational culture, the role of team leaders, attitudes of staff and patients, and administrative hurdles. This course will discuss some of the difficulties of involving peer support workers in specialised settings, such as forensic mental health clinics. It is important that peer supporters are themselves supported throughout this process, especially if they are new. Therefore, the course will address approaches to maintaining the wellbeing and occupational health of peer supporters. Participants will be given learning materials and vignettes that encourage them to reflect on how peer support may be implemented or sustained in their own care settings.

Time of the course: Monday, 12 April 2021, 15:00-17:00 (CET)

Course Director: Georgios Schoretsanitis, Switzerland

Course Co-director: Michael Paulzen, Germany

Routine challenges such as non-response at established daily doses, poor adherence or pharmacokinetic interactions with clinical consequences and adverse effects (pharmacovigilance) comprise a major part of psychopharmacotherapy. Therapeutic drug monitoring and pharmacogenetic tests are valuable tools that allow fort treatment tailoring in routine clinical care. This course will be centered on the following issues: • Introduction: Definition of TDM in psychiatry, theoretical background, practical recommendations; cytochrome P-450: polymorphisms, clinical consequences of a genetic particularity in metabolism, practical recommendations for genotyping and phenotyping. • Presentation of vignettes: TDM alone and in combination with pharmacogenetic tests: general situations; situations of interactions, combination treatments; in special populations (elderly, forensic patients, pregnant patients, adolescents, somatically ill patients); pharmacovigilance.

The course material is available only to registered participants via the following link.

Time of the course: Monday, 12 April 2021, 17:30-19:30 (CET)

Course Director: Victor Pereira-Sanchez, USA

Course Co-director: Laura Orsolini, Italy

Proposed by the EPA section on TeleMental Health

Psychiatry is being highly benefited from the possibilities enabled by globalisation and the digital world to conduct valuable international research. Researchers can set up diverse teams coordinated in real-time and easily design different studies and interventions to be applied globally. Moreover, the current COVID-19 pandemic has highlighted the value and need for such collaborations. This course aims at providing the audience with practical methods, tools, and skills for conducting internet-based international research, harnessing the growing expertise of a group of young European psychiatrists. The faculty will be available to assist each of the attendees before, during and after the course, and will be providing additional handouts, references, templates, written guidelines, and video tutorials. This activity is meant to be eminently practical and interactive, combining presentations with discussions of examples of work from the faculty and supervised individual and group exercises. The contents will include the introduction of skills, tips, and free tools for designing research proposals, team coordination, international surveys, systematic reviews, reference managing, analysis of social media contents, manuscript writing and publishing, and science dissemination, among other topics. The course would welcome any mental health practitioner/researcher. It will not necessarily require experience in the methods and tools to be presented and will be further tailored to the actual audience. It may be of particular use for early-career psychiatrists and trainees. This course aligns with the conference general theme and is a joint proposal of the EPA Scientific Section of TeleMental Health and the Early Career Psychiatrists Committee.

The course material is available only to registered participants via the following link.

Time of the course: Tuesday, 13 April 2021, 8:00-10:00 (CET)

Course Director: Pilar Lusilla Palacios, Spain

Course Co-director: Antoni Gual Sole, Spain

Proposed by the EPA section on Addictive Behaviours

Motivational interviewing is defined as a patient-centred and collaborative approach that guides people to initiate and maintain a strategy of behaviour change through the resolution of their ambivalence. This approach has become in the last decades the golden standard to manage addictions as opposed to classic confrontational models. Different meta-analysis, have demonstrated its moderate but robust effect in improving both adherence to treatment and addictive behaviours. Brief interventions have proven its efficacy in primary health settings, to help patients reduce their drug use, specially concerning alcohol and tobacco. Motivational adaptations of those brief counselling interventions have been developed and tested in recent years. In this course, attendees will receive training on how to use brief motivational interventions (BMI) with patients suffering addictive disorders in the Emergency Room. The course will address the following topics: • How to identify which clinical situations are, and are not, suitable for a brief intervention • Key elements of a successful brief motivational intervention • Barriers (and how to overcome them) to deliver BMI in the Emergency Room • Elements that influence adherence to treatment and successful referral • Review of the existing scientific evidence The course will be very interactive. Videos, group dynamics, and role playing techniques will be used. At the end of the course, trainees should be able to: • Identify when a BMI is suitable • Know the theoretical principles of BMI • Be able to deliver consistent BMI to patients in need • Understand key elements for a successful referral.

The course material is available only to registered participants via the following link.

Time of the course: Tuesday, 13 April 2021, 15:00-17:00 (CET)

Course Director: Andrea Fiorillo, Italy

Course Co-director: Sophia Frangou, USA

Scientific research is essential in improving care of patients with mental health problems. European Psychiatry is the official journal of the European Psychiatric Association and is published since 1986 with the aim to improve the lives of patients with psychiatric disorders and to promote professional excellence through education and research. The course will provide essential information on how to write and successfully publish a paper in European Psychiatry. The teachers of the course are the two editors of the journal who will actively interact with participants in order to improve their writing skills. In particular, during the course, participants will be invited to discuss their experience with scientific journals and will be provided with practical suggestions on how to write good papers. Participants will be guided through the journey of publication from the hypothesis-based approach to Editor’s expectations until acceptance of manuscripts.

The course material is available only to registered participants via the following link.

Time of the course: Tuesday, 13 April 2021, 8:00 – 10:00 (CET)

Course Director: Daniel Hamiel, Israel

This course should be taken as part of the current innovative approach to psychotherapy, directed to address masses of people who might need psychological assistance. This approach is based on principles of the 3rd wave CBT and of Low Intensity CBT Interventions (LICBT-I). This course will present a universal short protocol mainly based on Acceptance and Commitment Therapy approach, created for psychotherapy and implemented and adapted to a resilience prevention intervention. Based on the therapeutic protocol, an intervention that integrates emotional, physiological and cognitive behavioural techniques as well as attentional regulation, mainly mindfulness, was developed to build resilience and prevention in the community. Thousands of teachers and counsellors have trained, to deliver resilience to their students (~1,000,000 nationwide). The program has been endorsed by the Ministry of Education of Israel to be part of the regular curriculum of every school. A series of empirical studies has shown the effectiveness of the program. This cost-effective approach, delivered by the teachers as mediators decreased by 50% the development of post-traumatic responses in children following severe stressful exposure. Based on this program we have developed and implemented resilience programs for different populations (e.g., parents and educational staff of infants in day-care centres and autistic kids, adolescents at risk, students in the university, medical stuff, and the elderly). The intervention is adapted to different cultures (Israeli Muslims, Refugees from Africa, Orthodox religious Jews and a pilot in schools in Norway).

The course material is available only to registered participants via the following link.

Time of the course: Tuesday, 13 April 2021, 17:30-19:30 (CET)

Course Director: Umberto Volpe, Italy

Course Co-director: Donald Hilty, USA

Proposed by the EPA section on TeleMetal Health

Telemental health care or Telepsychiatry (TP) is the use of telecommunication and information technologies to deliver psychiatric and mental health services at a distance. The evidence-base for this field of psychiatry has rapidly grown, over the past years. Evidence related to faculty and trainee competencies is strong for TP direct service and consultation to primary care. Promising evidence is accumulating also for asynchronous video and Internet-based cognitive behavioural therapy. New research fields concerning technology-based self-help and support groups, clinical use of social media, smartphone apps for self-care (e.g., anxiety and depression management) and other e-mental health applications are also rapidly emerging. TP interventions increase access to mental healthcare, result in quality of care equivalent to in-person care and often reduce costs. Competencies that focus on skills, more than knowledge, can help clinicians adjust to differences with in-person care, ensure quality, and prevent and manage potential challenges (e.g., boundary, privacy and other regulatory issues; barriers to assessment; therapeutic barriers). Telemental health care (spanning across psychiatry, psychology, social work, counseling, marriage and family) and social media competences are today necessary also in routine settings. The course will provide a knowledge base about TP, a rationale for use of TP approach in a variety of psychiatric settings and practical hints about how to deliver TP care in a wide range of populations. The course will be organised in collaboration with the EPA Early Career Psychiatrists Committee and its Chair (M. Pinto da Costa) will act as a Course Facilitator.

The course material is available only to registered participants via the following link.