The coronavirus disease (COVID-19) pandemic is causing a global health crisis of unprecedented proportions in modern times. Importantly, the pandemic is expected to have negative health consequences beyond those caused by the coronavirus per se – including significant psychological distress. This symposium will focus on the mental health consequences of the COVID-19 pandemic. First, Dr. Christoph U. Correll will provide an overview of the design of the “Collaborative Outcomes study on Health and Functioning during Infection Times” (COH-FIT), putting it in the context of available evidence when the study started. He will present also global results from over 100 countries across 6 continents, focusing on the subgroup of >15,000 minors, in whom their caregivers rated the impact of COVID-19 on their physical and mental well-being. Second, Dr. Marco Solmi will present global results of COH-FIT study in adults from over 100 countries and >50,000 participants across 6 continents, with a specific focus on Italian sample (over 7,000 respondents, including a nationally representative sample). Third, Dr. Karolina Skonieczna-Żydecka will present results of the COH-FIT study in Poland with >1500 participants, with a specific focus on health workers. Fourth, Dr. Søren D. Østergaard will present the results of a survey in which 6000 randomly drawn patients with mental disorders undergoing treatment in the psychiatric services of the Central Denmark Region (catchment area of 1.3 million people) will be involved. The survey, which will be conducted in June 2020, will focus on well-being and symptom levels of the participants during the COVID-19 pandemic.

Proposed by the EPA Section on Psychotherapy -This symposium will present current knowledge, development and clinical experiences on internet-based cognitive behavioural therapy (ICBT) developed in various settings and countries. Presentations include a description of the journey towards national implementation of ICBT and its outcomes in Sweden (MK), of individually tailored ICBT with different modes of delivery and different degrees of therapist support. Moreover, a presentation by VK include Adaptive Treatment Strategies, where a wide range of data before and during treatment are processed by an AI-driven clinical decision support tool guiding the adaption of therapist-guided ICBT at the individual level. Another presentation (KM) will describe the implementation of a national ICBT clinic in Denmark, from the first initial steps through to becoming a national service. Current evidence of effectiveness and implementation efforts conducted at the clinic. JB will report on a pilot study comparing online versus face-to-face transdiagnostic therapy in Arabic-speaking refugees. She will describe the different aspects of tailoring treatment contents in these two settings and discuss potential advantages of a tailored approach for the specific patient population.

Developed over 80 years ago, ECT continues to be the most powerful and acutely effective treatment available for severe, often treatment-resistant, depression. Its use is supported by data from randomised trials and meta-analyses. However, there is still a need to develop better strategies to optimise ECT practice, by identifying both patient-level and treatment-level characteristics that predict therapeutic benefit and minimise side effects. This symposium will be informed by our on-going, or recently completed, clinical studies and trials. We will discuss whether we should focus our attention on the ‘average’ ECT treatment technique that suits the majority of our patients (i.e. “one size fits all”) or tailor the treatment to the needs of individual patients. Pascal Sienaert will discuss the available evidence to guide clinicians in personalising electrode position, dosing strategies and parameter selection, and to make individualised adjustments during the ECT course. Linda van Diermen will identify key clinical elements that predispose to beneficial treatment effects, distinguishing between primary and secondary predictors, and formulate recommendations to aid in patient-treatment matching. Esmee Verwijk will address why outcome measures at the group level do not always fit individual patients and how patients can be helped by preventing and/or treating cognitive side effects. The relatively neglected issue of optimising speed of response to ECT and the role of electrode placement and other clinical factors will be discussed by Declan McLoughlin. Together, the sessions in this symposium will help participants to apply evidence-based methods to personalising ECT practice for their patients.

The work of psychiatrists has been profoundly disrupted by the COVID-19 pandemic (e.g., redeployment, shifting institutional priorities, sudden massive use of telehealth services). At the same time, mental health concerns in the population have been exacerbated by the pandemic (e.g., due to isolation, anxiety, substance use), resulting in increased need for services at a time when accessing services is more difficult. This symposium will present the results of two large longitudinal studies that speak to these issues. The first is a global, multilingual study of the impact of the COVID-19 pandemic on clinical practice and well-being of psychiatrists and other mental health professionals. Results will be presented from two waves of data collection with members of the World Health Organization's Global Clinical Practice Network (GCPN), comprising 15,500 clinicians from 159 countries. The first speaker will focus on predictors of distress, occupational burnout, and practice disruption over time and the use of distance technologies for evaluation and treatment. The second and third speakers will focus on China and Russia, examining impact on GCPN members as a function of the course of the pandemic in those countries. The fourth speaker will focus on the mental health impact of the COVID-19 pandemic among a representative sample of the general population of Madrid (n = 900), interviewed by telephone at two time points. The symposium will consider the implications of the results for the delivery of mental health services and for programs and policies that protect well-being and reduce occupational burnout among psychiatrists.

Key processes in human neurodevelopment take place within the biological environment of pregnancy and birth. Insults within this biological context can have long-term consequences on brain function, ranging from learning disabilities to complex psychiatric disorders such as schizophrenia. Birth asphyxia is the failure to start regular respiration within a minute of birth and is a neonatal emergency that may cause hypoxia (insufficient supply of oxygen to the brain and tissues) and possible brain damage or death, if left untreated. The perinatal period is associated with high risks and represents one of the first developmental milestones of brain development. During childbirth, there are cellular processes in place that increase the resistance of neurons to hypoxia and ischemic damage. These cellular processes are resilience factors that should protect against hypoxic insult. Previous reports have found alterations in genes regulated by hypoxia in schizophrenia and the lack of hypoxia related resilience factors in the presence of birth asphyxia might increase the risk for schizophrenia development. Therapeutic interventions for birth asphyxia, typically before the onset of clear neurological and behavioral symptoms, might prevent or ameliorate the development of schizophrenia later in life.