Welcome to the EPA 2021 Interactive Programme
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Fully Live with Live Q&A On Demand with Live Q&A ECP Session Section Session EPA Course (Pre-Registration Required) Product Theatre
Sessions with Voting Ask the Expert Live TV
Proposed by the EPA section on Addictive Behaviours -Patients with psychiatric disorders and co-occurring addictive disorders often pose a clinical challenge, both in the diagnostic process, as well as during treatment. Co-occurring substance use may interfere with clinical assessment and often requires adjustment of pharmacological and psychological treatment approaches. However, comorbidity between psychiatric disorders and addictive disorders is rather common with about 30% of cases also having a substance use disorder, depending on the type of psychiatric condition and treatment setting. As a result, every clinician working in psychiatry will encounter clinical dilemma’s as described above. In this symposium, experts in the field co-occurring addictive disorders in psychosis, bipolar disorder, suicidal behavior and ADHD will share clinical dilemma’s and scientific answers to these dilemma’s. With this symposium, the speakers intend to provide tools and advice to come to more personalized and integrated treatment for your patients. Speakers will share data, recent literature and their view on diagnosis and treatment in patients with psychosis, bipolar disorder, suicidal behavior and ADHD. All speakers are connected to the Network of Early Career Professionals working in the area of Addiction Medicine (NECPAM: http://necpam.co/).
S0013 - Clinical Challenges in Psychosis Spectrum Disorders: Treating Co-morbid Substance Use Disorders and ADHD
S0014 - Suicidal Behaviour and Addiction: An Inseparable Couple? Mechanisms Underlying the Association and Targets for Interventions
Suicidal behaviour is common in people with substance use disorder or behavioural addictions, and vice versa. Suicidal behaviour and addiction share many risk factors, such as increased allostatic load, and are associated with dysregulations of reward processing and impaired prefrontal cortex functioning, resulting in decision-making problems, loss of cognitive control, and impulsivity. Trait impulsivity predisposes the individual to increased sensitization to stressors or addictive stimuli. Addiction emerges when the motive for a pleasurable substance or activity transitions from positive to negative reinforcement. At this point, the stress response system is activated, and the main motivator shifts from pleasure to the escape from an aversive stimulus –withdrawal and craving. In parallel, insufferable psychological pain is the core component of the suicidal process, and a suicide attempt has been conceptualized as a way to reduce or escape it. Both states are associated with increased pain perception, stress system activation, inflammation, and anhedonia. However, while addiction generally reflects a shift from pleasure to the avoidance of negative stimuli, the pleasure is less identifiable in the suicidal process. Furthermore, not all individuals that engage in suicidal behaviours are impulsive or have an addiction, and not all individuals with addiction engage in suicidal behaviours. Yet, the understanding of the shared neurobiological component of addiction and suicidal behaviours may inform possible interventions in some individuals. Reward, pain, and stress systems are possible targets. Promising substances related to these systems that could reduce suicide risk include buprenorphine, lithium, ketamine, and psychological interventions aimed at psychological pain reduction and resilience.
S0015 - Temperament, Bipolar Disorder and Addictive Disorders: Which Personalised and Integrated Approach?
Affective Disorders are on a clinical continuum in which temperaments and other coexisting or emerging mental conditions may cover the role of risk factors or determinants of specific dimensional aspects of Bipolar Disorder. Overall, it is important to better characterize the psychopathological conditions associated to the clinical picture of an affective disorder in order to perform more personalized and integrated approach for the assessment, diagnosis and treatment of individuals with dual disorder.