Welcome to the EPA 2022 Interactive Programme 

Recent racist events in the United States, e.g. Black Lives Matter movement in connection with the death of Georg Floyd, have focused the attention of much of the world on the terrible impact of systemic racism on the lives and mental health of communities of color. For mental health professionals, the disastrous psychological consequences of racism and discrimination are obvious. Racism is significantly related to poor health, including mental health. The impact of racism in psychiatric research and clinical practice is not sufficiently investigated. Findings clearly show that the concept of "race" is genetically incorrect. Therefore, the implicit racism that underlies many established "scientific" paradigms need be changed. Furthermore, to overcome the internalized, interpersonal and institutional racism, the impact of racism on health and on mental health must be an integral part of educational curricula, from undergraduate levels through continuing professional development, clinical work and research. In awareness of the consequences of racism at all levels (micro, meso and macro), the EPA Task Force on “Racism and Mental Health and the role of mental health professionals” worked out recommendations for clinicians, policymakers and researchers, which will be presented and discussed with the plenum.

Organised 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.

Organised by the EPA Section on Schizophrenia. Psychotic symptoms such as persistent hallucinations or delusions can have severe consequences for the patients’ ability to interact with other people, and for some patients, it prevents them from conducting daily activities as well as inflicting on their quality of life. Approximately 25% of people with psychotic conditions continue to experience psychotic symptoms in spite of medication. Exposure therapy is proven to be an important part of cognitive behavioural therapy for anxiety disorders, but the evidence for the efficacy of exposure therapy for disorders within the schizophrenia spectrum is not well established. The late Julian Leff developed the AVATAR treatment and piloted in the UK. Since then, several initiatives were launched in different European countries. There is a great potential for the use of virtual reality as it enables researchers and clinicians to bring real-time life experiences into a lab environment. The use of virtual reality allows exposure to challenging situations in an immersive, but also protected, flexible, and controlled environment. In this symposium we will present very promising ongoing studies in different European countries using Virtual Reality technology in the treatment of auditory hallucinations, negative symptoms and paranoid ideations and delusions.

Organised by the EPA Section on Schizophrenia. The early phases of psychosis have been hypothesized to constitute a critical period, a window of opportunity. At the same time, the early phases of psychosis are associated with increased risk of unwanted outcome, such as suicidal behaviour and social isolation. This was the background for the emergence of early intervention services, and in Denmark, the OPUS trial was initiated as part of that process. Now there is convincing evidence for the effectiveness of early intervention services from trials all over the world- The different elements in early intervention services will be presented together with the principles for involving families. The psychoeducational multifamily treatment model will be presented. questions to the audience will be included in the presentations. there will be role play demonstrating the problem solving method

Violence against women is rooted in gender-based discrimination, social norms that accept violence, and gender stereotypes that continue cycles of violence. To date, efforts to eliminate violence against women have mainly focused on responding to and providing services for survivors of violence. However, prevention—addressing the structural causes, as well as the risk and protective factors, associated with violence—is pivotal to eliminating violence against women completely. Prevention is the only way to stop violence before it even occurs. It requires political commitment, implementing laws that promote gender equality, investing in women’s organizations, and addressing the multiple forms of discrimination women face daily. Opened for signature in 2011, the Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence (Istanbul Convention) is the most far-reaching international treaty to tackle this serious violation of human rights. The convention aims at prevention of violence, victim protection and to end the impunity of perpetrators. 2019, it has been signed by 45 countries and the European Union. March 2021, the President of Turkey announced Turkey's withdrawal from the treaty with a presidential decree. Other countries are also discussing a withdrawal from this convention. This is a hugh step backwards as it is known that the high prevalence of sexual and domestic violence suffered by women and the correspondingly high rate depressive disorders, of anxiety disorder, and of post-traumatic stress disorder makes women the largest single group of people affected by this disorder. Therefore, there is an urgent need for action.

Suicidality lies on a broad continuum between passive thoughts and completed suicide and can be sub-categorised under suicidal ideation and suicidal behaviour. It does not always stem from a psychiatric disorder, but a link is well-established. Sensitivity or specificity of suicidal ideation to predict suicide is low, but persons showing suicidal ideation are nonetheless at increased risk of attempting suicide. Suicide is etiologically heterogeneous and occurs due to a convergence of a broad spectrum of individual and non-individual risk factors, with significant differences in its patterns across gender, age, culture, geographic location and personal history. The issue of suicide has come to the fore with Covid-19, especially with the substantial increase in domestic violence that has probably disproportionately increased in immigrant and refugee communities for economic and other reasons that have been exacerbated by the Covid pandemic. Therefore, there is a need to have a better understanding of the prevalence, onset, and course of suicidality, related mental health problems and of risk and protective factors in the high-risk groups. In this symposium, the first speaker will focus on “Suicidality, Trauma and Covid-19 Pandemic”, the second speaker will give an “Overview on current research on suicidality in vulnerable groups e.g. refugees and immigrants during the Covid-19 Pandemic”, the third speaker will talk on Cultural factors of Suicidality” and the last speaker will present “A culturally adapted suicide prevention strategy for the Vietnamese community in Victoria, Australia”. All presentations will be discussed with the plenum.

Organised by the EPA Sections of Forensic Psychiatry and Old Age Psychiatry. Old age forensic psychiatry encompasses a broad variety of issues. Psychiatrists may be asked to assess elderly individuals' competency or capacity for decision making or activities that may pose a risk to themselves or others, such as living independently. Aging persons can also become involved in the criminal justice systems, more commonly as victims but also as offenders. In this symposium, two papers will be presented from the victim's perpective (sexual abuse and violence, and homicide-suicide). Next, two papers will be presented from the offender's perspective (problematic behaviours, such as disinhibition, agitation and aggression, and criminal behaviour, and prison psychiatry for aged offenders).

Organised by the EPA Section on Old Age Psychiatry. Apathy is a symptom that can be encountered in various psychiatric (affective disorder, psychosis), neurological (neuro-cognitive disorder such as Alzheimer disease, frontotemporal dementia or Parkinson’s disease) and also general affections (for example stroke, cancers, hypothyroidism). It is frequent and associated with both poor health outcomes and the caregiver burden. It is not described in the international classification of mental disorders, yet a growing body of literature strengthen apathy as a strong component of neuropsychiatric disorders. It is currently understood as a trans-nosographic and multi-dimensional concept including reduced goal-oriented behaviors, cognitions and social-interactions. It has relied for a long-time on motivation, which, although difficult to define and to quantify, remains a psychological construct of interest. During this course, we will address i) the diagnosis pathway starting with apathy in light of the clinical context and of the concurrent symptoms ii) a clear strategy to lead a clinical examination of apathy (including the caregiver burden assessment associated with apathy) iii) the different screening tools and more advanced scales to quantify apathy iv) the most robust data related to the pathophysiological mechanisms underlying apathy and v) the possible psychopharmacological and psychotherapeutics available at hand. To this, we will provide clinical vignettes and enhance experience sharing using small groups discussion interactions. Role play will be performed so that participants can integrate the basics apathy clinical examination. Participants will be able to provide questions throughout the course and regular tests will be carried out to ensure appropriate understandings of the topic.

Organised by the EPA Section on TeleMental Health. Widespread use of video, mobile health and other technologies during the COVID-19 pandemic has given users a vision of what is possible in the future to reshape the delivery of healthcare worldwide. The pandemic has not only necessitated a shift in health technology adoption, but it has also highlighted a shift in the needs from health technology awareness, to an era where the focus is digital and cultural literacy to optimize the benefits that can be leveraged to health outcomes. Skills (i.e., competencies) and attitudes are as important knowledge to ensure patient-centered care. Published competencies focus on Patient Care (history, assessment, management, medico-legal issues, privacy, confidentiality), Communication (engagement, interpersonal skills), Systems-based Practice (quality improvement, safety), Practice-based Learning and Knowledge. Video and mobile health skills are now in demand, particularly in low- and middle-income countries. For clinicians and institutions to implement services, they need to consider the human-computer interaction, ethical and legal, models of care and quality of life issues.

Organised by the EPA Section on Suicidology and Suicide Prevention. Social isolation and loneliness are the new scourges of our hyper-connected civilisations. They are associated with premature mortality and very clearly with the risk of suicide. During the covid-19 pandemic, the increase in loneliness has been one of the major burdens on the mental health of the population. Conversely, one avenue of prevention that is developing considerably at present is to remain in contact with at-risk patients through telephone calls. Caring contacts is becoming a gold standard in care management of suicide attempters in some countries. In his presentation, Ph Courtet (F) will explore if social cohesion, social connection and social prescription may represent good ways for preventing suicide, and how to implement these strategies in clinical practice. Diego Palao (E) will present the Catalan experience of follow up by contact phones of suicide attempters, and the results of a 10 years follow up study. Enrique Baca Garcia (E) a pioneer of the use of smartphone applications in psychiatry, will give an overview of its research program regarding the effectiveness and implementation of ecological momentary assessments and interventions techniques for preventing suicide and in research. Mirian Iosue (S) will give an overview of the effectiveness and practicability of national helplines for suicidal behaviour, and present the aims of the task force of the Section of Suicidology and Suicide Prevention of the EPA.

Organised by the EPA Section on Cultural Psychiatry. Adolescence is a time of considerable neuronal growth and psychosocial change, and in the context of migration can be particularly challenging for mental health care. This workshop will explore some of the more complex intersections of adolescence, immigration, and mental health, including gender, trauma, migration status. Effective psychiatric care of adolescents in itself requires specialization, however this specialization, for the most part, is monocultural and predicated on "Western" social and cultural norms. To that end this workshop will consist of brief presentations on some of the key issues related to adolescence and migration and interactive discussions in which participants can share questions and strategies used to both understand and to treat young people with immigrant backgrounds in general and unaccompanied migrant youth in particular

Organised by the EPA Sections on Forensic Psychaitry and Neurodevelopmental Disorders Across the Lifespan (NDAL). Hyperactivity and impulsivity are among the most important personality or individual difference factors that predict later offending. Hyperactivity tends to persist into adolescence, but may continue into adult life. It is associated with restlessness, impulsivity and a short attention span. Individuals with ADHD may also have poor ability to defer gratification and a short future time perspective. In this symposium, knowledge and experience from different European countries will be presented from a variety of perspectives, such as ADHD and intimate partner violence, and ADHD and treatment implementation in prisoners and other forensic psychiatric settings.