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 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.

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 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 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.

Organised by the EPA Section on Cultural Psychiatry. Racism and racial discrimination are one of many factors which can have a significant, negative impact on a person’s life chances and mental health. There is a particularly disproportionate impact on people from Black, Asian and minority ethnic communities, notably those of Black African and Caribbean heritage. Racism is pervasive and can manifest in several often-overlapping forms (including personal, cultural, structural and institutional racism). Like other types of discrimination, it can lead to a profound feeling of pain, harm and humiliation among members of the target group, often leading to despair and exclusion. This symposium will adress racism in the context of migration, the neurobiological underpinnings of racism as well as it’s impact on mental health, and racism and psychiatry. Efforts to tackle this should be urgently prioritised by health policies and professional bodies. Implications for mental health care and mental health care systems will be discussed.

Organised by the EPA Section on Eating Disorders. Eating disorders (EDs) are severe psychiatric conditions with potential life-threatening complications. Although, the overvaluation of shape and weight are believed to be the central core of ED psychopathology, recent studies also demonstrated the centrality of general psychiatric symptoms (anxiety and depressive symptoms, post-traumatic stress symptoms, autism spectrum disorder symptoms, interpersonal problems and ineffectiveness) together with ED core symptoms (drive to thinness and interoceptive awareness) in patients suffering from anorexia nervosa, bulimia nervosa or binge-eating disorder. Therefore, there is a need for clinicians and researchers to provide a detailed characterization of the patient’s psychopathology in order to identify possible treatment targets, characterize new pathophysiological mechanisms and propose more accurate therapeutic and prevention interventions. The aim of this symposium is to illustrate new advances in psychopathology and treatment of EDs, which may provide a more comprehensive clinical evaluation of people suffering from these conditions in order to suggest new perspectives for research, prevention and/or treatment of EDs. To this purpose, Prof. Kate Tchanturia (London, UK) will discuss the relationships between EDs and autism spectrum disorders. Prof. Alessio Maria Monteleone (Naples, Italy,) will present the impact of the recent COVID-19 pandemic on the psychopathology and treatment of people suffering from an ED. Prof. Ashish Kumar (London, UK) will illustrate new advances in the treatment of children with EDs. Prof. Fernando Fernandez-Aranda (Barcelona, Spain) will analyze factors that predict the outcome of treatments in person with EDs.

“There Are things patients Want to Say But clinicians Do Not Ask”. The patient-centred perspective on treatment outcomes is an effective way to provide care that really matters to patients. Assessing users' outcomes and experiences of treatements will help to understand whether the care provided contributes to better results – in terms of symptoms, functioning and quality of life... -, to a better experience of care, and is more tailored to their needs. Clinicians will learn how integrating the patient perspective and Patient-Reported Measures into their practice can improve care outcomes and how these findings could be included in routine care for optimal treatment outcome. The different talks will then be devoted to: (1) developing and implementing indicators that measure the outcomes and experiences of mental health care that matter most to patients (K. Debienassis), (2) how to integrate patient reported measures in routine care: lessons learned from experiences in 6 European countries (Pr Puschner), (3) the value and challenges of implementing patient centered measures in a psychiatric hospital setting (E. Scanferla, PhD), (4) how to optimise the collection of patient-reported outcomes in the context of a specific disease such as eating disorders (Pr Schmdt).

Organised by the EPA Sections on Old Age Psychiatry and Suicidology and Suicide Prevention. Suicide rates are highest in old age, especially in elderly men. The symposium will discuss the evidence on risk factors for suicidal behaviour, showing (again), that the recognition and treatment of depressive disorders and (related) social dysfunction is crucial. Since our societies are in the process of digitalization we want to discuss e-mental-health and give a focus on the attitude to such approaches in older people as well as to the relationship between age and antidepressant outcome when using the iFightDepression-tool of the European Alliance against Depression. We will also discuss the potential influence of ageism – in the media and the society - on suicidality, a potentially underresearched area. Dying with dignity is a subject that has come up regularly in the news in Europe in recent years and applies especially to the older population. One presentation will focus on the ethical debates in various countries and especially France to allow assisted suicide and/or euthanasia. The other presentation will grasp the newest trends concerning assisted suicide during the pandemia, especially in Switzerland.

The transdiagnostic approach is gaining momentum in psychiatry, probing the appropriateness of the categorical classification of mental diseases by diagnostic manuals, such as the ICD-10 or the DSM-5. The proposed symposium examines the transdiagnostic approach and provides an overview of its key components. The first lecture starts with the introduction of the transdiagnostic concept itself, and then diving into more details, the second presentation introduces psychiatric disorders’ polygenic and multifactorial architecture, as well as their shared genetic aetiology. The third lecture focuses on the impact of phenotypic overlap on intra- and inter-disease considerations and the fluidity of diagnostic criteria. Finally, in light of the presented notions, the last lecture discusses the therapeutic opportunities in transdiagnostic psychiatry with a special focus on antipsychotic treatment and the significance of partial agonists.