Welcome to the EPA 2022 Interactive Programme 

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 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 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.

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.

Organised by the EPA Section on Schizophrenia. Cognitive dysfunctions represent a core feature of schizophrenia, are present at any stage of the disease and in subjects at high risk for psychosis (UHR), and have a significant impact on patient psychosocial functioning. Pharmacological treatment is modestly effective on cognitive dimension while there is considerable evidence of the efficacy of cognitive remediation interventions on cognition and functioning. The Workshop, proposed within the activities of the Section on Schizophrenia, has the aim of updating knowledge and discussing about the definition of cognitive impairment in schizophrenia, the impact of cognitive dysfunctions on the patients' real life functioning and quality of life, the available assessment instruments, the detection of impairment in early intervention settings, and the possible treatments, both pharmacological and non-pharmacological, with a special focus on cognitive remediation techniques. All these topics will be debated by the panel of experts involved in the preparation of the EPA guidance paper on the assessment and treatment of cognitive impairment in schizophrenia.

Organised by the EPA Section on TeleMental Health. Telepsychiatry, an aspect of digital psychiatry, is rapidly being adopted throughout the world as a solution for disparities in access to mental health care. Its spread has been significantly accelerated a consequence of measures taken to combat the COVID-19 pandemic. Whilst the evidence supports the use of telepsychiatry in clinical practice, clinicians have often started from a base with little or no specific training. The skills required for effective telepsychiatric care are distinct from our practices in the traditional clinic, face-to-face; adaptation of our usual practices are required to achieve optimal outcomes. The current situation may pose new risks, and there are controversies. The workshop aims to provide the audience with up-to-date techniques and information on the more important issues in telepsychiatric care, delivered by European experts in managing psychosis, suicide risk, substance misuse, transition psychiatry, care of the elderly, and forensic issues.

Organised by the EPA Section on Prevention of Mental Disorders. Early intervention in psychosis has an already established role in reducing the duration of untreated psychosis, preventing or at least delaying psychosis onset, and relieving clinical high-risk (CHR) patients them from their presenting symptoms. However, as a thorough diagnosis is always the prerequisite of a good intervention, the accurate early detection of psychoses by their CHR states is a prerequisite for an early tailored intervention in psychosis. In this course we will therefore focus on the early detection. The course participants will learn and discuss: - the concept of early detection, the rationale for the clinical approach, and the existing evidence-base - to recognize potential early signs of psychosis and learn the basics of diagnosing CHR states using different instruments for their assessment - to discuss potential ethical dilemmas, - the main theoretical challenges and - common obstacles in early detection. The course is practical and interactive, and suitable for mental health professional of all levels of experience. The participants will be able to present cases and problems from their daily work. The knowledge and experience acquired in this course are relevant as basis for the EPA course on Early Intervention and applicable to all areas of mental health. After the course the participants shall be able to detect patients possibly at clinical high-risk for psychosis.

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.

Organised by the EPA Sections on Old Age Psychiatry and Psychopharmacology. Patients with mental disorders are frequently treated for other comorbidities, including psychiatric and somatic comorbidities. While often underreported and undertreated, somatic comorbidities represent a high burden in patients with mental disorders and represent the most important cause of death. The most prevalent somatic comorbidities are cerebral- and cardiovascular diseases, different infections, and metabolic diseases. Insomnia and pain also frequently occur in multimorbid elderly patients. Despite a high burden of somatic comorbidities in this population, different studies have shown their inadequate treatment, low screening, and low treatment rates have been described. Medication selection in this population is mainly based on possible drug-drug interactions and irrational polypharmacy minimizing, often presented in this population. There are some tools available to help in pharmacotherapy selection in clinical practice, including different medication lists (e.g., Beers criteria, STOPP/START, and general guidelines). Although most important evidence-based papers and treatment guidelines describe the treatment of psychiatric disorders by often excluding somatic and non-somatic comorbidities. In this context, pharmacotherapy of comorbidities is complicated, and well-designed treatment guidelines are urgently needed. This proposed joint workshop of the Section of Old Age Psychiatry and the Section of Psychopharmacology will address a neglected topic: how to treat somatic and non-somatic comorbidities in elderly patients with mental disorders. Experts in psychiatry and psychopharmacology will address pharmacotherapy in this vulnerable population. The participants will learn how to treat these patients supported by the evidence-based data and real clinical pharmacological tools useful for daily practice.