Welcome to the EPA 2022 Interactive Programme 

Organised by the EPA Section on Neuroimaging. Functional Near Infrared Spectroscopy (fNIRS) is an optical technique that, using light at specific wavelengths, allows to probe changes in oxygenated and deoxygenated hemoglobin cortical concentration over time. In the last two decades, fNIRS has been widely used in the study of neuro cortical correlates of cognition and emotional processing, due to several advantages it offers over other neuroimaging modalities. In particular, fNIRS is harmless, tolerant to body movements, and highly portable, which makes it particularly suitable for subjects with different psychiatric disorders that present difficulty staying still. In the light of these premises, in this symposium the speakers will discuss present and future prospects of fNIRS for assessing cerebral cortex function in several typical and atypical conditions, from childhood to adulthood, providing examples of applications using different cognitive and emotional tasks.

Organised by the EPA Section on Old Age Psychiatry. Depression is the most frequent mental disorder also in the elderly population and it is soften unrecognized and untreated. Compared to other age groups, there are differences in risk factors, symptomatology, comorbidity, differential diagnosis and management. In the course epidemiology and risk factors will be presented. Diagnosis will be discussed with special focus on the differential diagnosis to grief, dementia and anxiety disorders. Sleep problems and suicidality will deserve special attention. Regarding therapy relevant modifications of drug therapy and psychological therapies will be presented. The different types of psychotherapy for elderly (schema based therapy, psychodynamic psychotherapy, cognitive behavioral therapy) will be discussed. We also discuss neuromodulation therapies, ECT, and exercise. The management in the presence of physical disability or in special settings requires tailored interventions. Case vignettes regarding diagnosis and therapy are discussed.

Organised by the EPA Sections on Consultation Liaison Psychiatry & Psychosomatics and Neuroimaging. The COVID pandemic has dramatically increased the need for help in mental health disorders, and has shown a specific effect of SARS-COV 2 in the brain, with effects that may persist longer than expected. In this joint symposium we will describe new-onset and pre-existing psychiatric disorders/syndromes after covid-19 infection. First, an overview concerning Delirium and covid 19 infection will be presented, including laboratorial and neuroimaging findings. Second the impact of Social isolation duo to pandemics and its brain correlations will be explored. Third, Pre existing and new onset cognitive impairment in patients with covid 19 will be explored. Finally, the evolution of pre-existing and new onset depression and anxiety disorders after covid 19 infection will be discussed in terms of their clinical and possible neuroimaging findings.

Organised by the EPA Section on Addictive Behaviours. Mental health and substance use problems in medical doctors remain are a highly relevant topic in many European Countries. The pandemic has only sharpened these needs and problems. However, prevalence data and treatment interventions remain understudied. In this symposium, we present recent data and trends within four European countries. Spain was one of the European countries that suffered the highest impact of the COVID pandemic. Health professionals had to deal with very stressful personal and professional situations. A number of relevant sequelae have been described, including PTSD, burn-out, substance abuse, mood and anxiety disorders. This presentation will describe the data available, the actions taken, and the lessons learned. We present the results of prospective and longitudinal studies on individual and organizational factors that predict mental health, burnout, and problematic drinking in Norwegian doctors. In addition, findings are presented of the effects of counseling for burnout (Villa Sana) and mindfulness training (RCT with 6-year follow-up). Data will be presented from the study “Physician Health: Results and caveats from surveys in Austria, Switzerland, and Germany “. This presentation focuses on alcohol use disorders in physicians, highlights pitfalls in this context, and presents results on a survey on physician health in the canton fo thurgau; Switzerland, and the State of Salzburg, Austria. Finally, data will be presented from a recent (2021) large (n = 4000) survey in medical doctors on their substance use (alcohol, psychoactive medication, and illicit drugs), medication self-prescription, and burn-out in Belgium.

Organised by the EPA Sections on Mental Health and Intellectual Disability (MHID) and Psychopathology. Recognition of psychiatric symptoms in patients with intellectual disability (ID) requires from the examiner not only using information gained during the interview, because many of the patients may have difficulties to express their internal perceptual experiences with the use of spoken language. One way to gather this information is to observe details of a person’s behavior and compare these behaviors to those of persons with known psychotic symptoms. In this symposium specific problems in psychiatric examination regarding different groups will be presented. In the first presentation the specificity of the interviewing and observing adult patients with ID with psychotic, affective and other disorders will be discussed. The second one will be devoted to psychiatric problems superimposed upon ID in children, underlying and permeating mental development. In the next presentation the an analysis of psychopathological symptoms in patients with autism spectrum disorders will be done. Finally the need of cooperation of different specialists and carers: doctors, nurses, psychologists, teachers, parents in a common framework in order to collect and share all possible information about possible patients` psychopathology will be discussed. The examiner must not only make his or her own observations, but must also very intentionally gather the observational data from those who know the person well. It is also very important to interpret the observations in the context of the person’s other symptoms and life experiences. All the above elements of examining a patient with ID and comorbid psychiatric disorders a very important for their proper diagnosis and treatment.

Organised by the EPA Section on Old Age Psychiatry. The United Nations has proclaimed that “Mental health is a human right” a position supported by WHO. Globally, mental health systems have been in crisis, and in violation of basic human rights, segregated from the rest of health care, prompting calls by the UN Special Rapporteur on the Right to Health, for a sea change in mental health care systems to end decades of abuse, neglect and violence. This imperative is driven by global population ageing, with progressive rises in the proportion of the population aged over 65. Of these, approximately 20% will have mental health conditions such as dementia, depression, anxiety and substance use, often complicated by physical and psychosocial comorbidities culminating in disability. As such, older people may experience multiple jeopardies of discrimination and stigma conferred by age itself (ageism) and having a mental disorder (“mentalism”), with marginalized groups such as older women, LGTBI and indigenous elders faring worst. Older persons facing this level of stigma are often “invisible”, have no voice, nor support for autonomy, nor advocacy. Older people facing ageism and mentalism are often left behind and disproportionately excluded from social protection and survival support. This symposium intends to debate some special contexts where Human Rights are violated and to describe some actions to promote the Human Rights of this population. Ref.: Peisah C, de Mendonça Lima CA, Verbeek H, Rabheru K. IPA and WPA-SOAP joint statement on the rights of older persons with mental health conditions and psychosocial disabilities. International Psychogeriatrics. doi:10.1017/S1041610221000454.

Organised by the EPA Section on Addictive Behaviours. Treatment of addictive disorders is often aimed at reaching abstinence. However, the goal of full abstinence is not always achievable. There is a long tradition on opioid substitution treatment (OST) worldwide. However, also for other substances of abuse substitution approaches might be a viable option. Substitution treatment in patients with addictive disorders might contribute to increased quality of life, a more stable personal and health situation, including both physical and mental health, better treatment retention and a better life expectancy. In this symposium developments in the field of substitution treatment will be shared. More specifically, the following substitution treatments will be discussed: Sodium Oxybate for alcohol use disorders, Cannabinoids for cannabis use disorders, new developments in opioid substitution treatment, and baclofen as a substitute for Gamma Hydroxy Butyric-acid (GHB) and alcohol. Furthermore, also for stimulants substitution treatment with long-acting stimulants seems potentially advantageous. This will be touched upon briefly in the discussion with the audience. The aim of the current symposium is to provide a state-of-the-art overview of current practice and future outlook of substitution treatment for patients with addictive disorders. After attending this symposium, participants gain insight in the current evidence base for substitution treatment, and receive practical recommendations directly transferable to clinical practice.

Organised by the EPA Section on Psychopharmachology. In 2019, the WHO has adopted the 11th revision of the International Classification of Diseases (ICD-11), with planned implementation from 2022 onwards. The chapter Mental, Behavioural or Neurodevelopmental Disorders in ICD-11 expands the number of categories, modifies terminology, and includes new diagnostic entities. Major change is a separation of Sleep-wake disorders and Sexual dysfunctions, Sexual pain disorders, and Gender incongruence into individual chapters. Although the impact of ICD-11 on clinical practice is yet to be examined, it is clear that treatment guidelines should be adjusted accordingly. Thus, it is urgent to determine the availability of approved treatments for new disorders, to look into the labels of psychotropic drugs based on classifications before ICD-11 and to determine how they fit into the new system. The symposium will focus on several clinically relevant groups of mental disorders that changed from the previous classification: psychotic disorders, neurodevelopmental disorders, eating disorders, and catatonia, which has been introduced into ICD-11 as an independent category. Available treatment options and therapeutic strategies for the updated classification will be discussed.

Organised by the EPA Section on Women, Gender and Mental Health. 1. Schizophrenia and women. What do we need to know and do to improve outcome for women? This presentation will look at the gender differences, lifespan course, risk assessment and care needs for women with schizophrenia. Dr Liz McDonald 2. Women with severe mental disorders: sexual health, fertility and planning for pregnancy and parenthood. This presentation will address the specific needs of women in relation to their fertility and how clinicians and services can best support women to ensure optimal outcome. Dr Lucinda Green. 3. Violence against women and mental health. This presentation will consider the many implications for mental health outcomes and services, of violence against women. Dr Hind Khalifeh. 4. Mental Health and Parenting. This presentation addresses risk factors and uses case examples to explore links between mental disorders and the barriers and challenges in relation to child safeguarding. Dr Lucinda Green.

Organised by the EPA Sections on Neuroimaging and Child and Adolescent Psychiatry. Neurodevelopment represents a period of increased plasticity and vulnerability, during which a complex confluence of genetic and environmental factors influences brain growth trajectories, cognition, emotion regulation and mental health outcomes. In this symposium, we will focus on the link between genes, disease-related behaviour and the brain, using a multidisciplinary perspective bridging epidemiology, genetic, neuroimaging and psychopathology. Specifically, we will discuss how genetic and environmental risks for developmental disorders translate to brain function, structure and connectivity and how this in turn – ultimately- translates to emotion regulation and behavioural development. In addition, we will explore examples of the long-term psychological and behavioural sequelae in individuals with typical and atypical development, particularly focusing on clinical phenotypes associated with emotional dysregulation. Ultimately, we will discuss the key role of genetic and neurobiological markers to improve the early detection and treatment of developmental disorders.

Organised by the EPA Sections on Neuroimaging and Psychotherapy. Resilience is a multifactorial construct that shapes the adaptive individual’s response to trauma, preventing the development of stress-related mental illness in the face of adversity. In this symposium, we will describe molecular, neurobiological and psychological mechanisms associated with trauma and resilience and integrate them into a translational perspective. Evidence from both animal and human studies will be discussed for this purpose. Unbalanced approach-avoidance tendencies, a highly prevalent endophenotype of psychopathology, will be discussed as a live example suitable to bring clinic and basic research in molecular psychiatry closer. Indeed, neurobiological substrates of resilience-related behaviors and their relevance in clinics can only be investigated through a translational research based on comparable paradigms between humans and animal models. Lastly, we will focus on the role of resilience as a translational endpoint in the treatment of stress-related disorders. Particularly, we will discuss the putative role of the neurobiological mechanisms underlying resilience in the development of novel interventions for stress-induced disorders that specifically target neural circuitry and brain areas associated with resilience outcomes.

Organised by the EPA Section on Prevention of Mental Disorders. During the last decades there has been a wide discussion in scientific literature about the effectiveness of early intervention, with many aspects where early intervention has been shown to be a more effective treatment option than standard care. The core philosophy of early intervention treatment includes multi-professional teamwork. In this workshop we aimed to present examples from different countries with different health care systems and different resources for mental health care- how they manage to build and integrate early intervention teamwork. The speakers will guide the audience through their journey of clinical and organizational work with patients with first-episode psychosis. During the symposium we will cover treatment for all important stages of first-episode psychosis: from early detection to treatment in acute psychosis wards, and afterwards follow-up and prevention from second psychosis in early psychosis programs in community or out-patient care. At the end of the workshop there will be time for educational, motivational, and encouraging discussions with specialists who’s work includes clinical work and who have gained excellent experience which is complimented with active work in psychosis research.