Recent evidence has questioned modern psychiatric clinical practice, specifically the prescribing of “atypical” antipsychotics. Our Pan-European Research Group wished to ascertain clinical practice amongst European trainees, which treatments trainees would desire for themselves, and factors influencing this.

A semi-structured survey was constructed from prior literature, piloted, and a homogenous sample size of at least 50 was agreed upon from each country, with 50% minimum response rate. It was distributed via web-link, with questions on preference of antipsychotic for patients in given scenarios, and factors influencing choice. Physicians were asked for their preference should they develop psychosis.

1. i) Treatment choice of antipsychotic for patients

93% (n=600) of respondents chose to prescribe “atypical” antipsychotics (excluding Clozapine), 6% (n=42) choosing “typical” antipsychotics, 1% (n=6) choosing Clozapine as first-line therapy.

1. ii) Treatment choice if trainees developed psychosis

89% (n=530) of responders chose to prescribe “atypical” antipsychotics (excluding Clozapine), 7% (n=40) choosing “typical” antipsychotics, 4% (n=23) choosing Clozapine as first-line therapy.

1. iii) Factors influencing choice

These mapped onto three domains: cost, efficacy and side-effect profile (less than 5% other reasons). 79% (n=458) of those who responded felt efficacy most important, 46% (n=270) felt side-effect profile most important and 3% (n=16) considered cost of paramount importance.

38% (n=272) of those who responded to the survey stated that the CATIE trial had influenced their decision-making.

Psychiatry trainees’ choice of antipsychotic medication for both patients and themselves is based on perceived benefits, as opposed to evidence base and recent literature.

Guidelines produced for management of Bipolar Disorder illustrate change in evidence-base for treatment of acute and maintenance phases of illness. Our Pan-European Research Group assessed clinical practice and desired treatments amongst amongst Psychiatry trainees.

A semi-structured survey was piloted, and homogenous sample size (at least 50) agreed upon from each country, with 50% minimum response rate. It was distributed via web-link, questioning preference of mood stabiliser for patients, trainees themselves and factors influencing choice.

Tables 1 summarise choices.

Factors influencing decision-making mapped onto cost, efficacy and side-effect profile (less than 4% other reasons). 66% (n=538) of respondents felt efficacy most important, 25% (n=202) felt side-effect profile most important and 3% (n=24) considered cost of most importance.

No clear difference exists in choice of mood stabiliser for European trainees and their patients, and decisions based on perceived efficacy are generally in keeping with established guidelines.

There is growing concern about the influence of the pharmaceutical industry on psychiatric teaching and psychiatric professionalism as a whole. As a consequence, several national and international medical and psychiatric associations have issued guidelines to regulate the interactions between physicians and industry.

The EFPT-PRIRS study aims to provide the lacking data on the extent and nature of these interactions among psychiatric trainees across Europe.

Study objectives were determined by the EFPT research group (EFPT-RG), after discussion with national and international experts. A survey was then devised compiling previously published questionnaires extending them by questions with specific relevance to psychiatric trainees. The resulting questionnaire was piloted amongst members of the EFPT-RG, modified accordingly and subsequently distributed to the national study coordinators. All 24 EFPT member countries were invited to participate in the study and data collection is currently ongoing.

Preliminary analysis reveals the vast differences in industry - trainee relationships across European countries as well as major differences in personal attitudes towards these interactions.

EFPT-PRIRS will potentially have an impact on the regulation of the interactions between the pharmaceutical industry and psychiatric trainees.

Despite recent recent evidence and subsequent guidelines that have suggested factors such as side-effect profile and cost should be taken into account when prescribing antidepressant medication, relatively little evidence exists on decision-making in clinical practice.

Our Pan-European Research Group looked at clinical practice regarding antidepressants amongst Psychiatry trainees, treatments trainees would desire themselves, and factors influencing decision-making.

A semi-structured survey was constructed from recent literature, was piloted, and a homogenous sample size of at least 50 agreed upon from each country, with 50% the minimum response rate. It was distributed via web-link, questioning preference of antidepressant for patients, and factors influencing choice. Trainees were asked for their preference should they develop a moderate to severe depressive episode, and require medication.

Treatment choices are summarised in Table 1. 79% of trainees would prescribe similar antidepressants for themselves as for patients.

Factors influencing decision-making mapped onto three main domains: cost, efficacy and side-effect profile (5% other reasons). 86% (n = 548) of those who responded felt efficacy most important, 38% (n = 237) felt side-effect profile most important and 6% (n = 33) considered cost of most importance.

Some differences exist in choice of antidepressant for European trainees and their patients, and factors affecting choice conflict with evidence base and guideline suggestions.

Depression represent an important and predictable complication in chronic haemodialysis.

The prevalence of depression, QoL indicators, correlations between number of years of hemodialysis, depression and quality of life.

To determine if higher depressive levels are correlated with years spent on haemodialysis.

We used Beck questionnaire two times, one at the beginning of the year, and one at the end for 102 patients, excluding diabetes, who were undergoing hemodialysis three times a week, for 4 hours and SF 36 questionnaire. We considered these values for depression: Normal: 0-10, Mild: 11-15, Moderate: 16-23, Severe: 24-63 according to Romanian Guidelines in Nephrology.

98 pacients answered to the Beck questionnaire. Years of haemodialysis: min=0.25, max=18, average=5.7, standard deviation= 4.37 (n=102). SF 36 has close values distributed between the intervals 80-100, 60-80, < 60%. The linear correlation between average depression and years of hemodialysis is very, very weak, square of the coefficient of regression is 0.00- (by the linear model we can explain < 0.1% of the dates) and also between SF36 total and years of hemodialysis:square of the coefficient of regression is 0.04- (by the linear model we can explain 4% of the dates). We followed other models (logaritmic, polinomial, exponential), for both correlations, but we couldn’t notice better results.

The study proved high levels of mild depression, lack of linear correlation between years of haemodialysis, depression and QoL indicators. Although this, there is an influence of time spent in haemodialysis and QoL.

IDEA project is the outcome of Association for the Improvement of Mental Health programme and coordinated at Institute of Psychiatry, King's College London.

Are to explore experience of people treated in a mental health setting across nations, determine how inpatient experiences can be improved. Experience gained from interviews will be used to propose questionnaire for routine use, develop versions of interview for other services, inform a possible follow-up study.

30 consecutive patients are interviewed on day of discharge in own language. Semi-structured interview covers physical condition in institutions, experiences of treatments like medication, satisfaction with staff, privacy, dignity and whether rights were respected. Responses are summarized on several visual analogue scales and quantitative analysis will be performed. The scale will also be analysed by demographic indices within centres to see whether different groups have different experiences.

Qualitative responses will be analysed thematically, both within and between centres, identifying core themes for each domain and core themes for the protocol as a whole.

10 countries are participating, 577 interviews are completed. It is noticed a large disparity between institutions in regards to the amount of contact patients have with family, access to phone, quality of food, surroundings and view of medication and therapy.

It will be a better understanding of the size, structure and staffing of the institutions included in the study, which will help us with our observations about inpatient experiences by putting them in context and make recommendations to institutions.

Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees.

One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire.

The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean) = 0.92, SD = 1.44, range = 0–12) and most in Portugal (M = 19.06, SD = 17.44, range = 0–100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M = 3.30, SD = 1.26 vs. M = 2.39, SD = 1.06 on a 5-point Likert scale: 1 “completely disagree” to 5 “completely agree”). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio) = 1.21, 95%CI = 1.12–1.30 and OR = 1.18, 95%CI = 1.02–1.37).

There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.

Depression is a common disorder in chronic hemodialysis.

We intended to determine the positive correlation between depression and quality of life in one year follow up study. Our hypothesis was that quality of life indicators measured by SF 36 questionnaire were directly correlated with depression.

We used SF 36 questionnaire, Beck questionnaire two times, one at the beginning of the year, and one at the end for 102 patients who were undergoing hemodialysis three times a week, for 4 hours in St Joan Emergency Hospital, Bucharest.

The linear correlation between depression at the revaluation and score SF 36 total is very, very weak, square of the coefficient of regression is 0.35 (by the linear model we can explain only 35% of the dates). We followed other models (logaritmic, polinomial, exponential), but we couldn’t notice better correlation results. P value for Wald test (0.000000) proves an influence of the variable depression on SF 36 total. We noticed the same conclusion for the media of depression at the two moments.

Statistical interpretation didn’t prove our hypothesis. From the medical point of view there is an influence of depression on quality of life, but without a linear correlation. It is not clear if depression has a direct causal role in the negative evolution of patients or depression represents a marker of comorbidities or indicator of severity. We have to consider cardiomiopathy, vascular pathology, artropathies in determining the indicators of quality of life.

IDEA project is the outcome of Association for the Improvement of Mental Health programme and coordinated at Institute of Psychiatry, King's College London.

Are to explore experience of people treated in a mental health setting across nations, determine how inpatient experiences can be improved. Experience gained from interviews will be used to propose questionnaire for routine use, develop versions of interview for other services, inform a possible follow-up study.

30 consecutive patients are interviewed on day of discharge in own language. Semi-structured interview covers physical condition in institutions, experiences of treatments like medication, satisfaction with staff, privacy, dignity and whether rights were respected. Responses are summarized on several visual analogue scales and quantitative analysis were performed. The scale was also be analysed by demographic indices within centres to see whether different groups have different experiences.

Qualitative responses were analysed thematically, both within and between centres, identifying core themes for each domain and core themes for the protocol as a whole.

10 countries are participating, 577 interviews are completed. We followed on visual analogue scale the degree patients felt their stay was beneficial, degree of satisfaction with staff, perceived harm in the hospital, if the right to confidentiality was respected, if individual rights and preferences were respected.

It will be a better understanding of the size, structure and staffing of the institutions included in the study, which will help us with our observations about inpatient experiences by putting them in context and make recommendations to institutions.