In the last decades, psychiatric training has undergone a major transformation due to the contribution of recent scientific developments in psychiatry. Nowadays, the information acquired during the Psychiatric training seems considerably variable in content and quality between different countries. However, data concerning access to information and also about the educational resources available to the trainees in Europe is very limited.

The ATIIPT survey aimed to evaluate Psychiatric trainees’ access to published, online, senior's or industry's information in Europe.

A short paper questionnaire constituted of 7 questions (Appendix 1) was created by the members of the EFPT Research Working Group and passed to each delegate of the 32 countries represented at the 19th EFPT Forum in Prague, Czech Republic, on the 2nd of July 2011.

According to the ATIIPT results, access to information among Psychiatric trainees in Europe is heterogeneous. The most available resources are books and websites, and the most preferable resource is journals. Most of the trainees find their resources sufficient, with the main obstacles being related to low availability of journals and books, lack of time and help from seniors.

Better access to information and more evidence in practice is warranted, since the introduction of novel approaches to access to information may create better psychiatrists in the future, encourage medical students to consider psychiatry as a potential career, and help reduce negative attitudes towards mental illness.

Interplay between nervous and immune systems plays an important part in clinical presentation and course of affective disorders.

The aim of the study has been to assess the relation between soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular cell adhesion molecule-1 (sICAM-1), in acute and remission phase of bipolar depression, in regard to acute and long-term measures of overall severity of the bipolar disorder.

The study has explored serum levels of sVCAM-1 and sICAM-1 in 43 patients with bipolar depression. The adhesion molecules’ levels of patient group have been analyzed in acute and remission phases, in regard to bipolarity index (BPIX) and in regard to global functioning (measured by Global Assesment of Functioning Scale- GAF)

The acute serum levels of sICAM-1 have been associated to BPIX. Moreover, sVCAM-1 serum selevels have been associated to BPIX in both phases of the disorder. In addition, acute sVCAM-1 levels have been associted to GAF score in accute phase.

Our results suggest that cellular adhesion is an important factor in clinical presentation and overall severity of bipolar disorder.

Migration of mental health professionals is an important phenomenon influencing mental health services of host and donor countries. Data on medical migration in Europe is very limited, particularly in the field of young doctors and psychiatry. To research this hot topic, the European Federation of Psychiatric Trainees (EFPT) conducted the EFPT Brain Drain Survey.

To identify the impact of previous short-term mobility on international migration and to understand characteristics, patterns and reasons of migration.

In this cross-sectional European multicentre study, data were collected from 2281 psychiatric trainees across 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on migration.

Two-thirds of the trainees had not had a short-mobility experience in their lifetime, but those that went abroad were satisfied with their experiences, reporting that these influenced their attitude towards migration positively. However, the majority of the trainees had not had a migratory experience of more than 1 year. Flows showed that Switzerland and United Kingdom have the greatest number of immigrant trainees, whereas Germany and Greece have the greatest number of trainees leaving. ‘'Pull factors'’ were mostly academic and personal reasons, whereas ‘'push factors'’ were mainly: academic and financial reasons. Trainees that wanted to leave the country were significantly more dissatisfied with their income.

The majority of the trainees has considered leaving the country they currently lived in, but a lower percentage has taken steps towards migration.

Growing evidence in the field of psychoneuroimmunology indicates an interconnection between psychiatric disorders, in particular schizophrenia and mood disorders, and cytokine alternations. Gender and aging are commonly reported to affect cytokine levels, but contrasting conclusions still represent a topic for debate.

Our aim was to investigate the role of age and gender in the serum levels of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α), in patients with schizophrenia (SCH) and major depression (MDD).

We measured serum levels of IL-6 and TNF-α in acute exacerbation of illness, in 37 patients with MDD, and compared them to 43 patients with SCH. The serum levels were measured by the enzyme-linked immunosorbent assay (ELISA). All patients fulfilled the ICD-10 criteria.

The significant interaction between gender and psychiatric disorders on serum cytokine levels, and the association between IL-6 and TNF-α and age, in both groups of patients, were not detected. However, when applied the linear regression model with the serum cytokine levels as dependant variable, and age, gender, and psychiatric disorder as independent variables, the significant predictive effect of age on levels of both investigated cytokines was detected. The patients over 35 years of age had higher levels of IL-6 and even significantly lower levels of TNF-α, regardless of the diagnosis.

The results suggest that the aging process could be a relevant factor influencing the immune status of patients with SCH and MDD. Further prospective studies are essential to further investigate biological mechanisms that underlie these multidimensional interconnections.

Longer duration of untreated bipolar disorder (DUB) can lead to a prolonged exposure to inflammatory and neurodegenerative processes, that are believed to underlie etiopathogenesis of bipolar affective disorder (BAD), and thus cause a more severe course of illness as well as difficulties in the maintenance of remission.

The aim was to determine the relationship between DUB and socio-demographic characteristics, along with clinical characteristics related to the course of illness, applied psychopharmacotherapy and the ability to maintain an adequate remission over 24 months period following hospital treatment.

The study used retrospective design and included patients with BAD (n = 127), hospitalized between 2006 and 2010. We acquired data on socio-demographic and clinical characteristics, previous treatment and the information on posthospital period between 0 and 24 months.

The average DUB was 130.59 ± 108.44 months. Patients with longer DUB presented with higher number of mood episodes of BAP, higher number of inpatient treatments, and required a significantly higher dose of lithium in the remission period. Female patients and those with metabolic syndrome more frequently failed to maintain remission for more than 24 months.

Interventions for monitoring of DUB, its diminishing duration, early detection and recognition, and timely treatment, would be useful for fewer relapses and therefore a better course and outcome of BAP. Furthermore, the results of the study strongly imply that a systematic, longitudinal monitoring of the course of illness and potential inflammatory, endocrine and metabolic markers that underlie its systemic nature is recommended.

Stigmatization of people with mental disorders often leads to impairment of quality of life (QoL) - lack of self-esteem and life opportunities, social isolation, decreased productivity, violation of human rights and inadequate health care. However, data comparing stigma and QoL between different psychiatric disorders is fairly limited.

To assess stigma and QoL of patients with affective disorders compared to patients with psychotic spectrum disorders and to assess the association of stigma to QoL.

A cross-sectional study. the patients from diagnostic groups F30–39 (n = 61) and F20–29, diagnosed according to ICD-10 criteria, in remission for at least six months at the time of testing, matched by age and gender were included in the study. A semi-structured socio-demographic questionnaire, Stigma Scale and World Health Organization Quality of Life Questionnaire (WHOQoL) - BREF were used in the study.

The QoL of patients from affective spectrum is significantly lower in some of its domains (overall perception of QoL, overall perception of health QoL, psychological domain) compared to the patients from psychotic spectrum. in addition, the affective spectrum patients scored higher on Stigma Scale, although not significantly. Furthermore, the scores on Stigma Scale showed strong, negative correlation with all domains of QoL.

The stigmatization strongly affects the QoL in psychiatric patients. Patients with affective disorders feel more stigmatized and perceive their own QoL as lower compared to the psychotic spectrum patients

Immune alterations are considered an important factor in etiopathogenesis of bipolar disorder.

The aim of the study has been to assess the relation between soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular cell adhesion molecule-1 (sICAM-1), in acute and remission phase of mania, in regard to severity of depressive and manic symptoms.

The study has explored serum levels of sVCAM-1 and sICAM-1 in 40 patients with mania. The adhesion molecules' levels of patient group have been analyzed in acute and remission phases, in regard to severity of depressive sympotoms (measured by Hamilton Depression Scale) and in regard to severity of manic symptoms (measured by Young Mania Rating Scale).

The acute serum levels of sVCAM-1 have been inversily associated to YMRS score and directly associated to HAMD score, in acute phase. Serum levels of sICAM-1 have shown no association to severity of affective symptoms, in both phases of the disorder.

Our results suggest that cellular adhesion acute could be one of the factors mediating affective symptoms presentation in bipolar mania.

There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country.

Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration.

A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have ‘ever’ considered to move to a different country in their future, 53.5% were considering it ‘now’, at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%).

A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.

Oestrogen fluctuations may be an important factor in the etiology of bipolar disorder and age at menarche is associated with the clinical course of BD. Moreover, it is associated with traits related to mood.

The aim of our study was to explore the differences in age at menarche between euthymic BD patients and healthy controls, as well as to explore the relationship between age at menarche and lifetime psychopathology within BD.

The study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.

Age at menarche in BD patients was similar to that in controls. After covarying for confounders, we observed that age at menarche is negatively related to number of previous depressive episodes in euthymic BD patients, but not other indicators of lifetime psychopathology.

BD patients with earlier age at menarche are more likely to present with more depressive episodes in the course of illness. Systemic, longitudinal monitoring of the course of illness, and potential hormonal fluctuations within particular groups of patients are warranted.

The authors have not supplied their declaration of competing interest.

Immune parameters are frequently associated with mood disorders and affective temperaments. In our study, we investigate the role of soluble intercellular adhesion molecule-1 (sICAM-1) in affective temperaments and mood symptoms in healthy adults.

Healthy adults were screened for psychiatric disorders using the non-patient version of the Structured Clinical Interview for DSM-IV-I and II. Affective temperaments were evaluated with Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A). State mood symptoms were assessed using the Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS). Serum sICAM-1 levels were measured using enzyme-linked immunosorbent assay.

We identified no association between sICAM-1 levels and affective temperament scores. We identified correlation between sICAM-1 levels and manic symptoms measured by YMRS. Furthermore, sICAM-1 was a significant predictor of manic symptoms in a linear regression model with age, gender, BMI and smoking habits as confounding variables.

Our findings suggest that sICAM-1 could be a relevant immune factor for severity of state affective symptoms and could contribute to better understanding of complexity of affective disorders.

The authors have not supplied their declaration of competing interest.

Immune alterations are believed to be an important part in etiopathogenesis of affective disorders. However, it is not clear if the altered immune mediators are related to distinct disorders or particular psychopathology.

The aim of our study was to explore the differences in C-reactive protein levels (CRP) between euthymic BD patients and healthy controls, as well as to explore the relationship between CRP and lifetime presented psychopathology within BD.

The study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.

The CRP levels were significantly higher in BD patients when compared to healthy controls. After covarying for confounders, we observed that CRP levels, in euthymic BD patients, were related to number of previous suicide attempts, but not other indicators of lifetime psychopathology.

BD patients per se, and particularly those with more suicide attempts, are more likely to present with proinflammatory state, even when in remission. Previous history of suicide attempts could bear specifically vulnerable endophenotype within BD. Systemic, longitudinal monitoring of the course of illness, and potential inflammatory mediators that underlie its systemic nature is warranted.

The authors have not supplied their declaration of competing interest.