Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social interaction and communication, and by restricted and repetitive behaviors. A meta-analysis describes motor difficulties in ASD (Downey and Rapport, 2012) in 85% to 90% of cases (Liu et al. 2010). Electronic devices will help to better characterize these movement impairments (Gargot et al., in press). Another meta-analysis shows difficulties in sensorial integration in ASD, with a prevalence ranging from 45 to 95% (Ben Sasson, 2009). Sensorimotor contigencies are learned interactively (Jacquey et al., 2020), in a perception-action loop, an early milestone in development (Piaget, 1937). A cascade model (Bonnet-Brilhault, 2017) hypothesizes that social difficulties stem in sensorimotor difficulties (Cook, 2016; Neal, 2011; Dziuk et al. 2007; Kojovic, 2019), themselves atypically developed due to a peculiar neurobiological background. This model predicts that early sensorimotor reeducation could prevent the development of social difficulties, whereas the rehabilitation of social skills would improve only part of the impairment, that is driven by sensorimotor processes. How to target these issues? Grandin, 1992 and Edelson et al., 1999 validated the efficacy of deep pressure therapy in ASD. It is important to improve attractivity and decrease the stigmatization of this method. Oto is a compressive armchair with inflatable cushions controlled electronically. It records level of pressure and its duration, chosen by the user. A systematic review showed the efficacy of virtual reality in ASD (Mesa-Gresa et al, 2018). A CAVE device could habituate children to ecological audio-visual stimulations.

Most psychiatric disorders (between 50% and 90%) remain untreated although effective treatments exist (Kohn et al., 2004). Stigma is frequent toward patients and mental health professionals (Rüsch et al., 2005). It impairs access to care especially during the early signs, amplifying the treatment gap, mainly due to a shortage of resources. How the brain makes prior internal models of the world could explain why we all stigmatize. The Bayesian brain hypothesis describes the optimal combination of priors, coming from our evolution, our memory and our perceptions, to make decisions (Parr et al., 2018). This can be intuitively understood by visual illusions, but also medical categorical diagnostic reasoning (Medow, 2011). These priors allow to simplify the world and categorize people (Sherman et al., 1998). Beyond cognitive modelling, Computational approaches also led to the development of several electronic devices, from apps to social robots, (Gargot et al., 2021). Patients reported that it was easier to self-disclose toward an avatar, that cannot judge, than toward a therapist (Hang and Gratch, 2010). These technologies could improve early, scalable as well as efficient access to care (Andersson et al., 2019). Empathy is the best strategy to tackle stigma. What is it exactly? Good therapist-patient synchronization of brains (Czeszumski et al., 2020) and bodies (Ramseyer et Tschacher, 2011) could foster better communication and thus empathy. There is an urgent need to promote research in empathy (Belzung, 2017), non-specific factors in psychotherapy mechanisms (Miller et Moyers, 2021) and psychotherapy online training resources (Gargot et al., 2020).

Difficulties in motor development are frequent and impairing. However, the assessment of these motor learning skills is difficult and limits early stage rehabilitation. Electronic sensors and algorithms can help to measure motor difficulties more easily and objectively. We will present a systematic review detailing these methods and challenges in Autism Spectrum Disorders (ASD). Electronic tablets, give access to handwriting features that are not usually evaluated in classical assessments. We describe how such digital features (in static, dynamic, pressure, and tilt domains) allow diagnosing dysgraphia and how they evolve during children development. From a finer analysis, three different clusters of dysgraphia emerge, longitudinal studies will allow to underline different patterns of development that seemingly require tailored remediation strategies. However, those digital features are not used in the context of conventional pen and paper therapies. It is possible to engage children with typical development in handwriting exercises by asking them to teach a robot to write. We implemented a long-term case study (20 sessions, 500 minutes in total) observing a child with severe Developmental Co-ordination Disorder who did not progress anymore with a classic pen and paper approach by enriching this setup with various training activities using real-time feedback loops (on tilt, pressure, dynamic, pauses). We show how this new method tackles previous child’s behaviour avoidances, boosting his motivation, and improving his motor and writing skills. This talk demonstrates how new motor digital features allow the implementation of innovative motor remediation interventions, which rely on fostering children’s personal characteristics and adaptation skills.

Le syndrome de Wernicke est caractérisé par un syndrome confusionnel, une paralysie oculomotrice, une ataxie cérébelleuse. Il serait secondaire à une carence en vitamine B1 souvent liée à une carence d’origine alcoolique. Le syndrome de Korsakoff est une complication du syndrome de Wernicke auquel s’ajoutent des troubles de la mémoire antérograde, des fabulations, des fausses reconnaissances et une polyneuropathie. Classiquement, le syndrome de Korsakoff est considéré de mauvais pronostic. Qu’apporte une prise en charge bio-psychosociale de ces troubles en secteur de psychiatrie ? Nous rapportons le cas d’un patient hospitalisé pour une tentative de suicide sans alcoolo-dépendance connue. Quelques jours après son admission, il présente un syndrome confusionnel, une paralysie oculomotrice, une ataxie cérébelleuse, une amnésie antérograde, des fabulations, des fausses reconnaissances et une polyneuropathie des membres inférieurs. Un diagnostic de syndrome de Wernicke compliqué de syndrome de Korsakoff a été posé. Par ailleurs, apparaissent une humeur dépressive, une alcoolo-dépendance niée, un délire confuso-onirique, une décompensation d’hypertension artérielle, diabétique et une hyperexcitabilité auriculaire. Des dosages montrent des carences en 25-OH vitamine D et en vitamine B9. Le dosage de la vitamine B1 est normal. Il reçoit des benzodiazépines à l’admission. En phase aiguë, il reçoit des vitamines B1, B6, D et B9. Après amélioration, il est traité par de la fluoxétine et de l’acamprosate. L’imagerie cérébrale après rémission ne montre pas d’atteinte des corps mamillaires. Un suivi psychométrique par mini mental state examination, un test de l’horloge et un test des 5 mots de Dubois a montré une normalisation. Après rémission, nous avons utilisé une approche psychothérapeutique motivationnelle. Une lourde prise en charge sociale axée sur la réinsertion a été nécessaire. Le syndrome de Korsakoff pris à un stade précoce ne serait pas toujours de mauvais pronostic. Une vision bio-psycho-sociale semble pertinente dans ces pathologies.

La fédération européenne des internes de psychiatrie (EFPT) a réalisé une étude observationnelle sur la migration des internes de psychiatrie en Europe suite à un rapport de la WPA . Entre 2013 et 2014, 2281 internes de 33 pays ont répondu à un questionnaire sur internet. Nous présenterons les résultats concernant les internes faisant leurs études en France. Au total, 193 personnes ont répondu en France (2e pays répondeur). Parmi ces internes, 8 n’avaient pas la nationalité française, ce qui fait de la France le 7e pays le plus attractif de l’étude. A contrario, 4 français émigrés à l’étranger ont répondu à l’étude. En termes d’expérience de mobilité, 30 % des français ont déjà vécu à l’étranger entre 3 et 12 mois. Seuls 5 % des internes ont passé plus d’un an à l’étranger, soit 3 fois moins que dans les autres pays européens (p < 10−4) ce qui place la France à la 14e place en termes de nombre d’émigrants. Cette faible mobilité ne s’explique pas par une désaffection : 71 % des internes ont déjà envisagé de partir à l’étranger. Cependant, 65 % des répondeurs pensent qu’ils resteront en France dans les 5 prochaines années. Les raisons principales pour quitter la France sont personnelles, académiques ou liées à l’environnement culturel. Le salaire des internes de psychiatrie en France est compris entre 1500 et 1999 €, ce qui est un salaire moyen en Europe et dont ils semblent modérément satisfaits et qui ne représente pas une réelle motivation à l’émigration. D’autres difficultés davantage culturelles ou liés à la faiblesse des aides à la mobilité pourraient expliquer cette moindre mobilité par rapport aux autres pays européens. Depuis 2011, l’EFPT cherche à répondre à cette volonté de mobilité par un programme d’échange de 2 à 6 semaines parmi 13 pays européens.

Psychiatrists have a unique place in the spectrum of mental health services, as being able to integrate psychotherapy and pharmacotherapy in clinical practice. It is through psychotherapy training that a trainee gains optimal communicative skills and competence in establishing therapeutic alliance with a patient. It helps developing empathic understanding, which is very important for a good collaboration and enable understanding, diagnostic and treatment. It improves trainees’ own insight. All are these fundamental aspects of a biopsychosocial approach of psychiatry.

In many countries psychiatry trainees have a positive attitude towards psychotherapy during their training. Moreover, patients often prefer and adhere to combined psychotherapy and medication than split-care treatments. Research in psychotherapy provides ample evidence that these treatments are effective. The UEMS considers psychotherapy education as mandatory. EFPT advocates that all trainees must gain competence in at least one recognised form of psychotherapy and have a basic knowledge for other forms. Altogether, there is a consensus among all actors of mental health services that psychotherapy training is essential and should be improved. Yet, it is still far from being a priority in psychiatric training and is subdued by biological training and research, which is easier, faster and prevailing in training institutions. Also, psychotherapy training is found less affordable by trainees.

With collaboration from other organizations, EFPT aims to improve standards of psychiatry training, including psychotherapy. We present some initiatives led by UEMS, EPA, WPA and ECNP. Today's technology allows trainees to reach various psychotherapeutic training availabilities, including online tools (Webinar, MOOCs, online guidebooks) and international courses. It is advisable that training institutions devote more time on psychotherapy training and supervision, associations provide costly training availabilities or scholarships, encourage more scientific research on psychotherapeutics and take into account the progress of research in psychology and neuroscience [1–5].

Psychiatrists have a unique place in the spectrum of mental health services, as being able to integrate psychotherapy and pharmacotherapy in clinical practice. It is through psychotherapy training that a trainee gains optimal communicative skills and competence in establishing therapeutic alliance with a patient. It helps developing empathic understanding, which is very important for a good collaboration and enable understanding, diagnostic and treatment. It improves trainees’ own insight. All are these fundamental aspects of a biopsychosocial approach of psychiatry.

In many countries psychiatry trainees have a positive attitude towards psychotherapy during their training. Moreover, patients often prefer and adhere to combined psychotherapy and medication than split-care treatments. Research in psychotherapy provides ample evidence that these treatments are effective. The UEMS considers psychotherapy education as mandatory. EFPT advocates that all trainees must gain competence in at least one recognized form of psychotherapy and have a basic knowledge for other forms. Altogether, there is a consensus among all actors of mental health services that psychotherapy training is essential and should be improved. Yet, it is still far from being a priority in psychiatric training and is subdued by biological training and research, which is easier, faster and prevailing in training institutions. Also, psychotherapy training is found less affordable by trainees.

With collaboration from other organizations, EFPT aims to improve standards of psychiatry training, including psychotherapy. We present some initiatives led by UEMS, EPA, WPA and ECNP. Today's technology allows trainees to reach various psychotherapeutic training availabilities, including online tools (Webinar, MOOCs, online guidebooks) and international courses. It is advisable that training institutions devote more time on psychotherapy training and supervision, associations provide costly training availabilities or scholarships, encourage more scientific research on psychotherapeutics and take into account the progress of research in psychology and neuroscience [1–5].