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Psiquiatria y adicciones. socidrogalcohol 2015 final

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Formación en adicciones de los médicos residentes en psiquiatría en el conjunto de la Unión Europea. Ponencia presentada en Logroño el 13 de marzo del 2015, en el marco de las 42º Jornadas Nacionales de Socidrogalcohol

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Psiquiatria y adicciones. socidrogalcohol 2015 final

  1. 1. Psiquiatría y adicciones: Encuentros y desencuentros desde una perspectiva Europea Antoni Gual Presidente de EUFAS (European Federation of Addiction Societies) Unidad de Conductas Adictivas. IDIBAPS. Hospital Clínic. Barcelona Red de trastornos Adictivos
  2. 2. Conflicts of interest Interest Name of organisation Current roles and affiliations Addictions Unit, Psychiatry Dept, Neurosciences Institute, Hospital Clinic, University of Barcelona; IDIBAPS; RTA; Vice President of INEBRIA, President of EUFAS Grants Lundbeck, D&A Pharma, FP7, SANCO Honoraria Lundbeck, D&A Pharma, Servier, Lilly, Abbvie Advisory board/consultant Lundbeck, D&A Pharma, Socidrogalcohol (Alcohol Clinical Guidelines) 2013
  3. 3. Índice • Introducción • EUFAS: La Federación de Sociedades científicas de Adicciones de la Unión Europea • Material y método • Resultados • Conclusiones
  4. 4. Índice • Introducción • EUFAS: La Federación de Sociedades científicas de Adicciones de la Unión Europea • Material y método • Resultados • Conclusiones
  5. 5. Introducción • Las adicciones, un olvido de la psiquiatría • Factores de cambio: – La adicción como enfermedad del cerebro – La eclosión de la patología dual
  6. 6. Índice • Introducción • EUFAS: La Federación de Sociedades científicas de Adicciones de la Unión Europea • Material y método • Resultados • Conclusiones
  7. 7. Mission & Aims of EUFAS • The purpose of the Federation is to promote education and the attainment of the highest level of knowledge and understanding in the field of addiction in all European countries. • Addiction disorders comprise all mental disorders related to the use of psychoactive substances and non-substance-related disorders related manifestations (such as gambling).
  8. 8. EUFAS
  9. 9. Member societies of EUFAS Austria: Austrian Society for Addiction Research and Addiction Therapy Belgium: Association for Alcohol and other Drug Problems Czech Republic: Czech Society of Addiction Medicine of the Czech Medical Society J.E. Purkyne Denmark: Danish Psychiatric Association Finland: Finnish Society of Addiction Medicine Flanders: Flemisch Society for Psychiatry, Section on addiction psychiatry (chaired by Dr. Hendrik Peuskens) France: Société Française d'Alcoologie Germany: Deutsche Gesellschaft für Suchtforschung und Suchttherapie (German Society for Addiction Research and Addiction Therapy, (DG-Sucht) Deutsche Gesellschaft für Suchtmedizin (DGS) Deutsche Gesellschaft für Suchtpsychologie (DG-SP) Holland: Dutch Society of Practitioners of Addiction Medicine (VVGN) Hungary: Hungarian Association on Addictions (HAA) Italy: Societa Italiana di Alcologia (SIA) Società Italiana Psichiatria delle Dipendenze) Ireland: St. Patricks University Hospital Lithuania: National Tobacco and Alcohol Coalition Lithuanian Association of Addiction Psychiatry Norway: Norwegian Association of Addiction Medicine (NFRAM) Poland: Polish Society for Addiction Research Medical University of Warsaw, Poland Portugal: Associação Portuguesa de Medicina da Adicção, A.P.M.A., Alcoolismo e Toxicodependências Associação Portuguesa para o Estudo das Drogas e das Dependências - (APA-APEDD) Romania: (Alliance against alcohol and drug addiction) ALIAT Russia: Russian Society for Addiction Medicine Spain: Socidrogalcohol Switzerland: Swiss Society for Addiction Medicine United Kingdom: Society for the Study of Addiction (SSA) Clinical Addiction Network Europe European Society for Biomedical Research on Alcoholism (ESBRA) European Association of Substance Abuse Research (EASAR)
  10. 10. Specifically EUFAS intends to: • Improve addiction care in European countries, • Improve prevention measures both on a national as well as a European level, • Support those European countries whose prevention and treatment systems may be less developed, • Influence the allocation of financial resources for addiction research on a national as well as a European level.
  11. 11. Major Goals of EUFAS: • Reinforce addiction research in Europe • Improve and harmonise prevention and treatment • Suggest policies based on evidence
  12. 12. Índice • Introducción • EUFAS: La Federación de Sociedades científicas de Adicciones de la Unión Europea. • Material y método • Resultados • Conclusiones
  13. 13. Methods • Online questionnaire sent to all Presidents of EUFAS member societies • Mix of questions on qualitative & quantitative aspects of training on addictions delivered to resident psychiatrists • Easy to answer (less than 10 minutes)
  14. 14. Questionnaire • Are addictions part of the training of psychiatrists in your country? • How many years lasts the residency in psychiatry? • Approximately which percentage of the training is devoted to addictions? • Do you have an approximate idea of how many months are devoted to addictions? • Can you briefly describe in which settings does training take place? • Are addictions recognized as a subspecialty of Psychiatry? • Could you briefly describe the strengths and weaknesses of the addiction training program for psychiatry residents in your country? • Which changes would you suggest to improve the actual situation? • In general how would you rate the level of competence in addiction psychiatry a resident has at the end of his/her training (from 1 not competent at all, to 5 extremely competent) • Do you think there is a need for a European harmonization in this area? If yes, what should be the main principles that should guide it? • Would you like to make any other considerations?
  15. 15. Índice • Introducción • EUFAS: La Federación de Sociedades científicas de Adicciones de la Unión Europea. • Material y método • Resultados • Conclusiones
  16. 16. COUNTRIES Belgium Finland France Germany Greece Ireland Italy Lithuania Luxembourg Netherlands Norway Poland Portugal Russia Spain Sweden Switzerland UK Response rate 18/21: 86%
  17. 17. Are addictions part of the training of psychiatrists in your country? 70% 20% 10% Yes No Optional
  18. 18. How many years lasts the residency in psychiatry? 2 years 5% 4 years 30% 5 years 55% 6 years 10%
  19. 19. Approximately which percentage of the training is devoted to addictions? 30% 20% 25% 25% Not specified 5% 6-10% 10-15%
  20. 20. Months devoted to addictions during psychiatry residency 29% 38% 14% 19% Not specified 3 or less 4 to 6 more than 6
  21. 21. Can you briefly describe in which settings does training take place? • In most countries a combination of inpatient, outpatient and day hospital settings • Usually inpatient settings take precedence • Settings are located both in general Psychiatric facilities and in specialized Addiction services. • In most countries the length of stay in each setting is not fix
  22. 22. Are addictions recognized as a subspeciality of Psychiatry? 84% 16% No Yes
  23. 23. Are addictions recognized as a subspeciality of Psychiatry? • Germany, Latvia and Russia do recognize Addictions as a subspeciality • France, Finland, Switzerland and Netherlands offer specialization in Addictions open to a variety of professionals • In the UK Addictions are recognized by the Royal College of Psychiatrists but not by the Health Deptartment • There are Chairs in Addictions in various countries.
  24. 24. Strengths of addiction training programs for psychiatry residents in your country? • Training schemes, clinical placements, CV and competencies defined (UK) • The program is both theory and competency oriented and there is a serious exam and practice evaluation (NL) • At some places well developed and integrated in standard training (B) • Regular part of psychiatric training.
  25. 25. • Too short • Not compulsory • Large variety within institutions • Not evidence based • Not well structured • Lack of training skills (in addictions) in some psychiatric institutions Weaknesses of addiction training programs for psychiatry residents in your country?
  26. 26. Which changes would you suggest to improve the actual situation? • Recognition of Addiction as a speciality (53%) • Improve training pathways for non psychiatrists • To extend length and content of training (1 year) • Expand the training on addiction at undergraduate level • Making training compulsory within psychiatric rotations
  27. 27. Level of competence in addictions that a psychiatry resident has at the end of his/her training 5% 20% 40% 25% 5% 5% Very good Quite good Fair Not too good Bad I don't know
  28. 28. Do you think there is a need for a European harmonization in this area? 90% 5% 5% Yes No I don't know
  29. 29. What are the main principles that should guide harmonization? • Every resident needs to get a clinical placement in addiction psychiatry, in both and inpatient and outpatient setting, including dual diagnosis training. • We should aim at the comparable level of training and competence to enable interchangeability in employment of doctors in the EU. • To standardize what a psychiatrist in EU should know about addictions, • To aim at EU wide competencies for specialists in addiction psychiatry. • EU guidelines for a training program, including exchanges and development of a shared core CV. • To develop EU modules of training materials. • European meetings for psychiatry residents in this area, i.e., summer schools or intensive courses
  30. 30. Índice • Introducción • EUFAS: La Federación de Sociedades científicas de Adicciones de la Unión Europea • Material y método • Resultados • Conclusiones
  31. 31. Summary • Addictions are part of the compulsory psychiatric training in 70% of countries • Addictions training is around 5-10% of the residency time (2-6 months) and in a variety of settings • Just 25% of respondents think that residents training is good or very good. • 90% think EU harmonization is needed • Harmonization should be achieved through: – EU guidelines for a training program – Development of a shared core CV
  32. 32. Psiquiatría y adicciones: Encuentros y desencuentros desde una perspectiva Europea Antoni Gual Presidente de EUFAS (European Federation of Addiction Societies) Unidad de Conductas Adictivas. IDIBAPS. Hospital Clínic. Barcelona Red de trastornos Adictivos Muchas gracias !!!

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