Psiquiatria y adicciones. socidrogalcohol 2015 final

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  • Psiquiatra 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 Clnic. Barcelona

    Red de trastornos Adictivos

  • 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

  • ndice

    Introduccin

    EUFAS: La Federacin de Sociedades cientficas de Adicciones de la Unin Europea

    Material y mtodo

    Resultados

    Conclusiones

  • ndice

    Introduccin

    EUFAS: La Federacin de Sociedades cientficas de Adicciones de la Unin Europea

    Material y mtodo

    Resultados

    Conclusiones

  • Introduccin

    Las adicciones, un olvido de la psiquiatra

    Factores de cambio:

    La adiccin como enfermedad del cerebro

    La eclosin de la patologa dual

  • ndice

    Introduccin

    EUFAS: La Federacin de Sociedades cientficas de Adicciones de la Unin Europea

    Material y mtodo

    Resultados

    Conclusiones

  • 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).

  • EUFAS

  • 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:

    Societe Francaise d'Alcoologie

    Germany:

    Deutsche Gesellschaft fur Suchtforschung und Suchttherapie (German Society for Addiction Research and Addiction Therapy, (DG-Sucht)

    Deutsche Gesellschaft fur Suchtmedizin (DGS)

    Deutsche Gesellschaft fur Suchtpsychologie (DG-SP)

    Holland:

    Dutch Society of Practitioners of Addiction Medicine (VVGN)

    Hungary:

    Hungarian Association on Addictions (HAA)

    Italy:

    Societa Italiana di Alcologia (SIA)

    Societa 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:

    Associacao Portuguesa de Medicina da Adiccao, A.P.M.A., Alcoolismo e Toxicodependencias

    Associacao Portuguesa para o Estudo das Drogas e das Dependencias - (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)

  • 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.

  • Major Goals of EUFAS:

    Reinforce addiction research in Europe

    Improve and harmonise prevention and

    treatment

    Suggest policies based on evidence

  • ndice

    Introduccin

    EUFAS: La Federacin de Sociedades cientficas de Adicciones de la Unin Europea.

    Material y mtodo

    Resultados

    Conclusiones

  • 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)

  • 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?

  • ndice

    Introduccin

    EUFAS: La Federacin de Sociedades cientficas de Adicciones de la Unin Europea.

    Material y mtodo

    Resultados

    Conclusiones

  • COUNTRIES Belgium Finland France Germany Greece Ireland Italy Lithuania Luxembourg Netherlands Norway Poland Portugal Russia Spain Sweden Switzerland UK

    Response rate 18/21: 86%

  • Are addictions part of the training of psychiatrists in your country?

    70%

    20%

    10%

    Yes

    No

    Optional

  • How many years lasts the residency in psychiatry?

    2 years 5%

    4 years 30%

    5 years 55%

    6 years 10%

  • Approximately which percentage of the training is devoted to addictions?

    30%

    20% 25%

    25%

    Not specified

    5%

    6-10%

    10-15%

  • Months devoted to addictions during psychiatry residency

    29%

    38%

    14%

    19%

    Not specified

    3 or less

    4 to 6

    more than 6

  • 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

  • Are addictions recognized as a subspeciality of Psychiatry?

    84%

    16%

    No

    Yes

  • 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.

  • 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.

  • 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?

  • 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

  • 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

  • Do you think there is a need for a European harmonization in this area?

    90%

    5% 5%

    Yes

    No

    I don't know

  • 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

  • ndice

    Introduccin

    EUFAS: La Federacin de Sociedades cientficas de Adicciones de la Unin Europea

    Material y mtodo

    Resultados

    Conclusiones

  • 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

  • Psiquiatra 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 Clnic. Barcelona

    Red de trastornos Adictivos

    Muchas gracias !!!