Course Director: Gabriel Robert, France

Course Co-Director: Cecile Hanon, France

Apathy is frequent and associated with both poor health outcomes and the caregiver burden. It is not described in the international classification of mental disorders, yet a growing body of literature strengthen apathy as a strong component of neuropsychiatric disorders. It is currently understood as a multi-dimensional concept including reduced goal-oriented behaviors, cognitions and social-interactions. It has relied for a long-time on motivation, which, although difficult to define and to quantify, remains a psychological construct of interest. During this course, we will address i) the diagnosis pathway starting with apathy in light of the clinical context and of the concurrent symptoms ii) a clear strategy to lead a clinical examination of apathy (including the caregiver burden assessment associated with apathy) iii) the different screening tools and more advanced scales to quantify apathy iv) the most robust data related to the pathophysiological mechanisms underlying apathy and v) the possible psychopharmacological and psychotherapeutics available at hand. To this, we will provide clinical vignettes and enhance experience sharing using small groups discussion interactions. Role play will be performed so that participants can integrate the basics apathy clinical examination.  Participants will be able to provide questions throughout the course and regular tests will be carried out to ensure appropriate understandings of the topic.

Course Director: David Okai, United Kingdom

Course Co-Director: Ivan Koychev, United Kingdom

Neuropsychiatry is a discipline that sits at the interface of both  neurology and psychiatry and deals with the psychiatric manifestations of psychiatric disorders. Due to the division of psychiatry and neurology in the past century and the complexity in the management of neuropsychiatric disorders, psychiatrists often lack consistent experience in this field. The course will address neurodegenerative diseases, epilepsy and non-epileptic seizures, head injury and movement disorders.

The first part of the course will provide participants with an overview of the general approach to neuropsychiatric diagnosis, examination and management. It will begin with an overview of the basics of interpreting key investigations in neuropsychiatry (magnetic resonance imaging and cognitive testing). Case studies will illustrate the cardinal neuropsychiatric presentations based on cortical and subcortical injury. The second part of the course will focus on the neuropsychiatry of seizure  and movement disorders and  Parkinson’s diseaseand their practical management. The final part of the course will be an interactive discussion based on cases from our daily practice illustrating the challenges faced by psychiatrists managing patients with primary neurological conditions.

Course Director: Meryam Schouler-Ocak, Germany

Course Co-Director: Danuta Wasserman, Sweden

Euthanasia and assisted suicide – Legal and ethical aspects and Ethical principles in mental health care of immigrant and minority patients

While euthanasia is legal in Benelux, Canada, Colombia, and Victoria, only PAS is legal in the United States. Switzerland is the only nation where the law allows for assisted suicide without the explicit aid of physicians.  Laws legalizing euthanasia and PAS have similar themes in their guidelines, though the specificities vary between regions. For example, the individual often needs to be an adult of at least 18 years of age, with exceptions in Belgium, Colombia, and the Netherlands where persons younger than 18 are eligible. To ensure that the individual is acting by their own free will, safeguards include multiple written or oral requests, which may require the co-signing of a witness who would not benefit from the death of the person requesting euthanasia or PAS.  

Ethical issues about euthanasia and PAS will be discussed in psychiatric patients, as well as patients with terminal somatic diseases who present symptoms of mental health disorders (e.g., depression). 

The second topic is on how culturally nuanced practice of medicine facilitates wider access to care, a more welcoming “patient experience,” more effective health care delivery, thus advancing the overarching goal of delivering more of the benefits of mental health care to greater numbers of people. Ethical dilemmas may arise because of differences between a clinician’s personal values and beliefs and those of the patient, even when both individuals have the same cultural background. In this course ethical principles in mental health care of immigrant and minority patients will be discussed with the participants. 

Course Director: Merete Nordentoft, Denmark

The there is strong scientific evidence for the effectiveness a range of outcomes of early intervention services in first episode psychosis in schizophrenia spectrum disorders. Early Intervention Services are characterized by comprehensive, multi-modal and phase-specific treatment of first-episode psychosis, modified to suit the needs of this patient population, including intensive/assertive case management and family involvement.

In this course, the evidence for Early Intervention Services will be presented together with the principles and rationale for involving families.

The format of psychoeducational multifamily groups will be explained in detail.

Participants will be involved actively with polls, and in a physical course, participants will train the problem solving live

Course Director: Takahiro Kato, Japan

Course Co-Director: Umberto Volpe, Italy

The constant growth of the use of digital technology has been paralleled by the rise of many reported digital addictions. Some of those have been specifically associated with pathological social withdrawal and a new psychopathological entity in the field of affective disorders has been recently described in the international literature (modern type depression). Indeed, a specific form of pathological social withdrawal, possibly related to digital addiction, has been first highlighted in Japan since the 1990s: Hikikomori has been defined as a condition that mainly affects adolescents or young adults who live isolated from the world, cloistered within their parents’ homes, locked in their rooms for months or years, and refusing to communicate even with their family. Once described in japan only, Hikikomori has been repeatedly reported to be spreading abroad due to globalization and internet society. COVID-19 is suggested to be a high risk factor to further increase the number of hikikomori worldwide. The present course will provide the audience with practical and theoretical knowledge about hikikomori over the following three main areas: 1) how to detect and assess hikikomori in clinical practice, based on the proposed international diagnostic criteria of pathological social withdrawal; 2) psychopathological features of Hikikomori in the European context, discussing the similarity and differences between Asian and European cases; 3) introducing bio-psycho-social intervention and novel therapeutic approach using digital tools such as communication robots and metaverse (avatar).

Course Director: Istvan Bitter, Hungary

Course Co-Director: Matej Štuhec, Slovenia

A practice oriented intensive course on pharmacological treatment of schizophrenia and some other disorders

This interactive, evidence-based course has been designed for early carrier psychiatrists, however other colleagues – especially those, who teach/supervise residents -  also may benefit from the structured teaching material.  The content of the course is primarily built on landmark studies and the data which will be discussed includes real world evidence as well.  The participants should be able after completing the course to individually plan antipsychotic treatment for patients with schizophrenia and with some other psychotic disorders.  The course will have a clinical focus and includes the following topics:

        - Short and long term treatment of schizophrenia with antipsychotics

        - Dose response relationship of antipsychotic drugs: How to define the right dose? Is there a therapeutic window? How do patients benefit from the use of therapeutic (plasma level) drug monitoring?

        - Comparative effectiveness of antipsychotics

        - Pharmacological treatment of negative symptoms in schizophrenia

        - The role of antipsychotics and other drugs in the management of agitation, suicidal and violent behavior in schizophrenia       

        - Possible treatment strategies to avoid antipsychotic polypharmacy

        - Length of antipsychotic treatment in schizophrenia; how to discontinue antipsychotic treatment; risks of antipsychotic withdrawal

        - Antipsychotic selection in different comorbidities

        - Antipsychotic treatment in the elderly: schizophrenia and psychosis related to dementia

        - Management of the most frequent side effects and drug-drug interactions during treatment with antipsychotics

Course Director: Ulrike Ehlert, Switzerland

How is it possible that some people, despite massive physical or mental crises and the resulting insecurity, cope with these burdens in a calm, friendly, goal-oriented and optimistic manner? Other people, on the other hand, are already overwhelmed by significantly lower stressors? Suffering from psychosomatic complaints such as insomnia, diffuse pain, irritability and dejection, or they develop psychological disorders such as depression, addiction or anxiety disorders.

Research has gained knowledge about the physical effects of stress. There are now also good theories on the psychological factors that promote healthy coping with stress. Cognitive evaluations, emotions and physical adaptation processes play a role for stress coping.. Repeated successful experiences of stress coping can lead to a resistance to life’s adversities. This characteristic is called resilience.

Various studies have shown that different epi(genetic), hormonal and psychological parameters are associated with resilience, or can promote a resilient adaptation to psychological stress. Epigenetic markers include, mythylation patterns of the genes NR3C1, FKBP5. Relevant hormonal axes include the hypothalamic-pituitary-adrenal axis and -gonadal axis. Psychological factors are characteristics such as self-efficacy, give and receive social support, the competence to learn from mistakes, compassion for oneself or serenity.

The workshop will

1. introduce basic concepts of stress research
2. explain the importance of different (epi)genetic processes for the control of physiological processes such as hormone release and the connection to psychological processes
3. show the complexity of socio-bio-psychological processes
4. give disorder-related knowledge about this complex process based on selected life phases, stressful events, disorder, diseases.

Course Director: Boris Chaumette, France

Course Co-Director: Kristiina Tammimies, Sweden

The last decade has witnessed major advances in psychiatric genetics and have established that the genetic architecture of major psychiatric disorders (i.e. schizophrenia, bipolar disorders…) includes both rare variants conferring high risk and common variants with low impact (polymorphisms). Rare variants refer to Single Nucleotide Variants (SNV) and Copy Number Variants (CNV, chromosomal microdeletions and microduplications). Polymorphisms can be aggregated into polygenic risk scores.

While polygenic risk scores are considered research analyses and are not recommended for clinical use, some results on rare genetic variants can already be translated into psychiatric practice. For instance, patients with neurodevelopmental disorders (i.e. autism, intellectual disability…) could benefit from chromosomal microarray analysis for CNV detection, fragile X molecular testing and whole-exome (WES) or whole genome sequencing (WGS). Geneticists and psychiatrists can already order genetic testing for psychotic disorders.

Identification of genetic variants may help psychiatric patients to better understand and accept their diagnoses and could improve the psychiatric genetic counselling for familial recurrence risk. The genetic approach could also be efficient for alleviating emotional distress and guilt and in improving self-efficacy and empowerment of patients and their family. Additionally, the detection of some rare variants can improve the care by allowing the detection of other comorbidities and by giving clues to adapt the psychotropic treatments. Integrating the genetic psychiatry into clinical practice requires a substantial training effort and awareness about legal, ethical and practical challenges.

In this course, Dr. Boris Chaumette and Dr. Kristiina Tammimies will present the current knowledge on the genetic architecture of major psychiatric disorders, will describe the state-of-the art of the genetic testing and counseling in Europe, will advertise some clinical vignettes showing the benefit and the pitfalls of genetics in psychiatry. The course will contain interactive presentations, role plays and a debate about the interest and the challenges of implementing genetic testing in clinical practice.

Course Director: Lionel Cailhol, Canada

Course Co-Director: Rémy Klein , France

Guidelines emphasize on psychotherapeutic treatment as they are the most studied and successful type of treatment. However, a large proportion of BPD patients do not have access to psychotherapy for different reasons (i.e.: this kind of treatment does not exist in their area, patient is not motivated). In this course, we will review clinically useful strategies to improve the outcome for these patients, which can be used whether the patient has access to psychotherapy or not. First, we will present ways to review diagnosis and efficient ways to offer psychoeducation to the client. Then we will consider treating clinical comorbidities such as addiction, PTSD, depressive disorder, ADHD. Furthermore, we will present the common medical disorders in this population and some tools to improve their medical management (screening, follow-up). We will highlight the potential of lifestyle medicine (improving nutrition, sleep, physical activity). We will discuss the strengths and weaknesses of psychiatric hospitalization and emergency services and offer guidelines for efficient case management. Considerations related to the usefulness of psychometric tools (screening and outcome measures) will be discussed. Lastly, we will introduce some new kinds of treatments and discuss prevention.

Course Director: JJ Sandra  Kooij, Netherlands

Course Co-Director: Toni Ramos-Quiroga, Spain

This basic course on Adult ADHD has been presented by the NDAL section at EPA annually, before the Covid episode. We want to continue the course in order to deliver basic and practical knowledge on assessement and treatment of ADHD in adults to our collegues in Europe and beyond.

The course consists of 4 themes:

1. prevalence and neurobiology of ADHD in adults
2. symptoms and impairment
3. patterns of physical and psychiatric comorbidities
4. treatment

Course Director: Giovanni Briganti, Belgium

In recent years, network analysis has been widely applied in psychiatry and psychopathology to identify and analyse the statistical association in multivariate data sets. Network analysis is the statistical counterpart of network theory, which conceives mental disorders to arise from a set of causal connections from symptoms themselves.

The added value of this new set of methods is clear: new research hypotheses can be generated through the analysis of retrospective data, new associations can be found among symptoms and new insights (such as the relative importance of symptoms in the network, redundancy, predictability, stability) can be created.

The network analytic framework heavily draws from the domain of artificial intelligence, with the use of networks themselves, but also algorithms, such as structure learning, causal inference, community detection, and so on.

Many works published in peer-reviewed journals in psychiatry, psychology etc. use network analysis as a tool: however, clinicians often lack the necessary introduction to A) critically read such works and B) carry out a network analysis themselves.  Because of the sophistication of the techniques used, it can be difficult to approach this very important new field of psychiatric research.

The goal of this course is to give a theoretical and practical hands-on introduction to the field of network analysis.

In the session, we will talk about the following items and practice them with pre-made code and data made available to all participants :

• The network theory of mental disorders
• The statistical foundations for network analysis
• Pairwise Markov Random Fields
• Bayesian Networks
• Network inference measures
• Network stability
• Community Detection algorithms

Course Director: Thomas Gargot, France

The methodology of scientific method can be sometimes difficult to understand and implement in psychiatry. Different tools exist to help this process by collecting and interpreting data but they can sometimes be quite expensive. Here we will present free and open source softwares that help to communicate but also randomize, collect, interpret and publish data. These tools can be easily reused and shared. That could improve validity and reproducibility of scientific research. In order to be interactive, we will involve the participants in the collection of the data of a prototypical scientific study, an international cake testing database! (http://bit.ly/cakereport)

We will see a study protocol and how we can pregister this protocol defining the primary outcome. Here what is the best cookie from 2 different brands?

We will discuss the issue of sample selection. Who will taste the cookies?

Randomizer.org will help us to attribute a condition (cookie A or B) to each subject.

Limesurvey helps to run easy online surveys. What did you think about each characteristic of your cookie?

R helps to analyse and plot the data. What the mean score? How to plot the results? Is the difference significant?

GitHub helps to publish publicly or not our data and analysis script.

ArXiv systems helps to publish early works and manuscripts before publication.

Equator-network.org can give guidelines that could help to write scientific articles.

We can promote our work then on wikipedia and discuss what are the advantages and issues to promote your own work on wikipedia.

Course Director: Judit Balazs, Hungary

Course Co-Director: Nora Kollarovics, Norway

Diagnosis of autism spectrum disorder (ASD), especially in adolescence and adulthood, can be a challenge even for experienced clinicians. ASD is manifested in a very heterogeneous way, even with the defined diagnostic criteria. Moreover, symptom formation in the same person also changes over time. Moreover, clients with ASD but not diagnosed often turn to psychiatric care with other diagnostic questions, and this often means that interacting and overlapping symptoms make it difficult to recognize the ASD behind surface. Consistent with research, the Diagnostic and Statistical Manual of Mental Disorders allows additional diagnoses among individuals with ASD. The prevalence of comorbid disorders among people with ASD varied across studies: it is suggested that 54-70% of children and adolescents with ASD have an associated psychiatric disorder, 41% of them have two or even more comorbidities and above 18 years even a higher prevalence of psychiatric comorbidity (up to 94%) is described compared to younger people with ASD. Comorbid psychiatric disorders can be anxiety, mood, eating, substance use, obsessive-compulsive and related, attention-deficit/hyperactivity, disruptive, impulse-control and conduct disorders, schizophrenia and suicidal behavior. Comorbid psychiatric disorders cause high burden to people with ASD.

Therefore, it is insufficient not only to have adequate knowledge of the diagnostic aspects of ASD, but also to have a comprehensive picture about the associated psychiatric disorders and their interaction with ASD. The aim of our course is to give uptodate knowledge and help deepen the diagnostic process and aspects of ASD, also in connection with possible comorbid psychiatric disorders.

Course Director: Kris Goethals, Belgium

Course Co-Director: Kolja Schiltz, Germany

The course will provide the knowledge and research results about the risk of psychiatric patients of becoming violent and of becoming offenders with violent crimes. It will focus on the indicators of risk for violence and delinquency but also on the indicators of immediate threat and imminent aggression on wards and in outpatient settings. It will teach on how to develop a structure in the assessment and to come to a professional judgment on the severity and on the imminence of risk. It will also teach on risk formulation and risk communication among staff and outside of the clinicians’ surroundings (relatives, police, courts, caretakers).It will address risk management, when to intervene and how, the methods of prevention and the long term guidance of risky patients.

Course Director: Richard Fredric Summers, United States

Course Co-Director: Jacques Barber, United States

This pragmatically-oriented course will help clinicians provide focused and evidence-based psychodynamic therapy to a wide range of appropriate patients.  By providing a clear and consistent model connected to evidence and technique, we simplify and clarify the psychodynamic approach and help clinicians provide state-of-the-art treatment.  

The course will focus on change in psychodynamic therapy.  What are the mechanisms of change that allow patients to feel and function more adaptively, and what are the strategies of change we employ as therapists to promote change in patients?  The course will review new empirical evidence that helps to understand the change process and discuss and illustrate the pragmatic clinical applications of these findings. 

The faculty are international and include a clinician and a researcher.  The goal of the course is to bring new evidence on psychotherapeutic change to bear in the real world clinical setting, being aware of and sensitive to the dynamics of gender, race and culture, as well as the social context of psychotherapy in our contemporary culture. 

Video clips of therapy with participant discussion about technique, a group exercise on defining the core psychodynamic problem of a presented patient, and audience response input on assessment of change in therapy will make for a highly engaging learning experience.