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Background: There are many barriers to engaging in current psychological treatments, including time, cost, and availability. Ultra-brief treatments overcome some of these barriers by delivering therapeutic information and skills using significantly less time than standard-length treatments. We developed a therapist-guided online ultra-brief treatment for depression and anxiety and compared it to an existing 8-week, 5-lesson therapist-guided standard-length treatment and a waitlist control. Methods: In a randomized controlled trial, adults with self-reported depression or anxiety were randomized (1:1:1) to the ultra-brief treatment, standard-length treatment, or waitlist control. The primary outcomes were depression symptoms and anxiety symptoms assessed at baseline, 5-weeks later, 9-weeks later (primary timepoint), and 3-months later. The trial was prospectively registered. Results: Between 7 February 2022, and 16 August 2022, 242 participants were enrolled in the ultra-brief treatment (n = 85), standard-length treatment (n = 80), and waitlist control (n = 77). Participants were mostly women with an average age of 48.56 years. At 9-weeks post-baseline, participants in the ultra-brief treatment group reported significantly lower depression (between groups d = 0.41) and anxiety (d = 0.53) than the waitlist control. The ultra-brief treatment was non-inferior for anxiety at both 9-weeks and 3-months follow-up. Non-inferiority for depression was observed at 9-weeks. Conclusions: The online ultra-brief treatment resulted in significant reductions in depression and anxiety that were non-inferior to a longer treatment course after 9-weeks. Remotely delivered ultra-brief treatments have the potential to provide accessible and effective care for those who cannot, or would prefer not to, access longer psychological interventions. [ABSTRACT FROM AUTHOR]

The digitalisation of mental health care is expected to improve the accessibility and quality of specialised treatment services and introduce innovative methods to study, assess, and monitor mental health disorders. In this narrative review and practical recommendation of the European Psychiatric Association (EPA), we aim to help healthcare providers and policymakers to navigate this rapidly evolving field. We provide an overview of the current scientific and implementation status across two major domains of digitalisation: i) digital mental health interventions and ii) digital phenotyping, discuss the potential of each domain to improve the accessibility and outcomes of mental health services, and highlight current challenges faced by researchers, clinicians, and service users. Furthermore, we make several recommendations meant to foster the widespread adoption of evidence-based digital solutions for mental health care in themember states of the EPA. To realise the vision of a digitalised, patient-centred, and data-driven mental health ecosystem, a number of implementation challenges must be considered and addressed, spanning from human, technical, ethical-legal, and economic barriers. The list of priority areas and action points our expert panel has identified could serve as a playbook for this process. [ABSTRACT FROM AUTHOR]

The use of digital technologies as a method of delivering health behaviour change (HBC) interventions is rapidly increasing across the general population. However, the role in severe mental illness (SMI) remains overlooked. In this study, we aimed to systematically identify and evaluate all of the existing evidence around digital HBC interventions in people with an SMI. A systematic search of online electronic databases was conducted. Data on adherence, feasibility, and outcomes of studies on digital HBC interventions in SMI were extracted. Our combined search identified 2196 titles and abstracts, of which 1934 remained after removing duplicates. Full-text screening was performed for 107 articles, leaving 36 studies to be included. From these, 14 focused on physical activity and/or cardio-metabolic health, 19 focused on smoking cessation, and three concerned other health behaviours. The outcomes measured varied considerably across studies. Although over 90% of studies measuring behavioural changes reported positive changes in behaviour/attitudes, there were too few studies collecting data on mental health to determine effects on psychiatric outcomes. Digital HBC interventions are acceptable to people with an SMI, and could present a promising option for addressing behavioural health in these populations. Feedback indicated that additional human support may be useful for promoting adherence/engagement, and the content of such interventions may benefit from more tailoring to specific needs. While the literature does not yet allow for conclusions regarding efficacy for mental health, the available evidence to date does support their potential to change behaviour across various domains. [ABSTRACT FROM AUTHOR]

The digitalisation of mental health care is expected to improve the accessibility and quality of specialised treatment services and introduce innovative methods to study, assess, and monitor mental health disorders. In this narrative review and practical recommendation of the European Psychiatric Association (EPA), we aim to help healthcare providers and policymakers to navigate this rapidly evolving field. We provide an overview of the current scientific and implementation status across two major domains of digitalisation: i) digital mental health interventions and ii) digital phenotyping, discuss the potential of each domain to improve the accessibility and outcomes of mental health services, and highlight current challenges faced by researchers, clinicians, and service users. Furthermore, we make several recommendations meant to foster the widespread adoption of evidence-based digital solutions for mental health care in the member states of the EPA. To realise the vision of a digitalised, patient-centred, and data-driven mental health ecosystem, a number of implementation challenges must be considered and addressed, spanning from human, technical, ethical–legal, and economic barriers. The list of priority areas and action points our expert panel has identified could serve as a playbook for this process.

Background: The COVID-19 pandemic has transformed healthcare significantly and telepsychiatry is now the primary means of treatment in some countries. Aims: To compare the efficacy of telepsychiatry and face-to-face treatment. Method: A comprehensive meta-analysis comparing telepsychiatry with face-to-face treatment for psychiatric disorders. The primary outcome was the mean change in the standard symptom scale scores used for each psychiatric disorder. Secondary outcomes included all meta-analysable outcomes, such as all-cause discontinuation and safety/tolerability. Results: We identified 32 studies (n = 3592 participants) across 11 mental illnesses. Disease-specific analyses showed that telepsychiatry was superior to face-to-face treatment regarding symptom improvement for depressive disorders (k = 6 studies, n = 561; standardised mean difference s.m.d. = −0.325, 95% CI −0.640 to −0.011, P = 0.043), whereas face-to-face treatment was superior to telepsychiatry for eating disorder (k = 1, n = 128; s.m.d. = 0.368, 95% CI 0.018–0.717, P = 0.039). No significant difference was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 26, n = 2290; P = 0.248). Telepsychiatry had significantly fewer all-cause discontinuations than face-to-face treatment for mild cognitive impairment (k = 1, n = 61; risk ratio RR = 0.552, 95% CI 0.312–0.975, P = 0.040), whereas the opposite was seen for substance misuse (k = 1, n = 85; RR = 37.41, 95% CI 2.356–594.1, P = 0.010). No significant difference regarding all-cause discontinuation was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 27, n = 3341; P = 0.564). Conclusions: Telepsychiatry achieved a symptom improvement effect for various psychiatric disorders similar to that of face-to-face treatment. However, some superiorities/inferiorities were seen across a few specific psychiatric disorders, suggesting that its efficacy may vary according to disease type. [ABSTRACT FROM AUTHOR]

SUMMARY: The COVID-19 pandemic has rapidly accelerated the use of online and remote mental healthcare provision. The immediate need to transform services has not allowed for thorough examination of the literature supporting remote delivery of psychiatric care. In this article we review the history of telepsychiatry, the rationale for continuing to offer services remotely and the limitations of psychiatry without in-person care. Focusing on randomised controlled trials we find that evidence for the efficacy of remotely delivered psychiatric care compared with in-person treatment is of low quality and limited scope but does not demonstrate clear superiority of one care delivery method over the other. [ABSTRACT FROM AUTHOR]

Aims and method This review aims to clarify the evidence on the effectiveness of telepsychiatry following the COVID-19 pandemic. We conducted a literature review of three databases (Cochrane Library, PubMed and PsycINFO), using the terms virtual consultation/telepsychiatry/video consultation AND psychiatry/mental illness. Results We identified 325 eligible papers and conducted a thematic analysis resulting in five themes: patient and clinical satisfaction, diagnostic reliability, outcomes, technology and professional guidance. The most significant factors linked to effectiveness of telepsychiatry were patient and clinician satisfaction and adequate technology to facilitate examination of the patient. Clinical implications The consistent diagnostic reliability, satisfactory clinical outcomes and patient satisfaction linked to telepsychiatry favour its continued use once the pandemic ends. The main barrier is reluctance among clinicians and lack of professional guidance. We recommend education on the uses of telepsychiatry among clinicians, and the provision of professional guidance for its use from medical bodies and organisations. [ABSTRACT FROM AUTHOR]

Background: Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. wait-list and care-as-usual controls. Methods: A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence. Results: A large, pooled effect size of g = 0.80 [95% Confidence Interval: 0.68–0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (g = 0.62), mixed anxiety samples (g = 0.68), panic disorder with or without agoraphobia (g = 1.08) and social anxiety disorder (g = 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (g = 0.84) and unguided interventions (g = 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [ g = 0.14 favoring digital interventions; Confidence Interval: −0.01 to 0.30]. Conclusion: The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care. [ABSTRACT FROM AUTHOR]

Ensuring continuity of care for patients with major depressive disorders poses multiple challenges. We conducted a systematic review and meta-analysis of randomised controlled trials comparing real-time telehealth to face-to-face therapy for individuals with depression. We searched Medline, Embase, and Cochrane Central (to November 2020), conducted a citation analysis (January 2021), and searched clinical trial registries (March 2021). We included randomised controlled trials comparing similar or identical care, delivered via real-time telehealth (phone, video) to face-to-face. Outcomes included: depression severity, quality of life, therapeutic alliance, and care satisfaction. Where data were sufficient, mean differences were calculated. Nine trials (1268 patients) were included. There were no differences between telehealth and face-to-face care for depression severity at post-treatment (SMD −0.04, 95% CI −0.21 to 0.13, p = 0.67) or at other time points, except at 9 months post-treatment (SMD −0.39, 95% CI −0.75 to −0.02, p = 0.04). One trial reported no differences in quality-of-life scores at 3- or 12-months post-treatment. One trial found no differences in therapeutic alliance at weeks 4 and 14 of treatment. There were no differences in treatment satisfaction between telehealth and face-to-face immediately post-treatment (SMD −0.14, 95% CI −0.56 to 0.28, p = 0.51) or at 3 or 12-months. Evidence suggests that for patients with depression or depression symptoms, the provision of care via telehealth may be a viable alternative to the provision of care face-to-face. However, additional trials are needed with longer follow-up, conducted in a wider range of settings, and with younger patients. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemedicine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic. Methods: We used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020. Results: Thirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations v. in-person consultations were reevaluated in four regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic. Conclusions: Our results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, which facilitate greater scale and spread of telepsychiatry globally. [ABSTRACT FROM AUTHOR]

Introduction: The concept of digital psychiatry, encompassing technologies such as mental health apps, Virtual Reality (VR), Artificial Intelligence (AI), and telepsychiatry, emerges as a potential solution to bridge the existing gaps in the mental health system of Pakistan. However, one of the major barriers to the implementation of these technologies is hesitancy to adopt digital tools by psychiatrists. Objectives: This study aims to explore the current understanding of digital psychiatry, the barriers faced by psychiatrists in its' widespread implementation, and their willingness to adopt these services in clinical practice. Methods: This cross-sectional study surveyed psychiatrists' knowledge, attitudes, and practices on digital psychiatry from 39 public hospitals across Pakistan using an online validated questionnaire from January to July 2023. Participants included psychiatry residents, fellows, and consultants practicing in Pakistan. Responses were analyzed with Raosoft software, Quirkos, and SPSS 26 using thematic analysis and correlation. Results: A total of 200 participants responded to the questionnaire, primarily in the age range of 20-30 years (56%). The gender distribution was 55% male (N = 111) and 45% female (N = 89). Among the professional roles, 23% were consultants, 7% were registrars, 54% were psychiatry residents, and 17% were medical officers. Respondents came from both rural (N = 148, 74%) and urban (N = 52, 26%) practice settings. Regarding telepsychiatry, 46% strongly agreed that they are familiar with telepsychiatry, while 58% agreed that telepsychiatry can save time and money. Additionally, 22% strongly agreed that it's a viable approach for patient care. Concerning perspectives on Artificial Intelligence (AI) in digital psychiatry readiness, only 40% of participants had received AI training. However, 55% expressed interest in collaborating with international centers on AI-related projects. In terms of mental health apps, 62% of respondents reported limited familiarity with them. Nevertheless, 65% believed that these apps could potentially save time and money for psychiatric health systems. Lastly, concerning Virtual Reality (VR) in psychiatric care, 57% of participants were familiar with VR technology, but only 43% were acquainted with its applications in psychiatry. Notably, 71% did not view VR as a viable replacement for in-person psychiatric management. Conclusions: This is the first study conducted on understanding digital psychiatry in Pakistan's healthcare system, which revealed multiple challenges to digital health competency among psychiatrists. This emphasizes on the need for formal training and funding towards resources to overcome obstacles in utilizing mental health technologies. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

SUMMARY: Values-based practice (VBP) is a framework of clinical theory and skills to facilitate a good process whereby the (often conflicting) values involved in clinical decision-making can be recognised and balanced productively. Many of these values come from the personal histories of the patient and of the clinician, and the traditions and history of psychiatry. New developments in science lead to increasing choice and increasing complexity of values. Therefore, psychiatrists will need more skills in this area, as reflected by the inclusion of VBP in the Royal College of Psychiatrists' training curricula. This article describes some tools for understanding and navigating this value diversity in applying science to clinical practice during history taking. [ABSTRACT FROM AUTHOR]

This article draws on research and clinical experience to discuss how and when to use video consultations in mental health settings. The appropriateness and impact of virtual consultations are influenced by the patient's clinical needs and social context, as well as by service-level socio-technical and logistical factors. [ABSTRACT FROM AUTHOR]

Covid-19 has induced many changes to society, including some in the practice of medicine and psychiatry. Among them is increasing use of telecommunications. A previous editorial outlined the possible uses and dangers of telemedicine with prisoners (Gunn et al 2020). Forensic psychiatry is also concerned with providing expert evidence to courts and other arbitration bodies and, increasingly, these bodies too are relying on such technology. Further in addition to traditional paper-style records (many now held electronically rather than literally on paper) there is increasing use of video recording of interviews, of day to day behaviour on secure hospital units and by bodycams when intervening in a tense, potentially violent situation. To what extent are these being used in court? Is there a European framework for guiding us on how to proceed? How has this been interpreted to date in countries across Europe? In this paper these issues will be addressed.

Introduction Telemedicine has been at the heart of healthcare system’s strategic response to the COVID-19 pandemic. Within psychiatry, there has been a surge of research and guidelines into the use of video-teleconferencing to replace face to face consultations across clinical settings. Clinical ward rounds are central to inpatient psychiatric care yet little guidance is available on how best to integrate telemedicine into the multidisciplinary work of inpatient psychiatry. Objectives We report on the introduction of video teleconferencing for psychiatric ward rounds on our acute inner-London psychiatric unit during the outbreak of COVID-19. Methods In undertaking the rapid transition to tele-ward rounds, we had to reconcile the multiple functions of psychiatric ward rounds with the technological resources available to us. Results Tele-ward rounds helped simplify care delivery, facilitate multidisciplinary collaboration and improve accessibility for patients and relatives in a time of crisis. The transition to tele-ward rounds also brought about technical, operational and communication issues that may impact on the patient experience and quality of care including governance challenges, contextual dissonance and technological limitations. Conclusions The routine use of newer technology in psychiatry ward rounds is unlikely to succeed on the basis of improvisation, particularly given the stream of technical innovations in telemedicine, and the multifarious quality of social interactions in our clinical setting. Staff training and the development of an adapted etiquette and code of communication are both essential. Patient participation in future developments will also help ensure tele-ward rounds continue to meet the standards of high quality inpatient psychiatric care beyond the COVID-19 pandemic. Disclosure No significant relationships.

Introduction The term “personalised therapy” refers to the use of genetic data to better treat or determine the predisposition to a specific genetic disease, with the ultimate goal of improving quality of life. Telepsychiatry and AI are key to support it.. Objectives Determine benefits of pharmacogenomic analysis (PGx) in CNS diseases regarding: - cost effectiveness - adverse drug reactions - reduced hospitalizations -drug interactions - efficacy - quality of life - “trial and error” approach avoidance Methods Questionnaires before and after the treatment provided using PGX tests Telepsychiatry for consultation along face to face sessions were conducted. Artificial intelligence in data analyses Results Benefits of pharmacogenomic analysis (PGx) in CNS diseases: - cost effective savings - prediction and prevention of adverse drug reactions - reduced hospitalization due to ineffectiveness of medication - reduced risk of drug interactions - more effective treatments - better quality of life for the patient - with the analysis (PGx) the “trial and error” approach is avoided Conclusions In a number of studies in patients with mental disorders, pharmacogenomic analysis (PGx) has led to an increase in both clinical response and remission, better tolerated treatments, fewer side effects, and reduced treatment costs. In conclusion, pharmacogenomic analysis is ideal for patients with CNS diseases: a) Not responding to treatment b) Who in their history have many relapses and hospitalizations c) They show serious side effects d) Who do not comply with the treatment e) Taking many medications and suffering from serious illnesses f ) Who are wary of taking psychotropic drugs Disclosure No significant relationships.

Introduction The COVID epidemic has forced psychiatrists to introduce changes in outpatient clinics. A significant proportion of visits began without the patient’s face-to-face contact with the doctor. Are these visits stigmatized with a worse assessment of mental state? We know that much of the information flow takes place outside of verbal contact. In telephone contact, psychiatrists are limited to listening to the patient’s response and we know that non-verbal speech does not always go hand in hand with words. Objectives The aim of the study is to compare face-to-face visits with a psychiatrist with outpatient visits by telephone in terms of changes in the treatment applied by psychiatrists. Methods The frequency of introducing changes in the current pharmacological treatment of patients was compared. Face-to-face visits to the outpatient clinic and visits where psychiatrists contacted patients via telephone were analyzed. Treatment change was defined as a reduction or increase in drug dose, drug discontinuation or the initiation of a new drug by a psychiatrist. Results We assumed that visits without non-verbal contact do not provide as much information as direct visits. Consequently, patients who are often negative about the need to take medications over the phone will present themselves better to psychiatrists, thus the change in treatment will be used less frequently in this group. The results will be presented at the conference. Conclusions Currently, various forms of psychiatric care are evolving to adapt to new needs. We should also be aware of the consequences of these changes. Disclosure No significant relationships.

Introduction Italy was the first European country to face up with COVID-19 pandemic, which posed challenges to National Health System (NHS), including the need to adapt mental health services/infrastructures and implement digitalization. Objectives Despite telepsychiatry (ie., delivery of psychiatric care remotely through IT), is extensively used in non-European countries, only during the COVID-19 pandemic, became a convincing alternative to face-to-face modality for many psychiatrists in their clinical practice. Our aim was investigating Italian psychiatrists’ opinion about telepsychiatry. Methods A questionnaire, disseminated during the third Italian phase, constituted by three sections (socio-demographic, opinions and personal experience about/with telepsychiatry) was build by adapting the 42-item questionnaire by Schubert (2019) and CAMH’s Client Experience Survey from the psychiatrist’s perspective. Results 90 questionnaires were collected from a sample of 54 women (60%) with an average age of 43(SD=11.4). Mostly were psychiatrists (85.6%) working in NHS (66.7%) with an average working years of 13.7(SD=11.5) and a previous experience in telepsychiatry (71.1%). Overall, participants do not believe that telepsychiatry is comparable with face-to-face modality. A significant positive opinion was reported among younger psychiatrists compared to those more experienced, regarding efficacy, feasibility and mental health access (p

Introduction European Federation of Psychiatric Trainees (EFPT) is a platform for psychiatric trainees from not only Europe but also various other countries. EFPT exclusively works on binding clinical practice and science for better mental health care. Research Working Group (RWG) of EFPT works on sharing knowledge with peers by brainstorming, collaborating and coordinating projects, organizing journal clubs and workshops. Objectives We will focus on tele-psychiatry also known as e-mental health, a subdivision of telemedicine, provides diagnostic interview, evaluation, therapies, psycho-education and treatment. We plan The Brain-Drain follow-up study, investigates immigration of psychiatric trainees. Also educational activities have planned. Methods With a questionnaire on the topic of psychiatry residents’ acceptance of tele-psychiatry using The Unified Theory of Acceptance and Use of Technology (UTAUT), we will hold the first multi-national survey among psychiatry residents. The Brain-Drain study was conducted by the EFPT-RWG in the past had a promising outcome. We are currently working on the follow-up of the study. We are starting to hold events. For instance we will commence the monthly journal club. Apart from giving a platform for scientific debate, journal club will also provide a chance have a elaborate discussion with author. We will organize a workshop on how to write a case-study with Neuro-Psycho-Pharmacology Working Group of EFPT. Results We assume diverse attitudes overlapping different telepsychiatry exposure and regualtions, comprehensive data on immigration of trainees and sharing knowledge on practice and research. Conclusions Hopefully, we will have clearer understanding of changes in working environment of trainees either with new technologies or in different countries. Disclosure No significant relationships.

Introduction Telepsychiatry is the best-documented e-Mental Health application. It refers to the use of videoconferencing in the provision of mental health services. During the COVID19 pandemic, in response to physical distancing, mental health services worldwide have turned to online consultations. For the vast majority of clinicians, it was the first time they use telepsychiatry, and very few have received training in how to do it. Objectives - to present the main objectives and messages of the WPA Global Guidelines for Telepsychiatry related to competencies & skills, educational & legislative needs, and international collaboration. Methods A structured review of the main challenges, innovations, and settings in the first Global Telepsychiatry Guidelines, published by WPA in February 2021. Results The benefits of increased access to telehealth services are apparent for telepsychiatry, but benefits can only be realized if the tools are used by clinicians who have the appropriate training and guidance. With proper preparation and thoughtful risk management, telepsychiatry can be an invaluable tool for allowing greater access to care. However, certain prerequisites must be fulfilled to achieve the desired goals. These prerequisites are e.g. choice of the technology, settings, patient/provider preferences as well as competencies and skills described in this document. Conclusions The need for training among health care professionals is the highest priority. The urgent need for clinical training and skills building around e-mental health inclusive telepsychiatry, will determine the influence that psychiatry can have in addressing the mental health sequelae of the COVID19 pandemic via competent practice and increased international collaboration. Disclosure I am the main author of “WPA Telepsychiatry Global Guidelines”

Introduction The COVID-19 pandemic led to the implementation of digital psychiatry (DP) in everyday clinical practice, resulting in the need for a skilled healthcare workforce. Objectives Our purpose was to investigate the level of training, knowledge and expertise of young mental health professionals and medical students in DP, as well as exploring their beliefs and experiences in this field. Methods An ad hoc cross-sectional survey was designed and administered to Italian medical students, psychiatry trainees, and early career psychiatrists. Results Most of the sample declared that the topic of DP was never discussed within their academic training (89.1%), mainly revealing an overall lack of knowledge on DP. Nevertheless, they mostly declared that DP represents a valuable therapeutic tool in mental health (80%) and that the academic background should include a dedicated course/module (54.4%). Moreover, most subjects declared that DP is less effective than in-person interventions (73.2%), despite the emerging evidence that being trained in DP is significantly associated with the belief that digital and in-person interventions are comparable in their effectiveness (p≤0.05). Conclusions During the current pandemic, DP represented an ideal response to the need for physical distancing by ensuring the advantage of greater access to care. However, DP interventions are still uncommon, and there remains a certain resistance to their use in mental health care. The lack of formal training during the academic training could be a limiting factor. Therefore, addressing these issues in academic settings could be crucial to spreading this innovative practice also in the post-COVID-19 era. Disclosure No significant relationships.

Introduction There is a significant psychiatry workforce shortage in Australia, particularly in rural and remote communities. Given the large distances involved, telehealth – providing consultation via videoconference – has been widely accepted. Psychiatrists were among the highest users of telehealth services in Australia before the COVID-19 pandemic. However, the outbreak of COVID-19 resulted in a major transformation to service delivery across Australia. Private psychiatrists and state public mental health services had to rapidly transition to largely telehealth delivery to ensure continuity of care for consumers. In March 2020, additional telehealth item numbers were added to the Australian Medicare Benefits Schedule (MBS) to encourage physical distancing for those accessing medical services during the pandemic. Objectives To provide an overview of the increase in telehealth activity since the COVID-19 pandemic. Methods The MBS is the list of services for which the Australian Government will pay a rebate. Key data on MBS telehealth activity since March 2020 was examined. Results The use of telehealth has increased during the pandemic. A survey of Royal Australian and New College of Psychiatrists (RANZCP) psychiatrists found that 93% supported retention of telehealth MBS item number numbers following the COVID-19 pandemic, noting increased accessibility for consumers. Positive feedback has been received from consumers. Conclusions During 2020 and 2021, the RANZCP worked with the Australian Government to ensure there were appropriate MBS telehealth services available for consumers. The RANZCP continues to work with the Government as they plan for a longer-term transformation of telehealth services beyond 2021. Disclosure No significant relationships.

Background COVID-19-related restrictions on in-person contact in healthcare, increasing psychiatric illness during the pandemic and pre-existing shortages of mental healthcare providers have led to the emergence of telepsychiatry as an attractive option for the delivery of care. Telepsychiatry has been promoted as economical and effective, but its acceptance in low- and middle-income countries is poorly understood. Aims To explore the acceptance, experiences and perspectives of patients and healthcare providers in the uptake of telepsychiatry services in a middle-income country. Method Focus group discussions were conducted on the WhatsApp platform with patients and care providers who have engaged in telepsychiatry. Data were analysed using a thematic approach. Results Three main themes emerged from the five focus groups: (a) technical access, (b) user experience and (c) perceived effectiveness compared with face-to-face (in-person) interactions. Care providers reported challenges establishing rapport with the patient, particularly for initial sessions, maintaining privacy during sessions and detecting non-verbal cues on video. Patients cited internet connectivity problems, difficulty finding private space to have their sessions and cost as major challenges. Patients also felt in-person sessions were better for initial visits. Both patients and providers reported difficulties making insurance payment claims for telepsychiatry services. Overall, participants were mostly positive about telepsychiatry, citing its convenience and overall perceived effectiveness compared with in-person sessions. Conclusions Telepsychiatry is an acceptable platform for delivery of out-patient psychiatric services in a middle-income country. Patients and providers appreciate the convenience it offers and would like it integrated as a routine mode of delivery of care.

Lt. Col. Owen Berkeley-Hill was a psychiatrist in India during the colonial era. He was known for his sharp wit and criticism of the Colonial Government and Indian society. Berkeley-Hill was interested in psychoanalysis and played a role in establishing the Indian branch of the Royal Medico-Psychological Association. He was married to Karimbil Kunhimanny, and his household included people from various regions and religions. Berkeley-Hill suggested breaking social barriers by organizing communal feasts to address the Hindu-Muslim conflict. Despite his brilliance, he clashed with authorities and was unable to carry out necessary reforms. Berkeley-Hill's life and career demonstrate the cosmopolitan and inclusive nature of psychiatry in mid-20th-century India. [Extracted from the article]

For many patients and healthcare providers, the move to virtual psychiatric care has been fast-tracked by the COVID-19 pandemic. In this article, we consider a patient perspective and a provider perspective on the transition to virtual psychiatric care and its strengths and limitations, as well as a call for much-needed future research. [ABSTRACT FROM AUTHOR]

Background: Tele-psychiatry is an increasingly acceptable and feasible platform to deliver mental health care with the potential to increase access to care in low-resource settings. We aim to examine the acceptability and preliminary impact of the delivery of assisted tele-psychiatry services in primary healthcare settings in Goa, India. Methods: Before-after uncontrolled treatment cohort study. In total, 161 adults with either a mental or alcohol use disorder were provided tele-consultation by psychiatrists through a customised video conferencing platform, along with medication or counselling (via trained lay counsellors) or both as needed. Data on socio-demographics, clinical outcomes and process indicators were collected at baseline and 3 months post-baseline. Paired t tests were used to assess clinical outcomes pre- and post-treatment using the General Health Questionnaire-12 (GHQ-12) and World Health Organisation Disability Adjustment Schedule (WHODAS) 2.0, and logistic regression was used to find associations between changes in these scores and various factors. Results: The most common diagnosis was depression (35%). Post-treatment, there was a significant reduction in both GHQ-12 and WHODAS 2.0 scores. Participants showed high satisfaction with the tele-psychiatry services and technology platform. Improvement in GHQ-12 score was associated with being employed [OR 8.74 (1.92–39.75, p = 0.005)] and being a homemaker [OR 6.42 (CI 1.61–25.57, p = 0.008)]. Conclusion: Treatment of mental disorders through a tele-psychiatry platform appears to be highly acceptable and is associated with improved clinical outcomes. Considering its potential for scalability, a model of assisted tele-psychiatry integrated into primary care can be an important strategy to increase access to mental healthcare in low-resource settings. [ABSTRACT FROM AUTHOR]

Background Previous studies into mental health service utilisation during the COVID-19 pandemic are limited to a few countries or specific type of service. In addition, data on changes in telepsychiatry are currently lacking. Aims We aimed to investigate whether the COVID-19 pandemic is associated with changes in mental health service utilisation, including telepsychiatry, and how these changes were distributed among patients with mental illness during the first COVID-19 outbreak. Method This retrospective study obtained routinely assessed healthcare data from a large Dutch mental healthcare institute. Data from the second quarter of 2020 (the first COVID-19 outbreak period) were compared with the pre-pandemic period between January 2018 and March 2020. Time-series analyses were performed with the quasi-Poisson generalised linear model, to examine the effect of the COVID-19 lockdown and the overall trend of mental health service utilisation per communication modality and diagnostic category. Results We analysed 204 808 care contacts of 28 038 patients. The overall number of care contacts in the second quarter of 2020 remained the same as in the previous 2 years, because the number of video consultations significantly increased (B = 2.17, P = 0.488 × 10−3) as the number of face-to-face out-patient contacts significantly decreased (B = −0.98, P = 0.011). This was true for all different diagnostic categories, although this change was less pronounced in patients with psychotic disorders. Conclusions Diminished face-to-face out-patient contacts were well-compensated by the substantial increase of video consultations during the first COVID-19 outbreak in The Netherlands. This increase was less pronounced for psychotic disorders. Further research should elucidate the need for disorder-specific digital mental healthcare delivery.

The COVID-19 pandemic has resulted in unique challenges for in-patients across the National Health Service as visitors, both family and friends, are prevented from visiting patients owing to infection prevention and control measures. The Attend Anywhere platform was used as the basis of a quality improvement project to mitigate the detrimental effects of reduced social contact for patients. The use of video conferencing led to increased subjective satisfaction for both patients and healthcare professionals, thereby providing further evidence of the benefit that this emerging technology has on healthcare delivery. [ABSTRACT FROM AUTHOR]

Telepsychiatry has emerged as a transformative force in the field of mental health care, addressing disparities in service delivery and increasing access to care. This exploration focuses on the role of telepsychiatry in achieving equitable mental health care for individuals with intellectual disabilities (ID). Intellectual disabilities affect millions globally, posing significant public health challenges. This vulnerable population encounters numerous barriers in accessing quality mental health care, including geographical isolation, limited transportation options, and a shortage of specialized providers. Telepsychiatry offers a promising solution, leveraging technology to overcome these challenges. The presentation reviews the current landscape of mental health care for individuals with intellectual disabilities and the specific barriers they encounter. It highlights the potential benefits of telepsychiatry, including increased availability of specialized care, reduced geographical barriers, and enhanced caregiver support. Ethical considerations and best practices associated with implementing telepsychiatry in the context of intellectual disabilities are discussed. Case studies and success stories illustrate how telepsychiatry positively impacts individuals with intellectual disabilities and their families. In conclusion, telepsychiatry plays a promising role in promoting equitable mental health care for individuals with intellectual disabilities. Embracing technology and adopting best practices pave the way for a more inclusive and accessible mental health care system, leaving no one behind. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Globally, health providers and patients alike have been forced to adapt rapidly to the use of telemedicine during the COVID-19 pandemic. Although telepsychiatry has been tested and found just as effective as face-to-face care, there still remains little uptake of this form of care provision in sub-Saharan Africa. This case study highlights the use of telepsychiatry in a previously telemedicine-naive private mental health facility in Kenya. We describe the challenges and lessons learned from the experience. We conclude on the need to test the effectiveness and acceptability of this mode of therapy in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Introduction During the Covid Outbreak, the deployment of psychiatric phone-based consultations (PbC) became a large necessity. Objectives The main objective of our study was to assess, 4 months after the end of the lockdown, the degree of satisfaction of the PbCs compared to that of usual face-to-face consultations (FC) in young adults presenting a first episode of psychosis (FEP) or entering schizophrenia (SCZ). Methods All patients beneficiated from PbCs conducted by hospital care staff during lockdown. A 15-items questionnaire evaluating satisfaction was carried out remotely (score ranging from 1 to 10). Primary outcome was satisfaction with consultation allowing the comparison of a group preferring FC (FC+) against a group in favor or equivalent of PbC (PbC +). Results 30 patients were recruited (mean age 26.93 years old (4.9 SD), Male 56%. Diagnoses were SCZ 60% and FEP 40%. 20/30 participants belonged to (FC+) group. Total scores of satisfaction for the PbC differed between the (PbC+) group (mean 9 (1.69 SD)) and (FC+) group (mean 6.80, (1.32 SD)) p < 0.05. The (FC+) group tends to have PbC more frequently (40%) than the (PbC+) group (10%) and to find the phone interface more stressfull (40%) than the PbC+ group (10%). The (FC+) group tends to less wish (40%) PbC follow up in future than the (PbC+) group (90%). Conclusions This study shows that the PbCs were favorably evaluated by a third of the patients. The anxiety-inducing experience of the PbC in the (FC+) group could be explained by the severity of their pathology.

Psychiatry has long been battling with a recruitment crisis in the UK which is also reflected across much of Europe. Covid-19 has brought about widespread changes to our ways of working, as well as driving technological developments, which provides potential opportunities for the profession to draw people into the speciality. Covid-19 has brought interest in digital psychiatry from the peripheries to the mainstream. Mental health professionals are currently using sophisticated technologies such as Virtual Reality, Artificial Intelligence and Natural Language Processing in the diagnosis and treatment of mental health disorders. Highlighting the ways in which our profession is at the cutting edge of innovation to junior doctors offers a fruitful avenue to improve recruitment into the speciality. Many outpatient clinics have made the move to online service delivery during the pandemic to varying degrees. For many clinicians this has allowed more flexible and efficient ways of working. Psychiatry is better placed than most other medical disciplines to retain online patient contact in future clinical practice, post pandemic and may provide an attractive proposition for future psychiatrists. This talk will review some of the ways in which developments in digital psychiatry have been used to help generate interest for recruitment into the discipline as well as evaluating the benefits and challenges of the shift to telepsychiatry during Covid-19 and will offer some suggestions what the profession can learn from this to help future recruitment.

Introduction Any outbreak of pandemic dimension will most likely produce a serious amount of distress and prejudice to anyone, in particular when it comes to mental health. The pandemic impact in primary care and in the psychiatric emergency department are some of the topics discussed in this review. Objectives It aims to review, evaluate and reflect over the impact of a deadly coronavirus pandemic on mental health, as well as presenting possible long-term challenges and potential ways to approach it. Methods A non-systematic literary review was performed on the Pubmed, PsycInfo and Cochrane databases using the key words “covid-19”, “psychiatry”, “self-isolation” and “telepsychiatry”. Results Globally and, as expected, there has been a general increase in need for psychiatric assessment and treatment due to the COVID-19 pandemic. Conclusions The role of psychiatry has faced quite some challenges in such a short period of time: the rise of telepsychiatry; the management of patients with both a psychiatric disorder and an infection with the new coronavirus and the need to provide an adequate psychiatric assistance in the emergency room has become the new normal.

Introduction The mental health care system in Ukraine is centralized and largely focuses on capacity for inpatient psychiatric treatment with 90% of funding allocated to inpatient psychiatric care at hospitals, much higher than countries who already have more decentralized care. Community-based mental health care options, including mental health provided at the primary health care level are currently limited or absent in the mental health system. Psychosocial support, as well as self-care and mental health promotion are also insufficiently developed. Covid-19 pandemic is serious challenge for health care system, especially for consultation liaison psychiatry. Objectives Mental health monitoring and psychological support in University Clinic of Kharkiv National Medical University, Ukraine during COVID-19 epidemic. Methods HADS, SCL-90, HDRS, HARS Results During COVID-19 epidemic, implemented combination of off-line and eye-to-eye methods of mental health monitoring and psychological counselling for patients and medical staff in University clinic of Kharkiv National Medical University. Model of early detection and management of mental disorders based on multidisciplinary teamwork principles, сombination of off-line and eye-to-eye methods of screening, monitoring and psychological counselling for patients and medical staff. The online format proved beneficial because many patients of University clinic have trust issues and preferred not to deal with psychiatric services locally when it comes to mental health problems and it was accessible on epidemic conditions. An important part of the outreach work by the project was to destigmatize mental health problems. Conclusions Combined model (off-line and eye-to-eye services) of mental health care is preferred compare to traditional approach in modern conditions.

Background More than 92% of people in Bangladesh are deprived from any sort of mental health care due to severe scarcity of mental health professionals, widespread stigma, lack of awareness, the inability to travel from remote area to Dhaka and maintaining the cost of travel and clinics. Moreover, the COVID-19 crisis made the scenario worse. To solve this problem we designed, developed and implemented “Monerdaktar”. Methods The process development Monerdaktar- website and mobile application started with the initial idea and concept by TRS followed by extensive literature review and naturalistic observation of the mental health care service delivery from two tertiary hospitals in Bangladesh. We conducted 3 focus group discussion with the patients, their care givers, mental health professions. Based on the user feedback and technical suggestion of the mental health professional and IT professionals we developed the prototype of the Monerdaktar mobile application and website. After piloting for two months, the final version of the mobile application and website was finalized incorporating the feedback of the patients and experts. Result Monerdaktar created the unique opportunity to connect with the most the reputed mental health professional both psychiatrists and clinical psychologists online. Moreover, monerdaktar delivered the service free of cost to more than 700 clients during the peak of COVID crisis in Bangladesh. Conclusion The COVID-19 crisis has potentiated the acceptance and adaptation of the Moenrdaktar solved the long-standing crisis of access to mental health care in Bangladesh and ensure the evidence-based care from anywhere. Disclosure The Monerdaktar website and mobile application was design and developed by under the leadership of Dr. Tanjir Rashid Soron. Though the initial support was delivered free of cost, the consulting expert psychiatrist and Clinical Psychologist may take their

Introduction Under the umbrella of e-Mental Health (eMH), Telepsychiatry (TP) keeps its place as the oldest and best-documented application. Legislative issues, and the concerns related to the quality of care and patient safety, have kept TP from broader adoption. COVID19 pandemic seems to be a turning point for TP as well as for the eMH in general. The use of TP has exploded as many regulatory barriers to its use have been temporarily lowered during the COVID-19 pandemic. What has to be done to sustain this momentum? Objectives -outline temporary changes in TP regulations made due to COVID19; -discuss which of these should be maintained, modified, or reversed; -suggest additional initiatives needed to facilitate patient and professional use of digital technology. Methods Examination of the use of digital technology in the light of regulatory, legislative, and other changes and initiatives made due to COVID 19. Results Among several policy changes, the most important is e.g. removal of the “originating site” rule so professionals can be paid for a remote appointment wherever the patient is, including in the patient’s home. Further, professionals were allowed to serve patients through everyday communication technologies such as FaceTime, WhatsApp, Viber, or Skype, all compromising patient/data safety. Conclusions EPA is perfectly positioned to be the frontrunner for the required initiatives i.e. mandatory lectures related to eMH at medical educational institutions, launching of TP-competency training of mental health professionals, regulatory and statutory changes e.g. unified licensure regulations, etc that are crucial for modernizing mental health care delivery and preparation for future unprecedented events. Disclosure No significant relationships.

Introduction Telepsychiatry (TP) can provide an alternative to traditional face-to-face (FTF) assessments. However, TP in the emergency room setting is much less prevalent, probably due to lack of solid evidence about its effectiveness and acceptability. Objectives To directly compare traditional FTF and TP modalities in the emergency room setting. Methods Psychiatric patients (n=38) presented to the emergency room went through traditional in-person and videoconference TP interviews in varying order. Both FTF and TP interviewers that examined the patients as well as a third psychiatrist, acting as an observer for both modalities, determined the diagnosis, disposition recommendation and indication for involuntary admission. Results Rater decisions had a high matching on disposition and indication for involuntary admission (Cohen’s Kappa (CK) of 0.84/0.81, 0.95/0.87 and 0.89/0.94 for FTF-TP, Observer-FTF and Observer-TP, respectively). Although identical diagnosis matching between the raters was relatively low, the partial diagnosis matching was high (CK of 0.52/0.81, 0.52/0.85 and 0.56/0.85 for FTF-TP, Observer-FTF and Observer-TP, respectively). Telepsychiatry assessments had comparable acceptability in items such as psychiatrists’ certainty and interviewers’ and patients’ satisfaction. Conclusions TP and FTF psychiatric assessments in the emergency room settings have similar validity and acceptability. Implementation of TP in emergency room settings might improve the mental health services’ quality and access especially for remote populations. TP is especially important during the COVID-19 pandemic to enable treatment for epidemiologically isolated patients and to protect the medical personnel.

Introduction Since October 2017 till 2019 the project of Psychosocial Care for internally displaced persons and the war affected population in Ukraine has been in place (short name “Let’s talk”). In 2020 this project continuing for counselling pandemic affected persons. Objectives The counsellors are professional psychologists who were trained within the scope of the project. Sessions may be held in Russian or Ukrainian, according to the user’s choice. Methods Analysis of protocols of online counseling sessions and supervisions. Results The key and most frequent issues mentioned by the clients are loneliness, the loss of the sense of life, fear, uncertainty, anxiety, difficulties in family relations, in particular, with children, job insecurity, addictions, psychosomatic disorders and so others. They are closely related to the situation in the country (military operation, the division into “We” and “Other”, the risk of provocations, the cases of treason and personal revenge, threats to the family members of the military). The above issue is in potential clients’ inadequately high suspicion level (in some cases on the border of paranoid fantasies), which is manifested in the fear of the possible infringement of confidentiality, over-listening, surveillance, recording of talks etc. Conclusions The online counseling is the way to provide professional, accessible, free for the users and fully anonymous psychosocial care. Most frequent issues mentioned by the IDPs and the war affected population peoples has been indicated. When presenting the project service, the focus is always made on the high level of data protection and strict confidentiality. Disclosure No significant relationships.

Background Remote consultation technology has been rapidly adopted due to the COVID-19 pandemic. However, some healthcare settings have faced barriers in implementation. We present a study to investigate changes in rates of remote consultation during the pandemic using a large electronic health record (EHR) dataset. Methods The Clinical Record Interactive Search tool (CRIS) was used to examine de-identified EHR data of people receiving mental healthcare in South London, UK. Data from around 37,500 patients were analysed for each week from 7th January 2019 and 20th September 2020 using linear regression and locally estimated scatterplot smoothing (LOESS) to investigate changes in the number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals and prescribing of antipsychotics and mood stabilisers. The data are presented in an interactive dashboard: http://rpatel.co.uk/TelepsychiatryDashboard. Results The frequency of in-person contacts was substantially reduced following the onset of the pandemic (β coefficient: -5829.6 contacts, 95% CI -6919.5 to -4739.6, p

Telemedicine has become increasingly used by prison mental health services throughout the COVID-19 pandemic. In this editorial, we explore the benefits and risks of the remote provision of forensic mental healthcare, with consideration of the clinical, financial, ethical and legal consequences.

B I recall the awful news footage of emotionally abandoned children in Romanian orphanages following the fall of Ceausescu's regime in the late 80s. b I was a child myself at the time, and I remember in particular the feeling of sadness hearing about some babies who had learned to no longer cry, as it evoked no response. B Finally, German DJ Tomcraft imprinted my 20s with his track "Loneliness": considering psychosis, how much is it affected by this social blight (isolation, not underground techno-trance anthems)? During this time, participants underwent repeated measurements of IQ, physical growth, brain activity via electroencephalographs, and evaluation for various types of psychopathology. [Extracted from the article]

The COVID-19 pandemic has necessitated a rapid escalation in the use of telepsychiatry. Herein we revisit some of the ethical issues regarding its use, including patient benefice, distributive justice, privacy, and autonomy. Based on these considerations we would hold that telepsychiatry is a vital aspect of providing psychiatric care, and ethically should be offered as a format for treatment, likely beyond the pandemic period. Investigative and advocacy efforts will need to continue to determine its exact role within psychiatric care, and expand its availability for those most in need. [ABSTRACT FROM AUTHOR]

Abstract Background Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia. Methods After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored. Results A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries. Conclusions Regional disparities in resources and services for seniors’ mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.

Fischer -> -> and it worked very FAST -> I am only missing Dr. Sprecht -> Dr. Kühl and Dr. Kiefer -> Kefer -> that is also the NAME of the man who showed me the -> flat with the police'. [The clinic opens all its doors, Franziska comes without a pause.] Hypergraphia has been most frequently described in the context of the eponymous Geschwind syndrome, where it tends to be accompanied by hyperreligiosity, hyposexuality, circumstantiality and an "intensified mental life" and is an interictal phenomenon of temporal lobe epilepsy. [Extracted from the article]

The release of the Telepsychiatry Operational Guidelines 2020 in India, during the COVID-19 pandemic, is a relief for both clinicians and patients. These guidelines embark on initiating and executing naive and recently started telepsychiatry services in India. The document is aligned with other ethical regulations, policies, laws and the 2020 Telemedicine Practice Guidelines in India. This paper discusses a few points about the broader applicability of the guideline for the benefit of humankind in the prevailing healthcare crisis. The guidelines may be extrapolated in policy-making for telepsychiatry services in other low- and middle-income countries sharing a similar socioeconomic, cultural and political milieu. [ABSTRACT FROM AUTHOR]

SUMMARY: Psychiatrists live and work in complex, clinically challenging times. Their paperwork is geared increasingly towards defensive practice, key performance indicators and risk assessment forms. Somewhere in the process, detailed understanding of patient experience and clinical formulation based on key psychiatric expertise and skill in mental state examination have taken a backseat. I review the history behind the Present State Examination, the realisation in the 1980s of the need for a common psychiatric language internationally and the current position on phenomenology in psychiatry curricula in the UK. I conclude that it is time to think seriously about a return to basics in psychiatric phenomenology and psychopathology. [ABSTRACT FROM AUTHOR]

Background. Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia. Methods. After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored. Results. A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries. Conclusions. Regional disparities in resources and services for seniors' mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals. [ABSTRACT FROM AUTHOR]

Objective: To find how healthy college going participants SRS were affected by a customized Mind Body Intervention (MBI). Participants and Methods: We performed a customized online tele-video course based MBI incorporating mindfulness and awareness training over a period of one month in 2021 to MBA students attending the Indian Institute of Management (IIM). Each subject was their own control. We used the World Health Organization Quality of Life Scale (QO-BREF) social relationship sub-scores pre and post intervention to assess participant SRS. Results: 277 MBA students from the IIM with a mean age of 26.89 ± 1.7 were analyzed. Of the 277 students, 90 (32.49%) were female. The MBI decreased the self-perceived Social Relationship score among 277 graduate students. The mean SRS before the intervention was 7.51 ± 1.7 while the mean SRS after was 6.9 ± 1.7. Univariate paired t-test showed a significant mean difference (t = 5.1, p<.001). On a multivariate linear-regression model, the SRS change estimate was 0.46, t-value was 9.3, p < 0.001; 95% confidence interval was 0.37 - 0.56; p-value <0.001. Conclusions: An online tele-video based customized Mind Body Intervention decreased the self-perceived social relationship score among graduate students at the IIM during the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]