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Aims and methodEducation leads for undergraduate psychiatry in UK medical schools completed questionnaires on adaptations made to undergraduate psychiatry education, their impact and what lessons could be learnt for the future.ResultsRespondents from 24 medical schools across the UK reported a major shift to online teaching delivery, with reduced workplace learning and increased use of teleconferencing, online tasks and self-directed learning. Changes were implemented with some faculty training provided, but little additional funding or resources from medical schools or National Health Service trusts. A variety of challenges and opportunities were reported.Clinical implicationsDespite the extraordinary efforts of education leads to maintain undergraduate psychiatry education, the pandemic may affect the development of students’ professional competencies and recruitment into psychiatry. Individual clinicians, trusts and medical and foundation schools have much to offer, and need to work with students to replace what has been lost during the pandemic.

Medical recruitment and retention are national problems. Psychiatry has been more affected than many specialties, as a result of stigma from the public and other healthcare professionals. The Royal College of Psychiatrists has undertaken several initiatives to redress this, notably the ‘Choose Psychiatry’ campaign. In this editorial we argue that student-led university psychiatry societies are a wonderful but frequently untapped resource to help attract the brightest and best medical students to our profession. We describe the activities of three ‘Psych Socs’ across the UK and propose next steps to continue this work.

Introduction During the COVID-19 pandemic, telesimulation became particularly important to continue the education of medical students during disrupted clerkships while maintaining social distancing. Objectives To describe our experiences of adapting to telesimulation and evaluate this from student and faculty perspectives. Methods The intervention was evaluated using anonymous surveys consisting of statements rated on a five-point Likert scale from strongly disagree to strongly agree and open-ended questions asking students and facilitators what went well, what they would change and why, and for any other comments. Results Adaptations addressed the logistics of online delivery and the structure and content of scenarios. Logistical considerations included central organization of sessions to relieve pressures on clinicians. Pre-session case discussions were introduced to maximise time with simulated patients and give students space to socialise. Content was modified to ensure functionality online and reflect the context of the pandemic. A total of 278 students and 24 facilitators participated in the telesimulation sessions. 98.1% of students (N=109) rated the sessions as very good or good. Students benefited from practicing skills, especially clinical situations which they would rarely encounter as students, and receiving feedback. Facilitators (N=6) felt that students learnt both skills for online consultations and skills that can be transferred to face-to-face situations, but were ambivalent on whether students would benefit more from face-to-face sessions. Conclusions Telesimulation is a safe and effective option that offers additional opportunities for students to develop telemedicine skills. Going forward, telesimulation should complement face-to-face delivery to develop future clinicians who are proficient in both remote and face-to-face working. Disclosure No significant relationships.

BackgroundAn association between depression and headache is well established, but the specificity to migraine is unclear.AimsTo investigate the specificity of the association of depression and migraine.MethodPeople with recurrent depression (n=1259) were compared with psychiatrically healthy controls (n=851) to investigate headache defined according to International Headache Society criteria in each group.ResultsAll headache types were more prevalent in the case group than in the controls. However, the strongest association was between depression and migraine with aura (OR=5.6). Among participants with recurrent headaches, migraine with aura (but not other forms of headache) was highly significantly associated with depression.ConclusionsThe data suggest that not only is there a general relationship between headache and depression but also that among people with recurrent headache there is a specific association between depression and migraine with aura. The association is likely to be explained by overlapping aetiological risk factors.

BackgroundFew studies have examined the rates of physical disorders in those with recurrent depression.AimsTo examine self-reported physical disorders in people with recurrent depression compared with a psychiatrically healthy control group.MethodAs part of a genetic case-control association study, 1546 participants with recurrent depression and 884 controls were interviewed about lifetime ever treatment for 16 different physical health disorders.ResultsThe cases group had a significantly higher frequency of 14 physical disorders and more obesity than the control group. After controlling for age, gender, body mass index (BMI) and multiple testing, those in the cases group had significantly higher rates of gastric ulcer, rhinitis/hay fever, osteoarthritis, thyroid disease, hypertension and asthma.ConclusionsPeople with recurrent depression show high rates of many common physical disorders. Although this can be partly explained by BMI, shared aetiological pathways such as dysfunction of the hypothalamic–pituitary axis may have a role.

Van Melle et al ([2007][1]) reported that cardiac prognosis post-myocardial infarction was not improved by antidepressant treatment (MIND–IT trial). The SADHART and ENRICHD trials reported similar findings and Carney & Freedland ([2007][2]), in their commentary in the same issue, suggest these

[Figure][1] An important relationship between depression and medical disorders has long been recognised and variously conceptualised according to prevailing beliefs – from black bile in ancient Greece to psychoanalytic theories in which the body is a theatre of the mind and a myocardial