Background: Although psychoactive substance use disorders (PSUDs) are a domain of mental health, addiction psychiatry is only formally recognized as a subspecialty in a few European countries, and there is no standardized training curriculum.Methods: A 76-item questionnaire was developed and disseminated through an online anonymous data-collecting system and hand-to-hand amongst psychiatric trainees from the 47 European countries of the Council of Europe plus Israel and Belarus.Results: 1,049/1,118 psychiatric trainees from 30 European countries completed the questionnaire. Fifty-nine-point nine percent of trainees stated to have training in addictions. Amongst the trainees who described having training in addictions, 43% documented a not well-structured training and 37% an unsatisfactory training, mainly due to poor acquired knowledge. Overall, 97% of trainees stated that addiction represents a core curriculum for their training. Overall, general adult psychiatric trainees reported a better knowledge in addictions, compared to trainees in child and adolescent psychiatry.Conclusion: Despite a growing spread of PSUDs in European countries, addiction psychiatry is a relatively poorly trained field within psychiatry training programs. Further research should investigate reasons for poor training and timings of the educational activities to optimize experiential education training in addiction psychiatry.
IntroductionHikikomori, a form of severe social isolation, once characterized as a Japanese cultural-bond behavior with social and economic consequences, it is now being described in other countries. Its presentation mimics some clinical features of various classified mental diseases, such as prodromal phase of schizophrenia, personality disorders, Internet dependence, social phobia or depression, without fulfilling their defining criteria.Objectives/methodThis work aimed to do a brief review of this subject, describing one case that is probably the first ever reported in Portugal, comparing it with similar cases around the world.ResultsThe patient was a 22-year-old male, taken to psychiatry evaluation after 4 years of social withdrawal, avoiding or blocking any contact even with family members, which resulted in work and school impairment. He spent most of his days locked at his room, investing his time in particular interests and Internet use, only leaving to eat or do his basic hygiene. At that time, he presented no affective or psychotic symptoms and perceived his behavior as egosintonic. After six appointments with psychotherapeutic approach, he was able to get a job and improved his communication with the others, especially with family.Discussion/conclusionThis case fits most of the reports found on literature, in its presentation and clinical management. Hikikomori is not considered yet a disorder and further documentation of these cases is still needed to define its place in psychiatric nosology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Many patients with severe mental illness are admission in hospital; but little is known about psychiatric re-hospitalization in this population. Our objective was to identify motives of psychiatric re-hospitalization in Dr. Rodriguez Lafora hospital. It is an observational, descriptive and retrospective study. We collected information about patients aged 18 to 64 who were hospitalized during the month of January of 2015 in the acute psychiatric hospitalization by Selene software. We reviewed psychiatric re-hospitalization for 6 months later and the results were analyzed by SPSS software. The percentage of inpatients with a diagnosis of schizophrenia spectrum and other psychotic disorders was 29.4%, 13.7% bipolar disorders, 13.7% personality disorders, 11.8% depressive disorders, 9.8% alcohol use disorders, 3.9% schizoaffective disorders, 3.9% intellectual disabilities, 3.9% adjustment disorders with depressed mood, 3.9% obsessive-compulsive and related disorders, 2% substance-related and addictive disorders, 2% feeding and eating disorders and 2% adjustment disorders with mixed anxiety and depressed mood. The percentage of psychiatric re-hospitalization in patients with alcohol use disorders was 60%, 57.1% personality disorders, 50% obsessive-compulsive and related disorders, 50% schizoaffective disorders, 28.6% bipolar disorders, 26.7% schizophrenia spectrum and other psychotic disorders and 0% in the other inpatients. Why the percentage of psychiatric re-hospitalization is higher in patients diagnosed with personality disorder and alcohol use disorders? It would be important to establish an approach through more appropriate units as alcoholic detoxification unit and personality disorders unit.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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