Psychiatry Trainees' Attitudes, Knowledge, and Training in Addiction Psychiatry—A European Survey

Abstract

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.

Psychiatry training in 42 European countries: A comparative analysis

“…Europe has the highest proportion in the world of total ill health and premature deaths due to alcohol, and the highest level of alcohol and tobacco consumption in the world (WHO, 2015) but psychiatry training in substance misuse was found to be lacking. Our results corroborate a recent study looking specifically at trainees attitudes, knowledge and training in addiction psychiatry (Orsolini et al, 2020). Similarly, rotations in old-age psychiatry were found to be 15% below the required level.…”

The scope and needs related to training, research, and mentorship among early-career addiction medicine professionals: an online global survey followed by expert group discussions

“…A survey in China revealed that doctors involved in drug treatment are not well prepared or experienced and have negative attitudes toward substance use disorders and afflicted patients (26). The low number and level of professional addiction experts are the potential outcomes of inadequate addiction medicine training for medical students and residents in the USA, which is highlighted previously (9).…”

“…The quality of training is an issue for both internal medicine residents in the USA and also among psychiatry trainees across European countries as per a recent survey, which makes the call for a structured curriculum ever more important and urgent (24,25). A survey in China revealed that doctors involved in drug treatment are not well prepared or experienced and have negative attitudes toward substance use disorders and afflicted patients (26). The low number and level of professional addiction experts are the potential outcomes of inadequate addiction medicine training for medical students and residents in the USA, which is highlighted previously (9).…”

The worrying, current state of addictions training in medicine

“…Of these, 43% reported problems with their training. This is a particular concern due to the significant variations in training opportunities, systems and curricula across Europe, demonstrating a greater role for regional organizations ( 15 ). The situation is even worse in low- and middle-income countries, which are simultaneously seeing the most rapid growth in the prevalence of drug use and the availability of addiction specialists will be even less.…”