IntroductionDespite efforts to unify psychiatric education among European member countries, there are still considerable variations between national training programmes. To ensure equivalence of training standards the current tendency of recommended guidelines and reports is steering psychiatric training towards becoming more competency focused.ObjectivesThe research group of the European Federation of Psychiatric Trainees (EFPT) conducted a multi-national study on postgraduate psychiatry training. The aims are to assess the psychiatric trainees’ experiences and opinions on their national training and assessment methods in respect to the Union européenne des médecins spécialistes (UEMS) 2009 competencies framework.MethodsThis study surveyed 745 psychiatric trainees from 10 EFPT member countries using a questionnaire designed specifically for assessing this issue.ResultsIn this sample, the majority are aware of having a competency based training programme but 86.5% are poorly acquainted with the UEMS competencies framework. All key competencies were rated as being important but not all as being relevant in the assessment process. One's level of preparedness and the degree of education one's receives during their training differs from one competency to another. Trainees who aren’t satisfied with their national training would be in favour of taking an end of training Pan-European exam which differs from the one's that are satisfied and wouldn’t be interested in undergoing this assessment method.ConclusionsThis sample isn’t fully acquainted with the competency-based concept for postgraduate training. The ones satisfied with their postgraduate psychiatric education seem to be less inclined to take an end of training Pan European exam.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Background: Patients with first-episode psychosis are mainly young people in the active phase of their social and professional lives, and psychosis is a serious disruption of normal life with high risk of disability. Integrated biopsychosocial early intervention treatment is crucial for patients with first-time psychosis episode. The purpose of this trial is to adapt the first early intervention program for patients with first-time non-affective psychosis in Latvia, and to investigate whether it is possible to integrate this kind of treatment approach in the frame of existing services and whether it provides better outcomes for patients than existing services.
Design/Methods: The study has a nonrandomized controlled design in a real-life environment. Participants are all consecutive patients presenting in the psychiatric emergency room with first-time non-affective schizophrenia spectrum psychosis episode (ICD criteria F23, F20) from a catchment area of 262,541 inhabitants, with urban and rural regions. The Latvian Early Intervention Program is a 6-month program developed from existing treatment guidelines and recommendations and adapted to a low-resource environment, integrated in an existing outpatient unit. This study aimed to test the hypothesis that the patients who received intervention have milder symptoms, higher functioning, and better adherence to outpatient treatment. The study primary aims are: 1) to establish and examine in practice the adapted early intervention for patients with first schizophrenia spectrum psychosis; 2) compare clinical and functional outcomes (including occupation, housing, and social relationships) between intervention treatment and standard treatment; and 3) compare the number of rehospitalizations, adherence to outpatient treatment, and assigned disability. Secondary aims are: 1) to compare full recovery status in both treatment groups at 12 months follow-up and 2) to develop recommendations for establishing early intervention programs in limited resource settings.
Discussion/Conclusions: Across the world, there is wide inequality in the availably and accessibility to early intervention treatment. This study will increase our knowledge in early intervention treatment approach and outcomes for patients with schizophrenia spectrum first psychosis episode in real-life working clinical practices. We hope to provide theoretical and practical aspects to develop strategies for early intervention service implementation in limited resource mental healthcare settings.
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