IntroductionExistential anxiety (EA) has been described as the anxiety about the meaning of life, death and the necessity to make choices (Tillich, 1953).Although recent research found EA to be associated with trauma and general psychological symptoms in community samples (Weems et al. 2004), to date, no study has investigated its relationship with trauma exposure and posttraumatic stress disorder (PTSD) symptoms in psychiatric outpatients.ObjectiveTo examine the association between EA and self-reported trauma history and PTSD symptoms in psychiatric outpatients.MethodsSeventy-two stable psychiatric outpatients (mean(SD) age=46.1(14), 55% females) were assessed with the Existential Anxiety Questionnaire (EAQ; score ranging 0-39), the Trauma History Questionnaire which reports on criminal experiences, natural disasters, death exposure and questioning about physical and sexual experiences, and the PTSD Checklist (PCL; score ranging 17-85).ResultsMean(SD) EAQ and PCL scores were 20.0(7.8) and 40.0(15), respectively. A majority of participants (93%) reported at least one lifetime trauma exposure. Results revealed a positive correlation between existential anxiety and lifetime trauma exposure (r=.28, p< .05).Furthermore, in patients with lifetime trauma exposure, increased EA was associated with increased PCL total score (r=.57, p< .001) as well as with all PTSD symptom clusters: re-experiencing (r=0.45, p < 0.001), hyperarousal (r=.51, p< .001) and avoidance (r=.53, p < .01).ConclusionOur findings suggest that EA might be an interesting construct to examine further in the assessment and treatment of PTSD and paves the way for empirical investigations of existential therapies.

ObjectivesAlthough the literature suggest that alcohol misuse is common in medical students, few studies have investigated it in French medical residents. The present study aims at exploring the prevalence and associated characteristics of alcohol misuse in French medical residentsMethodsMedical residents working in one of 3 University Hospital in France (n=292) were invited to fill out an online survey using the mailing lists of the participating centers. Alcohol use was assessed with the 10-item self-report Alcohol Use Disorders Identification Test (AUDIT) (range 0-40) which provides scores for hazardous alcohol use, dependency symptoms and harmful alcohol use. Background variables were also collected.ResultsMean participants’ age was 27.7 (SD=1.7) and 65.5% (n=190) of them were of female gender. Mean weekly hours of work at the hospital was 57.8 (SD=13.6) and mean number of validated rotations at the time of the assessment was 5.1 (SD=2.4). Mean AUDIT score was 4.5 (SD=3). Forty-four (15.1%) participants scored on the AUDIT above the cut-off (>7) for problem use and 51 of them (17.5%) reported binge drinking at least once a month. AUDIT total score was positively correlated with male gender (r=0.26) and cannabis use (r=0.40) while negatively associated with weekly hours of work (r=-0.12) and number of rotations validated (-0.13). In a regression analysis, only male gender predicted alcohol use.ConclusionsAlcohol problem use is prevalent in French medical residents, is predicted by male gender and is strongly associated with cannabis use. Future research is needed to confirm these results.

AimsTo compare the usage of remote consultations before and after the first wave of the SARS-CoV-2 outbreak and explore mental health workers’ views on the usage of telemedicine.MethodAn online questionnaire survey was developed, and disseminated to mental healthcare professionals via e-mail and social media. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using Braun and Clarke's six step procedure for thematic analysis.1ResultThere were 40 responses from mental healthcare professionals of varying grades from different sub-specialties, predominantly from the UK. Compared to before the SARS-CoV-2 outbreak, there was an increase in usage of telephone (9(22.5% to (29)72.5%) and video consultations (4(10%) to 17(42.5%)). Respondents reported an increase in virtual MDTs (35(87.5%) during the pandemic, 9(22.5%) pre-pandemic).Based on a 5-point Likert scale, the mean technical quality of telephone consultations was 3.56/5 (Range 2-5), with 75% rating telephone consultations as not being as good as face-to-face consultations. The mean technical quality of video consultations was 3.58/5 (Range 2-5), with 63% rating video consultations as not being as good as face-to-face consultations. 25 (62.5%) respondents felt comfortable using telephone consultations during the pandemic, 20(50%) felt comfortable using video consultations. Recurring themes identified from the qualitative data regarding reasons for the technical quality ratings were: connection issues, poor infrastructure and security concerns.Nine (23%) respondents felt that using video conferencing consultations had a detrimental impact on the mental health of patients while 14(35%) felt that telephone consultations had a detrimental impact on patients’ mental health. Recurring themes for health practitioners’ perceived effect of the use of telemedicine on patients’ mental heath were the loss of personal touch and reduced patient engagement.ConclusionThere was a substantial increase in usage of remote consultations during the first wave of the SARS-CoV-2 pandemic among mental healthcare professionals. The results reported in the present study suggest there are numerous barriers to the use of telemedicine in psychiatry, which require future exploration, ideally through interview or ethnographic studies.