PORTAL FOR LIFELONG LEARNING IN PSYCHOPATHOLOGY

HELLENIC PSYCHIATRIC ASSOCIATION CLINICAL WORKSHOP

Coordinator:

Dimitris Ploumpidis

Professor of Psychiatry, Chairman of the Hellenic Psychiatric Association

Trainers:

George Konstantakopoulos

Psychiatrist, MD, PhD

Scientific associate of the First Department of Psychiatry of the University of Athens & Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK

Nikoleta Ioannidi,

Clinical psychologist, MSc

Scientific associate of the First Department of Psychiatry of the University of Athens

Duration: 4 hours

Aim - Subjects:

In psychiatric practice and in clinical education respectively, cognitive deficits (related to memory, attention, judgment, etc.) have been closely associated with neurodevelopmental (learning difficulties) and neurodegenerative (dementia) disorders. However, contemporary research data has already documented the existence of cognitive dysfunction in a wide range of mental disorders as well as the great significance of this dysfunction in the occupational and social functioning of patients and, more generally, in their quality of life.

In schizophrenia, even when "positive" symptoms of the disease are effectively treated, most patients experience also cognitive symptoms, such as memory and attention dysfunction, information processing issues, problem solving issues, and issues with social contacts. In patients with bipolar disorder and chronic or recurrent major depression, similar cognitive problems are observed, more limited, but capable of causing significant functioning impairment.

The same is observed in the most chronic and severe types of anxiety disorders.

Therefore, improving cognitive functioning is an independent and important goal in the context of treatment. The modern psychiatrist must be able to clinically assess cognitive dysfunction, to monitor the effect of treatment, and to make appropriate therapeutic choices, or to direct the patient to a specific therapeutic treatment of the cognitive symptoms. The modern psychiatrist, therefore, needs to be aware of the effects of medication on cognitive functions and of the use of specific therapeutic techniques, such as cognitive remediation therapy and social skills training.

We now have the possibility to rapidly transfer to psychiatrists the main body of knowledge concerning:

• Cognitive functions and their assessment
• Cognitive impairment in specific mental disorders
• The effect of current medication on cognitive functions and the appropriate treatment options
• The indications, principles and result of specific interventions for cognitive dysfunction.

The Clinical Workshop is addressed to psychiatrists, clinical psychologists and other mental health professionals who work with patients with psychoses and affective disorders.

The purpose of the Clinical Workshop is to adequately train clinicians in order for them to be able to reliably assess patients' cognitive dysfunction, monitor their progression during the course of therapy, and use special interventions in therapeutic planning. Participants will become familiar with specific methods and tools which will provide them the expertise for this clinical assessment.

In particular, the reinforcement of psychiatrists will be pursued in the clinical workshop through the following means:

• Provision of basic knowledge on the clinical manifestations, significance and prognosis of cognitive dysfunction in mental disorders: schizophrenia, bipolar disorder and depression.
• Presentation of the modern means of treatment for cognitive dysfunction in patients with mental disorders.
• Presentation of all available methods for the detection and reliable assessment of cognitive dysfunction in mental disorders, through clinical examination, questionnaires, scales and neuropsychological bedside tests.
• Training in brief modes of cognitive functioning assessment and monitoring.
• Presentation of special printed Guides.

TRAINING PROGRAM

1st part: COGNITIVE FUNCTIONS WHICH ARE IMPAIRED IN MENTAL DISORDERS

2nd part: COGNITIVE DYSFUNCTION IN MENTAL DISORDERS

1. A) Schizophrenia
2. B) Bipolar disorder
3. C) Major depression

3rd part: TREATMENT OF COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA, BIPOLAR DISORDER AND MAJOR DEPRESSION

1. A) Pharmaceutical treatment
2. B) Non-pharmaceutical treatments

4th part: DETECTING AND ASSESSING COGNITIVE DYSFUNCTION

1. A) Detecting and assessing via a clinical interview

Cognitive Functions Check-list

1. B) Clinical assessment with the use of scales and questionnaires

Perceived Deficits Questionnaire - Depression (PDQ-D)

1. C) Neuropsychological Assessment

Brief Cognitive Assessment Tool for Schizophrenia (B-CATS)

5th part: TRAINING IN THE ASSESSMENT OF COGNITIVE DYSFUNCTION WITH THE USE OF CLINICAL CASES

1. A) Assessment and follow-up in major depression with PDQ-D
2. B) Assessment and follow-up in psychoses with the use of B-CATS

“The clinical training course has already been held as a pilot and will be repeated within the context of the program of the Hellenic Psychiatric Association which will be implemented with the sponsorship of MYLAN.”

HELLENIC PSYCHIATRIC ASSOCIATION CLINICAL WORKSHOP

Coordinator:

Dimitris Ploumpidis

Professor of Psychiatry, Chairman of the Hellenic Psychiatry Association

Trainers:

George Konstantakopoulos

Psychiatrist, MD, PhD

Scientific associate of the First Department of Psychiatry of the University of Athens & Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK

Nikoleta Ioannidi

Clinical psychologist, MSc

Scientific associate of the First Department of Psychiatry of the University of Athens

Duration: 3 hours

Aim - Subjects:

Depression and anxiety disorders are the most common diseases in economically developed countries and the dysfunction they cause to patients is extremely important. It is estimated that in 2030, depression will be the main cause of disability worldwide. In addition, depressive and anxiety disorders often accompany a variety of physical illnesses the development and prognosis of which are significantly affected by it.

A large number of patients with mental disorders are increasingly using health services regardless of the co-existence or absence of physical illnesses. In particular, depression is the third most common cause, among both physical and mental illnesses, for seeking primary health care services. Patients with depression are estimated to reach out to doctors of specialties other than psychiatry by a rate of 70-80%. However, according to relevant studies, the identification rates of depression and anxiety in Primary Health Care settings are particularly low (36-56% and 15-36%, respectively). As a result, about half of the patients suffering from depressive and anxiety disorders remain undiagnosed and therefore untreated.

This clinical workshop focuses on addressing this major issue of public health. The ability to diagnose and treat depression within the context of Primary Health Care must be reinforced. Primary care physicians must be appropriately trained in order to be able to diagnose and treat depression, while distinguishing the cases they must refer to an expert. Appropriate methods and tools in order to facilitate primary care physicians in this task have been developed in recent years in many countries with well-organized health systems. This clinical workshop is part of an effort to develop a specific methodology and to provide appropriate training for physicians in our country as well.

The clinical workshop is addressed to general practitioners and doctors of specialties other than psychiatry who work in Primary Health Care services.

The purpose of the Clinical Workshop is to adequately train primary health care physicians in order for them to be able to diagnose and treat depression, while distinguishing the cases that they must refer to an expert. Participants will familiarize with methods and tools that facilitate primary care physicians in this task.

In particular, the reinforcement of primary care physicians will be pursued in the clinical workshop through the following means:

• Provision of basic knowledge on the epidemiology, clinical manifestation and prognosis of depression
• Training in brief mode of detection of depression by identifying risk factors and addressing only two questions to the patient
• Presentation of a method for the diagnosis, clinical assessment and therapeutic planning of depression
• Training in the use of a short questionnaire for the diagnosis and monitoring of depression (PHQ-9) and of a short questionnaire for the assessment and monitoring of anxiety (GAD-7)
• Short training in treatment, monitoring of therapeutic response and management of medication
• Presentation of special printed Guides

TRAINING PROGRAM

1st part: INTRODUCTION

Α) Depression: Epidemiological data and consequences:

1. B) The Issue: Detection - Diagnosis and Treatment in Primary Health Care
2. C) Clinical manifestations, clinical types and prognosis of depression

2nd part: DETECTION AND DIAGNOSIS OF DEPRESSION IN PRIMARY HEALTH CARE

Α) The patient with depression in Primary Health Care: “Red Flags”:

1. B) A brief mode of detection of depression
2. C) Diagnosis and clinical assessment with the use of PHQ-9.
3. D) Training in detection and diagnosis (vignettes - discussion)

3rd part: ADDITIONAL KNOWLEDGE FOR DIAGNOSIS AND CLINICAL ASSESSMENT

Α) Differential Diagnosis - Useful tools

Β) Suicidal risk assessment

1. C) Assessment of concurrent anxiety with the use of GAD-7
2. D) Training in suicidal risk and anxiety assessment (vignettes - discussion)

4th part: TREATMENT OF DEPRESSION IN PRIMARY HEALTH CARE

Α) Therapeutic options

Β) Antidepressant medication

1. C) Assessment of the therapeutic response with the use of PHQ-9 and GAD-7
2. D) Strategies for handling difficulties - management of pharmaceutical treatment
3. E) Therapeutic goals – maintenance therapy
4. F) Training in patient follow-up (vignettes - discussion)

“Clinical workshops during the years 2015 and 2016 were provided free of charge within the context of a program of the Hellenic Psychiatric Association, which was implemented with the sponsorship of MYLAN.”

We envisioned it for the past two years, while organizing and implementing courses and clinical workshops.

Our students have repeatedly asked for more information and access to educational material.

For long time we have been planning to take a step forward in the training of psychiatrists, psychologists and other mental health professionals.

First Department of Psychiatry of the National and Kapodistrian University of Athens, Eginition Hospital

University Research Institute of Mental Health

 Hellenic Psychiatric Association

 Pro-noesis

 obrela.gr

TEACHERS 2015-16

Annual Course in Clinical Psychopathology “PANAGIOTIS OULIS”

TEACHERS 2016-17

Annual Course in Clinical Psychopathology “PANAGIOTIS OULIS”

Annual Course in Clinical Skills in Psychopathology “PANAGIOTIS OULIS”

TEACHERS 2017-18

Annual Course in Clinical Psychopathology “PANAGIOTIS OULIS”

Annual Course in Clinical Skills in Psychopathology “PANAGIOTIS OULIS”

Born in Athens in 1990. She studied psychology at the Panteion University of Social and Political Sciences and graduated in February 2013. Since 2014, she holds a license to practice as a psychologist. In July 2018, she completed the MSc Program "Clinical Neuropsychology - Mental Neurosciences" of the Medical School of the University of Athens in collaboration with the Montreal Neurological Institute (MNI), McGill University.

She has been trained in Psycho-Educational Interventions – Behavioral Family Therapy in Psychosis (EPIPSY) and she is completing her training in Cognitive Behavioral Therapy (EPIPSY – Hellenic Society of Cognitive Psychotherapies). She has also attended the annual Course in Counseling Psychology (Panteion University) and during the academic year 2013-2014, she attended the Course in Clinical Psychopathology, which she graduated from with honors and was selected to continue her training in the context of an internship at the Byron-Kessariani Community Mental Health Center of the First Department of Psychiatry of the University of Athens for the academic year 2014-2015.

From 2014 until the end of 2016 she worked pro bono as scientific associate at Byron-Kessariani Community Mental Health Center (Department of Adult Psychiatry), providing clinical work and participating in research activities. During her MSc studies, she completed an internship as neuropsychologist at Byron-Kessariani Community Mental Health Center (Department of Adult and Child Psychiatry) and at First Department of Neurology of the University of Athens (Eginition Hospital). She work as a psychologist, while in the past she was a volunteer at the Chronic Disease Care Center of Eastern Athens and, during her bachelor studies, she completed an internship at the Day Center for Adolescents with Autism in Western Attica, "Stin Avli tou Kosmou".

Since October 2016, she has been a member of the teaching team of the Course in Clinical Psychopathology "Panagiotis Oulis" of the First Department of Psychiatry of the University of Athens and the University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS" (EPIPSY). She is also a member of the teaching team of the Course in Clinical Skills in Psychopathology "Panagiotis Oulis" of the First Department of Psychiatry of the University of Athens and the Hellenic Psychiatric Association.

She has participated in research studies, which has been presented (posters and speeches) at Greek and international conferences, while she is also co-author of books on substance dependence and psychotherapeutic intervention.

She was born in Deskati, Grevena. She studied psychology at the National and Kapodistrian University of Athens and graduated in 1993. She has been trained in Person-Centered approach and Cognitive Behavioral Therapy. She has also trained in the treatment and social rehabilitation of juvenile delinquents and in the planning of psychosocial support for victims of trafficking on a national and international level. She holds a MSc Degree in Organizational and Economic Psychology from the Panteion University and is a PhD candidate in the Department of Psychology, also at the Panteion University.

She worked as a psychologist in 2005 in adaptation and housing centers for people with disabilities and mental disorders. She was a member of a trans-European committee with the goal to investigate training and autonomous living programs of people with disabilities in Austria, France and Germany and their implementation in Greece.

From 2006 until today, she has been working as a psychologist at her private practice. At the same time, from 2009 until now, she has been a member of the teaching team of the Course in Clinical Psychopathology "Panagiotis Oulis" of the First Department of Psychiatry of the University of Athens and the University Research Institute of Mental Health (EPIPSY).

She studied Psychology at the University of Crete. Since 2008, she has been at the Eginition Hospital, at the Experimental Psychology Laboratory, under the supervision of Associate Professor E. Tsalta, and has been systematically involved in neuropsychological research and, in particular, in research concerning the neuropsychological profile of various psychiatric disorders with emphasis on depression, obsessive compulsive disorder, bipolar disorder and other psychopathological entities. Her research is based on both clinical data and experimental data from rats. She has been trained in clinical psychopathology at the Short-term Hospitalization Unit of the First Department of Psychiatry of the University of Athens since 2008 and at the Course in Clinical Psychopathology taught by the Associate Professor P. Oulis. As a valedictorian of the course and enrolled student of the MSc Program in Clinical Neuropsychology of the First Department of Neurology of the University of Athens, in 2009, she joined the teaching team of the course with her subjects being Neuropsychology and Psychopathology.

In 2010, she attended a 3-month training as an intern neuropsychologist at the University of Texas Health Science Center in Houston, Texas, USA, under the supervision of Assistant Professor J. Largen at the Houston Neuropsychology Group. In 2011, she received a MSc Degree in Clinical Neuropsychology from the Medical School of the University of Athens in collaboration with the University of Texas. Since 2013, she has been teaching in undergraduate courses at the Psychology Department of the Panteion University and at the Medical School, as well as postgraduate and MSc programs at the Medical School and the Department of Primary Education of the National and Kapodistrian University of Athens.

Since 2015, she has been working on her PhD thesis at the Medical School on the subject of neuropsychology and experimental psychology. Since 2016, she has been a University Scholar of the Medical School in the First Department of Psychiatry at the Eginition Hospital with the educational and research subject of psychology. She is a member of the Board of Directors of the Hellenic Neuropsychological Society and one of the founding members. She also works as a psychologist at her own private practice, while completing her education in Cognitive Behavioral Therapy. To date, she has published her work in 4 international scientific journals and has presented 10 studies at international and Greek conferences.