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.
Highlights
According to the Global Burden Disease study [1], alcohol, tobacco, and illicit substance use significantly determine the global burden of disability, morbidity and mortality, being considered amongst the top four health burdens across many upper-middle and high-income countries
Among the framework of the European Federation of Psychiatric Trainees (EFPT), a working group dedicated to the psychoactive substance use disorders (PSUDs) developed a self-administered survey that was disseminated at European level, by involving both Child and Adolescent Psychiatry (CAP) and General Adult Psychiatric (GAP) trainees
There were differences in the gender distribution, being most of them women (68.7%) and this difference is statistically significant when we stratified the sample by subspecialty (χ2 = 25, p < 0.001), being 84.6% of the CAP sample represented by women, whilst in the GAP sample, a percentage of 64% was represented by women, by reaching a total amount of GAP and CAP trainees of 936
Summary
According to the Global Burden Disease study [1], alcohol, tobacco, and illicit substance use significantly determine the global burden of disability, morbidity and mortality, being considered amongst the top four health burdens across many upper-middle and high-income countries. People with PSUD, including those classified as affected with a dual disorder, have been considered, compared to the general population, at higher risk of developing a range of medical and psychiatric disorders in comorbidity [7,8,9]. PSUD subjects, those with concurrent mental disorders, are overall associated with poorest outcomes, higher psychopathological severity and an increased rate of risky behaviors (i.e., hypersexuality, syringes/needles sharing, etc.) which can predispose them to an increased occurrence of serious infection diseases like Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and Hepatitis C Virus (HCV), compared to the general population [10]. 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
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