In a recent study developed with a community sample, we have found that although PNT mediated the relationship between perfectionist cognitions and bulimic behavior, the effect of perfectionism on other disordered eating dimensions, such as diet, was independent of the PNT levels (Monteiro et al., 2015).

To investigate if PNT mediates the relationship between perfectionism and disordered eating behaviors in a clinical sample.

Fifty-two patients with eating disorders/ED (mean age = 22.54 ± 7.637; mean BMI = 20.07 ± 4.192; 14.5% Anorexia Nervosa cases; 7.8% Bulimia Nervosa and 9.0% EDNOS) were assessed with the ED section of the Diagnostic Interview for Genetic Studies and fill in the Portuguese validated versions of Eating Attitudes Test/EAT-25 (to evaluate Bulimic behaviors/BB, Diet and Social pressure to eat), Multidimensional Perfectionism Scales (to evaluate perfectionism composite dimensions Evaluative Concerns/EC and Perfectionistic Strivings/PS) and Perseverative Thinking Questionnaire/PTQ-15 (to evaluate Repetitive Thought/RT, Cognitive interference and unproductiveness/CIU). Only variables significantly correlated with the outcomes (EAT-25_Total and its dimensions) were entered in the regression models. Mediation analyses using Preacher and Hayes bootstrapping methodology were performed.

EC, PS, CIU and RT were significant predictors of EAT_Total. PA, CIU and PR were significant predictors of BB. EC and PS were significant predictors of Diet. CIU partially mediated the relationship between EC and EAT_Total (95% CI = 0.0025–0.3296) and between EC and BB (95% CI = 0.0037–0.1877).

Also in a clinical sample, CII, the most pernicious dimension of PNT, mediates the relationship between perfectionism and disordered eating behavior, particularly bulimic behavior; diet is predicted by perfectionism independently of PNT.

The authors have not supplied their declaration of competing interest.

Perfectionism is considered a multidimensional key risk factor for Eating Disorders (EDs). There are discrepancies regarding if it is mainly associated to Anorexia nervosa (AN) but not to other EDs.

To study if Perfectionism is not only related with AN, but it is present in all EDs and associated with more transdiagnostic attitudes and behaviors.

To see if there were significant differences among EDs subgroups concerning Perfectionism and to study which abnormal eating attitudes were more associated with this trait.

Participants were 151 outpatients with EDs. DSM-IVTR diagnoses were: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders not Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2) subscale; general psychopathology with the Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self-Esteem Questionnaire (RSE). Eating psychopathology was measured with the Bulimic Investigatory Test (BITE), Eating Attitude Test (EAT-40), EDI-2 and the Body Shape Questionnaire (BSQ).

No significant differences were found regarding Perfectionism among the three groups. Body dissatisfaction was the variable most associated with Perfectionism (β = 0.330, F = 14.2, P < 0.001, 10.9% of the variance) adjusting for general and eating psychopathology. Ascetism and Interoceptive awareness were the EDI-2 subscales most associated with Perfectionism.

The findings confirm that Perfectionism is present in all EDs and there is a relationship between body dissatisfaction and Perfectionism. Interplay has been suggested between these two factors for the development of EDs.

The authors have not supplied their declaration of competing interest.

Anorexia nervosa is a disorder of eating behavior that is a major health problem on our society. It is characterized by three main criteria: self-induced starvation, desire for thinness or fear of obesity, and the presence of medical signs and symptoms due to improper feeding. This work is focused on its treatment. The biopsychosocial approach allows the design and application of effective therapeutic strategies and a multidisciplinary team collaboration is essential.

Research of current pharmacological and psychotherapy treatments options of the disease.

Literature review based on articles and publications on this topic.

In anorexia nervosa, it is necessary to establish a therapeutic alliance between doctor and patient. Patient usually feels no motivation to improve. The different treatments options to combine, in terms of the patient status, are: nutritional rehabilitation, cognitive-behavioral, family and interpersonal psychotherapies and pharmacological treatment. It can be carried out at the ambulatory, at the day-hospital or by medical stay, even beyond patient will.

Nowadays, the nutritional rehabilitation is the best treatment established and it is the core treatment. About the psychotherapies, the cognitive-behavioral is the most used because it has exposed better results in all different studies proved and in clinical practices, followed by the family therapy which is the responsible of the patient family's treatment. Pharmacological treatment should not be used systematically and its exclusive use is not enough to resolve anorexia nervosa as there are needed also other treatments combined.

The authors have not supplied their declaration of competing interest.

Disorders of eating behavior can affect all people regardless of socioeconomic or cultural situation. More common in females (90-95%), has its peak incidence in adolescence. These are processes that can subtly start and go unnoticed at first.

To analyze the clinical, epidemiological, diagnostic approach of the disorder, evolution and treatment of disordered eating behavior.

Review of the subject and recent articles on eating behavior disorders in Psychiatric guides and magazines.

The eating behavior disorders arise as a result of three factors: predisposing, precipitating and perpetuating. We must take into account the genetics and family history, dissatisfaction with body weight resulting in a restriction of diet and multi-disciplinary consequences of this disorder (physical, psychological and social) as perpetuating factors. We consider the coexistence of comorbidity between disordered eating behavior and personality disorders, mood disorders (depression) and disorders of impulse control.

Eating behavior disorders represent a major health problem that threatens the patient's life. Very important are the rapid detection of the same and the establishment of treatment. Treatment should be multidisciplinary with the patient and family, providing information on the approach to the patient, taking into account the lack of awareness of disease that often exists in patients.

The authors have not supplied their declaration of competing interest.

The eating disorder are not only isolated power problems. They interweave issues and pathologies in patients often difficult to approach and have crimping going to reach a solution and get to the real problem of the patient. As it has been observed in studies if they have established relationships between patients with an impulsive nature and traumatized regarding the presentation of eating disorders.

Our study aims to establish the relationship between eating disorder such as anorexia and bulimia with factors such as impulsivity and suffered traumas.

It has used a sample (n = 57) and patients spent three scales “Barratt Impulsiveness Scale” (BIS-11), “Questionnaire traumatic experiences” (TQ) and the BSQ, scale measuring dissatisfaction disorders eating behavior. The aim is to see the relationship between anorexia and bulimia regarding trauma and impulsivity.

It is intended to check if having character traits of impulsivity or miss having lived or suffered traumatic experiences such as the unexpected death of a family member, rape, kidnapping… establishes a relationship in patients who develop conduct disorders food.

This study aims to see if there is a correlation between eating disorder and factors such as traumatic experiences and an influential feature in this pathology such as the impulsivity through a sample of patients (n = 57) over 18 years.

The authors have not supplied their declaration of competing interest.

Nowadays “reflection” and “reflective practice” is nearly in every curriculum for psychiatric training. Trainees are asked to keep reflection diaries, journals, and participate in “reflection workshops”.

To prove that reflection on or in action does not lead to learning.

Using epistemological notation.

Because sciences including psychiatry are approximate, evolving and inexact, the classical definition of propositional knowledge becomes: A knows that p if:

– (a’) A believes that p is an approximate true;

– (b’) p is approximate truth;

– (c’) A has reason to claim that p is a better approximation than its rivals on available evidence.

Condition (c’) implies that A is not possible at the same time to have two mutually contradictive approximate truths.

In reflective learning we need to add two more conditions:

– (d’) A knows the outcome of p;

– (e’) A is satisfied in believing that p.

In cases of reflection in-action, the (e’) remains even the outcome is not favourable. Similarly, in reflection on-action the condition (e’) remains unchanged since this happened in the past. This leads to controversy. Is p better or worse approximation of truth than its’ rival p’? However, p has passed rigorous and different scientific tests and has proved scientifically superior to its rival p’. Therefore subject A cannot change his knowledge despite the unfavourable outcome, but A can tests further the p. Within the former reflecting learning does not occur, within the latter “critical thinking” occurred.

Reflection does not lead to learning but critical thinking does.

The authors have not supplied their declaration of competing interest.

The quality of care provided to psychiatry patients by doctors can be influenced by attitudes towards mental illness. Equally important is the attitude of medical students as future treating doctors towards mental illness. This survey compares the differences in the attitudes of pre-clinical and clinical years student to mental illness.

To compare attitudes of pre-clinical and clinical medical students’ to mental illness.

A cross-sectional survey of 212 clinical students (CS) and pre-clinical students (PS) at Newcastle University. Each responded anonymously to an electronic questionnaire. The responses take the form of: Yes/No, free text, order of preference, and Likert scale. Results were analysed based on basic statistical analysis.

Little differences exist between the 2 groups in their beliefs that psychiatric patients are not difficult to like, mental illness can be a result of social adversity, psychiatry patients often recover and that people with mental illness should be offered a job with responsibility. However, 54% PS disagreed that mental illness often leads to violence, compared to 66% CS and 87% of PS identified that mental illness can be genetic in origin compared with CS of 91%.

This survey did not identify any significant difference between the attitudes of pre-clinical and clinical students in most of the domains. However, a higher percentage of clinical students associate violence with mental illness and are unwilling to consider an elective period in psychiatry.

The authors have not supplied their declaration of competing interest.

Psychiatry recruitment is currently insufficient to meet the targeted mentalhealth service needs in the UK. Psychiatry is unpopular amongst medicalstudents and in 2011, only 61% of junior training posts were filled by thefirst recruitment. RCPsych is currently working to promote psychiatry as acareer choice for medical students.

To compare preclinical and clinical medical students’ attitudestowards psychiatry as a career choice.

A cross-sectional survey of 212 clinical students (CS) and pre-clinicalstudents (PS) at Newcastle University. Each student responded anonymously toan electronic questionnaire. The responses take the form of: Yes/No, freetext, order of preference, and Likert scale. Results were analysed based onbasic statistical analysis.

A total of 29% PS rated psychiatry in their top 3 career choices comparedwith 16% CS. Fifty-seven percent PS believe that psychiatry is a respectedbranch of medicine and 70% believes it makes good use of medical training,while CS rated these at 50% and 52% respectively. Sixty-nine percent PSbelieve that psychiatry is scientific evidence based compared with 63% CS.Eighty-one percent PS disagreed with the statement that they feel negativeabout psychiatry compared with 61% CS.

The outcome shows increase in negative attitude to psychiatry betweenpre-clinical and clinical years at the medical school. This makes psychiatryan unpopular speciality among final year students. Further research isrequired to ascertain the reason for this decline in interest and negativeattitude.

The authors have not supplied their declaration of competing interest.

Psychiatry is historically unpopular amongst medical students. The perception that psychiatry is remote from the rest of medicine and not evidence-based has been identified. However, there is evidence that psychiatry placement has positive effects on students. There are reports that medical students experience a positive change of attitude towards psychiatry following their undergraduate psychiatric attachment. There is evidence that medical students experience a positive change of attitude towards psychiatry following their undergraduate psychiatric attachment.

To determine the effect of a four-week psychiatry placement on 3rd year medical students’ attitudes towards psychiatry.

Pre-and post-attachment questionnaires were administered to four cohorts of 3rd year students. Responses were anonymised and based on Yes/No, free-text, order of preference and Likert scale. Analysis was by basic statistical methods.

A total of 98 pre- and 81 post-placement students responded. Mean positive attitude increased by 6% and the percentage of students choosing psychiatry in their top three career choices increased from 7 to 20%. Ninety percent of students post-attachment thought that psychiatry is relevant to their future jobs, compared to 86% pre-attachment. The percentage of students who think that psychiatry makes little use of medical training decreased from 20% to 16%.

The survey showed a period of 4 weeks psychiatry placement has a positive effect on the attitudes of medical students towards psychiatry. It also increases the number of students wanting to pursue a career in psychiatry.

The authors have not supplied their declaration of competing interest.

Mental illness is subject to stigma, discrimination and prejudice by both healthcare professionals and public. Fortunately, students are still flexible in their beliefs and there is evidence that education in psychiatry may help to positively alter these beliefs. This survey looks into how psychiatry placement positively influences attitudes of medical students to mental illness.

To elicit the effect of clinical attachment in psychiatry on 3rd year medical students’ attitudes toward mental illness.

Questionnaires were administered to four cohorts of students pre- and post-attachment. Responses were anonymised. Responses were based on Yes/No, free text, order of preference and Likert scale. Analysis was with basic statistical analysis.

Ninety-eight pre- and 81 post-placement students responded. There was a 4% increase in mean positive attitude scores following the placement. There was no significant difference in the medical students’ attitudes to violence in mental illness and that patients with mental illness do not want you to help them. Students post-attachment were more likely to disagree with the statement, ‘Psychiatric patients are difficult to like’. However, 6% more students agreed with the statement ‘Alcohol abusers have no self-control’ after the placement!

Following the 4-week attachments, the percentage of students reporting more positive attitudes to mental illness showed only a marginal increase. A possible explanation may be insufficient contacts with patients and a feeling of not been part of the treating team.

The authors have not supplied their declaration of competing interest.

Simulation provides a non-judgemental environment where trainees learn skills without compromising patients’ safety or dignity. It also provides safe environment where anxiety-provoking, real-life clinical situations can be recreated and repeatedly practiced. Mental health review tribunal is an anxiety-provoking experience for higher trainees and use of simulation can alleviate this anxiety.

To develop trainees’ skills in writing of tribunal reports and giving oral evidence using simulation technique (ST).

To facilitate trainees’ familiarisation with the process of Mental Health tribunal and improve their skills in completing report and giving oral evidence using ST.

There are 2 sessions: one half-day session of interactive teaching providing fundamental details on essential elements of the tribunal process, duties and report. This is followed by 4-weeks gap to allow participants to prepare and submit anonymised patients’ reports to the panel. Finally, a second full day of presentation and cross-examination by (real) tribunal panel with 25-minutes of formative feedback.

Six trainees participated in the pilot: A high percentage of participants strongly agreed or agreed that ST is an effective learning experience for tribunal report writing and cross-examination by the panel. Similar proportion agreed that ST helped to facilitate familiarisation with the tribunal process and that it is a satisfactory teaching method. Finally, all participants agreed that ST helped to achieve personal objectives for attending the seminar.

Simulation in psychiatry is becoming an effective learning experience. The outcome of this pilot on report writing and cross-examination by tribunal panels how its increasing effectiveness and relevance in psychiatry.

The authors have not supplied their declaration of competing interest.

Continuous education of physicians is critical for the quality of medical care.

To investigate the attitudes of general practitioners towards depression and to evaluate the short- and long-term impact of a specific designed postgraduate university program in depression.

In this prospective, interventional study participated 1322-certificated Family Practice specialist. They filled out the Depression Attitude Questionnaire (DAQ) Spanish validated version before starting the educational intervention; an official approved 12 ECTS postgraduate university program. The participant refilled the questionnaires at the end of the course and 6 months later.

A total of 885 females and 420 males (mean 48 years) and with a mean clinical experience of 25 years participated in this study. Short-term after training, PGs positively significant (P < 0.05) changed their attitudes in the management of depression in 18 out 20 items of the DAQ. There were not significant changes in only item 1 related to the number of patients presenting depressive symptoms seen in the last 5 years and the knowledge of the underlying biochemical abnormality. In the long-term, the positive effects observed in the short-term did not significantly change. However, in item 1 a significantly increase was observed. The effectiveness of the intervention was related nor to the to the age and sex of the physician nor to the years of medical practice.

A specific designed educational program can improve the attitudes in depression of GPs. Years of clinical practice are not a limitation for improving the medical attitudes of General practitioners in mental health.

The authors have not supplied their declaration of competing interest.

The literature has shown that young adults reveal lack of knowledge about factors that influence fertility. Given this gap of knowledge regarding fertility, several authors indicate the need for awareness-raising and promotion of attitudes and behaviors that preserve fertility.

This study aimed to assess the knowledge about factors that affect fertility as well as the impact of information transmission on this topic.

Five hundred and fifty-one subjects aged between 18 and 40 years old without children completed an online questionnaire specifically developed for this study. Two assessment moments were considered and participants were randomly assigned to three groups:

– video group;

– website group;

– control group.

The video and website groups accessed information on fertility-related factos such as age, weight, exercise, substance abuse, irregular menstrual cycles, pollution, etc. The control group had no access to this information.

Male participants revealed more knowledge about the factors that affect fertility in both moments. Participants in the groups that had access to fertility information (video group and website group) improved their level of expertise. No significant differences were found in the control group.

Groups that watched the video or visited the website where information on fertility-related lifestyle and other factors was available increased their level of knowledge, suggesting that education on this subject should be provided to general population. The means used for the information dissemination had no impact on the improvement of knowledge.

The authors have not supplied their declaration of competing interest.

Doctors qualified outside the UK constitute > 40% workforce in psychiatry. Differential examinations’ attainment and poor career progression are key issues for International Medical Graduates (IMGs). Due to increased migration, this is transversal to many countries. Varying ethical standards and values in different countries can create difficulties in the workplace and impact quality of patient-care.

To understand current support available for IMGs across countries; identify areas of best practice.

We ran a preliminary open consultation to establish which initiatives were available across Europe and worldwide to address IMGs’ training abroad impact on their training/work in the host country and if any support exists for supervisors of IMGs. Representatives of European trainees were contacted through European Federation of Psychiatric Trainees network and early career psychiatrists through World Psychiatric Association network. Emphasis was given to identified host countries of IMGs.

No specific initiatives were identified in Europe. Out of the six main host countries – Denmark, Finland, Norway, Sweden, Switzerland, UK – one did not provide information. Many countries reported specific requirements for a doctor to be accepted to work. There are courses on language and medicolegal processes. Some support is available for doctors doing short clinical placements. However, once an IMG has been accepted to work in the host country, there is no special support given by way of supervision.

Reports suggest IMGs welcome initiatives to help them gain skills related to the system, its culture, and appreciate feedback on their performance. There is a need to help host countries better support IMGs.

The authors have not supplied their declaration of competing interest.

Learning from the patient presents a pedagogical experience where patients expert in mental health participate as teachers in the teaching-learning processes.

This training activity is a pilot aimed to assess the impact and integration in the study plan of the students following the training course in auxiliary nursing care, Barcelona.

To offer a global vision on mental health problems in order to break the stigma, being the persons affected the main actors.

Stress the value of the patient voice and its particular way of living and suffering the illness in order to offer a suitable attention.

Promote the integration of expert patients as teachers in the education programs.

The training activity starts with the evaluation of the previous mental health knowledge and believes of the students.

Round table with the participation of:

– 2 expert patients explain their history of life and how the illness affects their day-to-day life;

– 2 mental health professionals explain how they help patients to recover and empower them.

Four groups about the impact of illness on a personal, educational, working and social level.

The expert patients were very optimistic and reinforced their own self-esteem. The students show a more positive attitude towards mental illness and express that patients’ are first PEOPLE, then patients’

The expert patients collaborating with professionals are ready to become teachers in the health care academic programs and, specifically, in mental health.

Taking into account the patient voice and vision improves the technical, personal and social competences of professionals.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Psycho-educational interventions for people diagnosed with schizophrenia (PDwS) and their primary caregivers (PC) can improve knowledge about schizophrenia, reduce PCs’ burden of care, PDwSs’ symptoms, and enhance PCs’ quality of life. However, the majority of existing studies have significant methodological weaknesses. Also, little is known about the impact of psycho-educational interventions delivered by booklets and in developing countries like Jordan.

The aim of this study was to examine the effectiveness of psycho-education delivered via a printed booklet for PDwS and their PCs’ in Jordan.

A single blind parallel randomized controlled trial was conducted between September 2012 and September 2013 at four mental outpatient clinics in Amman, Jordan. One hundred and twenty-one PDwS with their PCs were allocated randomly to an experimental (psycho-educational intervention plus treatment as usual in outpatient clinic) group (n = 58) or control (treatment as usual alone) group (n = 63). Outcomes, measured prior randomization (pretest), immediately post-intervention (posttest 1) and at three months after intervention (posttest 2).

Participants receiving psycho-education and treatment as usual had better knowledge of schizophrenia, reduced positive and negative symptoms and hospitalisation at both follow-up points. PCs had reduced burden of care and experienced a better quality of life.

Psycho-education delivered via printed booklets improves outcomes for PDwS and their PCs in Jordan better than treatment as usual. Our hypothesis is supported.

The author has not supplied his declaration of competing interest.

The authors have not supplied their declaration of competing interest.

In the United Kingdom, a drive has been initiated to duly attract and recruit medical student into career psychiatry. However, most medical students attending university find the psychiatry lacks structure and organised model in teaching delivery.

As a result, many medical students put off earlier on in their studies by psychiatry.

We wanted to test the above hypothesis with the introduction of structure by allocating de-centralised teaching and hands on clinical experience for medical students.

The collective survey tool is devised to reflect the needs of medical students with de-centralised teaching separate but to complement university studies. This included introduction of induction package, set out syllabus, structured learning sessions. The results of the feedback from the medical students were collated and the results are discussed.

The results indicate the success of the decentralized and borough based teaching, with improved interest in psychiatry and higher attendance rate. The feedback has been positive, and efforts of the tutors have been appreciated. Whether this will translate into higher recruitment rate number is to be seen.

The authors have not supplied their declaration of competing interest.

The most common intervention performed by physicians is the writing of a prescription. All elements in the complex process of prescribing and administering drugs are susceptible to error.

To measure the extent to which information recorded on prescription cards conforms to basic standards of prescription writing.

To improve prescribing, recording and staff knowledge.

To identify common prescribing errors and focus on the same to improve our standard of practice.

An audit tool was designed to collect data and standard was set 100%.

In the initial audit, there was significant deficiency in prescription writing, which was presented at the internal teaching to all doctors and recommendations were made. This audit was repeated after a month, which showed improvement in prescription writing and recording.

Write all drugs in CAPITALS ensuring correct spelling, dose, route of administration and frequency.

Complete all fields on front of the prescription card legibly.

Document any change in prescription card in clinical notes.

All doctors to go through their current clients medication cards and ensure any gaps filled and errors corrected.

Audit report will be kept in audit folder as a reference for any rotating doctor to repeat the audit every six months in the services.

Doctors should continue to improve prescription writing and reduce any adverse events or errors.

The authors have not supplied their declaration of competing interest.