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Over 4 psychiatrists, including 250 from Poland, debated in Warsaw on the successes and challenges facing European psychiatry. The 580th European Congress of Psychiatrists, which was held in Poland for the first time, gathered a record number of participants.
– It is a great honor that this year we hosted European psychiatrists in Warsaw. We joined the group of countries such as France, Italy, Germany and Spain, which hosted the EPA in previous years. This proves that Polish psychiatry and Polish psychiatrists are appreciated in Europe. But we are aware that there are still many challenges ahead of us – says prof. Agata Szulc, President of the Main Board of the Polish Psychiatric Association.
Psychiatry in a period of change
The European Psychiatric Association (EPA) is the leading representation of psychiatry in Europe. It has over 78 members from 000 countries. Every year, it organizes an international event – the European Congress of Psychiatry, which is a platform for discussion and exchange of experiences between experts in the field of mental health. The 88th edition of the Congress (EPA27) was held under the slogan “Psychiatrist in a period of change. New models, goals
i wyzwania” (ang. Psychiatry in transition. Towards new models, goals & challenges).
– Psychiatry is undergoing a transformation. We realized that the care of people struggling with mental illnesses, carried out by many institutions, does not meet the real needs of patients and is not the best solution. Today, thanks to various methods of treatment, when treatment is started very early, we can afford to treat patients effectively enough to allow them to live as part of society. Patients return to school, work, and family. The basic aspect regarding the transformation of psychiatric treatment is that, whenever possible, we want to replace the model based on hospitalization with treatment of the patient in his environment. We must create alternative solutions – so that hospitalization is an exceptional situation – said prof. Silvana Galderisi during the press briefing accompanying the EPA.
This is the goal of the National Mental Health Program, the pilot of which was launched in 2018 in 27 centers in the country. Its assumption is a departure from the institutional model of psychiatric care – replacing large psychiatric hospitals with smaller units and shifting services towards community care. The main task of community care is to enable a person with a mental illness to function in society, and thus to learn and work.
The treatment of schizophrenia remains a challenge
A group of patients who want to remain professionally active despite their mental illness
and socially there are patients struggling with schizophrenia. The first symptoms of schizophrenia appear
at a young age. At the time of diagnosis, patients are usually under the age of 30, on the threshold of adulthood. In Poland, about 400 people * suffer from schizophrenia, and up to 50 million ** worldwide. Schizophrenia is a chronic disease that has periods of relapse, but with proper treatment, the patient does not show any symptoms of the disease. However, it must absolutely apply
as prescribed by your doctor and take your medications regularly.
– About 80-85 percent patients with one episode of schizophrenia develop further episodes. The primary function of drug therapy is therefore to treat the patient during episodes as well as to prevent relapse. However, some patients take the medication, others do not. Let’s think about us – when the doctor prescribes an antibiotic and we are to take it for 10 days or always for
do we take every pill these 10 days? It is a human trait to forget, and in addition, in the case of this disease, there are some patients who do not believe they are sick. Meanwhile, as long as the patient takes the prescribed drug, he will not relapse and will not be hospitalized – said Prof. Istvan Bitter from the University of Budapest.
Prof. Istvan Bitter cited data from Hungary that many patients stop taking their prescribed medication after the first month. After three months, more than half of the patients do not accept them, and after a year, almost everyone.
– Half of the patients after the first episode of schizophrenia do not go to the pharmacy and buy drugs. And the small group that actually buys these drugs stops taking them anyway. This problem also affects financial issues. In patients who will not take the drug for a long time, discontinue it, they will develop symptoms of the disease – delusions, hallucinations. Accordingly, the patient will have to be hospitalized. The highest rates of hospitalized patients who develop relapses and patients who die from the disease are those who do not take medication. However, we do have long-acting drugs that are injected once in a while. Data collected over 20 years in Finland show that the relapse and hospitalization rates are the lowest among patients taking long-acting drugs, he added.
In Poland, long-acting drugs are available in the form of injections once a month. In Europe, commonly (in 20 European Union countries) those taken by patients every three months are already used.
Warsaw hosts the EPA for the first time
Every year, the EPA Congress hosts a different European city – in 2018, European psychiatrists were hosted by France, 2017 – Italy, 2016 – Spain. This year Poland joined the elite group of EPA hosts.
– We are very happy that this year’s edition of the European Psychiatric Congress was a great success. A record number of participants in the history of the Congresses of the European Psychiatric Association gathered in the capital of Poland. On the one hand, we have international success, modern treatment methods – second-generation drugs – are almost within our reach. Polish patients can now use most of the modern drugs used in the treatment of schizophrenia. We are waiting for a long-acting drug taken once every 3 months. On the other hand, Polish psychiatry is underfunded. Our goal is to move psychiatric care from large hospitals to community care. We want patients to be treated outside the hospital
– in your environment. We would like the patient we helped not to come back to us in a moment with a relapse because he stopped taking medications. Unfortunately, the patients are coming back – said prof. Agata Szulc.
– Changes in psychiatry make it necessary not only to educate doctors and nurses, but also patients and their families. What is the treatment? Why is it important for them to take medication? And finally, providing them with drugs that keep the human factor to a minimum. Who remembers taking medication for a short period? And patients with schizophrenia must take them all their lives. If we can provide patients with drugs administered less frequently – once every 2 weeks, once a month, or even once every 3 months, this is a significant breakthrough in psychiatry – summed up Prof. Jerzy Samochowiec, President-Elect of the Main Board of the Polish Psychiatric Association.
* https://www.mp.pl/pacjent/psychiatria/aktualnosci/144697,na-schizofrenie-choruje-prawie-400-tys-polakow, accessed on: 02.04.2019/XNUMX/XNUMX.
** Stilo SA, Murray RM (2010), The epidemiology of schizophrenia: replacing dogma with knowledge, “Dialogues Clin Neurosci” 12(3): 305-315.