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Child and adolescent psychiatry training and mental health care in Southeast Europe

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Abstract

There is very limited information available on child and adolescent psychiatry (CAP) training in the Southeast European (SEE) region. The objective of this study was to fill in this gap by presenting descriptive data on CAP training and national mental health services for children and adolescent in 11 SEE countries. On the initiative of World Psychiatric Association—CAP section, national CAP association boards from each SEE country allocated one member to the Consortium on Academic Child and Adolescent Psychiatry in SEE (CACAP SEE) in 2018. Using an internally distributed questionnaire, CACAP SEE members provided information on the CAP training structure and mental health care. Ten out of eleven SEE countries recognized CAP as a separate specialty. Duration of training did not differ much between the SEE countries. Other components were more variable (availability of rotations, overseas electives, and inclusion of psychotherapy). Ten countries were familiar with the CAP requirements of the European Union of Medical Specialists (UEMS–CAP) and five provided the training in accordance with it. Nine countries had less than 36 board-certified child and adolescent psychiatrists practicing in the country. The number of general psychiatrists treating children and adolescents with mental disorders was higher than the number of CAP specialists in five of the countries. Although CAP was recognized as a separate specialty in the vast majority of SEE countries, there was a substantial variation among them in available CAP training. In most of the countries, there is a considerable lack of CAP specialists for several reasons, including loss of trained specialists to other countries.

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Notes

  1. *Kosovo is used in accordance with UN Security Council Resolution 1244 (1999).

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Authors and Affiliations

  1. Department for Child and Adolescent Psychiatry, University Medical Centre Maribor, Faculty of Medicine, University of Maribor, Maribor, Slovenia

    H. Gregoric Kumperscak

  2. Norwegian University of Science and Technology, Trondheim, Norway

    C. Clausen

  3. Department of Child Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    D. Anagnostopoulos

  4. Psychiatry Clinic, Clinical Centre Montenegro, Podgorica, Montenegro

    Z. Barac Otasevic

  5. Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia

    V. Boricevic Marsanic

  6. Department for Child and Adolescent Psychiatry, University Clinical Centre Banja Luka, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina

    M. Burgic

  7. Department of Neuroscience, Tirana University Hospital Center Mother Teresa, Tirana Medical University, Tirana, Albania

    A. Como

  8. Child and Adolescent Psychiatry Clinic, Neurosciences Department, “V. Babes”, University of Medicine and Pharmacy, Timisoara, Romania

    L. Nussbaum

  9. Department for Child and Adolescent Psychiatry, Institute of Mental Health Belgrade, School of Medicine, University of Belgrade, Belgrade, Serbia

    M. Pejovic Milovancevic

  10. Department for Child and Adolescent Psychiatry, University Clinic of Psychiatry, Skopje, School of Medicine St. Cyril and Methodius University Skopje, Skopje, Macedonia

    M. Raleva

  11. Association for the Improvement of Mental Health Programmes, Geneva, Switzerland

    N. Sartorius

  12. University of Mitrovica “Isa Boletini”, Mitrovica, Kosovo

    M. Shahini

  13. Clinic of Child Psychiatry, University Hospital Alexandrovska, Medical University of Sofia, Sofia, Bulgaria

    D. Terziev

  14. Centre for Child and Adolescent Mental Health, Norwegian University of Science and Technology, Trondheim, Norway

    N. Skokauskas

Authors
  1. H. Gregoric Kumperscak
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  2. C. Clausen
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  3. D. Anagnostopoulos
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  4. Z. Barac Otasevic
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  5. V. Boricevic Marsanic
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  6. M. Burgic
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  7. A. Como
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  8. L. Nussbaum
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  9. M. Pejovic Milovancevic
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  10. M. Raleva
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  11. N. Sartorius
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  12. M. Shahini
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  13. D. Terziev
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  14. N. Skokauskas
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Corresponding author

Correspondence to H. Gregoric Kumperscak.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Additional information

This article is the part of focused issue “The European and Global Perspective on Training in Child and Adolescent Psychiatry”.

Appendix i

Appendix i

Questionnaire

  1. 1.

    How many qualified (board-certified) general psychiatrists currently practice in your country?

  2. 2.

    How many of the general psychiatrists treat child and adolescent populations?

  3. 3.

    Is there a national curriculum for postgraduate general psychiatry training? Yes/No

  4. 4.

    What is the duration of general psychiatry training?

  5. 5.

    Is there any CAP exposure during general psychiatry training? Yes/No; if yes, please answer question 5(a).

    1. a.

      What is the duration of CAP exposure during general psychiatry training?

  6. 6.

    Is child and adolescent psychiatry recognized as a separate specialty (subspecialty)? Yes/No

  7. 7.

    Is there a specialized postgraduate training program in CAP? If YES, please answer 7a-7i. If NO, please skip ahead to question 8.

    1. a.

      Is the completion of general psychiatry training required before entering CAP training? Yes/No

    2. b.

      Is an in-patient child and adolescent psychiatry unit rotation available for trainees? Yes/No

    3. c.

      Is a child and adolescent psychiatry outpatient rotation available for trainees? Yes/No

    4. d.

      Is a consultation-Liaison (psychosomatic medicine) rotation available for CAP trainees? Yes/No

    5. e.

      Is a pediatric neurology rotation available for CAP trainees? Yes/No

    6. f.

      Is a general pediatric rotation available for CAP trainees? Yes/No

    7. g.

      Is a school consultation rotation available for CAP trainees? Yes/No

    8. h.

      Is a forensic training rotation available for CAP trainees? Yes/No

    9. i.

      Are there exit exams in CAP training? Yes/No

  8. 8.

    Is there a national curriculum for postgraduate CAP training? Yes/No

  9. 9.

    Are overseas CAP electives available for CAP trainees? Yes/No

    1. a.

      If YES to Question 9, in which countries are these electives available?

  10. 10.

    Is there a need for more child and adolescent psychiatrists in your country? Yes/No

    1. a.

      If you answered YES to question 10, what are the estimated numbers of required child and adolescent psychiatrists in your country?

  11. 11.

    Is there a need for more allied professionals, other than child and adolescent psychiatrists? Yes/No

    1. a.

      If YES to question 11, what is the estimated number of required allied professionals, other than child and adolescent psychiatrists?

  12. 12.

    Is there a board certification system for child and adolescent psychiatrists?

  13. 13.

    How many qualified (board-certified) child and adolescent psychiatrists practice in your country?

  14. 14.

    How many CAP departments affiliated with universities operate in your country?

  15. 15.

    Is there a CAP society? Yes/No

  16. 16.

    Is there a national CAP journal? Yes/No

  17. 17.

    Is there a national child and adolescent mental health policy? Yes/No

  18. 18.

    If CAP is an independent medical specialty, when did this begin?

  19. 19.

    If a Specialist Society exists, when did this begin?

  20. 20.

    How long is CAP training in total?

    1. a.

      Of this CAP training time, what is the duration spent in the field of child and adolescent psychiatry?

    2. b.

      How much time does a CAP trainee spend in total in other specialties (general psychiatry, child neurology, paediatrics, etc.)?

  21. 21.

    Are you familiar with UEMS-CAP requirements regarding CAP training? Yes/No

    1. a.

      If YES to question 21, is the training in your country in accordance with UEMS-CAP requirements? Yes/No

  22. 22.

    Is there systematic integration of psychotherapy training during CAP training? Yes/No

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Gregoric Kumperscak, H., Clausen, C., Anagnostopoulos, D. et al. Child and adolescent psychiatry training and mental health care in Southeast Europe. Eur Child Adolesc Psychiatry 29, 29–39 (2020). https://doi.org/10.1007/s00787-019-01362-0

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