French Psychiatry on Internet

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French Psychiatry on Internet

• Dr Jean-Michel THURIN
• 1. International Symposium on Psychiatry and
  Internet
• MUNICH O5.04.2001

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• Psydoc-France is the internet site of the French
  Federation of Psychiatry (FFP). This Federation
  brings together all the French scientific
  societies (To day, 50).
• Psydoc-France was opened in February 1996, in the
  context of a close collaboration between FFP and
  INSERM (National Institute for Health and Medical
  Research).

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Initial objectives

• First, offer to the French psychiatrists an easy
  access to the many scientific journals (one
  Society - one Journal !), in order to reduce the
  mental and cultural barriers between practices
  (public, academic or private) and approaches
  (psychodynamic, biological, behavioral, etc.)
• Linked to this, the main purpose was to boost
  clinical research in psychiatry which was
  especially poor in France.
• An other aim was to avoid the internet
  restriction to one culture with one language.
  Psychopathology is essential in the cultural
  foundations of French psychiatry and most of the
  clinicians use psychodynamic approach, which
  differs from DSMIV culture

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new challenges

• These aims are still topical. But others emerged.
• French psychiatrists now appreciate to practice
  in an integrative and opened way, and the era of
  compartmentalization is over.So, Psydoc has
  became a common frame for exchanges and shared
  works.
• International exchanges have increased,
  particularly with USA, South America and Maghreb.

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and social evolutions

• Continuing medical training became obligatory for
  each French physician.
• Psychiatry is not only the field of -
  psychiatrists only - , but more and more the one
  of mental health workers and general
  practitioners.
• Patients and proxies are becoming consumers and
  even partners in health care.
• Within a few years, we entered the new era of
  Public health policy and Management care.
• Scientific information, strengthened by its
  quality with rapid access means, is now an
  important resource for the professionals , and
  for the users (Cybermedecine).
• This situation has generated new
  responsibilitiesfor the scientific societies.

http//www.bmj.com/cgi/content/full/319/7220/1294
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How is the site organized ?

• Six to twelve persons work for the site. It is
  divided in domains, with a person in charge for
  each one.
• We try to train every one, so that he could
  himself modify and send its own html pages.
• For example, every day M. T. modifies the
  Permanent Journal, D.T. theSite of the Day,
  S. K. its column Humor, M.V and JM. T the
  Scientific Actuality.
• A librarian C.P. joined the team. She helps for
  the information research in the international
  data bases and the realization of a French
  thesaurus compatible with the MeSH
  (Medline thesaurus).
• I carry out the programming of the data bases
  and of the general organization.
• Psydoc-France is now composed of about 3000 html
  files and six data bases with 30 000 files.
• Every day, about 6000 internet surfers search
  information on the site.

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Main headings a living interactive workshop

• Scientific Associations and Societies
• Congress announces and proceedings
• Research
• Bibliographic data basis
• CME and Cyberconferences
• Scientific Platforms data bases
• Health care system
• Consensus conferences
• Selected links
• Information and exchanges with patients and
  relatives
• Personal information
• General information and documentation

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Scientific Societies

• 50 scientific societies presented with their
  aims, the names of their President, General
  Secretary, Treasurer, their address, and URL of
  web site when it exists.

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Congress (announces and proceedings)
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Announces by interactive data basis
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Proceedings with video Interviews
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Proceedings with video Interviews
Live broadcast from WPA Jubilee Congress
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All is not composed of video
Abstracts and full communication can be accessed
by data basis completed by html pages
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Research

• Research is an important domain, with on-line
  reports, information, and a data base of current
  programs.
• We try to incite the research Groups to present
  their work on-line, but this objective remains
  difficult.

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Bibliographic data basis

• It is possible to access to the presentation of
  the main French psychiatric journals .
• For twelve of them, it is possible to read their
  abstracts.
• Six of them (Pour la Recherche, Depression,
  Pluriels, Handicap Letter, Perspectives
  Psychiatriques, Psychiatrie Française) are
  accessible in full text.

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CME and Cyberconferences

• Since February 1998, FFP organizes
  Cyberconferences (partnership with Pfizer
  laboratory).
• Cyberconferences are a new way of Continuing
  medical training using new technologies to do
  away with geographic and interpersonal distances

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CME and Cyberconferences

• Since February 2000, each Cybernaut can not only
  hear and write to the contributors who present a
  topic (one to six), but also see them in live .
  Social interaction is reinforced.
• Actually 35 Cyberconferences are available on the
  site, with more than 70 experts. A data base
  offers access to the topics, the contributors and
  the abstract of their communication, with key
  words.

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CME and Cyberconferences

• Three Cyberconferences have been realized in live
  from a congress (Toronto, Washington, Paris) and
  even one from the French Department of Health and
  Social Security
• Our objectives are to day the opening of the
  exchanges with general practitioners and other
  specialists as well as international exchanges.

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Scientific platforms

• Each platform puts together a structured
  collection of information about one specific
  domain, from bibliographic references, articles
  and Internet links
• Today, five platforms can be consulted on
  Psydoc-France Psychotherapies assessment,
  Stress and immunity, Depression and environment,
  Psychotherapy of cranial traumas, and Drug
  addictions.

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Health care system

• There is actually an important transformation of
  the health care system in psychiatry. It is
  important for everybody to have at ones disposal
  information about epidemiology, number of
  psychiatrists, duration of hospitalization,
  health and medico-social organizations, laws and
  regulations, etc.

• We put together governmental reports and
  statistics arranged by agencies and unions.

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Information exchange among psychiatrists and
patients

• Nearly each day, we receive questions from
  patients or their relatives by the way of
  Internet.
• These questions are not exactly those that we
  learned in the lectures and in the books, or even
  those that are asked during the consulting
  session.
• Patients ask for an information, an advice or an
  orientation in health care systems.
• It is difficult to answer to many of these
  questions because of the difficulty due to the
  writing form and to deontological problems.
• For instance My brother is in the X hospital.
  He suffers from chronic asthenia. I never could
  meet anybody of the medical team. Could you give
  me the address of another psychiatrist or clinic
  ?
• I want to consult a specialist of depression in
  France. Where can I find him ?
• Other questions are real case reports
• So, to answer to the most difficult of these, we
  have set up a peers group

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Information about illness and treatments

• FFP has organized 4 consensus conferences
  (Schizophrenia, Opiate addictions, child
  depression and suicide). Their recommendations
  and reports are published on the site.
• We have also published clinical practice
  recommendations about ECT, antidepressants, an
  important report about depression
• The information is performed by a data base of
  selected sites with the description of their
  content and key words.
• So, Psydoc-France is a living data base, using
  the interaction between the questionersand a
  large answering group from experts.

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International Exchanges

• Today, different international openings have been
  initiated on Psydoc-France
• Links with major National Scientific Associations
• Proceedings of congress between FFP and APA
• Proceedings of the WPA Jubilee congress organized
  by France in June 2000
• Cyberconferences to which many foreign colleagues
  participate
• Information transmitted by email (congress,
  questions, etc.)
• Accommodation on the site of texts (WPA) and
  Journal (Tunisian Journal of Psychiatry)
• Exchanges about Honor Codes and Quality Charters
• Professional texts of UEMS and OMS
• Etc.

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How can these exchanges progress ?

• Real and not only virtual meetings are necessary
  to initiate and perform exchanges about specific
  questions.
• Common actions are also necessary about these
  topics.
• Europe is beginning an important frame work.
• Thank you for this international workshop, which
  is not only virtual and opens the possibility of
  personal links