title: Pharmaceutical industry interactions of psychiatric trainees from 20 European countries.
abstract: BACKGROUND
  Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees.
  
  
  METHODS
  One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire.
  
  
  RESULTS
  The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean)=0.92, SD=1.44, range=0-12) and most in Portugal (M=19.06, SD=17.44, range=0-100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M=3.30, SD=1.26 vs. M=2.39, SD=1.06 on a 5-point Likert scale: 1 "completely disagree" to 5 "completely agree"). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio)=1.21, 95%CI=1.12-1.30 and OR=1.18, 95%CI=1.02-1.37).
  
  
  CONCLUSIONS
  There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.
authors.affiliation: Psychiatric University Hospital Zurich, Division of Psychiatry Research and Psychogeriatric Medicine, Lenggstr. 31, 8032 Zurich, Switzerland. Electronic address: florian.riese@bli.uzh.ch.
authors.forename: F
authors.initials: F
authors.lastname: Riese
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, EURON, Maastricht, The Netherlands; Department of Psychiatry, Yale University, New Haven, CT, USA.
authors.forename: S
authors.initials: S
authors.lastname: Guloksuz
authors.affiliation: University Psychiatry Hospital Pr. Dr. Al. Obregia, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Roventa
authors.affiliation: Kershaw Unit, Gartnavel Royal Hospital, Glasgow, United Kingdom.
authors.forename: J D
authors.initials: JD
authors.lastname: Fair
authors.affiliation: Hospital District of Helsinki and Uusimaa, Kellokoski Hospital and National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Haravuori
authors.affiliation: Psychiatric Clinic, Tartu University Hospital, Tartu, Estonia.
authors.forename: T
authors.initials: T
authors.lastname: Rolko
authors.affiliation: Department of Psychiatry, St. Lukes Hospital, Kilkenny, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: Flynn
authors.affiliation: Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
authors.forename: D
authors.initials: D
authors.lastname: Giacco
authors.affiliation: Clinic for Psychiatry, University Clinical Center Banjaluka, Banjaluka, Bosnia-Herzegovina.
authors.forename: V
authors.initials: V
authors.lastname: Banjac
authors.affiliation: Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: N
authors.initials: N
authors.lastname: Jovanovic
authors.affiliation: Arkin Psychiatric Institution, Amsterdam, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Bayat
authors.affiliation: Department of Neuroscience and Sense Organ, University of Bari, Bari, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Palumbo
authors.affiliation: Riga Stradins University, Riga, Latvia.
authors.forename: M
authors.initials: M
authors.lastname: Rusaka
authors.affiliation: Department of Psychiatry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Kilic
authors.affiliation: Vilnius University Psychiatric Clinic, Vilnius, Lithuania.
authors.forename: J
authors.initials: J
authors.lastname: Augėnaitė
authors.affiliation: Department of Psychiatry, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: A
authors.initials: A
authors.lastname: Nawka
authors.affiliation: Central Ostrobothnia Hospital District, Kokkola Central Hospital, Kokkola, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Zenger
authors.affiliation: Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: I
authors.initials: I
authors.lastname: Kekin
authors.affiliation: UPC KU Leuven, Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Wuyts
authors.affiliation: Our Lady's Hospital for Children, Crumlin, Dublin, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Barrett
authors.affiliation: Psychiatric University Hospital Zurich, Division of Psychiatry Research and Psychogeriatric Medicine, Lenggstr. 31, 8032 Zurich, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Bausch-Becker
authors.affiliation: Vilnius University Psychiatric Clinic, Vilnius, Lithuania.
authors.forename: J
authors.initials: J
authors.lastname: Mikaliūnas
authors.affiliation: Centre Hospitalier Universitaire de La Tronche, 38700 Grenoble, France.
authors.forename: E
authors.initials: E
authors.lastname: Del Valle
authors.affiliation: Shalvata Mental Health Center, Hod Hashron, Israel.
authors.forename: K
authors.initials: K
authors.lastname: Feffer
authors.affiliation: South West London and St George's Mental Health Trust, London, United Kingdom.
authors.forename: G A
authors.initials: GA
authors.lastname: Lomax
authors.affiliation: Centro Hospitalar Psiquiatrico de Lisboa, Lisbon, Portugal.
authors.forename: J G
authors.initials: JG
authors.lastname: Marques
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, King's College, London, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Jauhar
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004345:Drug Industry; D004503:Education, Medical, Graduate; D005060:Europe; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011570:Psychiatry / Q000193:education*; D011795:Surveys and Questionnaires
keywords: Conflict of interest; EFPT; European Federation of Psychiatric Trainees; Industry interactions; Pharmaceutical industry; Psychiatric training