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Purpose: Descriptive psychopathology (DP) is the language of psychiatry and is dedicated to the description of mental symptoms. Despite its core importance, a systematic review identified a series of shortcomings in its training. This Delphi study seeks to provide guidance for better didactic and clinical training in DP. Method: The authors used the Delphi method in order to gather, pool, and optimize the knowledgeable opinion of a highly qualified panel of international experts on how to improve DP training. A preliminary phase with open-ended questions was the basis to elaborate a Delphi questionnaire consisting of 14 questions on didactic and clinical training, which was then used in two successive Delphi rounds. Twenty-nine international experts in DP participated throughout the study. Results: A series of hierarchical lists on how to improve DP training were elaborated. Regarding didactic training, the experts valued the contents and educational methods, as well as recommended authors and texts. Regarding clinical training, the experts valued educational methods, desirable characteristics in clinical supervisors, how to improve the supervisors’ expertise, useful aspects and facilitating questions for direct supervision, and the suitability of including other evaluators besides the supervisor. In the final survey, 94% of the experts considered that the Delphi method had been effective to obtain and improve their opinions. Conclusions: Insufficient direct supervision in live interviews was considered the most important problem. A series of general measures were proposed to improve DP training: (i) adapting DP training throughout residency, with introductory and advanced levels; (ii) making DP training compulsory in psychiatry curricula; (iii) assessing residents’ DP knowledge and clinical use; and (iv) training the trainers/supervisors in both content (DP) and form (how to train/supervise residents). Within didactic training, epistemology of DP and contemporary and classic authors/texts were the highest rated contents, while supervised discussions based on cases, videos, or readings were the highest rated methods. Within clinical training, 8 aspects of DP that could guide the supervisor were highly rated: mental state examination, dialogue, empathy and understanding, attitude/willingness, knowledge-practice bridge, mental symptom formation, implications for decision-making, and the written report of the encounter.

Idiopathic normal pressure hydrocephalus has a complex multifactorial pathogenesis and is associated with Alzheimer’s disease in many patients. To date, it is not well known if a similar association exists with behavioural variant of frontotemporal lobar degeneration. In a first step, we compare the prevalence of idiopathic normal pressure hydrocephalus in two groups of patients, one with behavioural variant of frontotemporal lobar degeneration (n = 69) and the other with Alzheimer’s disease (n = 178). In the second step, we describe more precisely the phenotype of patients with the association of idiopathic normal pressure hydrocephalus and behavioural variant of frontotemporal lobar degeneration. Firstly, we report that the prevalence of idiopathic normal pressure hydrocephalus was far higher in the group of patients with behavioural variant of frontotemporal lobar degeneration than in the group of patients with Alzheimer’s disease (7.25% and 1.1%, respectively, P = 0.02). Secondly, we show that patients with the double diagnosis share common clinical and para-clinical features of both idiopathic normal pressure hydrocephalus and behavioural variant of frontotemporal lobar degeneration patients, including CSF shunting efficacy in real-life experience. Overall, our results suggest a link between these two conditions and should encourage neurologists to look for idiopathic normal pressure hydrocephalus in their behavioural variant of frontotemporal lobar degeneration patients in the event of gait disturbances; the benefit/risk balance could indeed be in favour of shunt surgery for selected patients with this newly described entity.

Purpose: Descriptive psychopathology (DP, sometimes called psychopathology or phenomenology) is the language of psychiatry and is dedicated to the description of mental symptoms. Due to its importance, there is an ongoing case to put it back at the heart of psychiatry and its training. This study seeks to examine the literature on how to train psychiatry residents in DP, including reported educational interventions and educational methods. Method: The authors conducted a systematic review following the PRISMA and BEME guidelines to identify literature on how to train psychiatry residents in DP. In May 2019, they searched in Embase, ERIC, PsycINFO, PubMed, Scopus, and Web of Science; of 7,199 initial results, 26 sources were finally included for analysis. The assessment tools were the CRAAP test, Kirkpatrick’s 4 levels, and (when applicable) the Medical Education Research Study Quality Instrument (MERSQI). Results: The mean CRAAP score was 38.885 of a possible 50 (SD 0.983; range: 36.859–40.910). Fourteen sources (53.8%) had some kind of training evaluation: Kirkpatrick’s level 1 was present in nearly all (13) and was the highest in half of them (7). Regarding the educational interventions, the mean MERSQI score was 10.592 of a possible 18 (SD 2.371; range 9.085–12.098). Lectures were the most widely reported educational method (5); among those in clinical settings, the live supervised interview with feedback was the most usual (4). Conclusions: Despite its core importance as the language of psychiatry, the literature about training psychiatry residents in DP is scarce and heterogeneous. General lack of training evaluation and ongoing overemphasis on Kirkpatrick’s levels 1–2 at the expense of levels 3–4 are causes for concern. During the review process, the authors identified a selection of educational interventions that could serve as the basis for the design of new training efforts in both clinical and nonclinical settings. Topics for future research are also suggested, such as the role of DP in competency-based training frameworks now in vogue and a series of neglected contents. Finally, the combined use of the CRAAP test and the MERSQI may be useful for future systematic reviews in medical education.

Introduction: Gender differences in the clinical presentation of patients with schizophrenia have been well documented, yet few studies have investigated gender-related clinical differences of auditory hallucinations in schizophrenia. We compared a group of men and women schizophrenics with auditory hallucinations (AH) in order to evaluate the possibility of characterizing relevant dimensions in this symptom between genders. Methods: The Psychotic symptom rating scale (PSYRATS) for auditory hallucinations was administered to 123 patients (86 men, 37 women) who met DSM-IV criteria for schizophrenia with AH. Patients were also assessed about demographic variables, including age of onset and whether AH were persistent. Results: The results showed that women had greater scores in the dimension “beliefs re-origin” (p