A nationwide study was carried out comprising 50,877 persons aged 18-66, who were registered in 2003 in the Danish Psychiatric Register or in the National Patient Register with a psychiatric ICD-10 diagnosis.

Of the population 87.1% were ethnic Danes, 7.8% migrants, 4.0% off-springs with one Danish born parent, 0.7% off-springs with both parents born outside Denmark and 0.3% adoptees. Males comprised 49% women 51% of the population.

The 5 ethnic groups had significant differences in utilization of care, diagnostic distribution and use of coercion.

Women had a higher contact rates in all groups apart from migrants.

The contact rate among persons of Middle Eastern background was relatively low.

Patients with a non-Danish background were more frequently non-voluntarily admitted and had significantly more frequently contact with services due to a forensic measures.

Substance abuse was higher among men in all ethnic groups.

Contacts due to schizophrenia were higher among non-Danish patients and highest among young off-spring males.

Self-mutilating behaviour was seen more frequently among female off-springs from non-Western countries than among migrant women from non-Western countries.

The paper will analyse selected significant differences among the ethnic groups.

During the last decades, the field of psychiatry has grown tremendously, but despite prevailing optimism we are faced with many challenges. A major challenge is that psychiatric services in many European countries are faced with increasing immigrant populations. Here there is a need to integrate knowledge hereof in the undergraduate, graduate and postgraduate training curriculum.

A main educational goal is to construct the core elements of a graduate training curriculum in psychiatry regarding cultural aspects to ensure high quality of psychiatric services via the creation of competent psychiatrists in all areas of Europe and promote the standard of training for cultural psychiatry by providing recommendations for training agreed upon by all stakeholders.

No explicit health policy has been formulated in many countries with respect to immigrants of which a large proportion has a traumatized background with a variety of problems linked to this.

Till now, the psychiatric curriculum in most areas comprises little training on cultural issues. On both under- and post-graduate level, the curriculum should comprise training in transcultural aspects of psychiatry.

With increased globalization there is a need to pay more attention to cultural aspects at all levels and develop strategies to increase the cultural competence of mental health professionals.

Consensus statements on psychiatric training and related issues related to cultural issues should be produced.

The paper will discuss the content of a culture sensitive curriculum and strategies to implement it.

WHO has predicted that in 2020 depression will be the second most important cause of disability.

Studies focusing on cross- cultural aspects of depression have increased during the last decade, and depression has been studied cross-culturally regarding their prevalence and symptomatology.

The WHO study assessing depression across cultures reported a core symptomatology across the participating centres, but with certain differences in the ranking of problems in e.g. patients from non -industrialised nations somatic symptoms often dominate.

Furthermore, there is increasing focus on the impact of migration on depressive illness. Depressive syndromes are clearly very common in migrants, and are probably the most frequent mental disorders in people who move to other countries. Refugees and asylum seekers are subjected to significant social and psychological stress and are more vulnerable. For scientific purposes it is vital though to differentiate between the different aspects of influence, for example the frequency of disorders and problems in treatment. Results of studies on increased psychological morbidity in migrants do not indicate whether increased vulnerability is associated with a migration background, or with acculturation problems in the host country due to cultural differences, or a combination of both factors. Both culture and migration-specific factors, as well as the level of integration into the host country, determine the conflicting arguments.

The presentation will provide an overview of the burden of depression in relation to culture, differences in symptomatology, the role of migration and other circumstantial factors having an impact on the appearance and outcome of the disorder.

The proportion of women entering psychiatry is gradually increasing and among psychiatrists in clinical leadership positions women comprise an increasing proportion.

Yet few women are taking up leadership positions in international professional organisations. These organisations aim at e.g.

• improving the care for the mentally ill

• promoting parity in the provision of care to the mentally ill

• preserving the rights of these patients and

• protecting the rights of psychiatrists.

All areas where the input of women may contribute significantly to the outcome of any intervention.

Other key domains relate to:

• the development of ethical standards and procedures how to monitor their observance.

• the growth of educational programs to be offered globally

• the mentorship of junior colleagues or colleagues working in professional isolation

The need to develop strategies to overcome the inner as well as outer obstacles preventing women from due representation in these organisations will be discussed and suggestions for strategies to overcome the obstacles outlined.