European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S171
Table 1 Scale scores before and after the SST.
Pre (n = 7) Post (n = 7) Wilcoxon-Signed-
Ranks-Test
SCL-90-Global-
Symptom-
Index
2.76± 0.5,
min–max =
1.84–3.21
2.73 ±0.8,
min–max =
1.50–3.63
Z = –0.507, P > 0.1
I-Q 203± 44.6,
min–max =
137–264
216.7± 44.8,
min–max =
128–265
Z = –1.183, P > 0.1
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW161
Ethnopsychiatry and anorexia
nervosa: Two clinical cases
N. Bragazzi ∗, G. Del Puente
1 University of Genoa, School of Public Health-Department of Health
Sciences DISSAL, Genoa, Italy
2 University of Genoa, Section of Psychiatry-Department of
Neuroscience-Rehabilitation-Ophthalmology-Genetics- Maternal and
Child Health DINOGMI, Genoa, Italy
∗ Corresponding author.
Introduction Usually anorexia nervosa (AN) is considered to be
typical only ofWestern societies, such as Europe and the USA. How-
ever, nowadays, this ethnocentric point of view and this position
are no more valid, since more often new cases of AN are found
and described in China, Singapore, Malaysia, Japan, India and in the
Arabic countries. Subtle differences between the Western and the
non-Western symptoms presentation of AN can be found concern-
ing the psycho-pathological and psycho-dynamic mechanisms.
Objectives and aims Here, in this contribution, we report and
compare the clinical cases of two African women from Tanzania
suffering from AN.
Methods The diagnosis of AN was confirmed according to the
criteria of DSM-IV TR. After obtaining the consent from the two
women, they were administered a semi-structured interview. The
psycho-social and anthropological contexts were also taken into
account.
Results The first patient was a woman that, after some months
spent in the USA, had adsorbedWestern stereotypes and had begun
to starve, obsessed by the skinny beauty of the American models.
Doing this, she underlined the distance between her and her tribal
identity and origin. The second patient refused to nourish after that
her family had imposed her a planned marriage. Starvation was
a strategy to lose her femininity and appeal, a kind of return to
infant-hood, and an escape from the marriage.
Conclusion Cultural influences and ethnocultural models are of
fundamental importance for properly diagnosing and treating AN,
even though often overlooked or underestimated.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW162
Immigrants in emergency rooms:
The role of culture in the diagnostic
process and diagnostic certainty
F. Collazossp ∗, C. Gutierrez , P.D.R. ruth , V.M. Carmen ,
L. William
1 Vall d’Hebron Institute of Research, Psychiatry, Barcelona, Spain
2 Hospital Sagrat Cor Martorell, Psychiatry, Barcelona, Spain
3 Fundación Jiménez Díaz, Psychiatry, Madrid, Spain
4 Disparities Research Unit Massachusetts General Hospital,
Psychology, Boston, USA
∗ Corresponding author.
Introduction Transnationalism provides a serious challenge in
mental health care, especially due to the crucial role of communica-
tion. Emergency room interactions offer an opportunity to analyze
the role of cultural competency among providers and how they
relate to immigrants in the clinical encounter.
Objectives This study addresses three aims: to assess the level
of provider-perceived accuracy of diagnoses; to evaluate the use
of restraints; and to compare diagnoses rates between patients of
diverse racial/ethnic groups.
Methods We examined patients’ race/ethnicity and their relation
to service use and perceived certainty of mental health diagnoses.
Three hundred and forty-seven migrants and 67 natives as well as
their providers were interviewed in psychiatry emergency rooms
in Barcelona (Spain).
Results The perceived certainty of clinical diagnosis is lower
for Asians (OR = 0.2, 95% CI [0.07–0.63]), and higher when the
clinician feels comfortable with the patient (OR = 5.41, 95% CI
[2.53–11.58]). The probability of restraints is higher for Maghreb
patients compared to native born (OR = 3.56, 95% CI [1.03–12.26]).
The probability of compulsory admission is lower for Latinos com-
pared to native born (OR = 0.26, 95% CI [0.08–0.88]). The probability
of receiving a diagnosis of psychosis is lower when the clini-
cian can communicate in the patient’s language (OR = 0.37, CI 95%
[0.16–0.83]).
Conclusions Cultural factors such as level of comfort and commu-
nication in the patient’s language play a central role indiagnosis and
treatment. This study highlights the importance of culture in psy-
chiatric diagnosis and the role of cultural competency for mental
health providers.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW163
Case report: Hallucinations as
depressive equivalents
E. Garcia ∗, I. Vicente , R. Martínez
1 Ciudad Real, Spain
2 Hospital General de Ciudad Real, USMIJ, Ciudad Real, Spain
∗ Corresponding author.
We comment the case of a 12 years old girl who started with
visual and auditive hallucinations. Hallucinations are not a com-
mon symptom between children. They may also be linked to many
conditions, some of them with poor outcome as schizophrenia.
Symptoms appeared in a short time, after a previous normal devel-
opment. She talked about a man who followed her and that was
always behind, she also had heard some insults of undeterminated
voices. These symptomswere just of one-month duration andmade
her feel anxious and very afraid. After a normal organical study and
a first proposal of medication they asked for our consultation. We
found that the patient was alone at home every afternoon. Family,
from other country, hadn’t any social support, and the father had
had to travel away some days before the child began to suffer hal-
lucinations. Suspecting an affective disorder as the basis of anxious
symptoms, and hallucinations as a cultural presentation of them,
we started with a social intervention mixed with support therapy.
After some sessions the patient could talk about her loneliness and
fears, disappearing the other symptoms. We will resume this case
and literature about other cultural presentations that may difficult
diagnosis or treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.