European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S193
Bristol medical students in their first clinical year, demonstrating
that this method is relevant beyond psychiatry.
Methods Initial focus groups with medical students indicated
that many felt unable to discuss distressing aspects of clinical
encounters. During 2013-2014, a Balint scheme run by psychiatry
trainees was started for 150 students in their psychiatry place-
ments. During 2014-15, the schemewas introduced to all third-year
medical students on theirmedicine/surgery placement. Balint lead-
ers have group supervision with a psychoanalytic psychotherapist.
Evaluation of the scheme was based on pre-and post-group ques-
tionnaires and leaders’ process notes.
Results Sixteen groups led by 12 trainees were run twice over
the year to serve 246medical students. Two example cases are dis-
cussed here. Students appreciated the chance to discuss complex
encounters with patients in a supportive peer environment, and
work through a range of emotionally challenging issues.
Conclusions Novel aspects of this work include the implementa-
tion of Balint groups within medicine and surgery placements; the
enrolment of psychiatry trainees as leaders with group supervision
and leadership training workshops from the UK Balint Society; and
the scale of the scheme.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Emergency psychiatry
EW230
Right to decide: Preferences and
satisfaction with treatment in women
and men patients with agitation and
bipolar or schizoaffective disorder
J. Arenaza ∗, S. Hernandez , M. Gutierrez Fraile ,
A. Gonzalez-pinto Arrillaga , I. Zorrilla
Hospital Universiatrio de Alava, Psiquiatria, Vitoria-Gasteiz, Spain
∗ Corresponding author.
Introduction Current recommendations on agitation manage-
ment advocate for involving patients in deciding the therapeutic
plan. Verbal de-escalation is directed to calming the patient while
clinical evaluation is performed, and allows agreeing treatment.
However, research on patients preferences and satisfaction is
scarce.
Objectives To assess patients preferences and satisfaction related
to treatment of agitation.
Methods Prospective observational study among patients that
were agitated during hospitalization in 2014. Patients with bipolar
disorder, schizoaffective disorder or schizophrenia were offered to
choose between inhaled loxapine or usual treatment (intramuscu-
lar antipsychotic). Satisfaction with treatment was measured at 7
and 14 days and satisfaction with hospitalization was measured at
discharge.
Results A total of 180 patients were agitated during 2014, but
the majority of agitations were attended in the emergency room.
Eighty patients presented agitation during hospitalization. Sixty of
them had bipolar disorder, schizophrenia or schizoaffective disor-
der, and 90% had comorbidity with substance abuse, alcohol abuse
or personality disorder. Forty patients were not able to deem their
preferences and were treated with intramuscular antipsychotics.
Twelve patients chose inhaled loxapine. Eight refused any treat-
ment and received IM antipsychotics. Satisfaction with treatment
was higher in patients receiving loxapine. More women than men
received loxapine. Satisfaction with hospitalization was higher in
women.
Conclusions It is important to consider patient opinion in order
to increase satisfaction with treatment and patient collaboration.
Inhaled loxapine is a new therapeutic option that facilitates this
approach.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW231
Delirium symptoms’ development
during the intensive care unit
post-surgery staying is related with
reduced intraoperative cerebral
oxygen saturation in the elderly
subjected to cardiac surgery
I. Bellido ∗, E. Aldana , J.L. Valverde , S. Medina , C. Green ,
V. Campos , A. Gomez-Luque
1 University of Malaga, Pharmacology and Therapeutic, Málaga, Spain
2 Xanit International Hospital, Department of Anaesthesiology,
Benalmadena, Spain
3 Xanit International Hospital, Department of Neurology,
Benalmadena, Spain
4 Virgen de la Victoria University Hospital, Department of
Anaesthesiology, Malaga, Spain
∗ Corresponding author.
Goal of study Our aim was to examine whether cerebral frontal
cortex O2 desaturation may be related with the development of
delirium symptoms’ after cardiac surgery in the elderly during the
intensive care unit (ICU) staying.
Materials and methods A prospective, before and after, longitudi-
nal study in II-IV ASA class patients scheduled for cardiac surgery
and undergoing intravenous general anesthesia with remifen-
tanil plus propofol was done. Clinical and surgical parameters,
cardiopulmonary function, intraoperative cerebral oxygen satu-
ration (rSO2) and bispectral index were continuously recorded
and corrected throughout the surgery. Severity of delirium
was represented as a score of the Intensive Care Delirium
Screening Checklist (ICDSC) during the patients’ stay in the ICU
under the assumption that higher ICDSC score indicated severe
delirium.
Results and discussion Patients, n = 44, 77.3%male, aged 59.9 ± 1.9
years old, scheduled to coronary (36.4%), aortic valve replace-
ment (18.2%), mitral valve replacement (13.6%), coronary plus valve
replacement (13.6%) and others (18.2%) surgery, on pump 98.4%
were enrolled. A reduction of the rSO2 higher than 10% at the
end of the surgery compared with basal values was detected in
a 46.5% of the patients. Reduction of rSO2 higher than 10% at the
end of the surgery was related with significantly higher values of
delirium symptoms’ development during the intensive care unit
post-surgery staying (rSO2 higher ≥ 10% 68.8 vs. rSO2 higher < 10%
31.3%, P < 0.05).
Conclusion Delirium symptoms’ development during the inten-
sive care unit post-surgery staying is related with reduced
intraoperative cerebral oxygen saturation in the elderly subjected
to cardiac surgery.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW232
Detection and management of
agitation in psychiatry: A Delphi
expert consensus study
M. Garriga ∗, I. Pacchiarotti , D. Hidalgo , M. Bernardo ,
E. Vieta