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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.347

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.348

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

1 ,

, E. Aldana

2

, J.L. Valverde

2

, S. Medina

2

, C. Green

2

,

V. Campos

3

, A. Gomez-Luque

4

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 O

2

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 (rSO

2

) 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 rSO

2

higher than 10% at the

end of the surgery compared with basal values was detected in

a 46.5% of the patients. Reduction of rSO

2

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 (rSO

2

higher

10% 68.8 vs. rSO

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.349

EW232

Detection and management of

agitation in psychiatry: A Delphi

expert consensus study

M. Garriga

1 ,

, I. Pacchiarotti

2

, D. Hidalgo

2

, M. Bernardo

3

,

E. Vieta

2