European Psychiatry - Volume 33 - March 2016

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S194 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
1 Hospital Clínic, Department of Psychiatry- Barcelona Clinic
Schizophrenia Unit and Bipolar Disorder Programme, Barcelona,
Spain
2 Hospital Clínic, Department of Psychiatry- Bipolar Disorder
Programme, Barcelona, Spain
3 Hospital Clínic, Department of Psychiatry- Barcelona Clinic
Schizophrenia Unit, Barcelona, Spain
∗ Corresponding author.
Introduction The assessment and management of psychomotor
agitation may result in the use of coercive or sedative treatments.
In the absence of conclusive evidence, the consensus of experts can
guide clinical decisions.
Objectives To seek consensus recommendations on the assess-
ment and management of psychomotor agitation.
Methods An international expert task force in this field developed
consensus using the Delphi method. Twenty-seven experts were
invited to participate and 91% of them agreed. Initial survey items
were gathered from the content of literature search (systematic
review). This included open-ended questions inviting participants
to add suggestions by e-mail correspondence. After this initial first
round, the Delphi study was conducted online using Google Forms.
Survey items were rated on a 5-point scale. Items rated by at least
80% of experts as essential or important were included. Items rated
as essential or important by 65–79% of experts were included in the
next survey for re-rating. Items with consensus below to 65% were
rejected and excluded.
Results The initial survey included 52 items. The second web-
based survey included 33 items. The briefer third survey consisted
of 6 items that needed rerating. Twenty-two of the initial 33 items
were endorsed and formed the clinical recommendations on the
assessment and management of the psychomotor agitation. The
endorsed items were categorized into 5 domains forming the clin-
ical recommendations.
Conclusions The panel expert generated 22 recommendations on
the assessment and management of agitation. The Delphi method
is a suitable formal iterative process for reaching consensus on
relevant and controversial issues.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW233
Suicide attempts in emergency
department
K. Hajji ∗, I. Marrag , R. Ben soussia , L. Zarrouk , S. Younes ,
M. Nasr
Universitary Hospital of Mahdia - Tunisia, Department of Psychiatry,
Mahdia, Tunisia
∗ Corresponding author.
Introduction The suicide attempt is a real challenge for the clini-
cian who works at the emergency department in order to identify
and propose an adequate care.
Aims To estimate the prevalence of the suicide attempts, to
describe the sociodemographic and clinical characteristics and to
identify the predictors of recurrence.
Methods Our cross-sectional study was conducted at the medical
emergency department of the university hospital of Mahdia and
lasted for 12 months. Data were collected using a questionnaire
of 51 items exploring the general and clinical characteristics and
providing information of the treatment.
Results Among the 513 consultants, 90 had attempted suicide
(17,5%). We found an average age of 26 years old, a sex-ratio (M/F)
of 0,3, a secondary education level (53,3%), an unemployment and
a single status (38,9% and 75,6%). The presence of psychiatric per-
sonal history and/or suicide attempts was found in 31,1% and 33,3%
of cases. Suicide attempts were taken place in all cases at home,
between 18 and midnight (43,3%), without premeditation (82,2%),
in the presence of triggering factor (95,6%), during the last 3 months
of the year (34,4%). In 70,2% of cases, the type of the suicide attempts
was a drug intoxication. 67,8% of the suicide attempters regretted
and criticized their acts.
Conclusion A good assessment of the suicide risk determines the
type of intervention that should be established and allows an ade-
quate care.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW234
Ensuring patient safety: Physical
health monitoring in rapid
tranquillisation for aggression and
violence of adult acute inpatients
R. Talukdar , M. Ludlam , L. Pout , N.P. Lekka∗
Sheffield Health and Social Care Foundation Trust, Acute Inpatient
Services, Sheffield, United Kingdom
∗ Corresponding author.
Introduction Intramuscular (IM) medications used in rapid tran-
quillisation (RT) to manage violent/aggressive behaviour can cause
serious physical side effects including suddendeath, therefore com-
prehensive physical health monitoring is advised.
Objectives To assess whether physical health monitoring of
patients who received IM medication for RT was completed as per
the Aggression/Violence NICE-guideline based local Policy.
Methods All patients that received IM benzodiazepines or
antipsychotics for RT were identified amongst 822 discharges
from February 2014 to February 2015. Demographics, diagnoses,
non-pharmacological interventions, types/doses of medication,
and associated seclusion/restraint episodes were recorded. Notes
were examined to determine whether physical health monitoring
protocols involving blood pressure, pulse, temperature, oxygen sat-
uration, respiratory rate and level of consciousness were followed.
Results There were a total of 218 episodes where these med-
ications were used, in which only 19 (8.8%) had any physical
observations completed; only one case (0.5%) was completed fully
as per the protocol. Of the cases that did not have observations
taken, in 12 (5.5%) cases observations were attempted but the
patient was too agitated/aggressive. A doctor was contacted in only
53 (24.3%) cases and an ECG was completed in 120 (55%) cases, of
which only 11 were completed within 24 hours.
Conclusions The results show poor compliance (or at least
recording) with the guidance, demonstrating the need for further
education of nursing and medical staff on the potential dangers of
RT and for better physical health monitoring of patients on RT. To
improve patient safety, staff training and well-timed recording of
physical observations on electronic tablets will commence.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW235
Mental health problems in the
aftermath of earthquakes in Nepal
N.P. Luitel∗ ene , M. Jordans , B. Kohrt , W. Tol
Transcultural Psychosocial Organization TPO Nepal, Research,
Kathmandu, Nepal
∗ Corresponding author.
Introduction Mental health problems may increase in popula-
tions affected by humanitarian emergencies, such as the 2015
earthquakes in Nepal.
Objectives We assessed mental health and psychosocial prob-
lems (depression, anxiety, post-traumatic stress disorder, alcohol