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S24

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55

and the meanings given to illness. Due to increasing migration and

globalisation the challenge of considering diagnosis in the con-

text of culture has become increasingly significant in Europe. And

globalization has further led to changes in value systems and our

awareness of patients with ethnic minority background.

Over recent decades, there has been an increasing development of

psychiatric diagnosing with nosological categorisation combined

with multi-axial schemas. Diagnosis, besides identifying a disorder

and distinguishing one disorder fromanother disorder - differential

diagnosis, has also an aim to include an overall understanding of

the patient’s situation.

We witness an upsurge in the attention paid to the cultural limita-

tions to psychiatric diagnostic practice and treatment modalities.

Guidelines for the psychiatric profession are in critical focus from

a transcultural perspective. Some claim their universality indepen-

dent of cultural context; others find cultural adaptation useful and

necessary.

Do the diagnoses and clinical and ethical guidelines give mean-

ing in the cultural setting? Are they compatible with the cultural

values of the therapist and those of the patient and the family? Sev-

eral sources claim the biomedical paradigm for beingWestern with

insufficient consideration of the socio-political context.

The cultural formulation developed as part of DSM-IV and now

DSM-5 is one model to support a systematic review of culture and

context in psychiatric diagnosing.

The paper will discuss the advantages and shortcomings of cur-

rent diagnostic categories and guidelines vis-à-vis the universe of

traumatized refugees with other ethnic backgrounds.

URL:

http://www.mariannekastrup.dk/

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.837

S22

Interview and therapeutic rapport in

diagnostic process

L. Küey

Istanbul Bilgi University, Department of Psychology, Istanbul, Turkey

Diagnostic assessment in psychiatry, as a formulation and as a joint

re-construction process between the clinician and the patient, is

essential in clinical care. Clinical interview is the crucial tool of the

clinician in this process. Accordingly, a two-fold task is faced. On

one hand, the clinician is in need of making a comprehensive diag-

nostic assessment to construct a valid and working formulation of

the patient’s situation and a treatment plan.

On the other hand, the bases for a psychotherapeutic alliance

and rapport should be established. A comprehensive diagnos-

tic assessment aims to bridge the current scientific evidence

and knowledge with the uniqueness of the specific person who

presents for care. The clinician facing the complexities of the

human existence in health and ill mental health constructs work-

ing hypotheses in the context of the interview, to understand and

formulate the psychopathological state. Clinical interview serv-

ing as a practical channel in constructing these hypotheses, also

serves as the main tool in establishing a therapeutic alliance.

The theory and practice of different schools of psychotherapies

offer considerable contributions to the clinician in managing these

tasks.

Understanding the meaning of the human suffering through empa-

thy in a judgment free milieu is essential in the establishment of

rapport, compliance and a better clinical outcome. This presenta-

tion will discuss the complexity of diagnostic process in psychiatry

and emphasize the contributions of psychotherapeutic theory and

skills and humanistic approaches in this process. Brief clinical

vignettes from the authors’ clinical practice will be used to broaden

the scope of discussion.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.838

Does diet affect mental health? The role of the

gut-brain axis in psychiatric disorders

S23

The role of IgG hypersensitivity and

changes in gut microbiota in the

pathogenesis and therapy of

depressive disorders

H. Karakula-Juchnowicz

1 ,

, P. Szachta

2

, D. Juchnowicz

3

,

S. Grochowski

4

, M. Gał˛ecka

5

1

Medical University, Department of Clinical Neuropsychiatry I,

Department of Psychiatry-Psychotherapy and Early Intervention,

Lublin, Poland

2

VitaImmun Medical Center, Research Department, Poznan, Poland

3

Medical University of Lublin, Department of Psychiatric Nursing,

Lublin, Poland

4

Privat Practice New York, Anti-aging and Functional Medicine, New

York, USA

5

Institute for Microecology, Research Department, Poznan, Poland

Corresponding author.

Depression is a complex, heterogeneous psychiatric disorder

with multifactorial aetiology. Substantial evidence indicates that

depressive episodes are associated not only with changes in neu-

rotransmission in the central nervous system (CNS), but also may

lead to structural changes in the brain through neuroendocrine,

inflammatory, and immunological mechanisms. Among the factors

deserving special attention connected with developing systematic

inflammation are altered intestinal permeability, IgG food intoler-

ance, and changes in gut microbiota.

We present a possible scenario of the development of depres-

sion, linking elevated zonulin production, loosening of the tight

junction barrier, an increase in permeability of the gut wall, and

the passage of macromolecules, normally staying the gut, into

the bloodstream, with the immuno-inflammatory cascade and

induction of IgG-dependent food sensitivity. Alterations in bidirec-

tional signaling between the gastrointestinal tract and the brain, so

called “microbiota–gut–brain axis”, may be normalized by dietary

immunomodulating factors, including prebiotics and probiotics. In

the case of increased IgG concentrations, the implementation of

an elimination–rotation diet may prove to be an effective method

of reducing inflammation and, in this way, alleviating depressive

symptoms.

Given complexity and variety of mood disorders, it is necessary

to develop improved integration models. Preliminary study results

raise hope that the new methods mentioned above, i.e. psychobi-

otics, prebiotics, an elimination-rotation diet, may be an important

addition to the psychiatrist’s armamentariumas therapeutic agents

improving the efficacy of the treatment for affective disorders

[1–3] .

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

References

[1] Karakuła-Juchnowicz H, Szachta P, Opolska A, Morylowska-

Topolska J, Gał˛ecka M, Juchnowicz D, et al. The role of IgG

hypersensitivity in the pathogenesis and therapy of depressive

disorders. Nutr Neurosci 2015.

[2] Kelly JR, Kennedy PJ, Cryan JF, Dinan TG, Clarke G, Hyland NP.

Breaking down the barriers: the gut microbiome, intestinal