European Psychiatry - Volume 33 - March 2016

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S40 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55
guaranteed to all people included in the Convention. However,
even in signatory states, violations often occur behind “closed or
open doors” and go unreported and consequently unprevented.
The growing number of people with mental health conditions in
the world has further contributed to a level of attention paid to
quality and human rights conditions in both outpatient and inpa-
tient facilities, which has never been greater. Persons with mental
health conditions need both de jure human rights protection and
de facto human rights practices.
Seven years after the CRPD came into force the care available in
many mental health facilities around Europe is still not only of
poor quality but in many instances hinders recovery. The level of
knowledge and understanding by staff of the rights of people with
mental disabilities is very poor. It is still common for people to
be locked away or to be chained to their beds, unable to move.
Inhuman and degrading treatment is common, and people in facil-
ities are often stripped of their dignity and treated with contempt.
Violations are not restricted to inpatient and residential facilities;
many people seeking care fromoutpatient and community care ser-
vices are disempowered and also experience extensive restrictions
to their basic human rights.
In the wider community, many people with mental disabilities are
still denied many basic rights that most people take for granted.
For example, they are denied opportunities to live where they
choose, marry, have families, attend school and seek employment.
There is a commonly held, yet false, assumption that people with
mental health conditions lack the capacity to assume responsi-
bility, manage their affairs and make decisions about their lives.
These misconceptions contribute to the ongoing marginalization,
disenfranchisement and invisibility of this group of people in their
communities.
One of the underlying reasons it is difficult to move through the
obstacles to fully embrace the CRPD, is that discrimination contin-
ues to affect people with mental health conditions on many levels.
Changing laws is only a partial solution. We have to change the
ways that we relate to each other at every level, and to offer people
information and tools to make the transition to a more equitable
social reality.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S69
Promoting stigma coping and
empowerment: Results from the
multi-center clinical trial STEM
W. Gaebel
Department of Psychiatry and Psychotherapy, Medical Faculty,
Heinrich-Heine-University, Düsseldorf, Germany
Introduction The stigma of mental illness is still amajor challenge
for psychiatry. For patients, stigma experiences and self-stigma are
associated with reduced quality of life and increased vulnerability
to amore chronicle illness course. Nevertheless, there is a scarcity of
validated therapeutic approaches addressing strategies for coping
with stigma.
Objectives and aims A manualized psycho-educational group
therapy for stigma coping and empowerment (STEM) should be
tested for efficacy in patients with depression and schizophrenia.
The study was funded by a research grant of the Federal Ministry
of Education and Research.
Methods A cluster-randomized RCT with two arms including 30
mental health care services (psychiatric inpatient services, day-
units, and outpatient services, as well as inpatient psychiatric
rehabilitation services) was conducted. The intervention consisted
of 8 sessions regular psycho-education group therapy and 3
sessions addressing stigma coping and empowerment. Controls
received 11 sessions regular psycho-education. Primary outcome
variable was quality of life (WHO-QOL). Assessments were con-
ducted directly before and after the intervention, and at 3, 6 and 12
months follow-ups.
Results A total of 469 patients participated and more than 300
participants (approx. 65%) completed the 12-month follow-up.
First results of the analysis will be presented at the conference.
Conclusions Since the statistical analysis is currently in progress,
no conclusions concerning the efficacy of the tested therapeutic
approach can be done by now. Nevertheless there is a strong need
for supporting patients in developing positive stigma coping strate-
gies. STEM is the first therapeutic approach to our knowledge tested
for efficacy in a RCT.
Disclosure of interest The author has not supplied his declaration
of competing interest.
Phenomenology of anxiety
S70
Temporality and spatiality of anxious
experience
O. Doerr-Zegers
Center for Studies on Phenomenology and Psychiatry, Diego Portales
University, Santiago, Chile
Since the first descriptions of anxiety, it has been related with tem-
porality and in particular with the dimension of future. Thus, we
already find anxiety defined as a general feeling of threatening
(fromthe future) in theGermanmystic Jakob Boehme (1575–1634).
He also used the image of “the wheel of anxiety”, with which he
refers to its probable origin in a conflict between two forces which
tend to separate themselves and are not able to do it, as a result from
this centrifugal rotationmovement of awheel. This image also has a
temporal character. In Kierkegaard, we read that “anxiety is always
related with the future. . . and when we are disturbed by the past
we are basically projecting toward the future. . .” In Heidegger’s
masterpiece, “Being and Time”, there is a chapter dedicated to the
temporality of Befindlichkeit, and in particular to anxiety. Fear and
anxiety have their roots, according to Heidegger, in the past, but
their relation with the future makes them different: anxiety arises
fromthe future as possibility, while fear arises fromthe lost present.
In this paper, we try to make a contribution to the phenomenology
of temporality (and of spatiality) of anxiety in relation with the
analysis of a concrete anxiety experience: flight phobia. The analy-
sis allows us to show both the desolation and narrowing of anxiety
space, and with respect to temporality, the disappearance of every
plan (the future), of every history (the past), and the reduction of
the present to a succession of mere punctualities, behind which
there arises, threatening, the nothingness itself.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S71
Being on the edge: The
psychopathology of the accelerated,
agitated and anxious subject
L. Madeira ∗, M.L. Figueira
1 Faculdade de Medicina, Universidade de Lisboa, Psychiatry, Lisbon,
Portugal
2 Universidade de Lisboa, Faculdade de Medicina, Lisboa, Portugal
∗ Corresponding author.