European Psychiatry - Volume 33 - March 2016

482 / 812

S478 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
premature birth of a child. This refers also to a compatible episode
of a dissociative fugue.
Results To establish the diagnosis, we differentiate against dis-
orders such as Simulation, factitious disorders with psychological
symptoms or Factitious Disorderswith somatic symptoms (Münch-
hausen syndrome). In order to support our diagnosis, we base on
the CIE-10 and the DSM-IVTR classification.
Conclusions We don’t diagnose the clinical pictures in which we
don’t think. The Syndrome of Ganser could be positioned between
neurosis and psychosis and between illness and simulation. The
recommended treatment includes hospitalization in order to insure
the diagnosis. While some authors recommend neuroleptics and
others - anxiolytics, the psychotherapy is obligatory. The goal is
to help the patient restore function and adapt to his environment
again.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV406
Impact of a type-D personality on
clinical and psychometric properties
of patients with a first myocardial
infarction in a Turkish sample
B. Annagür ∗, K. Demir , A. Avcı , Ö. Uygur
1 Selcuk university- faculty of medicine, psychiatry, Konya, Turkey
2 Selcuk university- faculty of medicine, cardiology, Konya, Turkey
∗ Corresponding author.
Objective Recent studies have shown that a Type D personal-
ity is associated with an increased risk of cardiac mortality. This
study aimed to examine impact of a Type D personality on clini-
cal and psychometric properties of patients with a first myocardial
infarction (MI) in a Turkish sample.
Method The study included 131 patients who were admitted to
the coronary care unit of a hospital with a first MI. All the patients
underwent a psychiatric assessment within 2–6 months post-MI.
Psychiatric interviews were conducted with the Structured Clinical
Interview for DSM-IV (SCID-I).
Results The first study group (Type D personality) included 50
patients, and the second study group (non-Type D personality)
included 81 patients. There was a 38.2% prevalence of the Type
D personality in the patients with a first MI. Those with this type
of personality had a significantly higher frequency of hypertension
and stressful life events. The Type D patients also had more psy-
chiatric disorders, depressive disorders, and anxiety disorders than
the non-Type D patients.
Conclusions Our findings suggest that Type D personality traits
may increase the risk of hypertension and the risk of psychiatric
morbidity in patients with a first MI. Considering that a Type D
personality is a stable trait; we suggest that this type of person-
ality is a facilitator of clinical depression and anxiety disorders.
These findings emphasize the importance of screening for a Type
D personality as a cardiovascular risk marker and a psychiatric risk
marker in MI patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV407
Misdiagnosis of anterior cutaneous
nerve entrapment syndrome as a
somatization disorder
M. Arts ∗, J. Buis , L. de Jonge
1 UMCG, Old Age Psychiatry, Groningen, Netherlands
2 GGZ Friesland, Psychiatry, Leeuwarden, Netherlands
∗ Corresponding author.
Introduction Anterior cutaneous nerve entrapment syndrome
(ACNES) is a frequently overlookeddisease, causing chronic abdom-
inal wall pain due to entrapment of an anterior cutaneous branch
of one or more thoracic intercostal nerves. It is often misdiagnosed
as a psychiatric condition, particularly under the heading of a som-
atization disorder.
Objectives We describe the case of a patient who developed
depressive symptoms after months of suffering from chronic
abdominal wall pain.
Aims To report a case-study, describing ACNES as a cause of per-
sistent depressive symptoms.
Methods A case-study is presented and discussed, followed by a
literature review.
Results A 35-year-female was referred to a psychiatrist for her
depressive symptoms and persistent cutaneous abdominal pain for
months. There she was diagnosed with a depression and possible
somatization disorder and she received psychotherapy. Through
Internet search, the patient found ACNES as a possible cause for
her persistent abdominal pain. Since administration of anesthetic
agents only shortly relieved her symptoms, a surgeon decided to
remove the nerve end twigs. After surgery, her somatic problems
and depressive mood disappeared.
Conclusion The awareness of ACNES is still very limited in
medicine. This may lead to incorrect diagnoses, including psychi-
atric disorders such as somatization disorder.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV408
Admitting biases before admitting
patients: Mental health simulation
training for clinical decision-making
C. Attoe ∗ abur
South London & Maudsley NHS Foundation Trust, Maudsley
Simulation, London, United Kingdom
∗ Corresponding author.
Introduction With the number of people presenting to services,
being diagnosed with, and requiring support for mental health
problems continuing to increase, more and more decisions are
being made by more and more mental health clinicians about the
treatment and futures of their patients. This is in the context of
reductions to inpatient psychiatric beds, and increasing numbers
of people attending Emergency Departments with mental health
concerns. However, decision-making can be an ambiguous process,
with clinicians having varied opinions, and guidelines not always
being clear.
Aims To outline briefly the design of a simulation course for
decision-making in mental health, before presenting the findings
of a mixed methods evaluation.
Method Simulation training used 6 scenarios involving every
participant and trained actors, followed by a structured and reflec-
tive debrief on the decisions made in assessment and treatment.
Pre- and post-questionnaires (n = 82) were employed to collect
quantitative and qualitative data regarding participants’ skills and
knowledge of decision-making, which was further bolstered by
qualitative follow-up surveys.
Results Analyses found statistically significant increases in par-
ticipants’ knowledge and awareness of the decision-making
process and personal biases, while qualitative responses showed
significant changes pre- and post-course. Themes from qualita-
tive feedback also identified self-reported changes to the clinical
practice of participants, from awareness of biases, to reflecting on
decisions.
Conclusion Decision-making processes require explicit acknowl-
edgement and exploration in psychiatry, with such training
have a potential impact on the care and decision delivered