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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1390

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

1 ,

, K. Demir

2

, A. Avcı

2

, Ö. Uygur

1

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1391

EV407

Misdiagnosis of anterior cutaneous

nerve entrapment syndrome as a

somatization disorder

M. Arts

1 ,

, J. Buis

2

, L. de Jonge

1

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1392

EV408

Admitting biases before admitting

patients: Mental health simulation

training for clinical decision-making

C. Attoe

, Z. J

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