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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S491

Ev445

A cognitive behavioral model for

panic attack treatment in comorbid

heart diseases (PATCHD): A pilot study

from the real-world

P. Tully

University of Adelaide, Medicine, Adelaide, Australia

Background

Treating panic disorder comorbid with heart disease

is challenging due to:

– diagnostic overlap;

– the risk associated with ignoring chest pain and delaying seeking

medical attention;

– that cognitive-behavioral therapy based on “catastrophic misin-

terpretation of bodily symptoms” requires adaption to incorporate

the element of risk;

–that some interoceptive symptom inductions may be harmful.

Objective

To describe a cognitive-behavioral therapy model of

panic attack treatment in comorbid heart diseases (PATCHD).

Methods

We developed a modified CBT model that is based

on enhancing coping skills, performing safe interoceptive expo-

sures, supervised exercise, and countering avoidance. Eighteen

persons referred to PATCHDhad a dominant clinical picture of panic

attack/panic disorder after their heart failure (HF) diagnosis. We

quantified the total number of admissions and the length of hos-

pital stay (LOS) for CVD (ICD Codes I00-99) and psychiatric causes

(F00-99). Hospital data was collated blinded to original diagnosis.

Results

Using paired t-tests bootsrapped 1000 times we found

evidence that there was a significant reduction in CVD admissions

and hospital LOS in the 6 months after participation in PATCHD.

There was however no significant change in psychiatric admissions

or psychiatric LOS. Pre- and post-treatment data from 14 HF par-

ticipants suggested a reduction in GAD-7 anxiety symptoms, total

PHQ-9 depression, cognitive-affective depression symptoms, but

not somatic depression symptoms.

Conclusions

Pilot data suggested that PATCHD was associated

with a reduction in cardiovascular hospital admission and LOS, gen-

eral anxiety and depression, however the findings were based on

non-randomized and paired-sample data.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1430

EV446

psychological experiences reported in

regarding hepatitis C and use of

interferon: A clinical-qualitative study

in a Brazilian university outpatient

service considering its possible side

effects

I.D. Fahl , F.D. Costa , R.S.B. Stucchi , E.R. Turato

University of Campinas, Laboratory of Clinical-Qualitative Research,

Campinas SP, Brazil

Corresponding author.

Relevant emotional and behavioural reactions are associated with

diagnosis and treatment of hepatitis C that can impair adherence to

medical management. Hepatitis C accounts for significant number

of both – liver transplants and deaths. Treatment has asmajor com-

ponent the interferon alpha, and many of patients can experience

side effects that often lead to non-adherence to drug treatment and

dose modification.

Objective

To discuss psychological meanings attributed to IFN

alpha treatment’s side effects and its symbolic relation with adher-

ence or not to treatment, on viewpoint of interviewed outpatients

at a Hepatitis Service.

Method

Data collection was conducted using the Clinical-

Qualitative Method, utilizing semi-directed interviews with

open-ended questions in depth, fully transcribed. Qualitative Con-

tent Analysis employed for processing data, emerging meaning

cores, with categorization into discussion topics. Sample closed by

information saturation.

Results

Nine interviews. The analysis revealed:

– coping attitude - handling the disease to have willpower; a moral

feeling regarding the need to overcome the disease and treatment

side effects to demonstrate “strength”, as well as to deny psycho-

logically the occurrence of side effects;

– disruptive attitude: reports of anxiety regarding to patients pre-

senting neuropsychiatric symptoms by medication;

– realistic attitude: speeches show perception of natural evolution

and treatment real function.

Conclusion

Guilt feelings emerged regarding to difficulties of

being loyal to treatment, a strongly valorative speech on being ill

what must lead to “overcome the evils of life”. Health teams must

understand these meanings to talk openly about human feelings on

illness and treatment, promoting an adequate adherence.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1431

EV447

Stress factors and mental disorders in

systemic sclerosis

D. Veltishchev

1 ,

, O.B. Kovalevskaya

1

, O.F. Seravina

1

,

M.N. Starovoitova

2

, T.A. Lisitsyna

2

1

Moscow Research Institute of Psychiatry, Stress Related Disorders,

Moscow, Russia

2

Nasonova Research Institute of Rheumatology, Systemic Rheumatic

Diseases, Moscow, Russia

Corresponding author.

Introduction

Systemic sclerosis (SSc) is a chronic, multisystem

disease of unknown etiology characterized by autoimmune inflam-

mation, abnormalities in small blood vessels, and progressive

fibrosis of the skin and visceral organs. Mental disorders (MD),

especially depression, occur quite often with SSc. The influence

of childhood experience, relations’ traumatic events with SSc and

MD, and MD’s clinical specific have not investigated carefully

still. The investigation has been realized in accordance with the

interdisciplinary program “stress factors and mental disorders in

auto-immune inflammatory rheumatic diseases”.

Methods

Sixty SSc patients (4 male and 56 female mean age

49.9

±

13.5) were included. ICD-10 criteria were used for MD semi-

structured interview. The stress factors were analyzed with the

specially elaborated scale. The cognitive disorders and their sever-

ity were diagnosed by neuropsychology tests.

Results

Early traumatic childhood experiences (parental depri-

vation mainly) observed in 90% cases. The significant stress factors

were preceded SSc symptoms in 80% and MD in 70% cases. Most

patients self-reported connection between stressful life events

and exacerbation of SSc. MD preceded SSc in 76.6% cases. MD

were diagnosed in 48 (80%) SSc patients: depressive episode

(mild, moderate)

26.6%, recurrent depressive disorder

16.6%,

dysthymia – 23.3%, adjustment disorder

6.6% and schizotypal dis-

order – 40%. The mild or moderate cognitive impairments were

diagnosed in all MD cases.

Conclusion

Individual history of stressful life events is important

factor for the predisposition and provocation of the rheumatic dis-

ease and MD in SSc patients. Depressive, schizotypal and cognitive

disorders are the common MD in SSc patients.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1432