European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S495
rehabilitation and social reintegration of the psychiatric patient.
To cope with the scarcity of human resources, a three-year techni-
cal degree was created, training medical technicians in psychiatry.
Presently, there are two specialized psychiatric hospitals, one in
Maputo and another in Nampula. Through the description of our
3-month community psychiatry internship in Mozambique, we
intend to depict the country’s mental health care reality. Our
internship took place in São João de Deus Mental Health Centre,
the psychiatric hospital located in Nampula, which is responsi-
ble for the country’s northern region. Besides offering in-patient
and ambulatory treatment, it also aims to intervene at a commu-
nity level. We will address the hospital’s community intervention
project, the developed activities, the most commonly observed
pathologies, the cross-cultural relevant aspects, as well as the chal-
lenges we had to face in a harsh environment. As one would expect,
the social and medical realities we encountered were quite differ-
ent from the ones we are used to, forcing us to adapt constantly in
order to surpass challenges of amultiple nature. Nonetheless, these
were also the circumstances that turned this experience into some-
thing unique, extremely enriching and certainly unrepeatable.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV458
Phenomenology and cultural aspects
of panic attacks and panic disorder
among patients attending a
psychiatric clinic in Northern India:
An exploratory study
A. Gupta ∗, P. Sharan , R. Sagar , S. Kant
1 All India Institute of Medical Sciences, Department of Psychiatry,
New Delhi, India
2 All India Institute of Medical Sciences, Centre for Community
Medicine, New Delhi, India
∗ Corresponding author.
Introduction The clinical presentation of panic attacks and panic
disorder in any culture is influenced by its concepts of physiology
and ensuing catastrophic beliefs. Western diagnostic paradigms
may be inconsistent with the concept of illness in the easternworld.
However, the role of culture in defining expression of panic symp-
toms in native Asian populations is rarely studied.
Objective The study was aimed at exploring the phenomenology
of panic attacks and panic disorder in Northern India to understand
the culturally relevant qualitative characteristics and contextual
features.
Methodology Six focus group discussions and five key infor-
mant interviews involving various stakeholders were conducted to
elicit local concepts and descriptions of the phenomena. Patients’
focus groups consisted of 30 participants (age range 23–45 years)
presenting with ‘panic attack-like episodes’. They were recruited
through purposive sampling from the rural and urban psychiatric
clinics of a tertiary care institution. Healthcare professionals’ views
were explored through focus groups comprising of 12 psychiatrists
and 5 key interviews with other medical specialists. The sessions
were tape-recorded and transcripts analyzed qualitatively using
grounded theory technique.
Results Four major themes emerged from the analysis:
– differential panic symptom endorsement and culture-specific
symptoms;
– idioms of distress with underlying unique ethnophysiological
concepts;
– possible existence of cultural variants of panic attacks not con-
firming to ICD-10 or DSM-5 classical descriptions;
– causal attribution of illness and help seeking.
Conclusion This is the first ethnographic study on panic disorder
from India. It provides preliminary insights into the issues of diag-
nostic universality and cultural specificity, which require further
systematic investigation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV459
EV459Aboriginal and Torres Strait
Islander. Not just a matter of cultural
diversity
M. Hernandez Garcia ∗, L. Rodriguez , T. Ballesta , G. Bellido ,
C. Medrano , I. Sevillano , S. Cepedello , S. Sanchez ,
R. Hernandez , C. Noval , H. De La Red , A. Alonso , A. Alvarez ,
L. Gallardo
1 Hospital Clínico Universitario de Valladolid, Psiquiatría, Valladolid,
Spain
2 Hospital Universitario Virgen del Rocio, Salud Mental, Sevilla, Spain
3 Hospital Universitario Reina Sofía, SaludMental, Córdoba, Spain
∗ Corresponding author.
Aboriginal and Torres Strait Islander culture is the oldest living cul-
ture in the world, dating over 60,000 years. An understanding of
the complexity and richness of Aboriginal and Torres Strait Islander
cultures, including the relationship between land and health, is
still yet to be fully realised and as a result this people suffer ongo-
ing social and health inequalities. These inequalities contribute to
higher rates of ill health and a 17-year life expectancy gap between
Aboriginal and Torres Strait Islander and non-Aboriginal and Tor-
res Strait Islander Australians. Aboriginal and Torres Strait Islander
Australians report higher levels of psychological distress compared
with other Australians, with 77 percent reporting experiencing at
least one major stressor in the past 12 months, the most com-
mon stressor being the death of a family member or close friend
(42%). Particularly in rural and remote Australia, have higher rates
of depression, substance abuse, co-morbidity and post-traumatic
stress disorder. However, Aboriginal and Torres Strait Islander Aus-
tralians do not access community and outpatient mental health
services at a level that is commensuratewith their need. In contrast,
hospitalisation rates for mental health-related causes involving
specialised psychiatric care are almost twice the rate, and for men-
tal health-related causes without specialised psychiatric care are
around three times higher, comparedwith non-Aboriginal and Tor-
res Strait Islander Australians and death rates from ‘mental and
behavioural disorders’ are much higher for Aboriginal and Torres
Strait Islander Australians than for non-Aboriginal and Torres Strait
Islander people.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV460
Cultural factors, depression, and
somatic symptoms among Chinese
Americans and European Americans
Z. Kalibatseva ∗ eong
1 Stockton University, Psychology, Galloway, USA
2 Michigan State University, Psychology, East Lansing, USA
∗ Corresponding author.
Introduction Previous research suggests that people of Chi-
nese descent may somatize psychological distress and depression.
Cultural variations in depression among Chinese may be asso-
ciated with differences in culturally relevant factors, such as
self-construal, loss of face, emotion regulation, and acculturation.