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S572

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

EV694

Explorations of cooperation and

recalcitrance in secure mental health

hospitals

M. McKeown

1 ,

, M. Chandley

2

, F. Jones

1

, K. Wright

1

,

J. Duxbury

1

, P. Foy

2

1

University of Central Lancashire, School of Nursing, Preston, United

Kingdom

2

Mersey Care NHS Trust, Ashworth Hospital, Liverpool, United

Kingdom

Corresponding author.

This paper reports on the findings of three qualitative research

studies undertaken within, respectively, medium and low secure

units in one UK region, and a high secure mental health hospital in

England (UK). The first study investigated alliance based involve-

ment practices. The second explored service user and staff views

and sense making of the notion of recovery. The third study is

ongoing into service user and staff experiences of extreme coer-

civemeasures, such as forms of restraint and long-termseclusion or

segregation. All studies utilised either semi-structured interviews

or focus groups. All data was subject to thematic analysis.

Selected and emergent themes include:

– the importance of relationships and communication; security

first; involvement as pacification;

– different understandings of recovery; the importance of

meaningful occupation; staff-service user relationships; recovery

journeys and dialogue with the past; and recovery as personal

responsibility;

– good and bad coercion; cooperation, resistance and recalcitrance;

and alternatives to coercion.

Findings suggest that cooperation is largely framed by services in

terms of compliance with a bio-medical model. The impact of the

secure environment, whilst ever-present, is not an absolute con-

straint on the realisation of recovery or involvement objectives.

The availability of extreme coercive measures raises some seem-

ingly paradoxical understandings from both service user and staff

perspectives. Critical social theory is drawn on to illuminate the

tensions between cooperation and recalcitrance and suggest fur-

ther exploration of their respective legitimacy.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1679

EV695

Effectiveness of paliperidone depot in

seriously violent men with comorbid

schizophrenia and dissocial

personality disorder in a UK

high-security hospital

A.M. Mortlock

, F. Larkin , C. Ross , S. Sengupta , M. Das

West London Mental Health NHS Trust, Broadmoor Hospital,

Berkshire, United Kingdom

Corresponding author.

Introduction

High-security hospital patients are often complex

in presentation characterised by treatment resistance, medication

non-concordance and history of violence. Paliperidone is licensed

as both an oral and depot antipsychotic for the treatment of

schizophrenia. Whilst there is data for the effectiveness of paliperi-

done palmitate (PP), there are no studies involving patients in

forensic settings or those with comorbid personality disorder.

Objective

To determine the effects of PP on violence, aggression

and personality pathology.

Aim

To evaluate the clinical effectiveness of PP.

Methods

This was a retrospective service evaluation involving 11

patients. Medical records and interviews with the treating psychia-

trist were used to formulate clinical global impression (CGI) and to

identify incidents of violence. The effect on personality symptom

domains; cognitive-perceptual, impulsive-behavioural dyscontrol

and affective dysregulationwas ascertained, as well as engagement

with occupational and psychological therapies.

Results

Six patients were being prescribed PP. All 6 showed

improvement in the CGI score with benefits in the symptom

domains. Two patients demonstrated a reduction in violence

risk and 2 remained incident-free. There was improvement in

engagement with therapies. Benefits were also seen in aspects of

personality for those who had discontinued PP.

Conclusions

This pragmatic study of a small but complex patient

group demonstrated that PP was effective in reducing symptoms of

schizophrenia. Additionally and for the first time, it was shown that

PP was also effective in reducing violence as well as improving per-

sonality pathology dimensions in a comorbid patient. This could

have significant implications for management of high-security

patients.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1680

EV696

The characteristics of alcohol

pharmacokinetics of Korean female

B. Nam

1 ,

, Y.J. Kwon

2

, K.H. Lee

3

, D.I. Jon

4

, I. Shon

5

, J.S. Seo

1

1

Konkuk University, psychiatry, Chungju, Republic of Korea

2

Soonchunhyang University, Psychiatry, Cheonan, Republic of Korea

3

Dongguk University, Psychiatry, Gyeongju, Republic of Korea

4

Hallym University, Psychiatry, Anyang, Republic of Korea

5

Keyo Hospital, Psychiatry, Uiwang, Republic of Korea

Corresponding author.

Introduction

The systematized and proper sized research of alco-

hol pharmacokinetics in Korean has not reported ever.

Objectives and aim

Aim of this study is to measure the value

and alcohol pharmacokinetic factors in Korean adult female and

the relationship between the value and some variables includ-

ing age, smoking, total body water, drinking capacity, BMI, blood

cholesterol, body fat and body fat ratio.

Methods

Ninety-one subjects were randomly divided into two

groups. One group was provided as much as 0.35mg/mL/kg of

alcohol and the other as much as 0.70mg/mL/kg, and blood alco-

hol concentration was measured 15, 30, 45, 60, 90, 120, 180, and

240min after the women finished drinking.

Results

The subjects’ mean alcohol elimination rate ( ) was

0.002379mg/100mL

·

h, and there was no statistically signifi-

cant difference in elimination rate between the two groups. The

mean time to reach maximum blood alcohol concentration was

45minutes, alcohol absorption rate was 0.1123

±

0.1799 g/L/min,

and the area under the concentration curve was 109.15

±

62.95.

Among the factors that correlatedwith alcohol metabolism, alcohol

absorption rate and follicle-stimulating hormone were statistically

significant, but age, body mass index, and body fat percentage were

not significantly correlated with alcohol metabolism.

Conclusions

These results suggest that the values for healthy

Korean females can differ from the cut-offs that are currently used

in Korea, which suggests that the legal limit for driving under intox-

ication should be adjusted.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1681