European Psychiatry - Volume 33 - March 2016

639 / 812

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S635
will be reviewed and some conclusions regarding the difficulties
and limitations of this concept will be highlighted.
Conclusions (a) Hacking’s “Historical Ontology” methodology
suggest that attempts to differentiate Bipolar I and Bipolar II dis-
orders by severity will always risk misdiagnosis, coinciding with
Gordon Parker’s state of the art conclusions; (b) the emergence of
the man-made Bipolar II construct appears to be one of the end
products – an unintended consequence – of Nancy Andreasen’s
“Death of phenomenology in America”.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV894
From DSM-5 to anthropopsychiatry:
(Re)search for a renewed psychiatry
M. Calmeyn
Loppem Zedelgem, Belgium
Introduction “DSM is the Esperanto of psychiatry”. Let it be? If
DSM is to be considered as a symptom of contemporary psychiatry,
the time for a change has come.
Objectives An important candidate towards an in depth move is
anthropopsychiatry. Anthropopsychiatry is the original confluence
of classical psychiatry, philosophy (phenomenology and structural-
ism) and psychoanalysis. An elegant evidence-based investigation
(Roelandts and Schotte, 1999) exemplifies its importance.
Methods A search in literature with authors like Frances, Edward
Shorter, Vanheule, Verhaeghe and Feys reveals several flaws in the
DSM construction. A four-fold analysis by means of the episte-
mological terms nosography, nosotaxy, nosology and nosognosy
makes clear that the DSM is a thinking under construction, cultur-
ally “child of its time”. The concerns from the British Psychological
Society and the objection by the NIMH are first moves towards
another psychiatric classification, and consequently another vision
on psychiatric theory and praxis.
Results Foregoing reveals anthropopsychiatry as an appeal
towards present day psychiatry. It grounds modern psychiatry as
an “autological” psychiatry (Kronfeld) with its own conceptual-
ization and not “heterological” as an assemblage of all kinds of
influences coming from neurobiological sources and human psy-
chological findings.
Conclusion Anthropopsychiatry can be considered to be a seri-
ous candidate in the development towards a renewed psychiatry
evidently based on clinical anthropology (Geyskens).
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV895
Mental health stigma: What’s been
done? Where to go?
P. Macedo ∗, A. Fornelos , A.R. Figueiredo , S. Nunes , M. Silva ,
F. Veríssimo
CHTMAD, Departamento de Psiquiatria e Saúde Mental, Vila Real,
Portugal
∗ Corresponding author.
Introduction Negative attitudes towards psychiatric patients still
exists in our society. Persons suffering from mental illness fre-
quently encounter public stigma and may internalize it leading
to self-stigma. Discrimination occurs across many aspects of eco-
nomic and social existence. It may represent a barrier for patients to
receive appropriate care. Many anti-stigma campaigns have been
taken to decrease people’s prejudice, but its effects are not well
documented.
Objective To characterize anti-stigma initiatives and its effects on
diminishing negative consequences of stigma.
Methods Bibliographical research on PubMed using keywords
“stigma” and “mental illness”.
Results Despite several approaches to eradicate stigma, it shows
a surprising consistency in population levels. It was expected
that focus on education would decrease stigma levels. The same
was expected following concentration on the genetic causation
of pathology. Most studies have revealed that education has lit-
tle value and endorsing genetic attributions has led to a greater
pessimism on the efficacy of mental health services, sense of per-
manence and guilty feelings within the family.
Conclusion Public stigma has had amajor impact onmany people
with mental illness, especially when leading to self-stigma, inter-
fering with various aspects in life, including work, housing, health
care, social life and self-esteem. As Goffman elucidated, stigma is
fundamentally a social phenomenon rooted in social relationships
and shaped by the culture and structure of society. Social inclusion
has been pointed as a potential direction for change.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV896
Veiling existence with clothing
O. Molina-Andreu ∗, A. González-Rodríguez ,
H. Pelegrina Cetrán
1 Hospital Universitari Mútua de Terrassa, Psychiatry, Terrassa, Spain
2 Fundació Clínic, Recerca Biomèdica, Barcelona, Spain
3 Universidad Autónoma de Madrid, Facultad de Filosofía y Letras,
Madrid, Spain
∗ Corresponding author.
Our aim is to discuss the notion of freedom in severe depression.
We will address it considering several phenomenological concep-
tions of the matter, from Binswanger’s nicht können to more recent
Ratcliffe’s loss of existential feelings and also by clinging to our own
clinical experience, in particular a case of melancholic depression
in a 67-year-old woman.
Our patient suffered a clear melancholic syndrome, with an intense
psychomotor inhibition, she felt uncapable of doing anything, spent
hours brooding over menial tasks and thought much about dying,
because she sensed the world as being devoid of possibilities and
the future closed, experiences she considered “not related to dis-
ease” but to her own “incurable moral failure”.
In order to discuss the notion of freedom in depression, we will
particularly focus on one of her psychopathologic phenomena,
the empoverishment delusion-like experience of having run-out
of proper clothing, which we consider was based on a inhibited
“perception” of reality, an unreflective experience of corporeal “not
being able”, a loss of the motivational force of intentionality. How-
ever, we will argue that this unreflective, pre-given experience
showed striking connections to the patient’s sub-depressive per-
sonhood, a classical Tellenbach’s typus melancholicus.
An hermeneutical analysis of her existence will be performed using
the anthropologic person-centered dialectic model developed by
one of the authors, and building on it, we will introduce the dis-
tinction between lived experience (Erlebnis) and factual experience
(Erfahrung) whichwe consider it is essential to enlighten the nature
of the loss of freedom that severe depression entails.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.