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

S639

EV907

Posttraumatic stress disorder,

violence and war

M.A. Dos Santos

1 , 2

1

Instituto de Higiene e Medicina Tropical da Universidade Nova de

Lisboa, Unidade de Ensino e Investigac¸ ão de Saúde Pública

Internacional e Bioestatística - Doutorado em Saúde Internacional,

Lisboa, Portugal

2

Mestrado em Psiquiatria Social e Cultural, Faculdade de Medicina

da Universidade de Coimbra, Coimbra, Portugal

Introduction

In a globalized world, violence, present in all forms

and in all places, is a public health problem with serious early or

late consequences for the mental health of those who are direct or

indirect victims. Violence is avoidable and preventable and is not

evenly distributed by population groups or regions being among

the top 20 causes worldwide of years lost due to disability and

with a projected increase by 2030 according to the World Health

Organization (Mathers, Fat & Boerma, 2008).

Methodology

The search was made on ScienceDirect database,

using the following keywords: posttraumatic stress disorder; vio-

lence and war. It was included documents in English published

between 2004 and 2015; as well as textbooks and documents offi-

cers.

Discussion

Violence is a risk factor for the disorder of post-

traumatic stress disorder (PTSD) which, in turn, is also a risk factor

for perpetrating violence. The PTSD can occur when a person faces

or faces an unexpected traumatic stressor, such as war, violent per-

sonal assault, have been held hostage or kidnapped confinement as

a prisoner of war, torture, terrorist attack, or serious car accidents

(Javidi & Yadollahie, 2012). The costs of violence are high and its

routinization for a living have important effects on mental health.

Considerations

Studies in relation to PTSD and violence are nec-

essary for us to have a better understanding of the phenomenon

and its consequences for public health, as well as to promote the

mental health of all.

References not available.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1892

EV908

Cognitive behavioral therapy in a

group of militaries with

posttraumatic stress disorder

H. El Kefi

, W. Abdelghaffar , A. Baatout , C. Bechikh Brahim ,

W. Krir , S. Eddif , A. Oumaya

Hôpital Militaire Principal D’instruction de Tunis, Psychiatry, Tunis,

Tunisia

Corresponding author.

Introduction

Posttraumatic stress disorder (PTSD) has a high

prevalence and severe impact in military populations. Cognitive

behavioral therapy (CBT) is indicated in this condition but it is a

structured therapy that requires patients’ motivation and doctors’

availability.

Objectives and aims

Assess feasibility and effectiveness of CBT in

a military group with PTSD.

Methods

A group of six militaries that witnessed the same trau-

matic event (an armed attack) and were diagnosed with PTSDwere

involved in a structured individual session CBT with one thera-

pist. An assessment using the PTSD checklist for DSM (PCL) was

performed initially and in halfway therapy. The therapy included

an education about PTSD, a cognitive restructuring, a behavioral

approach via home tasks and relaxation techniques.

Results

The initial PCL scores varied from 25 to 55. All patients

were initially on sick leave. Five patients had adjunctive antide-

pressant medications and one patient was only on therapy. Three

patients showed nomotivation andwere excluded after 3 sessions.

Two patients have had 7 weekly sessions and were able to return

to work in the same place. One patient with severe PTSD had 2

sessions monthly, he had slight clinical improvement and could

not come back to military work. The three patients who are still in

therapy have improved PCL scores.

Conclusions

CBT can be effective in PTSD. The outcome depends

on initial severity of PTSD and assiduity.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1893

EV909

Challenging MCMI-III results with

in-depth psychometric assessment

and Lacter & Lehmann (2008) complex

trauma guidelines

R. Kurz

Cubiks, IPT, Guildford, United Kingdom

Introduction

Complex trauma resulting from neglect and abuse

in early childhood is frequently misdiagnosed.

Objective

This presentation shares emerging “best assessment

practices” that help to differentiate complex trauma from

Schizophrenia.

Aims

The case study demonstrates that a wide-ranging psycho-

metric assessment and the application of Lacter & Lehmann (2008)

guidelines provide accurate results while MCMI-III results can be

spurious.

Method

“Unbelievable” disclosures of an adult survivor

prompted a search for scientific references, experiences in

the survivor scene and historical examples. Work-related person-

ality questionnaires, in-depth ability tests and Lacter & Lehmann

(2008) guidelines were deployed to differentiate complex trauma

from an erroneous diagnosis based largely on MCMI-III results.

Results

The research identified measurement issues with the

MCMI-III clinical personality questionnaire that generated spu-

rious elevations on Narcissistic, Delusional and Paranoid scales.

Work-related personality questionnaires providedmuchmore use-

ful information showing no “personality disorder” risks at all. WAIS

results confirmed an earlier “Twice Exceptional” ability pattern

with very high verbal IQ (95%ile) and extraordinarily poor auditory

working memory (2nd%ile) i.e. a “Dyslexia” performance pattern.

Lacter & Lehmann (2008) guidelines showed that none of the

42 schizophrenia indicators applied and only 1/3 of the complex

trauma indicators.

Conclusion

Mental health professionals must remain cognizant

to the chilling notion that extreme abusers may “frame” victims

in order to make them “appear” schizophrenic. As MCMI-III was

developed originally for those seeking therapy, its use in forensic

settings with the general population should be avoided. Tests do

not diagnose people – people do!

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1894

EV910

PTSD and quality of life among

firefighters and municipal police

forces

C. Lima

1 ,

, Â. Maia

2

, R. Ferreira

1

, A. Magalhães

1

, H. Nunes

1

,

S. Pinheiro

1

, L. Ribeiro

1

, C. Rodrigues

1

, P. Santos

1

, V. Santos

1

,

R. Teles

1

1

Portuguese Red Cross, Vila Nova de Gaia, psychology, Vila Nova de

Gaia, Portugal