European Psychiatry - Volume 33 - March 2016

643 / 812

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S639
EV907
Posttraumatic stress disorder,
violence and war
M.A. Dos Santos
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.
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.
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.
EV910
PTSD and quality of life among
firefighters and municipal police
forces
C. Lima ∗, Â. Maia , R. Ferreira , A. Magalhães , H. Nunes ,
S. Pinheiro , L. Ribeiro , C. Rodrigues , P. Santos , V. Santos ,
R. Teles
1 Portuguese Red Cross, Vila Nova de Gaia, psychology, Vila Nova de
Gaia, Portugal