European Psychiatry - Volume 33 - March 2016

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S70 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S56–S71
Conclusions Negative symptoms can be observed outside the
schizophrenia diagnosis. However, in order to fully explore the con-
tinuity of negative symptoms, measurement instruments need to
be designed to cover the full range of symptomatology starting at a
subclinical level. We propose the newly developed Zurich Negative
Symptom Scale as a useful tool in this respect.
Disclosure of interest The author has not supplied his declaration
of competing interest.
W46
The second-generation assessment
scales: Brief negative symptom scale
and clinical assessment interview for
negative symptoms
A. Mucci ∗, S. Galderisi
University of Naples SUN, Department of Psychiatry, Naples, Italy
∗ Corresponding author.
The construct of negative symptoms has undergone significant
changes since the introduction of first generation assessment
scales, such as the Scale for the Assessment of Negative Symptoms
or the Positive and Negative Syndrome Scale. Blunted affect, Alogia,
Asociality, Anhedonia and Avolition are largely recognized as valid
domains of the negative symptoms construct.
Among the new assessment instruments, both the Brief Nega-
tive Symptom Scale (BNSS) and the Clinical Assessment Interview
for Negative Symptoms (CAINS) are considered adequate in their
coverage of the negative symptoms domains. They include the
assessment of both behavior and internal experience for Anhe-
donia, Asociality and Avolition to avoid overlap with functional
outcome measures, as well as consummatory and anticipatory
components of anhedonia with an emphasis on the internal expe-
rience of pleasure.
Strengths and limitations of these newassessment instrumentswill
be reviewed in the light of some existing challenges, such as the dis-
tinction between primary and secondary negative symptoms and
development of innovative treatments.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
The impact of societal forces on the mental health
of LGBT populations across cultures
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LGBT adolescents in America:
Depression, discrimination and
suicide
A. Ahuja
Los Angeles LGBT Center, Los Angeles, USA
Introduction The mental health of Adolescents in America is a
major concern for the field of psychiatry. In particular, Lesbian,
Gay, Bisexual and Transgender (LGBT) adolescents are at higher
risk of adverse mental health outcomes. This is largely attributed
to “minority stress” and from outright bullying and discrimination.
In this presentation, this link between bullying and depression will
be explored.
Objectives By the end of this presentation, the audience will be
able to better understand the link between anti-LGBT bullying and
mental illness and identify the ways to help their patients.
Methods This presentation is informed by a literature search
from PubMed In addition, it is informed by a symposium previ-
ously done at the American Psychiatric Association (APA) annual
meeting in 2014.
Results There is clear evidence in the literature that bullying of
LGBT adolescents is pervasive. In addition, LGBT people are more
likely to be depressed than their heterosexual counterparts. This
combination has led to 4-5 times higher rates of attempted sui-
cide by LGBT adolescents. Having Gay-Straight Alliances in schools,
supportive teachers and school administrators, and broader anti-
discrimination legislation has a protective effect on this.
Conclusion LGBT adolescents are exposed tomore stress by being
a minority in society and by being explicitly bullied and dis-
criminated against. This can lead to depression in some of these
adolescents, and can also lead to suicide in the most vulnerable
among them. There are proven ways to reduce these risks, and
psychiatrists have a role to play in advocating for these reforms.
Disclosure of interest The author has not supplied his declaration
of competing interest.
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Cultural variations in LGBT issues
D. Bhugra
World Psychiatric Association, London, United Kingdom
Culturally determined gender roles influence relationships
between different-sex partners, and cultural values affect attitudes
towards sexual variation. LGBT patients face stigma, discrimina-
tion and prejudice and have specific issues related to a number
of factors, in addition to the nature of sexuality. These factors
affect help-seeking and also cause delays in pathways to care. In
specific instances, gay, lesbian and transgender individuals show
higher than expected levels of psychopathology. The clinician’s
attitudes affect therapeutic adherence and therapeutic alliance.
LGBT patients may also have specific issues related to “coming out”
and this may influence their relationships directly and indirectly.
Furthermore, they may experience a reluctance to share their
sexual orientation. Matching of therapists may offer one way
forward but this is not always possible, and may not work due to a
number of reasons.
Disclosure of interest The author has not supplied his declaration
of competing interest.
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HIV pre-exposure prophylaxis (PrEP)
and treatment as prevention (TasP):
What mental health providers should
know
T. Hall
University of California-Los Angeles, Center for Behavior and
Addiction Medicine, Los Angeles, USA
Pharmacologic methods of treating and preventing HIV have
advanced tremendously in recent years. Understandings of HIV
risk and recommendations for risk-reduction strategies have also
changed substantially. A majority of new cases of HIV in many
developed countries are now acquired through sex with long-term
partners who are unaware of their HIV-positive status, rather than
from casual or anonymous sexual encounters. Persons with bipolar
disorder and substance use disorders are at particularly high risk.
Mental health providers who work with LGBT persons and other
populations at higher risk for HIV need to understand strategies
their patients are using for HIV risk reduction, and to refer appropri-
ate patients for consideration for pre-exposure prophylaxis (PrEP).
PrEP is the daily use of an antiretroviral (ARV) medication for