European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S793
many justifiable or ill reasons. In Pakistani society, lower socio-
economic class describes it, more children means more helping
hands. Higher birth order withmale gender is conceived a desirable
fulfilment of family.
Design Cross sectional study.
Place and duration Out patients clinic of Liquate University Hos-
pital Hyderabad during 1st January 2012 to 31st January2012.
Measures One hundred consecutive subjects attending a psy-
chiatric OPD with psychiatric symptoms have been assessed for
the total siblings, birth order among siblings and their psychiatric
diagnosis. The socio-demographic data was recorded through a
designed semi structured proforma, and diagnosis was established
by Diagnostic and Statistical Manual-IV Text Revised Criteria (DSM-
IV TR).
Results The age range remained 9–60 years and numbers of sib-
lings were in the range of 1–12 siblings and fourth birth order was
found to be dominant in this study to have psychiatric morbidity
(38%). While first order birth was 17%. Generalized anxiety disor-
der and depressive disorders were dominant diagnosis (55%), while
GAD was more in the male gender.
Conclusion This study shows that psychiatric morbidity was
more common in the lower birth order. This study may be carried
out at different centres of psychiatry for the better assessment of
psychiatric morbidity.
Keywords Gender; Birth order; Diagnostic; Psychiatry;
Hyderabad
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV1396
A non-smoking program in the
psychiatric clinic: Eradicating tobacco
from the therapeutic space
J. Jaber ∗ omé , B. Reys
Clínica Jorge Jaber, Saúde Mental, Rio de Janeiro, Brazil
∗ Corresponding author.
Introduction The work describes the well-succeeded experience
of the Non-Smoking Program developed in a psychiatric clinic in
Rio de Janeiro city, Rio de Janeiro, Brazil.
Objective To treat the tobacco dependence in patients with dis-
orders for the use of substances and other psychiatric disorders. To
transform the clinic therapeutic space in a free tobacco environ-
ment.
Aims To promote the restoring of the patients’ health integrally,
considering the use of tobacco is responsible for a large number of
avoidable deaths, in addition to much harm to health.
Methods In a clinic of hospitalization for diverse mental disor-
ders treatment, especially disorders for the use of substances, in
the city of Rio de Janeiro, Rio de Janeiro, Brazil, was simultane-
ously established a non-smoking treatment program. It was used
the pharmacological therapy, associated with cognitive-behavioral
therapy, occupational therapy and moderate physical activity. The
average time of permanence in the non-smoking program was on
average 90 days.
Results There was significant acceptance to the proposed pro-
gram. In the long-term monitoring, over 12 months, it was
evidenced that most patients found themselves in tobacco absti-
nence.
Conclusion The project achieved its objectives, promoting the
tobacco abstinence in patients with comorbidities in hospital treat-
ment. The study proved that it is possible to remove tobacco in
patients dependent on this substance during a psychiatric hospi-
talization.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1397
Attachment style and significant
relationships in severe mental illness
adults
M. Jiménez Pérez ∗, J. Sáiz Galdós
1 Grupo 5, Centro de Día Aranjuez 2, Aranjuez, Spain
2 UCM, Social Psychology, Madrid, Spain
∗ Corresponding author.
Introduction The way in which we establish our relationships,
our attachment styles, it is crucial for a more active and fulfilling
social life, as well as to achieve greater personal satisfaction and
quality of life. Attachment style, learned during the early stages of
life, regarding to parental figures or other figures, seems to have
some relation to the quality of relationships that we will have later
in adulthood.
Objectives/aims Describe attachment styles established with sig-
nificant people in a sample of patients with severe mental illness
(SMI).
Methods Implementationof an adhoc questionnaire based on the
“interview adult attachment prototypes” (EPAA), which explores
attachment relationships with the father, mother and significant
others. A sample of 24 participants diagnosed with SMI was
explored.
Results After examination of “past” relationships, we foundmore
extreme scores in “significant others” above “mother” and “father.”
Especially in dimensions that would be closer to a secure attach-
ment. The analysis of the “actual” relationship again identified the
“significant others” as establishing closer interactions to secure
attachment. The “significant others” were composed mainly by
“grandfathers” and “brothers” in the past, and “brothers” and
“friends” in the present.
Conclusions It is important to note that, for our sample, parents
appear less associated to a secure attachment, highlighting this
the importance of intervening with families to develop healthier
relationships. On the other hand, we found fluctuations in time of
significant others, which might suggest the need to intervene on
these issues from a psychosocial and historical perspective.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
1398
Mechanical restraint and staffing level
in a psychiatric ward
J.S. Kodal ∗, J. Nørgaard Kjær , J. Dahlstrøm Severinsen ,
E. Roj Larsen
1 Aarhus University Hospital, Department of Affective Disorders,
Mood Disorders Research Unit, Aarhus, Denmark
2 Aarhus University Hospital, Department of Organic Psychiatric
Disorders and Emergency Ward Department M, Aarhus, Denmark
3 Aarhus University Hospital, Denmark, Deptartment of Affective
Disorders, Mood Disorders Research Unit, Aarhus, Denmark
∗ Corresponding author.
Introduction The use of coercion raises ethical dilemmas, as it
deprives patients of their autonomy. In Denmark, the subject has
gained political attention, and decreases in the use of coercion are
demanded. In the attempt of reducing the use of coercion, it is of
interest to obtain more knowledge about the circumstances bound
to it.
Aim The aim of this study was to investigate a possible corre-
lation between the incidence of mechanical restraint (MR), and
staffing level, staff demographics, patient characteristics, type of
shift (day/evening/night) and change of shifts.
Methods A naturalistic descriptive method was used to study
cases of mechanical restraint in patients admitted to a psychi-
atric ward. In the study period of one year, 114 cases of MR were