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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2380

EV1396

A non-smoking program in the

psychiatric clinic: Eradicating tobacco

from the therapeutic space

J. Jaber

, A. T

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2381

EV1397

Attachment style and significant

relationships in severe mental illness

adults

M. Jiménez Pérez

1 ,

, J. Sáiz Galdós

1 , 2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2382

1398

Mechanical restraint and staffing level

in a psychiatric ward

J.S. Kodal

1 ,

, J. Nørgaard Kjær

2

, J. Dahlstrøm Severinsen

3

,

E. Roj Larsen

1

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