European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S797
in 43% of cases and severe burnout in 6.7%. The causes of burnout
reported by our population were bad working conditions (71.50%),
quality of working relationships (65.5%) and overloadwork (30.3%).
Bad working conditions were associated with a high level of emo-
tional exhaustion (P < 0.005) and a low level of professional efficacy
(P < 0.001), while poor quality of work relationships and overload
work were associated to a high score on cynicism (P < 0.001) and a
low score on professional efficacy (P < 0.001).
Conclusion According to our study, poor working conditions,
overload work and bad quality of relationships seem to be risk
factors of burnout in teachers. Preventivemeasures should be insti-
tuted against those factors to reduce the constraints of work and
improve the professional quality of life of these individuals, essen-
tial thing to optimize the educational level in our country.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1409
The treatment of “shell shock” in
World War 1: Early attitudes and
treatments for post-traumatic stress
disorder and combat stress reaction
H. Matson
Portsmouth, United Kingdom
Combat stress reaction is amental health disorder first documented
in the latter half of the 19th century. But it was not until World
War 1 when men were put through the horrific ordeals of trench
warfare that the term, “shell shocked” was coined. Many soldiers
with shell shock then developed what is now called post-traumatic
stress disorder (though the term was not defined until 1983) or
acute stress disorder. The prevailing opinion was that these men
who had often not suffered from any physical trauma were suf-
ferers of cowardice. The British army created the PIE (proximity,
immediacy, and expectancy) principles to get such men back to
the trenches promptly where manpower was always needed. It
was rarely regarded as a real psychiatric condition, which had two
consequences. Firstly, that many soldiers progressed from shell
shock to post-traumatic stress disorder and secondly, over 150
soldiers were executed by the British army for, “displaying cow-
ardice”whilst in the grip of the illness. The diagnosis of “shell shock”
was to be made increasingly frequently as wars became larger and
moremechanized throughout the 20th century. Psychiatrists’ man-
agement of such patients initially was primitive and influenced
by the zeitgeist that such servicemen were not ill, having never
come across such a widespread prevalence of mental health prob-
lems until the Great War. These ranged from prescriptions of milk
to lobotomies. Understanding how “shell shock” was understood,
treated and learning from the mistakes made then, continues to
inform management of our patients today.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV1410
The chaos involved in Münchausen
syndrome and Münchausen syndrome
by proxy
L.D. Gherman , A.M. Ciobanu , N. C˘apraru , A.I. Mih˘ailescu ∗,
L.M. Gâz˘a
Clinical Hospital of Psychiatry “Prof dr Al. Obregia”, Clinic, Bucharest,
Romania
∗ Corresponding author.
Background Encountering a patient with Münchausen syndrome
(MS) or with MS by proxy is more frequent than it is assumed.
Treating this type of patient is indeed a challenge, thus, knowing to
depict the signs is important for every doctor. A specific therapeutic
approach is needed and sometimes, even law enforcement must be
involved.
Objective We plan to highlight the signs and consequences of
Münchausen syndrome and Münchausen syndrome by proxy.
Method Clinical data were collected during admissions of
patients in the psychiatric hospital. A literature review has been
performed.
Results We report the case of a nurse diagnosedwithMS, whohad
multiple admissions with different diagnostics, before the patient
was exposed with the factious disorder diagnosis. We also report
the case of a mother diagnosed with MS by proxy and the case of
another mother where the obsessive-compulsive elements of her
depressive disorder are combined with signs of MS by proxy, both
of them inflicting consequences upon the child in care.
Discussion and conclusions Patients suffering from Münchausen
syndrome andMünchausen syndrome by proxy can be a burden for
society and for themselves. The relationshipwith them is sabotaged
from the start. The diagnostic is difficult to establish. Numerous
expensive procedures are being taken and a considerable amount
of funds is spent. Most importantly, the abuse of a child with a
parent or guardian suffering from this disease is incommensurable
and can even lead to death. It is vital to take action as soon as these
syndromes are discovered.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1411
Theory of mind in preschool children
and its relationship with social
maturity
A. Nesayan ∗ sadi Gandomani
University of Bojnord, Psychology, Bojnord, Iran
∗ Corresponding author.
Introduction Theory of mind (ToM) is the intuitive understanding
of one’s own and other people’s minds or mental states – includ-
ing thoughts, beliefs, perceptions, knowledge, intentions, desires,
and emotions – and of how those mental states influence behavior.
Theory of mind is an innate human ability that is sometimes called
intuitive psychology, folk psychology, or even mind reading. Social
maturity is the process of appropriate attitudes for personal, inter-
personal and social adequacies of an individual, which are essential
for functioning effectively in the society. According to the findings,
there were not statistically significant relationship between theory
of mind and social maturity and there is a need for more research
in this area.
Objective The objective of this study is to survey preschool chil-
dren’s theory of mind and its relationship with social maturity.
Method Research method is correlational research and sample
included 30 children between 5–6 years old. In this study, theory
of mind test and Vineland social maturity scale were used.
Results The results showed that 5- and 6-years-old children’s
performance in third-level theory of mind had significant differ-
ence and in first and second level theory of mind had no significant
difference. The findings also showed that there was no relationship
between theory of mind and social maturity in preschool children.
Conclusion According to the findings, there was no statistically
significant relationship between theory of mind and social maturity
and there is a need for more research in this area.
Keywords Theory of mind; Social maturity; Preschool children
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.