European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S799
Introduction Aggressiveness is amultidimensional phenomenon,
characterized by many cognitive and emotional processes, which
is often present in psychiatric disorders. Until the present time,
mechanical restraint has been a tool used in order to avoid risks
for patients or other people around them. It should be used as a
last option, so new strategies to reduce the use of these measures
favoring others are being developed.
Aim We try to analyze the influence of clinical and organizational
changes in the frequency and duration of mechanical restraints, in
order to provide new data and built hypothesis for future interven-
tion plans.
Methodology This oral communication presents a retrospective
analysis of mechanical restraints carried out in the Mental Health
Hospital Unit of Jerez de la Frontera between 2007 and 2014, both
inclusive, a sample of 950 episodes. Several variables will be ana-
lyzed and related to the different organizational events conducted
in the Clinical Management Unit of Jerez de la Frontera.
Results There has been a gradual reduction in the duration of
mechanical restraints carried out in the Mental Health Unit Hos-
pital of Jerez de la Frontera over the eight years studied, specially
after the implementation of the agitation protocol developed in
2011.
Conclusion In our experience, the implementation of a compre-
hensive clinical record, deep observation of the patient by the
professionals and the development of protocols to regularize inter-
ventions performed during an episode of psychomotor agitation
are useful strategies to reduce the duration of each mechanical
restraint episode.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1416
Descriptive study of mechanical
restraint in acute psychiatric
inpatient unit of Jerez De La Frontera:
Analysis of a risk profile
J. Pérez Revuelta ∗ arabias Contreras
E. Fernández Nicolás , E. Valverde González ,
A. Jiménez Espinosa , R. Guerrero Vida , J.M. Villagrán Moreno
1 Hospital del S.A.S. de Jerez, Clinical Management Unit of Mental
Health, Jerez de la Frontera Cádiz, Spain
2 Hospital del S.A.S. de Málaga, Clinical Management Unit of Mental
Health, Málaga, Spain
∗ Corresponding author.
Introduction Various medical and psychiatric conditions can
determine the occurrence of disruptive behavior and aggression.
Mechanical restraint is part of the strategies for managing these
risks. Its use implies a multidisciplinary, phased and individualized
for each case strategy, with attention to the ethical and legal issues
surrounding this coercive intervention.
Objective The objective of thiswork is the analysis of the profile of
patients who required mechanical restraint during hospitalization
in a psychiatric inpatient unit.
Methodology Retrospective descriptive analysis by collecting
data of patients, who required mechanical restraint during admis-
sion, between 2007 and 2014. The data sources were medical
clinical history and nursing records. Variables analyzed were sex,
age, clinical diagnosis at discharge and clinical state during the
episode of mechanical restraint.
Results Of the total sample of patients requiring restraint
(n = 266), 66.92% were men. The mean age of patients was 38.01
years. Distribution of clinical diagnoses based on ICD-10 cod-
ing: 30.23% F60 personality disorder (n = 289), 19.56% diagnosed
with F31 bipolar disorder (n = 187) and 14.02% F20 schizophre-
nia. Regarding the clinical characteristics of the episode, 49.47% of
patients had an agitation/violent state and in 23.11% risk of impul-
sive self-injury was evident, 13.47% had confusional syndrome.
Conclusion Data analyzed shows differences in frequency distri-
bution because of patient profile and clinical diagnosis. Otherwise,
organizational factors and appropriate amendments to this level
appear to play a key role in minimizing the use of such coercive
measures.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1417
New data of the theory of
self-medication
I. Prieto Sánchez ∗, M.D.L.C. Ramírez Domínguez ,
N. Garrido Torres , S. Fernández León , M. Reina Domínguez ,
A. Rodríguez Martínez , A.S. Biedma Martín , C. González Macías
Complejo Hospitalario Universitario de Huelva Juan Ramón Jimenez,
Unidad de Salud Mental, Huelva, Spain
∗ Corresponding author.
Objective The theory of self-medication in patients with severe
mental illness has been exposed for years but to date has not been
confirmed or ruled out. With this study, we intend to show the
latest available evidence regarding this context.
Methods An exhaustive literature research in Medline and the
latest forth in APA 2015.
Results More andmore evidence refute the veracity of this theory
deeply rooted among some professionals.
Conclusion There are theoretical alternatives that relate more
sustainedmanner the relationship between consumption and toxic
psychosis.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1418
Can I have a quality seizure? A review
J. Ramos ∗, A. Arriba , M. Urretavizcaya
1 Centro Hospitalar Tondela-viseu, Psychiatry, Viseu, Portugal
2 Hospital Universitari de Bellvitge, Psychiatry, Barcelona, Spain
∗ Corresponding author.
Introduction After seventy-five years of its introduction, electro-
convulsive therapy (ECT) remains the most effective treatment for
severe depressive disorders. It is known that the antidepressant
effect is not due only to the electric current itself, but by the general
seizure activity. As so, for beneficial or adverse effects of ECTs, it’s
mainly important to induct a well-generalized seizure. Those can
be influence by several variables like, seizure duration and thresh-
old, ECT practice factors andmedication, resulting in a lack efficacy.
It’s advantageous to treatment if physiological markers of adequacy
are established to seizure quality, because a high seizure quality has
been successfully correlated with better outcome in many studies.
Aims and methods The aim of this work is to review the avail-
able international literature regarding to identified parameters that
influence and evidence seizure quality.
Conclusion Although throughout history ECT is embroiled in
controversy, according to international bibliography, this is a tech-
nique of great therapeutic relevance and precise indications. It
is noteworthy, that it has been shown to be an effective and
safe treatment for many psychiatric disorders. Nevertheless, there
is not a consensus regarding to the parameters to its efficacy,
particularly the seizure quality. Thus, it’s important to current prac-
tice, to do more studies in this field, in order to establish those
parameters, have homogenise clinical practice and promote better
results.