The authors have not supplied their declaration of competing interest.

Professional stress is a misfit between a person's skills and demands of the job. It has been found to be common among psychiatrists and affects their personal and professional life.

To rank order the factors and manifestations of professional stress among Indian psychiatrists.

To determine the factors and manifestations associated with professional stress among Indian psychiatrists.

A qualitative ranking type Delphi study was conducted at National Institute of Mental Health & Neurosciences, Bangalore. The Delphi team comprised of 43 randomly selected Indian psychiatrists with at least 10 years of clinical experience in psychiatry. Questionnaires were mailed & the replies were analyzed and a consolidated list was sent back to rank order them. Agreeability was assessed & the final list of factors and manifestations was shared with the experts.

Forty-eight percent of the experts completed all 3 stages of the study, 53% opined that age & gender were not a factor; however 58% & 44% opined that personality attributes & relationship status were significant factors contributing to professional stress (Table 1).

Professional stress in Indian psychiatrists is largely secondary to increased workload and inadequate support system. System level changes, like increase in manpower and handling stigma regarding psychiatry, is required.

The authors have not supplied their declaration of competing interest.

The European Federation of Psychiatric Trainees (EFPT) is an independent Federation of Psychiatric Trainees and represents the consensus of psychiatric trainee's organizations across European countries and advocates for what training should look like, regardless of the country. Spain was one of the last countries to be part of the Association. Finally, and after months of hard work and networking, on September 2015 the Spanish Society of Psychiatry Trainees(SERP), was founded and Spain became a observer member of the EFPT.

One of the main goals of the SERP, is creating a program of clerkships, in both directions, from other trainees to come to Spain, and for Spanish Trainees to go abroad.

Our idea in this poster is to explain a first look of which Hospitals/Units would be appropriate to make a rotation, and to explain the first steps in order to create a database with information about the nightshifts, possible accommodation and other aspects related to the organization. We want to use this poster to present to Europe our new Association.

On September 25 at the National Congress of Psychiatry in Santiago de Compostela, a Group of Spanish trainees founded the SERP, organized the first Board and signed the Founding Amendments.

After two previous failed attempts, finally on 25th September 201; the Spanish Society of Psychiatry Residents (SERP) was founded, an important part of the activity of this company is promoting exchanges between residents of member countries in Spain.

The authors have not supplied their declaration of competing interest.

Despite efforts to unify psychiatric education among European member countries, there are still considerable variations between national training programmes. To ensure equivalence of training standards the current tendency of recommended guidelines and reports is steering psychiatric training towards becoming more competency focused.

The research group of the European Federation of Psychiatric Trainees (EFPT) conducted a multi-national study on postgraduate psychiatry training. The aims are to assess the psychiatric trainees’ experiences and opinions on their national training and assessment methods in respect to the Union européenne des médecins spécialistes (UEMS) 2009 competencies framework.

This study surveyed 745 psychiatric trainees from 10 EFPT member countries using a questionnaire designed specifically for assessing this issue.

In this sample, the majority are aware of having a competency based training programme but 86.5% are poorly acquainted with the UEMS competencies framework. All key competencies were rated as being important but not all as being relevant in the assessment process. One's level of preparedness and the degree of education one's receives during their training differs from one competency to another. Trainees who aren’t satisfied with their national training would be in favour of taking an end of training Pan-European exam which differs from the one's that are satisfied and wouldn’t be interested in undergoing this assessment method.

This sample isn’t fully acquainted with the competency-based concept for postgraduate training. The ones satisfied with their postgraduate psychiatric education seem to be less inclined to take an end of training Pan European exam.

The authors have not supplied their declaration of competing interest.

Older people with mental ill health are more likely to receive lower quality of health care, inappropriate prescriptions and reduced access to services, leading to increased rates of mortality [1–3]. There is increase focus on supporting people with multiple long-term physical and mental health conditions, particularly by embracing opportunities created by technology [4] (references are not available for this abstract).

To identify the common medical comorbidities on the Old Age Psychiatry Wards.

To develop simulation training from the medical scenarios.

We audited all patients referred to the Liaison Geriatrician from 2008 to October 2015 from the Mount Hospital Leeds, which consists of 4 Old Age Psychiatry wards. Data was collected in October 2015 and included referral date, patients’ age and sex, number of referrals, reason for referral and the outcome.

We assessed 339 (142 F, 197 M) patients with a mean age of 77 (range: 56-94). The cardiovascular problems constituted the majority (34%) of the referrals, central nervous system (11%), respiratory (8%), gastrointestinal (8%), infection (8%), musculoskeletal (7%), renal (3%), others (19%) and the reasons were unknown in (2%) of the 440 referrals. Some unusual problems were diagnosed including a spontaneous pneumothorax, primary biliary cirrhosis.

The audit highlights the essence for more training in recognising and assessing medical problems in psychiatric settings - the simulation programme (RAMPPS) in Old Age Psychiatry. As a result of the service model, we are developing a simulation-training course tailored to the mental and physical health needs of the elderly.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The UK General Medical Council highlights the centrality of effective communication, reflective practice and the doctor-patient relationship in medical practice. A decline in empathy has been documented as occurring within clinical and early postgraduate years, potentially affecting diagnostic processes and patient engagement. Access to Balint groups can enhance awareness of the patient beyond the medical model, but remains limited at many UK medical schools. This scheme offered Balint groups to Bristol medical students in their first clinical year, demonstrating that this method is relevant beyond psychiatry.

Initial focus groups with medical students indicated that many felt unable to discuss distressing aspects of clinical encounters. During 2013-2014, a Balint scheme run by psychiatry trainees was started for 150 students in their psychiatry placements. During 2014-15, the scheme was introduced to all third-year medical students on their medicine/surgery placement. Balint leaders have group supervision with a psychoanalytic psychotherapist. Evaluation of the scheme was based on pre-and post-group questionnaires and leaders’ process notes.

Sixteen groups led by 12 trainees were run twice over the year to serve 246 medical students. Two example cases are discussed here. Students appreciated the chance to discuss complex encounters with patients in a supportive peer environment, and work through a range of emotionally challenging issues.

Novel aspects of this work include the implementation of Balint groups within medicine and surgery placements; the enrolment of psychiatry trainees as leaders with group supervision and leadership training workshops from the UK Balint Society; and the scale of the scheme.

The authors have not supplied their declaration of competing interest.

Our aim was to examine whether cerebral frontal cortex O2 desaturation may be related with the development of delirium symptoms’ after cardiac surgery in the elderly during the intensive care unit (ICU) staying.

A prospective, before and after, longitudinal study in II-IV ASA class patients scheduled for cardiac surgery and undergoing intravenous general anesthesia with remifentanil plus propofol was done. Clinical and surgical parameters, cardiopulmonary function, intraoperative cerebral oxygen saturation (rSO2) and bispectral index were continuously recorded and corrected throughout the surgery. Severity of delirium was represented as a score of the Intensive Care Delirium Screening Checklist (ICDSC) during the patients’ stay in the ICU under the assumption that higher ICDSC score indicated severe delirium.

Patients, n = 44, 77.3% male, aged 59.9 ± 1.9 years old, scheduled to coronary (36.4%), aortic valve replacement (18.2%), mitral valve replacement (13.6%), coronary plus valve replacement (13.6%) and others (18.2%) surgery, on pump 98.4% were enrolled. A reduction of the rSO2 higher than 10% at the end of the surgery compared with basal values was detected in a 46.5% of the patients. Reduction of rSO2 higher than 10% at the end of the surgery was related with significantly higher values of delirium symptoms’ development during the intensive care unit post-surgery staying (rSO2 higher ≥ 10% 68.8 vs. rSO2 higher < 10% 31.3%, P < 0.05).

Delirium symptoms’ development during the intensive care unit post-surgery staying is related with reduced intraoperative cerebral oxygen saturation in the elderly subjected to cardiac surgery.

The authors have not supplied their declaration of competing interest.

The assessment and management of psychomotor agitation may result in the use of coercive or sedative treatments. In the absence of conclusive evidence, the consensus of experts can guide clinical decisions.

To seek consensus recommendations on the assessment and management of psychomotor agitation.

An international expert task force in this field developed consensus using the Delphi method. Twenty-seven experts were invited to participate and 91% of them agreed. Initial survey items were gathered from the content of literature search (systematic review). This included open-ended questions inviting participants to add suggestions by e-mail correspondence. After this initial first round, the Delphi study was conducted online using Google Forms. Survey items were rated on a 5-point scale. Items rated by at least 80% of experts as essential or important were included. Items rated as essential or important by 65–79% of experts were included in the next survey for re-rating. Items with consensus below to 65% were rejected and excluded.

The initial survey included 52 items. The second web-based survey included 33 items. The briefer third survey consisted of 6 items that needed rerating. Twenty-two of the initial 33 items were endorsed and formed the clinical recommendations on the assessment and management of the psychomotor agitation. The endorsed items were categorized into 5 domains forming the clinical recommendations.

The panel expert generated 22 recommendations on the assessment and management of agitation. The Delphi method is a suitable formal iterative process for reaching consensus on relevant and controversial issues.

The authors have not supplied their declaration of competing interest.

The suicide attempt is a real challenge for the clinician who works at the emergency department in order to identify and propose an adequate care.

To estimate the prevalence of the suicide attempts, to describe the sociodemographic and clinical characteristics and to identify the predictors of recurrence.

Our cross-sectional study was conducted at the medical emergency department of the university hospital of Mahdia and lasted for 12 months. Data were collected using a questionnaire of 51 items exploring the general and clinical characteristics and providing information of the treatment.

Among the 513 consultants, 90 had attempted suicide (17,5%). We found an average age of 26 years old, a sex-ratio (M/F) of 0,3, a secondary education level (53,3%), an unemployment and a single status (38,9% and 75,6%). The presence of psychiatric personal history and/or suicide attempts was found in 31,1% and 33,3% of cases. Suicide attempts were taken place in all cases at home, between 18 and midnight (43,3%), without premeditation (82,2%), in the presence of triggering factor (95,6%), during the last 3 months of the year (34,4%). In 70,2% of cases, the type of the suicide attempts was a drug intoxication. 67,8% of the suicide attempters regretted and criticized their acts.

A good assessment of the suicide risk determines the type of intervention that should be established and allows an adequate care.

The authors have not supplied their declaration of competing interest.

Intramuscular (IM) medications used in rapid tranquillisation (RT) to manage violent/aggressive behaviour can cause serious physical side effects including sudden death, therefore comprehensive physical health monitoring is advised.

To assess whether physical health monitoring of patients who received IM medication for RT was completed as per the Aggression/Violence NICE-guideline based local Policy.

All patients that received IM benzodiazepines or antipsychotics for RT were identified amongst 822 discharges from February 2014 to February 2015. Demographics, diagnoses, non-pharmacological interventions, types/doses of medication, and associated seclusion/restraint episodes were recorded. Notes were examined to determine whether physical health monitoring protocols involving blood pressure, pulse, temperature, oxygen saturation, respiratory rate and level of consciousness were followed.

There were a total of 218 episodes where these medications were used, in which only 19 (8.8%) had any physical observations completed; only one case (0.5%) was completed fully as per the protocol. Of the cases that did not have observations taken, in 12 (5.5%) cases observations were attempted but the patient was too agitated/aggressive. A doctor was contacted in only 53 (24.3%) cases and an ECG was completed in 120 (55%) cases, of which only 11 were completed within 24 hours.

The results show poor compliance (or at least recording) with the guidance, demonstrating the need for further education of nursing and medical staff on the potential dangers of RT and for better physical health monitoring of patients on RT. To improve patient safety, staff training and well-timed recording of physical observations on electronic tablets will commence.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

New Psychoactive Substances (NPS) appear to be increasing in popularity because they mimic the effect of traditional drugs. DOB is a world-wide controlled phenethylamine, with agonist activity in 5HT2A receptors. Its effects are comparable to those of LSD, with dosage range 1.0–3.0 mg and duration 18–30 h.

To assess the presence of DOB in the substances submitted to, and analyzed by, energy control.

All samples presented to Energy Control (EC) from August 2009 to August 2015 were analyzed. EC is a spanish harm-reduction non governmental organization that offers to users the possibility of analyzing the substances they intend to consume. Samples in which DOB was detected using gas chromatography-mass spectrometry were selected for this study.

From a total of 20,062 samples, 13 contained DOB (0,06%), with no clear variations among the years studied. The samples were mostly sold as DOC(8), DOB(2) and LSD(2). Nine out of total 13 samples presented as blotter.

Results suggest that availability of DOB in the Spanish drug market is anecdotic. Nonetheless, a number of the samples containing DOB were not sold as such, increasing the possibility of side effects, as users may ignore which substance they are actually using. When a patient presents at an Emergency Department with persistent hallucinogenic symptomatology after ingesting a blotter, psychiatrist should be aware of long-lasting psychedelics such as DOB.

The authors have not supplied their declaration of competing interest.

Agitation is a frequent and complex emergency. Its early detection and adequate treatment are crucial to ensure the best outcomes. Pre-hospital management of agitation requires appropriate measures to preserve patients’ safety, stabilize the patient and alleviate suffering, and transfer to the hospital psychiatric services, including involuntary admission if needed.

To describe the management of agitation by the Emergency Medical Services (EMS) in Spain.

Observational retrospective survey on the protocols and procedures used, the number of in-calls received and the resources dedicated to attend emergencies in 2013.

Seven out of the seventeen EMS in Spain provided information. All of them registered in a database in-calls and actions taken. Four of them had a specific protocol to attend psychiatric emergencies and agitation in-calls, and five coded the initial diagnostic with ICD-9. Paramedics attending emergencies register the diagnostic in 3/7 EMS. Nursing and Medical staff code the final diagnostic with ICD-9 in all. Emergency Coordination Centres received 4,437,388 in-calls (209/1000 inhabitants); 2.6% classified as psychiatric (6.2/1000 inhab.). Healthcare teams attended 2,028,467 emergencies, 84,933 (4.2%) were psychiatric (4.0/1000 inhab.) and 37,951 (1.9%) were patients with agitation (2.0/1000 inhab.). General practitioners attended 17% of all psychiatric emergencies, while ambulances attended 61%.

The incidence of acute agitation accounts for almost half of the total psychiatric emergencies in the pre-hospital setting. Since there are different healthcare providers in charge, specific protocols as well as treatment procedures are needed to provide the most adequate management, in order to ensure the best Psychiatric Emergency Chain.

The authors have not supplied their declaration of competing interest.

After legal restrictions regarding coerced medication in Saxony, we monitored significant increases in aggressive behaviour and regarding the use of physical restraints at our closed psychiatric ward. Alternative measures for managing dangerous behaviour were discussed.

There are limitations regarding the use of treatment interventions in emergency psychiatry, e.g. the use of constant observation is limited in its efficiency generally and video surveillance is prohibited by law in high-risk areas (e.g. bathroom).

To find appropriate solutions for patient safety improvement in emergency psychiatry including high-risk areas, prospects of the field of “technical assistance” entered the limelight of interest.

In 2014, a cooperation of Chemnitz University of Technology, Intenta GmbH, Eckstein Design and the affiliated partner Klinikum Chemnitz started a project*, which focuses on the development of a technical assistance system for recognizing high-risk behavioural patterns (e.g. suicide attempt) in risk areas in emergency psychiatry. The system is based on a smart-sensor technology and waives a recording and storing of sound and vision.

In the 1st half of the project technical development and the design of the system were the focus of attention. Special requirements regarding use cases, user acceptance, data protection and ethical concerns were processed by our psychiatric department. Testing and further development of the system in clinical settings are planned.

The development of the system must be seen as a big challenge in many regards. Further research is indispensable.

*Sponsored by the Central Innovation Program Mittelstand of the Federal Ministry for Economic Affairs and Energy.

The authors have not supplied their declaration of competing interest.

The objective was to determine a patient's level of psyche pain when they present to an emergency department (ED) and whether there was a relationship between this psyche pain and the patient's level of agitation.

This was a prospective study using a convenience sample of 300 patients presenting to an ED with a psychiatric complaint. This study was conducted in an urban, inner-city trauma center with 60,000 ED visits a year. After obtaining consent, a research fellow administered validated tools for assessing agitation, BAM, PANSS-EC, ACES, assessment of psyche pain, MBPPAS and a self-assessment of agitation at admission. SPSS version 22 was used for statistical analysis and the study was IRB approved.

A total of 74 patients were enrolled at this time. The most common ED diagnoses were depression, schizophrenia, or bipolar disorder. Majority of patients were African-American (59%), falling in the 25–44-year-old age range (56%). Fifty-two percent male and 48% female. Psyche pain was rated by MBPPAS as marked (18.9%) or moderate (67.6%). The self-reported tool demonstrated 20% none, 16% mild, 21% moderate and 42% marked level of agitation. The agitation rating varied by the tool with self-reported level of agitation having the highest correlation with level of psyche pain (P < 0.05).

Psychiatric patients frequently present to the emergency department with a high level of psyche pain and high level of self-reported agitation. This correlation may signal the need to address a patients’ level of agitation early in evaluation process.

The authors have not supplied their declaration of competing interest.

Health related quality of life (HRQoL) can be measured and compared, to give us an understanding of the impact different diseases have on health. The diagnostic tests for attention-deficit/hyperactive disorder (ADHD) in adulthood fail to catch the diversity of ways the condition affects one's life. Disease-specific quality-of-life scales try to reach beyond the typical symptoms of the condition, to find those specific difficulties a person subjectively grades as challenging.

To assess the levels of general and disease-specific HRQoL in adults with ADHD-like symptoms.

To understand the impact ADHD-like symptoms have on adults’ HRQoL.

A random, nationwide sample of 3000 Finnish speaking citizens (aged 18-44 years) was drawn from the national population register. A subsample of 171 people, 57 screener (Adult ADHD Self-Report Scale [ASRS]) positive cases and two age- and sex-matched controls for each case, participated in a telephone interview. General HRQoL was measured with 15D, and disease-specific HRQoL with Adult ADHD Quality-of-Life (AAQoL) scale.

The 15D score was 0.866 for the screener positives, 0.943 for the controls, and 0.945 for the Finnish population reference. The difference between the screener positives and controls was significant (P < 0.001). The AAQoL sum score was worse for the screener positives than controls (61.9 vs. 82.1, P < 0.001), and all the subscales were affected accordingly.

Adults with ADHD-like symptoms have a lower quality of life, as measured both on the general and on the condition-specific quality of life scales.

The authors have not supplied their declaration of competing interest.

Every year, 1 million people commit suicide in the world. Major Depressive Disorder is the first cause of loss of Disability-Adjusted Life Years (DALYs) in developed countries.

To study the references to psychiatric disorders in the media and to measure their media impact compared with other topics such as politics, sports and tabloids.

We focused on the top-six journals in terms number of readers in the USA. Our research strategy included the introduction of several terms of interest (ex: “anxiety”) on each journal's Twitter account. The search was restricted to 2014, and yielded a database of 6296 news, which was categorized in four areas: health, politics, sports and tabloids.

Six hundred and eighty-one (10.8%) news dealt with psychiatric disorders. The term with the highest impact in mass media was “suicide”, present in 1 of every 3 Psychiatrics-related news. Anorexia was the psychiatric disorder with the lowest impact (just 1 tweet). We noticed certain peaks-patterns in the number of tweets coincidentally with the suicide of any famous person. Within the total of terms included in our study, suicide ranked the 8th position regarding media impact.

Social networks can be a useful tool for the divulgation of mental disorders and their awareness among the general population. Despite psychiatric disorders are very prevalent and cause high morbidity, they have a relatively low media impact. Despite the WHO recommendation of avoiding specific information regarding the suicide of famous people, for preventive reasons, suicide is the psychiatric disorder with the highest media impact.

The authors have not supplied their declaration of competing interest.

The Psychiatry consultation is a collaborative approach between primary health care services and community mental health teams. Our clinic provides support to three Oporto areas (Bonfim/Paranhos, Campanhã and Maia/Valongo) corresponding to a population of 350,000 inhabitants.

To analyze and collect Psychiatry consultation data of the first semester of 2015 in Maia/Valongo region. We aim to describe our population's sociodemographic characteristics, the most common referral motive, diagnosis and therapeutics, and orientation.

Psychiatry consultation data of the first semester of 2015 were collected and analyzed using SPSS software (version 20).

One hundred and sixty-one patients were evaluated. A total of 26.09% were male and 73.91% were female. The mean age was 51.61 years old. The most frequent referral motives were depressive (47.82%) and anxiety (23.60%) symptoms. The two most common diagnostic groups according to the International Classification of Diseases (version 10) were F30-F39–Mood affective disorders (57.76%) and F40-F48–Neurotic, stress-related and somatoform disorders (18.63%). 22.36% of the patients were referred without medication, but only four were discharged drug-free, corresponding to bereavement situations. 34.16% of our population were previously prescribed two or more psychotropic drugs, increasing to 63.98% after assessment. Only 18.63% met criteria to hospital referral.

The Psychiatry consultation selects the most severe patients and allows a faster evaluation of mentally ill patients awaiting hospital consultation, thus preventing unnecessary access to the emergency room. Authors consider that all the patients referred to a hospital consultation should be previously evaluated by a consultant psychiatrist on a primary health care setting.

The authors have not supplied their declaration of competing interest.

Unemployment is a risk factor for later development of mental health problems, but characterisation of this in real world clinical data is limited. This study aimed to investigate the association between employment status and time-to-first-contact with mental health services using survey data linked to electronic health records(EHR).

SELCoH (n = 1698, 2008–2010) was a representative population survey of South East London, with a 71.9% household participation rate. Anonymised survey data for participants was linked with EHR, generating survival data for time-to-first-contact. Cox regression was used to assess associations between unemployment and time to first contact with mental health services.

The rate in the unemployed was 22.84 contacts per 1000 person-years, and in those not unemployed, it was 10 contacts per 1000 person-years. The crude (age-adjusted) hazard ratio (HR) for unemployment was 3.09 (95% CI: 1.66–5.75). The HR for contact for unemployment, after adjusting for age, gender, ethnicity and education, was 2.8 (95% CI: 1.44–5.47). On addition of symptoms of common mental disorder, post-traumatic stress, psychosis and suicide attempts, to the model, unemployed participants remained at elevated risk (HR:2.65, 95% CI: 1.33–5.27). Finally, illicit drugs and alcohol had minimal influence on estimates, giving a fully-adjusted estimate for the association between unemployment and rate of contact of 2.6 (95% CI: 1.31–5.14).

Unemployment was associated with a greater than two-fold increase in risk of accessing mental health care for the first time within the observation time, after adjustment for sociodemographic confounders, psychopathology, and substance use. Explanations for this association could include unobserved confounding, health behaviours associated with unemployment or effects of unemployment on stress processing.

The authors have not supplied their declaration of competing interest.