Werther effect in the juvenile population. About a series of cases

Introduction Suicide is currently one of the biggest public health problems, it is the third cause of death in the age group between 15 and 29 years (16.36% of young people who died in 2013). The ‘Werther effect’ refers to the mimetic behavior of the suicidal act, thus making reference to the controversial novel “The Sorrows of Young Werther” by Goethe, in 1774. The population most susceptible to this influence is the most vulnerable and ambivalent, such as they can be adolescents and young people, people with personality disorders and drug use. Durkheim considered that imitation was not due to the contagion effect of making suicides public, but to the social conditions of some places, which were what caused people to commit suicide. Objectives The objective of the case is to expose the vulnerability to the imitation of suicidal behaviors of young people suffering from personality disorder and drug use. Methods We present the case of 4 young people between 18 and 21 years old (3 women and 1 man) from the same group of friends who, after the death by suicide of a 20-year-old boy, in the following 2 months, carried out suicidal behavior by taking medication they found at home and consumption of different drugs. Results The two 21-year-old patients planned for the first month of the anniversary of the friend’s death, the intake of drugs and medication and leave a farewell note explaining the reasons. The patients required hospitalization in an acute mental health unit, one patient developed myocarditis secondary to toxins, during hospitalization they undergo psychotherapeutic treatment and are evaluated, leading to the diagnosis of Borderline Personality Disorder and Multiple Drug Use Disorder. The 20-year-old patient took medication on the anniversary month but did not require hospitalization. He underwent outpatient follow-up at a day hospital. During the therapeutic process, he was diagnosed with schizoid personality disorder. The 18-year-old patient required hospitalization for structured self-injurious ideation with a risk of acting out at 2 months, psychotherapeutic treatment was started and she was diagnosed with borderline personality disorder and harmful drug use. The 4 young people continue outpatient follow-up by both the community mental health unit and the addiction treatment center. Conclusions We observe in the series of cases exposed, the vulnerability of young people suffering from personality disorders and drug use to suicidal behavior, so risk factors for their prevention must be identified and continue working on adequate information of suicidal acts, whether completed or not, to avoid imitation phenomena. In all cases, suicide should not be seen as a desirable alternative and strategies to cope with difficulties and emotional management should be offered and promoted, especially in this young population that is still developing and is more vulnerable. Disclosure of Interest None Declared

Introduction: More than 90 percent of patients who attempt suicide have a psychiatric disorder.The diagnosis of schizophrenia is associated with a decrease in life expectancy of about 10 years, with suicide being the most important related factor.Literature suggests that the risk of suicide death in this population has been found to be 10 to 20 times higher than that in the general population Objectives: To present a case report of a patient with a first psychotic episode and suicide attempt focusing on clinical features and risk factors.Methods: Presentation of a clinical case supported by a nonsystematic review of literature containing the key-words "suicide", "Suicidal ideation", "psychosis" and "schizophrenia".Results: This is a case report of a male 28-year-old patient, with no known psychiatric history, admitted to our inpatient service after a suicide attempt by precipitation.In a first evaluation, the patient presented psychotic symptoms consisting of paranoid delusions, auditory hallucinations, tendency to social isolation and the appearance of self-harming ideation in the days prior to the episode.After initiation of antipsychotic medication, a significant improvement in positive symptoms was observed.The patient has since had no delusions or hallucinations and is living independently at home.Contemporary research studies indicate that the lifetime rate of completed suicide in individuals with schizophrenia is between 4% and 13%.Several specific risk factors have been described in the schizophrenia population, such as early stage of the illness, lack of adherence to treatment, recurrent relapses, comorbid depression and the paranoid subtype.The antipsychotic treatments with the most scientific evidence are clozapine, risperidone, olanzapine and quetiapine.Within psychotherapy, cognitive behavioral therapy appears to be the most effective.

Conclusions:
-It is important to know the risk factors that are associated with an increased risk of suicide in patients diagnosed with schizophrenia.-An early intervention and specific treatment can improve prognosis of this population.

EPV1076
Werther effect in the juvenile population.About a series of cases M. Valverde Barea1 *, A. Alvarado Dafonte2 , L. Soldado Rodriguez3 and A. España Osuna 1 Introduction: Suicide is currently one of the biggest public health problems, it is the third cause of death in the age group between 15 and 29 years (16.36% of young people who died in 2013).The 'Werther effect' refers to the mimetic behavior of the suicidal act, thus making reference to the controversial novel "The Sorrows of Young Werther" by Goethe, in 1774.The population most susceptible to this influence is the most vulnerable and ambivalent, such as they can be adolescents and young people, people with personality disorders and drug use.Durkheim considered that imitation was not due to the contagion effect of making suicides public, but to the social conditions of some places, which were what caused people to commit suicide.

S1112 E-Poster Viewing
Objectives: The objective of the case is to expose the vulnerability to the imitation of suicidal behaviors of young people suffering from personality disorder and drug use.Methods: We present the case of 4 young people between 18 and 21 years old (3 women and 1 man) from the same group of friends who, after the death by suicide of a 20-year-old boy, in the following 2 months, carried out suicidal behavior by taking medication they found at home and consumption of different drugs.

Results:
The two 21-year-old patients planned for the first month of the anniversary of the friend's death, the intake of drugs and medication and leave a farewell note explaining the reasons.The patients required hospitalization in an acute mental health unit, one patient developed myocarditis secondary to toxins, during hospitalization they undergo psychotherapeutic treatment and are evaluated, leading to the diagnosis of Borderline Personality Disorder and Multiple Drug Use Disorder.The 20-year-old patient took medication on the anniversary month but did not require hospitalization.He underwent outpatient follow-up at a day hospital.
During the therapeutic process, he was diagnosed with schizoid personality disorder.The 18-year-old patient required hospitalization for structured self-injurious ideation with a risk of acting out at 2 months, psychotherapeutic treatment was started and she was diagnosed with borderline personality disorder and harmful drug use.The 4 young people continue outpatient follow-up by both the community mental health unit and the addiction treatment center.
Conclusions: We observe in the series of cases exposed, the vulnerability of young people suffering from personality disorders and drug use to suicidal behavior, so risk factors for their prevention must be identified and continue working on adequate information of suicidal acts, whether completed or not, to avoid imitation phenomena.In all cases, suicide should not be seen as a desirable alternative and strategies to cope with difficulties and emotional management should be offered and promoted, especially in this young population that is still developing and is more vulnerable.

EPV1077
Journey of young self-harm survivors from being vulnerable to resilient: Participants' perspective on a culturally-adapted self-harm prevention intervention Introduction: Repeated self-harm represents the single strongest risk factor for suicide.Worldwide, suicide is the second leading cause of death in young people aged 15-29 year, and the leading cause of death in many Asian countries.
Objectives: This qualitative study was nested in a multi-center effectiveness trial of a Youth Culturally-adapted Manual Assisted Problem-solving intervention (Y-CMAP) for prevention of self-harm in Pakistan and aimed to explore young people's perspective on the intervention.Methods: One-to-one in-depth qualitative interviews were conducted with 20 participants from 5 cities across Pakistan, using a semi-structured topic guide to explore their views about self-harm, Y-CMAP intervention content, perceived effectiveness and challenges.Interviews were conducted in Urdu language, digitally recorded, transcribed verbatim and translated into English.Thematic analysis was conducted by the trained qualitative researchers.
Results: Interpersonal conflicts including relationship difficulties, financial problems, and lack of social support were highlighted as precipitating factors of self-harm.Participants reported that Y-CMAP intervention is structured and easy to understand.They acknowledged the role of distraction techniques, cost-benefit analysis, discussion on thinking pattern, problem-solving and anger management in improving their mental health and wellbeing and reduce self-harm.Participants also shared their initial fears regarding the intervention, such as fear of disclosure of information to media.School and job timings were described as potential challenges for participation in the intervention.
Conclusions: Exploring the perspectives of young people about culturally-appropriate intervention is imperative in their journey towards preventing suicide, which is a preventable cause of premature death.Findings are particularly relevant for Pakistan, one of the youngest nations in the world with limited resources for suicide prevention.
Disclosure of Interest: None Declared

EPV1078
The qualitative study of intentional self-harm in Thailand: Focusing on predisposing child -rearing environments and self-harm cessation

N. Limsuwan
Introduction: Intentional self-harm in adolescents and young people included both suicidal behaviors and nonsuicidal self-injury (NSSI) is a serious issue in mental health systems.However, the majority of studies on self-harm in adolescents and young people focused on quantitative methodology which might has limitations to explain this complex phenomenon of intentional self-harm.
Objectives: This study aimed to describe the subjective experiences of adolescents and young people who presented with intentional self-harm in order to provide better understanding of this behavioral phenomenon.Methods: This is an exploratory qualitative study used phenomenological processes and thematic analysis.
Results: Twenty subjects aged 13-29 years were included in this study.The results revealed 6 themes regarding predisposing childrearing environments and 9 themes regarding factors related to cessation of intentional self-harm.