Social cohesion and artistic resources, Two Clinical cases.

Introduction Two emblematic clinical cases will be addressed in this poster. The purpose of the poster is to relate the aspect of how the artistic resources of psychiatric patients are useful to improve social cohesion. Objectives Correlate psychotherapy work on superior defenses to social cohesion and clinical improvement. Methods Psychopharmacotherapy. Psychoanalytically oriented psychotherapy. Psychiatric rehabilitation. Social jutice idex (Schraad-Tishler, 2015) and BES (Istat 2015) as sources of social cohesion indicators. Results In the first case we have a man with ciclotimic personality disorder and substace abuse with psicotic episodes. Previously, the patient underwent repeated hospitalizations . Once the therapeutic relationship was hooked up and introduced in addition to pharmacological treatment, a psychotherapy also aimed at activating personal resources, the patient began to take an interest in the activity of a street artist. Over time and with the improvement of this activity, aspects of social cohesion have been highlighted in the social context. Social relations both linked to work and affective activity, as well as friends; improvement of the economic situation both through the economic return of this activity and through associative loans linked to this activity; an improvement of social inclusion and non-discrimination in the cities where the artistic activities were carried out; the use of fixed environmental spaces where the activity can be carried out. These aspects have favored a recovery that has reached the complete economic independence of the patient, the establishment of a family unit of their own, the progressive remission of the toxicophilic relapses and therefore the psychotic imbalances they induce. In a second case, we have a 30-year-old patient with a severe depressive disorder, with narcissistic, paranoid and obsessive personality traits, graduated from the Academy of Fine Arts and with an artistic production both before and after the illness. In addition pharmacological therapy, the patient began psychotherapeutic interventions on the enhancement of superior defenses such as sublimation through artistic activity. So she began to rededicate herself to the artistic activity , she however progressively improved the recovery aspects for a long period of time up to living, working and emotional autonomy. During this path the aspects of social cohesion were also decisive, such an economic autonomy linked to the work activity of an employee in an art gallery, a progressive social inclusion, the conquest of spaces where you can exhibit your works and an increase in trust both towards the family and towards health workers and towards friends and work relationships. Image: Image 2: Image 3: Conclusions In this Clinical cases and others not reported exist correlation between psychotherapy work on superior defenses to social cohesion and clinical improvement. Disclosure of Interest None Declared

Introduction: The University Clinic of Skopje -Skopje was part of two Horizon 2020 projects -IMPULSE and RECOVER-e that finished in December 2021. The advances in the field of community mental health in the capital of Skopje, the idea to combine the best aspects of the aforementioned projects and the need of continual implementation and research on an evidence-based communitybased service delivery model for recovery-oriented care led to this study which aims to improve functioning, quality of life, and mental health outcomes for people with severe and enduring mental ill health, such as schizophrenia, bipolar disorder, severe depression. Objectives: The objectives of the study are: -to design, implement and evaluate recovery-oriented care for people with severe mental illness in community settings using a psychosocial digital intervention -DIALOGþ;-to recognize the value of experiential knowledge through inclusion of peer experts as members of community mental health teams;-to develop scale-up plans for national decisionmakers, as informed by the intervention's implementation and impact, for sustained implementation and scale up after the research study's timeline.-to improve the conditions of people suffering from psychotic disorders and to overcome financial barriers encountered in the treatment of psychotic disorders in N. Macedonia. Methods: DIALOGþ represents an affordable and effective intervention which has already demonstrated positive outcomes in previous research. This study involves the use of the DIALOGþ intervention during home visits, so that patients themselves can decide which aspects of their life that they would like to discuss and work on improving. DIALOGþ lets them rate 12 domains that are related to quality of life, such as physical health, relationships and employment. Patient decide which of these they would like to discuss in detail during the meeting. There is then a 4-step approach to help improve this aspect of their life, using the principles of solution-focused therapy. Researchers will collect information about demographic characteristics, quality of life, and symptoms in patients taking part in the study through the administration of questionnaires and clinical scales. Results: The study is still in phase of completion. The results will be shown at the EPA Congress 2023.
Conclusions: Having the previous positive outcomes from IMPULSE and RECOVER-e, with this combined approach we expect even more improvement in functioning and better quality of life in patients suffering from severe and enduring mental ill health. Introduction: Most studies on post-traumatic stress disorder (PTSD) have involved a small sample size and a specific traumatic event, with few studies reporting on subjects who have been continuously exposed to a traumatic event. Timely assessment and treatment are crucial for individuals chronically exposed to a traumatic event.

Disclosure of Interest: None Declared
Objectives: This study investigated the prevalence of PTSD and associated factors in all residents of Gangjeong village, who, recently, have been exposed to a traumatic event for a prolonged period. Methods: The subjects of this study were the residents of Gangjeong village, who have been exposed to a traumatic event related to the construction of the Jeju Civilian-Military Complex Port. The survey included items related to general characteristics and PTSD symptoms, which were assessed using the Impact of Event Scale-Revised, Korean version. Results: The prevalence of PTSD symptoms was 26.8% (95% confidence interval=23.54-30.04). Multivariate logistic regression analysis identified age, length of residence, and marital status as factors significantly associated with PTSD symptoms. Conclusions: The prevalence of PTSD symptoms was higher among the study population than in the general population. Economically active age groups, people exposed to the traumatic event throughout their duration of residence in the village, and unmarried individuals were found to be more likely to develop PTSD symptoms. Mental, social, and financial support should be directed to the affected groups of individuals. Introduction: Two emblematic clinical cases will be addressed in this poster. The purpose of the poster is to relate the aspect of how the artistic resources of psychiatric patients are useful to improve social cohesion.

Disclosure of Interest: None Declared
Objectives: Correlate psychotherapy work on superior defenses to social cohesion and clinical improvement. Methods: Psychopharmacotherapy. Psychoanalytically oriented psychotherapy. Psychiatric rehabilitation. Social jutice idex (Schraad-Tishler, 2015) and BES (Istat 2015) as sources of social cohesion indicators. Results: In the first case we have a man with ciclotimic personality disorder and substace abuse with psicotic episodes. Previously, the patient underwent repeated hospitalizations . Once the therapeutic relationship was hooked up and introduced in addition to pharmacological treatment, a psychotherapy also aimed at activating personal resources, the patient began to take an interest in the activity of a street artist. Over time and with the improvement of this activity, aspects of social cohesion have been highlighted in the social context. Social relations both linked to work and affective activity, as well as friends; improvement of the economic situation both through the economic return of this activity and through associative loans linked to this activity; an improvement of social inclusion and non-discrimination in the cities where the artistic activities were carried out; the use of fixed environmental spaces where the activity can be carried out. These aspects have favored a recovery that has reached the complete economic independence of the patient, the establishment of a family unit of their own, the progressive remission of the toxicophilic relapses and therefore the psychotic imbalances they induce. In a second case, we have a 30-year-old patient with a severe depressive disorder, with narcissistic, paranoid and obsessive personality traits, graduated from the Academy of Fine Arts and with an artistic production both before and after the illness. In addition pharmacological therapy, the patient began psychotherapeutic interventions on the enhancement of superior defenses such as sublimation through artistic activity. So she began to rededicate herself to the artistic activity , she however progressively improved the recovery aspects for a long period of time up to living, working and emotional autonomy. During this path the aspects of social cohesion were also decisive, such an economic autonomy linked to the work activity of an employee in an art gallery, a progressive social inclusion, the conquest of spaces where you can exhibit your works and an increase in trust both towards the family and towards health workers and towards friends and work relationships. Image: Conclusions: In this Clinical cases and others not reported exist correlation between psychotherapy work on superior defenses to social cohesion and clinical improvement. Introduction: The recent approval of euthanasia in the Spanish legal code and its posible extension to psychiatric patients opens an unprecedented scenario in the Iberian country. We analize the experience of the Netherlands, a country where euthanasia has been in practice for over two decades, in order to foresee epidemiological trends that could be replicated in Spain. Objectives: To review the legislation on euthanasia in Spain and the Netherlands, as well as the epidemiological data regarding euthanasia applicants affected by mental health conditions in the Netherlands, to predict future epidemiological trends in a similar population in Spain. Methods: We studied the legislation on euthanasia in Spain and the Netherlands, as well as the directives of the Regional Commisions for Euthanasia in the Netherlands to analize differences and similarities between the legal codes on both countries. We also sought epidemiological data regarding the application of euthanasia on psychiatric patients in the Netherlands, gathering data from seven articles in English language obtained through a search in PubMed using the MeSH terms "Euthanasia" AND "Netherlands" and "Psychiatry". Results: Euthanasia on psychiatric patients in the Netherlands has been a practice on the rise during the last decade, despite the elevated proportion of rejected applications and the high survival rate of this patients in later longitudinal studies. Affective disorders and personality disorders stand out as major psychiatric causes between the applicants. The Spanish legislation bears important resemblance to its Dutch predecessor, but also significant differences. Conclusions: The available data on the application of euthanasia on mental health patients in the Netherlands show an in increasing trend regarding the execution of this practice, specially on patients who gather distinct clinical features. The data provided by the Dutch experience could have some replication in Spain, as well as anticipate possible future ethical conflicts regarding the application of this service.

EPV0521
Socio-demographic characteristics and clinical profile among suicide attempters R. Ouali 1 *, R. Masmoudi 1 , F. Guermazi 1 , F. cherif 1 , I. Feki 1 , O. Chakroun 2 , E. Derbel 3 , R. sellami 1 , J. Masmoudi 1 and N. Rekik 2 Introduction: Suicide is a real public health problem. Like many other countries, Tunisia seems to be experiencing an amplification of the phenomenon. Suicide attempts are much more frequent and are estimated to be around 20 times the number of suicides Objectives: The objective was to describe the sociodemographic characteristics and clinical profile of suicide attempters in patients hospitalized in the emergency room. Methods: This study was carried out with patients admitted to vital emergencies for attempted suicide over a period of 6 months. A pre-made questionnaire was used to collect sociodemographic and clinical data. We used the SIS "suicide intention scale" to assess the intent of the suicide attempt and the PHQ9 "PATIENT HEALTH QUESTIONNAIRE" to assess the presence and severity of depressive symptoms. We excluded Patients with major cognitive impairment, which prevents understanding of the questionnaire. Results: Our sample consisted of 101 patients. Of the participants, 69.3% were female. Their age varied between 18 and 65 years with an average age of 30.93 years. The socioeconomic level was low in 23.8% of cases. The level of education did not exceed secondary school for 91% of suicides. Almost half of suicide attempters (45%) have been professionally inactive. Participants included in our study were single in 51.5% of cases. Participants had a family history of attempted suicide in 15% of cases. Prior psychiatric follow-up was found in 34% of suicides attempts. More than a third (36.6%) of participants had moderate to severe depression according to the results of the PHQ-9. Recurrences concerned 44% of suicides attempt in our survey and the average number of previous suicides attempts was 3.9. Suicidal intent was rated strong in 47% of suicides attempts . Conclusions: Suicidal behavior is one of the leading causes of death and disability worldwide. In our study, more than 1 in 3 suicide attempters had depression. Further research is needed to identify suicide risk factors and to examine the relationship between the presence of mental illness and suicidal attempt