European Psychiatry - Volume 41 - April 2017

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S154 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169
Objectives From a sample that is made up of 100 YPCL, the main
objective is to deduce the social determinants, which encourage the
criminal desistance in YPCL, it means young people who commit
crimes.
Aims To infer the social determinants (circumstances in which
people are born, grow, live, including the health system) which
foster the desistance in YPCL.
Methods The results of a sample of 100 YPCL were assessed with
three profiles as follows: I: DSM-IV personality disorders (PD T-
Scores). II: swap personality syndromes (Q-Factor T-Scores). III.
factor T-scores.
Results This research shows the prevalence of the following
social determinants associated with the desistance: (1) integrated
families. (2) Educational and cultural opportunities (3) academic
progress. (4) Healthy relationships that support and help. (5) Sta-
ble living arrangements (6) social conditions preserved the use of
psychoactive substances and alcohol abuse.
Conclusions It is possible to identify the prevalence of social
determinants which encourage the desistance in YPCL. Those
allows them to transform their risk path in another that shows a
positive development, associated with individual transformations
that take them away from the criminal life and reintegrate into the
community.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EW0146
Assessing violence in psychosis –
A clinical prediction rule
F. Seena ∗, A. Wolf , T. Fanshawe
1 University of Oxford, Psychiatry, Oxford, United Kingdom
2 University of Oxford, Department of Primary Health Care Sciences,
Oxford, United Kingdom
∗ Corresponding author.
Background Current approaches to stratify patients with psy-
chosis into risk groups are limited by inconsistency, variable
accuracy, and unscalability.
Methods This paper will present an overview of current
approaches based on a systematic review. It will also present a
novel scalable approach based on a total national cohort of 75 158
Swedish individuals aged 15–65 with a diagnosis of severe mental
illness (schizophrenia, schizophrenic-spectrum, bipolar disorder,
and other psychotic illnesses). We developed predictive models
for violent offending through linkage of population-based registers
and tested them in external validation. We measured discrimina-
tion and calibration for prediction of violent offending at 1 year
using specified risk cut-offs.
Findings : A 16-item model was developed from pre-specified
routinely collected criminal history, socio-demographic and clin-
ical risk factors. In external validation, the model showed good
measures of discrimination (c-index 0.89) and calibration. For risk
of violent offending at 1 year, using a 5% cut off, sensitivity was
64% and specificitywas 94%. Positive and negative predictive values
were 11% and 99%, respectively. The model was used to generate a
simple web-based risk calculator (OxMIV).
Interpretation We have developed a prediction score in a national
cohort of all patients with psychosis that can be used as an adjunct
to decision-making in clinical practice by identifying those who
are at low risk of future violent offending and higher risk individ-
uals who may benefit from additional risk management. Further
evaluation in other populations and countries is needed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0147
Forensic psychiatric assessment of
individuals with mental and
behavioral disorders due to use of
alcohol, who committed homicide
A. Survilaite
National forensic psychiatry service, adult department, Vilnius,
Lithuania
Introduction The rate of pure alcohol consumption per capita in
Lithuania is reported to be one of the highest in Europe Union.
Many studies illustrate the relationship between alcohol and vio-
lent crimes. Though dual diagnosis of severe mental disorder and
alcohol dependency is common.
Aim To evaluate peculiarities of mental status of individuals with
mental disorders due to use of alcohol, who had committed homi-
cide.
Methods Forensic psychiatry examination reports in alcohol con-
sumption cases and homicide acts ( n 110) were taken from archive
of national service of forensic psychiatry in Lithuania, 2010–2014.
Results In total, 93% (n 91) men and 100% (n 12) women at the
time of homicide act were under the influence of alcohol. A total
of, 83% ( n 91) of cases reported impulsiveness, emotional lability
and personality degradation due to long term of alcohol consump-
tion; 52% (n 57) of cases motives for violence remained unclear:
offenders indicated they remember nothing because of alcohol
intoxication, also possiblemalingeringwas evaluated. In total, 100%
women (n 12) and 97%men (n 95)were criminally responsible. Only
2 individuals committed homicide as a result of psychosis due to
paranoid schizophrenia and 1 individual had significant intellec-
tual deficiency due to moderate mental retardation, which lead
them to inability to appreciate the dangerous nature of their acts
and to control their behavior. Compulsory medical treatment was
recommended to all three of them.
Conclusion Impulse control deficiency and emotional lability are
prevalent amongst homicide offenders with mental disorders due
to use of alcohol. Only 3 individuals were irresponsible for their
criminal acts as a result of severe mental disorders.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EW0148
Assessments of need for treatment
and danger in decisions about
community treatment orders
H.K. Stuen , A. Landheim , J. Rugkåsa , R. Wynn ∗
1 Innlandet Hospital Trust, Norwegian National Advisory Unit on
Concurrent Substance Abuse and Mental Health Disorders,
Brummundal, Norway
2 Akershus University Hospital, Health Services Research Unit,
Lørenskog, Norway
3 UiT The Arctic University of Norway, Department of Clinical
Medicine, Tromso, Norway
∗ Corresponding author.
Background A total of, 14 Norwegian assertive community treat-
ment (ACT) teams have been established. During the teams’ first
year of operation, approximately 35% of the enrolled patients were
subjected to community treatment orders (CTOs) at intake. CTOs
are a legal mechanism to secure treatment adherence, and may be
used in Norway when severely mentally ill patients refuse neces-
sary treatment (‘treatment criterion’) or when they are considered
a danger to themselves or others (‘danger criterion’). Even if the use
of CTOs seems to increase in Norway, few have examined in detail
how and why these decisions are made. The purpose of the present
study was to explore assessments of need for treatment and danger
in decisions about CTOs.