European Psychiatry - Volume 41 - April 2017

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S160 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169
R.M. Jeppesen ∗, T. Christensen
External researcher, Department of psychiatry- Aarhus University
Hospital Risskov Skovagervej 2 DK-8240 Risskov, Aarhus N, Denmark
∗ Corresponding author.
Introduction The Danish psychiatric system has gone through
several structural changes in the last four decades. The deinstitu-
tionalization of the mental healthcare system was implemented in
Denmark in the late 1970s with the intention of increasing outpa-
tient treatment. One of the aims in the reorganization was to treat
the patient in the local environment rather than during long-term
hospitalization.
Objectives This study focuses on the changes in the utilization of
hospital facilities for patients diagnosed with schizophrenia.
Aims The aims of this study were to analyze the development
of admission/readmission, bed days and occupancy rates over four
decades (1970–2012) inDenmark in schizophrenia treatment using
admission statistics for in-patients only.
Methods Using register data from secondary healthcare treat-
ment of patients diagnosed with schizophrenia in Denmark
1970–2012, we analyzed the development in the use of hospital
facilities.
Results Our major findingwas a 220% increase between 1970 and
2012 in the total number of hospital admissions due to schizophre-
nia each year, while at the same time the number of annual
schizophrenia bed days was reduced by 76%. Furthermore, the
readmission rate within a year after discharge with a diagnosis
of schizophrenia reached 70% in 2012 compared to 51% in 1970.
Finally, the total bed occupancy continued to rise over the four
decades and has exceeded 100% in several years since 1999.
Conclusion The findings indicate that the reorganization of the
Danish mental healthcare system has created a problem of “revolv-
ing door” schizophrenia patients’ who since the 1970s have been
increasingly hospitalized but for shorter periods.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0164
Pathways to care and patterns of care
in first episode psychosis patients
treated in community based-mental
health services. A 5-years follow-up
from the PICOS
E. Miglietta ∗, A. Lasalvia , C. Comacchio , D. Cristofalo ,
C. Bonetto , S. Tosato , K. De Santi , G. Zanatta , S. Petterlini ,
S. Zoppei , G. Dimitri , C. Cremonese , L. Ramon , M. Ruggeri
1 University of Verona, Department of Neurosciences, Biomedicine
and Movement Sciences, Section of Psychiatry, Verona, Italy
2 Psychiatric Clinic, Department of Neuroscience, University of Padua,
Italy, Padua, Italy
3 NHS Local Health Authority Portogruaro, Department of Mental
Health, Portogruaro, Italy
∗ Corresponding author.
Introduction International treatment guidelines recommend that
key elements to reduce the burden of psychosis are the early iden-
tification of people and the adoption of specific evidence based
interventions.
Objectives To investigate the pathway to care and patterns of
interventions provided by community based-mental health ser-
vices (CMHS) to a cohort of first-episode psychosis (FEP) patients
over 5-years period, exploring in which degree guidelines are met
in routine clinical practice.
Methods Study conducted in the context of the Psychosis Incident
Cohort Outcome Study (PICOS), a multisite naturalistic research
conducted in the Veneto Region (Italy) on FEP patients in a 4.6
million inhabitants catchment area. A comprehensive set of stan-
dardized measures was used, including ad hoc schedules to collect
information on referrals to psychiatric services and on pharma-
cological and psycho-social treatments according to a multiwave
follow-up design (1-, 2- and 5 years).
Results Three hundred and ninety-seven FEP patients were
assessed at BL, 286 at 1 year, 233 at 2 years and 205 at 5 years. 47.4%
of patients were helped to seek care by a relative and more than
one half entered the treatment route through an emergency access.
Regarding the interventions received, 96% of patients had been pre-
scribed neuroleptics and atypical were the most prescribed class
(66.9%). Only half received a psychosocial intervention during the
first year and this percentage progressively decreased at each FU.
Discussion Findings highlight discrepancies between interven-
tions provided by CMHS and the best treatment options
recommended by guidelines, suggesting the need to implement
specific initiatives aiming to close the gap between research and
clinical practice.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0165
The relation between
socio-environmental factors and
intellectual disability: Unraveling the
knot
E. Rondini∗, M. Bertelli , D. Scuticchio
Fondazione San Sebastiano, CREA Centro di Ricerca e Ambulatori,
Florence, Italy
∗ Corresponding author.
Background and aim The current literature indicates that people
with intellectual disabilities (ID) present quantitative and qualita-
tive peculiarities of various socio-environmental factors than the
general population. Although the identification of such peculiari-
tieswould have very important implications for the development of
preventive, rehabilitative and inclusive procedures, valuable data
are still lacking. The aim of the present paper was to assess the
significance of the relationship between socio-environmental vari-
ables in person with ID, with particular reference to individual
history and life contexts.
Methods A consecutively recruited sample of 112 participants
with ID attending residential or clinic/rehabilitative services across
Italy was evaluated by the administration of ISTORIA (Histori-
ographical organized interview for adult intellectual retard), a
semi-structured questionnaire designed to investigate clinical and
personal history of the person. A considerable percentage of the
samples have co-occurent psychiatric disorder. Scores obtained
were statistically processed through frequency analysis and cal-
culation of correlation indexes.
Results Significant correlations were found between the family,
the educational/professional environments, and the inclusion in
society. Further associations concerned social relationships within
and outside the family, the changes of living accommodation, and
the level of environmental stimulation received.
Conclusions Both findings from previous research and the ones
of this work confirm the importance of investigating the mech-
anisms involved in the acquisition of social skills by persons
with ID, through family dynamics and participation in commu-
nity life, as protective factor against the worsening of disabilities
and potentially of psychopathological vulnerability that affects this
population.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.