European Psychiatry - Volume 41 - April 2017

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S244 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302
EW0405
Self-stigma, hope, dissociation, and
personality features in treatment of
depressive inpatients resistant to
pharmacotherapy
J. Prasko ∗, M. Ociskova , Z. Sigmundova , P. Kasalova ,
A. Grambal , M. Holubova , M. Marackova , K. Vrbova ,
K. Latalova , M. Slepecky , M. Zatkova , A. Kotianova
1 University Hospital Olomouc, Department of Psychiatry, Olomouc,
Czech Republic
2 Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
3 Faculty of Social Science and Health Care, Constantine the
Philosopher University in Nitra, Department of Psychology Sciences,
Nitra, Slovak Republic
∗ Corresponding author.
Objective The goal of this study was to examine the influence
of dissociation, hope, personality trait and selected demographic
factors in treatment response of this group of patients.
Methods Pharmacoresistant depressive inpatients completed
clinical global impression – both objective and subjective form,
Beck depression inventory, and Beck anxiety inventory at baseline
and after sixweeks of combined pharmacotherapy and psychother-
apy (group cognitive behavioral or group psychodynamic). The
Internalized Stigma Of Mental Illness Scale, Dissociative Expe-
rience Scale Adult Dispositional Hope Scale, and temperament
and character inventory were completed at the start of the
treatment with the intention to find predictors of treatment
efficacy.
Results The study included 72 patients hospitalized for the phar-
macoresistant major depression, 63 of them finished the study.
The mean scores of BDI-II, BAI, subjCGI, and objCGI significantly
decreased during the treatment. BDI-II relative change statistically
significantly correlated with the total ISMI score, discrimination
experience (ISMI subscale), and harm avoidance (TCI-R personality
trait). According to stepwise regression, the strongest factors con-
nected to BDI-II relative change were the duration of the disorder
and discrimination experience (ISMI). ObjCGI relative change sig-
nificantly correlated with the level of dissociation, the total ISMI
score, and hope in ADHS total score, and self-directedness. Accord-
ing to stepwise regression, the strongest factor connected to objCGI
relative change was discrimination experience (ISMI).
Conclusions According to our results, the patients with pharma-
coresistant depressive disorders, who have had more experience
with discrimination because of their mental struggles, showed a
poorer response to treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0406
The major depressive disorder
hierarchy: Rasch analysis of 6 items of
the Hamilton depression scale
covering the continuum of depressive
syndrome
L. Primo de Carvalho Alves ∗, M. Pio de Almeida Fleck , A. Boni ,
N. Sica da Rocha
1 Universidade Federal do Rio Grande do Sul, Programa de
Pós-graduac¸ ão em Psiquiatria e Ciências do Comportamento, Porto
Alegre, Brazil
2 Universidade Federal do Rio Grande do Sul, Faculdade de Medicina,
Porto Alegre, Brazil
∗ Corresponding author.
Objectives Melancholic features of depression (MFD) seem to be
a unidimensional group of signs and symptoms. However, little
importance has been given to the evaluation of what features are
related to a more severe disorder. That is, what are the MFD that
appear only in themost depressed patients. We aim to demonstrate
how each MFD is related to the severity of the major depressive
disorder.
Methods We evaluated both the Hamilton depression rating
scale (HDRS-17) and its 6-item melancholic subscale (HAM-D6) in
291 depressed inpatients using Rasch analysis, which computes
the severity of each MFD. Overall measures of model fit were
mean ( ±SD) of items and persons residual = 0 (±1); low 2 value;
P > 0.01.
Results For the HDRS–17 model fit, mean (± SD) of item residu-
als = 0.35 (±1.4); mean (± SD) of person residuals = –0.15 (±1.09);
2 = 309.74; P < 0.00001. For the HAM-D6 model fit, mean (±SD)
of item residuals = 0.5 (± 0.86); mean (±SD) of person residu-
als = 0.15 (±0.91); 2 = 56.13; P = 0.196. MFD ordered by crescent
severity were depressed mood, work and activities, somatic
symptoms, psychic anxiety, guilt feelings, and psychomotor
retardation.
Conclusions Depressed mood is less severe, while guilt feelings
and psychomotor retardation are more severe MFD in a psychi-
atric hospitalization. Understanding depression, as a continuum of
symptoms can improve the understanding of the disorder and may
improve its perspective of treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0407
Depression among Tunisian young
mothers
O. Zerriaa ∗, O. Moula , S. Ben Saadi , S. Chebli , R. Ghachem
Razi Hospital, B, Mannouba, Tunisia
∗ Corresponding author.
Introduction In the Tunisian cultural context, the mother is in
charge of childcare, housekeeping and the well-being of the whole
family, which can lead to exhaustion and depression.
Objective To estimate the frequency of depression among moth-
ers aged between 20 and 40 years, its consequences and the
possible solutions.
Method Transversal study using an anonymous questionnaire of
26 questions published through social media sites to mother with
young aged children.
Results Three hundred and twenty-seven mothers participated
in the study: 20% of them aged between 20 and 30 years and 80%
between 30 and 40. Ninety-seven percent of the participants were
married; 96% of them had university education. Seventy-nine per-
cent of themwereworkingmothers and 50% of themdid not get any
help in childcare. Forty-two percent of the participants had only 1
child, 49% had 2 children, 8% 3 children and only 1 mother had 4
children. Depressive symptoms were present in 73% of the partici-
pants and were significantly higher among mothers aged between
30 and 40. However, depressionwas certain in only 36% of themand
there was no significant difference between the two age groups.
Eighteen percent of the participants noticed an increase in con-
summation of cigarettes, 31% resorted to tranquilizers, 25% needed
sick leaves, and 2% resorted to alcohol use. Less working hours was
suggested as a solution in 36% cases, sharing house chores in 30%
cases.
Conclusion Depression among young mother is a public health
problem in Tunisia. It is underestimated and not always treated,
which can have a serious impact on the whole family well-being.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.