European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302 S249
EW0419
A study of patient’s perspective of
schizophrenia using emic perspective
D. Sanyal ∗, D. Das
1 KPC Medical College, Jadavpur, Psychiatry, Kolkata, India
2 Manasi Mental Health Service Centre-Nanda-Singur, Psychiatry,
Hoogly, India
∗ Corresponding author.
Introduction Knowledge about how patients perceive mental ill-
ness and how it possibly influences help seeking behaviour is
important in development of proper plan for mental health reform.
Objective This study planned to study disease related percep-
tion, first help seeking behaviour and stigma among schizophrenia
patients admitted at a hospital.
Aims (1) To know about patient’s view regarding the problems;
(2) attempt to predict help seeking behaviour.
Methods Fifty-one patients suffering from schizophrenia accord-
ing to DSM-5 and fit to be interviewed were assessed using EMIC
(Explanatory Model Interview Catalogue) to get emic (insider or
person’s own cultural) perspective of disease related perception,
help seeking behaviour and stigma.
Results Terms used to describe their illness included “depres-
sion” (21.6%), “mental” (17.6%) “matha kharap” (9.8%). Most
common perceived cause was stress (25.5%) and sorcery (23.5).
Mental health specialist was visited by 27.5% Faith healer consul-
tation was high (29.4%). Stigma score was higher with marriage
related issues and social isolation. Using exhaustive CHAID analy-
sis, it was found that patientswith negative themes as disease name
like “matha kharap” (loosely meaning crazy) are more likely to visit
faith healers, while patients naming the condition with some med-
ical related term like depression were more likely to visit mental
health specialist.
Conclusion Clearly perception of patients regarding mental ill-
ness and its causation varies greatly from the way psychiatrists’
viewpoint and this perception is likely to influence help seeking
behaviour. Understanding these issues is likely to enable better
patient awareness and proper formulation of plans to address men-
tal health issues.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0420
Neighbourhood ethnic density and
incidence of psychosis – First and
second generation migrants
compared
P. Schofield ∗, J. Das-Munshi , L. Becares , E. Agerbo
1 King’s College London, Division of Health & Social Care Research,
London, United Kingdom
2 King’s College London, Health Service & Population Research
Department, Institute of Psychiatry, Psychology & Neuroscience,
London, United Kingdom
3 The University of Manchester, Centre on Dynamics of Ethnicity,
Manchester, United Kingdom
4 Aarhus University, CIRRAU, Centre for Integrated Register-based
Research, Aarhus, Denmark
∗ Corresponding author.
Introduction Living in an area with few people from the same
ethnic background has been associated with increased incidence
of psychosis (the ethnic density effect).
Objectives Compare associations between neighbourhood eth-
nic density and incidence of non-affective psychosis for first and
second generation migrants.
Methods Population based cohort (2.2 million) of all those born
1st January 1965 or later and living in Denmark on their 15th birth-
day. We looked at a total of 106,000 migrants, including 62% first
generation migrants. Ethnic density was determined at age 15 and
we adjusted for age, gender, calendar period, parental psychiatric
history and parental income at age 15.
Results For the first generation, we found no evidence that
rates of non-affective psychosis were related to neighbourhood
ethnic density for migrants from Africa (comparing lowest and
highest quintiles): IRR 1.02 (95% CI 0.6–1.73), and the Mid-
dle East: IRR 0.96 (CI 0.68–1.35) and only weak evidence for
migrants from Europe (excluding Scandinavia): IRR 1.35 (CI
0.98–1.84). Conversely, for the second generation rates of non-
affective psychosiswere increased formigrants fromAfrica in lower
ethnic density neighbourhoods (comparing lowest and highest
quintiles): IRR 3.97 (95% CI 1.81–8.69), Europe (excluding Scan-
dinavia): IRR 1.82 (CI 1.28–2.59) and the Middle East: IRR 2.42
(CI 1.18–4.99).
Conclusions There is strong evidence for an area ethnic den-
sity effect on psychosis incidence for second generation migrants,
but not for first generation migrants. This could reflect a greater
resilience among the latter group to the adverse effects of minority
status.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0421
What is the prevailing diagnosis on
admission into adult psychiatric
wards? A meta-analysis of trends in
the United Kingdom
A. Shoka ∗, C. Lazzari , Katherine Gower
1 School of Health and Social Care, University of Essex, Colchester,
United Kingdom
2 General Adult Psychiatry, North Essex NHS University Foundation
Trust, Colchester, United Kingdom
∗ Corresponding author.
Introduction There seems to be an upsurge in psychiatric admis-
sions related to female patients with borderline personality
disorder. Does this reflect the actual trend?
Objectives Study of the typology of admission into acute psychi-
atric wards for an adult population.
Aims To understand the trend of actual psychopathology in the
general population admitted into psychiatric wards.
Methods A total population of 197 psychiatric admissions was
diagnosed in the period March 2015–March 2016 in a general psy-
chiatric ward in the United Kingdom. The four major diagnostic
categories were: personality disorder (mostly inclusive of border-
line p.d.) (n = 77), paranoid schizophrenia (n = 24), schizoaffective
(n = 11) and other (n = 82). Meta-analysis of the population ana-
lyzed the results. Gender was divided into 82 male and 125 female
admissions, with 181 informal admissions, 68 under Sections of the
Mental Health Act, and 5 under recall from Community Treatment
Order.
Results Meta-analysis of the whole study showed
a statistically significant heterogeneity in results with Tau
squared t2 = 0.031, Cochrane’s Q (df = 3) = 141.90, P < .001, and
I2 = 97.87, a prevalence of borderline personality disorder over
other diagnoses; a prevalence of female over male admissions,
(t2 = .02, Q (df = 1) = 18.67, P< .001, I2 = 94.64), and a prevalence
of patients admitted informally (t2 = 0.131, Q (df = 2) = 586.366,
P < .001, I2 = 99.65).
Conclusions The prevailing population of acute psychiatric wards
for the general adult population is females who are admitted infor-
mally with diagnosis of borderline personality disorder.