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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52

briefly reviewed including cross-cultural considerations and devel-

opmental psychology studies on these emotions. Yet this keynote

focuses in the phenomenology and epistemology of guilt and shame

as complex emotions. This includes considering that guilt is experi-

enced in twomoments (decompressed into amoment of negligence

and another of guilt) while shame only in one moment (prolonged

in a “frozen now”). All the inputs have suggested an operational-

ization of epistemic and phenomenic differences considering their

context, formal object, particular object and action tendency. Lastly

it refers to the relation of these experiences with psychopathology

and nosology concerning their adaptive and maladaptive nature,

their relation with empathy as well as their presence in several

disorders such as anxious, depressive and obsessive compulsive


Disclosure of interest

The author has not supplied his declaration

of competing interest.


Shame and guilt inducing drugs

G. DiPetta

Neuropsychiatrist- addiction center consultant, department of

mental health, Naples, Italy

The Author in this presentation examines the role of two com-

plex human experiences, the Guilt and the Shame, in the field of

the substances addiction. The population of abuser can be divided

between users of sedatives and users of stimulants. Sedative drugs

and stimulant drug belong to two different way of being-in-the-

world. Sedative drugs are able to medicate the internal pain, which

is constitutive of the guilt. Stimulant drugs are able to medicate

the dysphoria, which is constitutive of the shame. In the realm of

psychopathology Tellenbach with the concept of premelancholic

personality in the guilty man and Kohut with the concept of narcis-

sism in the tragicman have put the bases for a different typification.

In both cases, the common final result, from a psychopathological

point of view, is a severe crisis of the temporalization.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

Symposium: Challenges in Europe: refugees and

asylum seeker patients in mental health


Suicidal behaviour among asylum

seekers in the Netherlands;

prevalence, background and


C.J. Laban

GGZDrenthe, De Evenaar- North Netherlands centre for transcultural

psychiatry, Beilen/Leeuwarden, The Netherlands


Problems of asylum seekers are multiple and com-

plex. Having experienced pre migration adversities, they face

multiple post-migration living problems in the host country. In clin-

ical practice suicidal ideations and suicidal behavior often occurs.


To increase knowledge and give directions for

preventive measures related to suicidal behavior among asylum



Literature, related to the subject, is summarized.


In this presentation the context of the receptionof asylum

seekers is explained. Data will be shown on suicides and suicidal

attempts among asylum seekers, in comparison with the Dutch

population and with international data. Moreover an overview

of qualitative and quantitative research findings will be shown

on the many risk factors asylum seekers experience: traumatic

experiences, loss, mental health problems, poor living conditions,

fear to be expelled, uncertain future and post migration living

problems. Attention will be given to the situation of imprisoned

undocumentedmigrants in The Netherlands. Hobfolls theory of the

Conservation of Resources will be used to explain the increased

risk for suicidal behavior and suicide among asylum seekers and

undocumented migrants. Prevention strategies contain coopera-

tion to decrease the risk factors, enhance the protective factors,

early detection of signals, and good access to mental health care.


Asylum seekers encounter many risk factors for sui-

cidal behavior and suicide. The impossibility to get control over

their lives and the lack of resources of resilience needs to be rec-

ognized as important risk factors. There is a need for cooperation

between all professionals and volunteers to change this situation.

Disclosure of interest

The author has not supplied his declaration

of competing interest.


How to deal with growing racism and

discrimination against refugees and

asylum seekers in Europe?

L. Küey

Associate professor of psychiatry world, psychiatric association,

Istanbul, Turkey

The growing number of refugees and asylum seekers pouring in

Europe due to wars and armed conflicts constitute a great chal-

lenge for psychiatry and the mental health field. This challenge also

includes the growing racism and discrimination against refugees

and asylum seekers. Discrimination could be defined as the atti-

tudes and behavior based on the group differences. Any group

acknowledged and proclaimed as ‘the other’ by prevailing



and dominant social powers, and further dehumanized may

become the subject of discrimination. In a spectrum from dis-

like and micro-aggression to overt violence towards the other,

it exists almost in all societies in varying degrees and forms; all

forms involving some practices of exclusion and rejection. Hence,

almost all the same specific human physical and psychosocial char-

acteristics that constitute the bases for in-group identities and

reference systems could also become the foundations of discrim-

ination towards the humans identified as out-groups. Added to

this, othering, rising from imagined and generalized differences

and used to distinguish groups of people as separate from the norm

reinforces and maintains discrimination.

Albeit the widespread exercise of discrimination against refugees

and asylum seekers, peoples and mental health professionals also

have a long history of aiming and practicing more inclusive ways

of solving conflicts of interests between in-groups and out-groups.

This presentation will mainly focus on the psychosocial aspects of

the anti-discriminative efforts and search an agenda for the Euro-

pean Psychiatry in this regard.

Disclosure of interest

The author has not supplied his declaration

of competing interest.


Action plan of the WPA: Action plan

which follows the objectives of the

association relating to refugees and

asylum seekers

D. Bhugra

Institute of psychiatry, psychology & Ne, London, United Kingdom