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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S303–S364



A neuro-developmentally sensitive

and trauma informed service delivery

approach for child and youth mental

health and psychiatry

T. Wilkes

1 ,

, E. Wang


, B. Perry



Foothills medical centre, psychiatry, Calgary, Canada


Hull services, NMT service director, Calgary, Canada


Child trauma academy, psychiatry and behavioral services,

Houston, USA

Corresponding author.

This presentation will introduce the innovative approach to child

and youth mental health and psychiatry using the neurosequen-

tial model of therapeutics (NMT). This is a neuro-developmentally

sensitive and trauma informed approach and acknowledges the

importance of early experiences shaping the organization of the

brain. An outline of the stress response and its relevance to hyper-

arousal and dissociative responses will be discussed as this impacts

attachment and the reward neuro-biology. The hierarchy of brain

development will be emphasized in the clinical approaches to

child psychiatry especially in reference to child maltreatment and

neglect. The critical role of sensory integration, self regulation,

relational health and cognitive development in treatment plan-

ning will be discussed versus the categorical diagnosis of ADHD,

autism, bipolar disorder and depression. This has profound eco-

nomic and psychopharm practice implications in child and youth

mental health treatments. Consequently the importance of these

concepts in informing public policy for early child development

and school mental health literacy will be emphasized. Additionally

the outcome of these approaches on the reduction of staff turno-

ver, critical incidents in schools and residential placements will be


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Family-based whole exome

sequencing of autism spectrum

disorder reveals novel de novo

variants in Korean population

H. Yoo

1 , 2 ,

, S.A. Kim


, M. Park


, J. Kim


, W.J. Lim

5 , 6

, D.H. Noh



D.W. Han


, C. Shin


, N. Kim

5 , 6


Seoul national university Bundang hospital, psychiatry, Seongnam,

Republic of Korea


Seoul national university college of medicine, psychiatry, Seoul,

Republic of Korea


Eulji university, pharmacology, Deajon, Republic of Korea


Eulji university, epidemiology, Deajon, Republic of Korea


Korea research institute of bioscience and biotechnology,

personalized genomic medicine research center, Deajon, Republic of



Korea university of science and technology, functional genomics,

Deajon, Republic of Korea


Konkuk university, school of medicine, stem cell biology, Seoul,

Republic of Korea


Konkuk university, school of medicine, pharmacology, Seoul,

Republic of Korea

Corresponding author.


The objective of this family-based whole exome

sequencing (WES) is to examine genetic variants of autism spec-

trum disorder (ASD) in Korean population.


The probands with ASD and their biological parents

were recruited in this study. We ascertained diagnosis based

on DSM-5


criteria, using Autism Diagnostic Observation Sche-

dule and Autism Diagnostic Interview–Revised. We selected

probands with typical phenotypes of ASD both in social inter-

action/communication and repetitive behaviour/limited interest

domains, with intellectual disability (IQ < 70), for attaining homo-

geneity of the phenotypes. First, we performed WES minimum



for 13 probands and high-coverage pooled sequencing for

their parents. We performed additional WES for 38 trio families,

at least 100


depth. De novo mutations were confirmed by Sanger

sequencing. All the sequence reads were mapped onto the human

reference genome (hg19 without Y chromosome). Bioinformatics

analyses were performed by BWA-MEM, Picard, GATK, and snpEff

for variant annotation. We selected de novo mutation candidates

from probands, which are neither detected in two pooled samples

nor both parents.


Fifty-one subjects with ASD (5 females, 40

175 months,

mean IQ 42) and their families were included in this study. We

discovered 109 de novo variants from 46 families. Twenty-nine

variants are expected to be amino acid changing, potentially cau-

sing deleterious effects. We assume CELSR3, MYH1, ATXN1, IDUA,

NFKB1, and C4A/C4B may have adverse effect on central nerve sys-



We observed novel de novo variants which are assu-

med to contribute to development of ASD with typical phenotypes

and low intelligence in WES study.

Disclosure of interest

Thiswork has been supported byHealthcare

Technology R&D project (No: A120029) by Ministry of Health and

Welfare, Republic of Korea.

e-Poster Walk: Comorbidity/Dual pathologies and

guidelines/Guidance - Part 2


Dual diagnosis and treatment:

The experience of a multiprofessional

team in mental health

J. Jaber

, J. Verissimo Jr , J. Mendonc¸ a , M. Schwartz , S. Leite ,

S. Humel , A. Moravia , T.T. Raposo , M. Garrido , E. Halabi ,

A. Hollanda , B. Reys

Clínica Jorge Jaber, Saúde Mental, Rio de Janeiro, Brazil

Corresponding author.


The work was developed with the people hospitali-

zed in the period of 1 year in a psychiatric clinic inRio de Janeiro city,

Brazil. 175 patients who presented dual diagnosis were evaluated.


The research aims to know the distribution of themost

frequent psychiatric diagnosis associated with the disorders for the

use of psychoactive substances. The work also has as objective to

assess the treatment of patients carrying these disorders so that

there is a better efficiency of the individual treatment plan.


The work consisted of the evaluation of all patients

who were admitted to the clinic in the period of 1 year, using

the ICD-10 for the diagnosis of dual pathologies. All the patients

were assessed by the multiprofessional team, composed by gene-

ral practicioner, psychiatrist, psychologist, pharmaceutic, therapist

in chemical dependence, family therapist and physiotherapist. The

patients were treated with the use of psychopharms, cognitive

behavioral psychotherapy, 12-step program, art therapy andmode-

rate physical activity. Family members of all patients were also



In the evaluation conducted by the team, it was found

the following distribution of the most frequent diagnosis associa-

ted to disorder for the use of psychoactive substances: depression

(26.3%), personality disorder (22.9%), bipolar disorder (22.3%), non-