European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S303–S364 S353
EW0719
Referrals and outcomes of assessment
for compulsory admission under the
mental health act 1983 in Norfolk,
England
J.N. Beezhold ∗, D. Fothergill , L. Jervis , G. Mosa , A. Pandey ,
S. Pandey
1 Norfolk and Suffolk NHS foundation trust, mental health liaison
service, Norwich, United Kingdom
2 University of East Anglia, Norwich medical school, Norwich, United
Kingdom
3 Norfolk and Suffolk NHS foundation trust, city 2 community mental
health team, Norwich, United Kingdom
4 Norfolk and Suffolk NHS foundation trust, North community mental
health team, Norwich, United Kingdom
∗ Corresponding author.
Introduction A significant number of people are not detained in
hospital following assessment under the Mental Health Act 1983
(MHA) for possible detention. However, since amendments in 2007,
some studies show an increase in total patient detentions. There is
currently a lack of published research describing both outcomes
and their affecting variables.
Objectives To determine rates, outcomes and affecting variables
of MHA assessments in Norfolk, 2001–2011.
Methods This observational study involved data collection from
all 11,509 referrals for detention assessment under the MHA. Data
was collected by Norfolk Social Services from 2001–2011 including
age, gender and marital status.
Results Following assessment, 6903 (60.0%) were admitted; of
those, 1157 (16.8%) were voluntary and 5746 (83.2%) were detai-
ned; 4606 (40%) were not admitted. Admission rates for males
(50.4%) and females (49.5%) were similar. Detention rates increased
with age: 37.6% of < 18s; 47.1% of 18–64s and 61.4% of 65+. A grea-
ter proportion of married (57.5%) and widowed patients (58.2%)
were detained, compared with patients who were single (48%).
Accommodation status showed 52% of those living with other were
detained versus 43.9% of those with no fixed abode.
Conclusions The finding that a higher proportion of married than
single people, and of those living with others versus living alone,
were detained following assessment is unexpected but significant
and needs further investigation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0720
Dissociative symptoms are associated
with neurocognitive dysfunction in
patients with MDD
E. Berdzenishvili ∗, G. Tcheishvili , M. Sinitsa
1 Acad. O. Gudushauri national medical centre
2 Georgian centre for psychosocial and medical rehabilitation of
torture victims
∗ Corresponding author
Introduction It is widely reported that persons with major
depressive disorder (MDD) show impaired performance on cog-
nitive functioning, including frontotemporally mediated cognitive
functions. The presence of cognitive dysfunction among patients
with dissociative symptoms in trauma-related disorders may
contribute to poorer treatment outcomes. Patients with major
depressive disorder (MDD) frequently report dissociative symp-
toms. Here we investigate association of dissociative symptoms
and neurocognitive dysfunction in patients with depression. We
predicted that higher levels of dissociative symptoms among per-
sons with MDDwould be associated with lower scores on objective
measures of frontotemporally mediated neurocognitive functions.
Methods Patients who met DSM-V diagnostic criteria for a pri-
mary diagnosis of recurrent MDD were recruited. The Hamilton
Rating Scale for Depression (HAM-D) was administered to assess
the severity of depressive symptoms. To assess dissociative symp-
toms participants completed the Multiscale Dissociation Inventory
(MDI). Two groups of patients were selected and matched. One
group consisted of 13 patients having MDD and dissociative symp-
toms and second group consisted of 12 patients having MDD only.
To measure frontotemporally mediated cognitive functioning fol-
lowing tests were administered: Color Trails Test; Wisconsin Card
Sorting Test; Conners’ Continuous Performance Test (CPT). To exa-
mine group differences on clinical and neuropsychological scores,
two-tailed independent samples t-tests was performed.
Results Group comparisons of performance on neuropsychologi-
cal tests showed that participants with depression and dissociative
symptoms performed worse on Color Trails Test Part 2 completion
time, a measure of mental flexibility and processing speed. MDI
depersonalization scores were correlated withmeasures of proces-
sing speed, mental flexibility and sustained attention. Specifically,
Color Trails Test Part 2 scores were negatively correlated with
depersonalization symptoms, where lower scores indicate slower
completion time. Depersonalization symptoms on the MDI were
also related to the CPT Hit Reaction Time Interstimulus Interval
Change (a measure of vigilance), such that higher levels of deper-
sonalization were related to better performance in a less active
environment.
Conclusions Our results suggest that dissociation is related to
specific subtle impairments in neurocognitive functioning. Disso-
ciative symptoms should ideally be assessed before treatment, as
they may influence MDD treatment response. The findings point
towards the need to further examine the impact of dissociation on
functioning in patients with depression.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0721
Factors influencing the rate of
incidents in a United Kingdom high
secure psychiatric hospital: Weekend,
ward round and diagnostic effect?
F. Lewis , H. Blott ∗, S. Bhattacherjee
West London mental health trust, forensic psychiatry, London, United
Kingdom
∗ Corresponding author.
Introduction Broadmoor is a high secure psychiatric hospital
divided into personality disorder (PD) andmental illness (MI) path-
ways. Whenever an incident occurs, it should be recorded. To better
understand which factors influence the rate of incidents, such as
diagnosis or intervention by medical and psychological staff, we
examined the difference in the number of incidents recorded on
weekdays versus weekends, ward round (WR) versus non-WR days
and the PD versus MI pathways.
Method All incidents recorded over a one-year period
(3.11.2014–2.11.2015) were examined. Extraneous incidents
were excluded, leaving subgroups of “aggressive” (physical and
verbal) and “physical” (excluding verbal) incidents which were
analysed. Data were adjusted for the difference in number of beds
in each pathway.
Results Of the 2369 incident reports included, more were recor-
ded per day on weekdays than weekends, with little difference on
WR versus non-WR days. The rates of both types of incidents were
similar on both PD and MI admission wards, although the rate of
“physical” incidents was 2.6 times higher and “aggressive” inci-
dents 3.3 times higher in PD compared to MI rehabilitation wards.
Conclusion The findings suggest the presence of medical and psy-
chological staff during the week, and possibly the requirements