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


on clinical staging and profiling of addictive behaviors combining

neurobiological findings and clinical practice

[6] .

Disclosure of interest

The author has not supplied his declaration

of competing interest.


[1] Lancet 2015;386(9995):743–800.

[2] Lancet 2013;382(9904):1575–86.

[3] European Psychiatry 2015;30(1).

[4] Addiction 2015;110(6):920–30.

[5] Tijdschr Psychiatr 2014;56(3):206–10.

[6] Tijdschr Psychiatr 2012;54(11):941–8.


Clinical staging of psychotic disorders:

From dimensions to neurobiology

A. Batalla

Radboudumc, Psychiatry, Nijmegen, The Netherlands

The clinical staging model is an approach used in medicine to

define the extent of disease. In psychiatry, this model has recently

been applied to psychotic disorders to distinguish the earlier, non-

specific features of illness (e.g. ultra-high risk [UHR]; at-riskmental

state [ARMS]), from later, more severe features associated with

chronic illness. A key element of the staging model is to identify

and classify the neurobiological processes underlying the disor-

der and to define potential interventions in the different stages.

With the premise that dysfunctional neural mechanisms underlie

symptomatology, the integration of categorical phenotypic classi-

fications (class of disorder) with dimensional criteria (domains of

dysfunction) becomes crucial. This approach aims to better classify

trans-diagnostic dimensions of disease and discrete symptom-

specific subgroup populationswithin biological frameworks, which

may lead to the detection of new biomarkers and the development

of more effective treatment and prevention strategies.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

Symposium: Mental health care in refugees and

asylum seekers


Providing care for migrants and


M. Schouler-Ocak

Psychiatric University Clinic of Charité at St. Hedwig Hospital,

Psychiatry and Psychotherapy, Berlin, Germany

With growing globalisation and an increasing number of people

on the move across boundaries, it has become vital that service

providers, policymakers andmental health professionals are aware

of the different needs of the patients they are responsible. One of

the most fundamental barriers for migrants, refugees and asylum

seekers in accessing health services are inadequate legal entitle-

ment and, mechanisms for ensuring that they are well known

and respected in practice. Access to the healthcare system is

impeded by language and cultural communication problems. Qual-

ified language and cultural mediators are not widely available, and

moreover, are not regularly asked to attend. This can lead tomisun-

derstandings, misdiagnosis and incorrect treatment, with serious

consequences for the afflicted. The language barrier represents

one of the main barriers to access to the healthcare system for

people who do not speak the local language; indeed, language is

the main working tool of psychiatry and psychotherapy, without

which successful communication is impossible. Additionally, the

lack of health literacy among the staff of institutions, which provide

care for refugees and asylum seekers means that there is a lack of

knowledge about the main symptoms of common mental health

problems among these groups. The healthcare services, which are

currently available, are not well prepared for these increasing spe-

cific groups. In dealing with ethnic minorities, including asylum

seekers and refugees, mental healthcare professionals need to be

culturally competent.

In this talk, main models for providing mental health care for

migrants and refugees will be presented and discussed.

Disclosure of interest

The author has not supplied his declaration

of competing interest.


Cultural competence training and

mental health care in refugees and

asylum seekers

D. Bhugra

Institute of Psychiatry, Psychology & Ne, London, United Kingdom

Recent mass movement of human beings in various parts of the

world has brought several challenges. Not only refugees from Syria

and Libya to Europe but also refugees, migrants and asylum seek-

ers in Latin America bring specific set of issues with them. It is

critical that clinicians are aware of both the vulnerability of indi-

viduals to mental ill health as a result of migratory experiences

but equally importantly their resilience. The impact on the mental

health of those who may be involved directly or indirectly in deliv-

ering care along with those new communities who receive these

groups need to be taken into account when planning and delivering

psychiatric services. It is essential to recognise that experiences of

being a refugee or asylum seeker are heterogeneous. Being an asy-

lum seeker carries with it legal definitions and legal imperatives

agreed at international levels.

Policymakers and clinicians need to be aware of differential rates

of psychiatric disorders in these vulnerable individuals and spe-

cific needs related to language, religious values and other cultural

factors. Mental health problemsmay be related to experiencing cul-

tural bereavement where individuals feel that they have lost their

cultures, relationships and cultural values. Judicious and careful

use of trained culture brokers and mediators should be encouraged

as these individuals can inform the team about community needs

and inform the community about the team functioning and its

principles so that community expectations can be managed appro-

priately. Such approaches may also help reduce stigma against

mental illness.

Disclosure of interest

The author has not supplied his declaration

of competing interest.


Suicide risk in refugees and asylum


D. Wasserman

Karolinska Institute, National Centre for Suicide Research and

Prevention of Mental-Ill Health NASP, Stockholm, Sweden

Increasing numbers of individuals forced to leave their home

countries in areas of war, conflict, human rights violations and

persecution pose a challenge for host countries to meet the

mental-health care needs of these individuals. Refugees and

asylum-seekers may face unique risk factors for mental disorder

before, during, and after their migration leading to suicidality.