European Psychiatry - Volume 41 - April 2017

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S42 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52
As it is in all cases, the first step of the diagnostic procedure of
suicidal adolescents is creating an appropriate environment for the
evaluation and rapport building.
More than 90% of suicidal adolescents has ongoing and usu-
ally untreated psychiatric disorder/s and about three-quarters of
them has at least one subthreshold diagnosis. Potential common
risk factors of adolescence suicide include both internalizing and
externalizing disorders, such as major depressive episode, sub-
stance use and conduct disorder. The comorbidity of psychiatric
disorders–both subthreshold and threshold - has been associ-
ated with increased risk for suicide. The careful assessment of
subthreshold and full psychiatric disorders of suicidal adolescent
is important in suicide prevention and the treatment of sui-
cidal adolescents. The diagnostic procedure includes both clinical
assessment and using validated (semi) structured diagnostic inter-
views. Rating scales can provide information on the severity of the
patient’s symptoms. Next to the assessment of the symptoms it is
important to take the history and to get know about adolescents’
possible life events. Clinicians should carefully screen potential sui-
cidal behavior itself, which includes both clinical assessment and
validated interviews and tests.Complex treatment of suicidal ado-
lescents can include, if it is necessary hospitalization due to the
management of acute suicide risk and the appropriate treatment
of subthreshold and threshold psychiatric disorders with the con-
sideration of possible life events.
Disclosure of interest This work was supported by OTKA K108336
grant.
Judit Balázswas supported by the János Bolyai Research Scholarship
of the Hungarian Academy of Sciences.
S113
When your patient dies by suicide;
aftermath and implications
B. Sadock
New York University School of Medicine, New York
Over fifty percent of psychiatrists will have at least one patient
die by suicide while in treatment and some will have more than
one patient suicide during the course of their career. The impact of
patient suicide on the personal and professional lives of those psy-
chiatrists can be profound. Personally, many suffer a grief reaction
than can progress to depression in some cases. Almost all experi-
ence a sense of shock upon first learning of the event. Feelings of
guilt are also common. Professionally, many fear disapproval from
peers and may never again treat a suicidal patient. Some psychia-
trists leave the field completely or go into administration so that
they never have to treat patients again.
Surveys of training programs have found that most provide training
in the assessment of suicide risk and in the management of the
suicidal patient but there is minimal training in how to deal with
the aftermath of a patient suicide. There is a need to teach and
to help practicing psychiatrists, at whatever stage in their career,
cope with the stress that occurs when one of their patients dies by
suicide during the course of therapy. Important issues are how and
when to contact family members and other survivors, whether or
not to attend a funeral or memorial service and what and what not
to do regarding discussing the casewith others. The risk of litigation
also is influenced by how psychiatrists behave after patient suicide
occurs. The case of Ernest Hemingway is used as an example to
illustrate some of these concepts.
Disclosure of interest The author declares that he has no compet-
ing interest.
Symposium: E-Mental Health in
Psychiatry–Future Perspectives of an Emerging
Field
S114
From Telepsychiatry to eMental
Health–Experiences and Prospects in
Europe
D. Mucic
The Little Prince Psychiatry Centre, eMental-Health, Copenhagen,
Denmark
What started with telepsychiatry (videoconference) has been
turned into e-Mental Health (eMH) due to rapid development of
IT technology, decreased prices and increased user experiences.
Access to mental health care is one of the identified problems
within EU mental health services. Increased migration into and
within EU cause the increased demands for clinicians with selected
skills. Telepsychiatry is the oldest and most common eMH applica-
tion. The first international telepsychiatry collaboration established
between Sweden and Denmark back in 2006 was a success. This
model might be used as collaboration prototype while speaking
about current refugee crisis in Europe and treatment of men-
tally ill migrants. The experiences from this pioneer international
transcultural telepsychiatry service in combination with various
eMH applications may be used as an inspiration for conducting of
larger international eMH service capable to provide mental health
care toward diversity of patient populations underserved on their
mother tongue within EU.
eMH applications could improve quality of care and access to men-
tal health care in rural, remote and under-served as well as in
metropolitan areas all around EU.
Disclosure of interest The author declares that he has no compet-
ing interest.
S115
E-Mental health for mental
disorders–focus on psychotic
disorders and PTSD
W. Gaebel
Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
Introduction E- mental health technologies have developed
rapidly over the past years and may support finding solutions to
challenges like scarce resources or the treatment gap in psychiatry.
Objectives Provision of guidance on eMental health technologies
in the treatment of post traumatic stress disorder and psychotic
disorders.
Methods Two evidence- and consensus-based EPA Guidance
papers on eMental health technologies for the treatment of post-
traumatic stress disorder and psychotic disorders were developed.
Conclusions The evidence on the efficacy of e-mental health
interventions for the treatment of PTSD and psychotic disorders
is promising. However, more research is needed in the field.
Disclosure of interest Unterstützung bei Symposien/Symposia
Support
− Janssen-Cilag GmbH, Neuss
− Aristo Pharma GmbH, Berlin
− Lilly Deutschland GmbH, Bad Homburg
− Servier Deutschland GmbH, München
Fakultätsmitglied/Faculty Member
− Lundbeck International Neuroscience Foundation (LINF), Däne-
mark