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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


Judit Balázswas supported by the János Bolyai Research Scholarship

of the Hungarian Academy of Sciences.


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



From Telepsychiatry to eMental

Health–Experiences and Prospects in


D. Mucic

The Little Prince Psychiatry Centre, eMental-Health, Copenhagen,


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.


E-Mental health for mental

disorders–focus on psychotic

disorders and PTSD

W. Gaebel

Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany


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.


Provision of guidance on eMental health technologies

in the treatment of post traumatic stress disorder and psychotic



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.


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


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-