European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S710–S771 S727
DASS-21, IES-R, and FS-ICUquestionnaireswas performed followed
by a repeat survey 90 days post discharge from ICU. An IES-R score
of > 33 was used to define PTSD. A FS-ICU score < 5 was used to
define dissatisfaction.
Results Forty subjects refused to participate, eight were
excluded, sixty family members were included for analysis on
an intention to treat basis which included 36 completed diaries.
Whilst there was no association between PTSD at 3-month follow-
up and diary use (P-value = 0.9), there was an associationwith PTSD
at baseline (P-value = 0.02) and unemployment ( P-value = 0.0045).
Medical patients had mean PTSD score 3.0 units greater than surgi-
cal (estimate = 3.0, 95% CI: 0.3, 5.7). Families who were dissatisfied
(FS-ICU score of < 5) were not at more at risk of developing PTSD
than families who were satisfied (P-value = 0.74).
Conclusion ICU diaries did not impact on the incidence of stress,
family satisfaction with care and PTSD in relatives of patients in
this index population.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0993
Repeated programmed
hospitalizations (RPH) in the care of
French military suffering for war
post-traumatic psychiatric disorders:
Interests and limitations
G. Thomas ∗, E. Le Pape , E. Py-Leroy , E. Mele , G. Tourinel
HIA Robert-Picque, Psychiatry Service, Villenave-d’Ornon, France
∗ Corresponding author.
Introduction The long-term management of psychiatric
wounded patients with prolonged disorders requires a rethinking
of our practice of care.
Objectives The aim is to propose an integrative model of all valid
therapies in the post-traumatic-stress disorder while taking care
of co-morbidities and ensuring patient support in the different
administrative procedures that permit reconstruction. Repeated
short-term hospitalizations can meet this objective by mobilizing
resources, creating group dynamics, restoring a space of safety,
allowing a rupture with the environment, preventing recurrence
of crises, and by encouraging the histicization of trauma by the
temporal sequences of intra/extra-hospitalisation repetition.
Method We propose, by means of a review of the literature, to
discuss on a psychopathological level the interest and limits of this
mode of care.
Results This work reveals the specific therapeutic effects of
repeated programmed hospitalizations, which constitute a new
modality of institutional psychotherapy.
Conclusion Rethinking the place of hospitalisation in the man-
agement of psychiatric illnesses can be useful to all psychiatrists
who follow patients with chronic and co-morbid disease.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0994
Impact of terrorist attacks on the
profile of consultants at the
outpatient department of Razi
hospital
R. Trabelsi ∗, A. Bouasker , H. Zalila
1 Razi Hospital, Department Psychiatry F, Mannouba, Tunisia
2 Razi Hospital, Outpatient Department, La Mannouba, Tunisia
∗ Corresponding author.
Introduction A trauma is an uncommon experience of violence
in which the physical and psychological integrity of an individual
or group has been threatened. Intentional violence in general and
terrorist attacks in particular are a perfect example of this. It turns
out that during the year 2015 Tunisia was shaken by a series of
terrorist attacks as sudden as violent. What impact would these
actions have on the profile of consultants at the Razi hospital?
Methods A retrospective and descriptive study of the consultants
between January 1, 2015 and December 31, 2015, while determin-
ing the socio-demographic, clinical and therapeutic profile of the
consultants for the first time at the outpatient clinic of the Razi
psychiatric hospital, and indicating the different changes during
the month following each attack; Bardo 18 March, Sousse 26 June
and Mohamed V 24 November.
Results Our study pointed to an increase in the number of con-
sultants at the hospital (31%) and outpatient (128%) levels during
the year 2015, without increasing the number of consultants New
consultants. The new consultants are younger with a strengthen-
ing of the female predominance (56.8). In the months following the
attacks from the same period of the previous year, we found that
diagnoses of acute and post-traumatic stress disorders (151%) and
(93%) increased in percentage.
Conclusion The impact of terrorist attacks is harmful to peo-
ple directly exposed but also to vulnerable people. It imposes the
necessity of a preventive activity involving multidisciplinary inter-
ventions in order to develop the concept of resilience.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0995
Five sessions of in vivo exposure
therapy for post-traumatic stress
disorder: A case report
T. Tuvia∗ ego
Montefiore Hospital, Psychiatry, Bronx, USA
∗ Corresponding author.
Introduction Prolonged exposure (PE) is recognized in many
guidelines as an effective, evidence based treatment for post-
traumatic stress disorder (PTSD), with the active ingredients being
in vivo and imaginal exposure. Despite this, patients and clinicians
are often reluctant to engage in this form of treatment. Imaginal
exposure can be perceived as too anxiety proving, leading to dis-
comfort among both patient and clinician. In vivo exposure alone,
however, has also been established as an effective treatment for
anxiety disorders that can provide significant results in a rapid
manner.
Methods A 31-year-old female with no prior psychiatric history
presented to treatment in an acute depressive episode following
a motor vehicle accident two years prior. She also met criteria for
PTSD. Her Beck Depression Inventory (BDI) and PTSD Checklist for
DSM-5 (PCL–5) scores were 42 (severe depression) and 64, respec-
tively. Due to constraints, a modified form of PE was initiated, with
five in vivo exposure sessions conducted.
Results After five sessions of in vivo exposure, the patient’s PCL–5
score decreased from 64 to 36 and her BDI score decreased from 42
to 13 (minimal depression).
Conclusions This case report underscores the effectiveness of a
modified formof PE, using in vivo exposure alone as a treatment for
PTSD. This has significant implications in particular for patients or
clinicians who are unable to initiate imaginal exposure (e.g., patient
finding it too difficult to tolerate/refusing to engage, language bar-
riers, etc.). In such situations, in vivo exposure appears to be an
alternate, effective, short-term treatment option.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.