European Psychiatry - Volume 41 - April 2017

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S782 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S772–S846
agement of acute symptoms. Cognitive-behavioral therapy (CBT),
whichhas beendemonstrated to be the first-line treatment for OCD,
can be a valid adjuvant during the difficult course of PANDAS to
target acute symptoms and prevent exacerbations.
Objectives The study presented a case of a patient with PANDAS
treated with antibiotic medication and CBT as augmentation.
Methods The 11-year-old patient (Y-BOCS pre-test score = 32),
had been hospitalized for three weeks for acute onset of PAN-
DAS. The clinical picture consisted of asthenia, contamination
fears and washing compulsions, separation anxiety, severe depres-
sion and anxiety. Pharmacotherapy involved risperidone 2mg/die
and sertraline 250mg/die for five months combined with antibi-
otic prophylaxis for two years. The CBT intervention started
at discharge from hospital and included psycho-education on
anxiety, intensive exposure and response prevention (2 hour
sessions three times a week) for twelve months, cognitive restruc-
turing, diffusion and mindfulness for the subsequent twelve
months.
Results Anxiety and OCD symptoms substantially improved. The
patient gradually started school again. Post-test score was 11 on
the Y-BOCS.
Conclusions Along with psychiatric and antibiotic medications,
CBT may be a valid augmentation strategy for PANDAS to reduce
risk of exacerbations and enhance symptom improvement. Limita-
tions are discussed.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV1159
Basic principles of supervision and its
ethics in cognitive behavioral therapy
J. Vyskocilova , J. Prasko ∗, M. Slepecky , A. Kotianova
1 Charles University in Prague, Prague 5, the Czech Republic, Faculty
of Humanities, Prague, Czech Republic
2 University Hospital Olomouc, Department of Psychiatry, Olomouc,
Czech Republic
3 Faculty of Social Science and Health Care, Constantine the
Philosopher University in Nitra, Slovak Republic, Department of
Psychology Sciences, Nitra, Slovak Republic
∗ Corresponding author.
Background Supervision is the systematic guidance of a therapist
by a supervisor. It is a basic part of training and ongoing education
in cognitive behavioral therapy (CBT). Self-reflection and ethical
reflection are an important part of supervision.
Method The Pubmed databasewas searched for articles using the
keywords supervision inCBT, therapeutic relations, ethics, transfer-
ence, counter transference, schema therapy, dialectical behavioral
therapy, acceptance and commitment therapy.
Results We discuss conceptual aspects related to supervision and
the role of self-reflection and ethical reflection. The task of supervi-
sion is to increase the value of the therapeutic process in the client’s
best interest. Establishing the supervisor-supervisee relationship
is based on principles similar to those in the therapeutic relation-
ship. Additionally, supervision is oriented towards increasing the
therapist’s competencies. The CBT therapist’s core competencies
involve good theoretical knowledge, professional behavior towards
clients, ability to use specific therapeutic strategies for maintain-
ing the therapeutic relationship, sensitivity to parallel processes
and accomplishment of changes, and adherence to ethical norms.
Given the fact that during supervision, the supervisee may be at
any stage of his/her training, supervision must take into consider-
ation where the therapist is in his/her training and development
and what he/she has or has not learnt.
Conclusions Both the literature and our experience underscore
the importance of careful supervision of cognitive behavioral ther-
apy. Numerous approaches are used in supervision, which is
associated with the abilities to self-reflect and to realize transfer-
ence and counter transference mechanisms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1160
Bion’s group psychotherapy for
dramatic personality disorders:
An empirical study in a public mental
health
M. Pacetti , M. Liotta , F. Ambrosini , R.P. Sant’Angelo ∗
1 Ausl Romagna, Mental Health Department, Forlì, Italy
2 University of Bologna, Faculty of Psychology, Cesena, Italy
3 Ausl Romagna, Mental Health Department, Cesena, Italy
∗ Corresponding author.
Educational objectives Psychotherapy is the most preferable
intervention for personality disorder patients and group psy-
chotherapy offers the possibility to increase the self-perception
through resonance and mirroring processes. When a group is
disorganized and emotionally tensioned generates regressive
movements, which make it a basic assumption group.
Purpose To highlight the change of a group of patients after the
inclusion of a new patient named Margherita.
Methods The patients were included within the group run by
two psychotherapists after a cluster B personality disorder’s clinical
diagnosis (except for antisocial personality disorder), confirmed by
SCID II and by a set of individual interviews aimed to prepare the
patient to the inclusion within the group.
Results Margherita, from the first sessions, showed the tendency
to coercively polarize the attention on herself through themes of
discouragement and helplessness, posing a threat for themembers’
identity and resulting in a disorganization of the work group, which
became a basic assumption group.
Conclusions The temporary disorganization of the group with
the consequent regression to a worse functioning condition has
subsequently allowed to revitalize the group and to avoid its dis-
solution. After the temporary regression, indeed, the work group
was restored and started again to function even based on the new
patient’s problems.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1161
Why do I have to die twice? EMDR
treatment after experience of clinical
death
R. Softic∗, E. Becirovic , M. Mirkovic Hajdukov
University Clinical Center Tuzla, Psychiatry Clinic, Tuzla, Bosnia and
Herzegovina
∗ Corresponding author.
Background Clinical death is etiologically non-specific state of
reversible cessation of blood circulation and breathing, the two
necessary criteria to sustain life. Serious consequences in form of
anxiety and/or depression can remains after recovery.
Case report Male patient 55 y/o with no prior history of psy-
chiatric difficulties, who experienced clinical death after cardiac
infarction. Reanimationwas successful and he was discharged with
minimal if any cardiac consequences. During the hospitalization
in Coronar unit he reacted with major depression, and aftermath
with disabilitating anxiety and panic attacks followed by avoidant
behavior, obsessive thoughts, social withdrawal, and consequently,
very poor quality of life, regardless of the favorable outcome of
somatic (cardiac) illness. The patient did not wanted psychiatric