European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S69–S105 S87
O051
Are volunteering and caregiving
associated with suicide risk? A
census-based longitudinal study
D. O’Reilly ∗, M. Rosato , A. Maguire
1 Queen’s University Belfast, Centre for Public Health, Belfast, United
Kingdom
2 Ulster University, Bamford Centre, Belfast, United Kingdom
∗ Corresponding author.
Background This record linkage study explores the suicide risk of
people engaged in caregiving and volunteering. Theory suggests
opposing risks as volunteering is associated with better mental
health and caregiving with a higher prevalence and incidence of
depression.
Methods A 2011 census-based study of 1,018,000 people aged
25–74 years (130,816 caregivers and 110,467 volunteers; 42,099
engaged in both). All attributes were based on census records.
Caregiving was categorised as either light (1–19 hours/week) or
more intense (20+ hours/week). Suicide risk was based on 45
months of death records and assessed using Cox proportional
hazards models with adjustment for and stratification by mental
health status at census.
Results More intense caregiving was associated with worse
mental health (ORadj = 1.15: 95%CI = 1.12, 1.18); volunteering with
better mental health (OR 0.87; 95%CIs 0.84, 0.89). The cohort
experienced 528 suicides during follow-up. Both volunteering and
caregiving were associated with a lower risk of suicide though this
was modified by baseline mental ill-health (P = 0.003), HR 0.66;
95%CIs 0.49, 0.88 for those engaged in either activity and with good
mental health at baseline and HR 1.02; 95%CIs 0.69, 1.51 for their
peers with poor mental health. There was some indication that
those engaged in both activities had the lowest suicide risk (HR
0.34; 95%CIs 0.14, 0.84).
Conclusions Despite the poorer mental health amongst care-
givers they are not at increased risk of suicide. The significant
overlap between caregiving and volunteering and the lower risk
of suicide for those engaged in both activities may indicate a syn-
ergism of action.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
O052
Incidence and predictors of suicide
attempts in bipolar I and II disorders:
A five-year follow-up
S. Pallaskorpi ∗, K. Suominen , M. Ketokivi , H. Valtonen ,
P. Arvilommi , O. Mantere , S. Leppämäki , E. Isometsä
1 Finnish National Institute for Health and Welfare - THL, Psychiatric
and Substance Abuse Services, Helsinki, Finland
2 Helsinki City Department of Social Services and Healthcare,
Psychiatric and Substance Abuse Services, Helsinki, Finland
3 IE Business School, Operations and Technology Department,
Madrid, Spain
4 McGill University, Department of Psychiatry, Montreal, Canada
5 Helsinki University Central Hospital, Department of Psychiatry,
Helsinki, Finland
6 University of Helsinki, Department of Psychiatry, Helsinki, Finland
∗ Corresponding author.
Introduction Although suicidal behavior is very common in
bipolar disorder (BD), few long-termstudies have investigated inci-
dence and risk factors of suicide attempts (SAs) specifically related
to illness phases of BD.
Objectives We examined incidence of SAs during different phases
of BD in a long-term prospective cohort of bipolar I (BD-I) and II
(BD-II) patients and risk factors specifically for SAs during major
depressive episodes (MDEs).
Methods In the Jorvi bipolar study (JoBS), 191 BD-I and BD-II
patients were followed using life-chart methodology. Prospective
information on SAs of 177 patients (92.7%) during different illness
phases was available up to five years. Incidence of SAs and their
predictors were investigated using logistic and Poisson regression
models. Analyses of risk factors for SAs occurring duringMDEswere
conducted using two-level random-intercept logistic regression
models.
Results During the five-year follow-up, 90 SAs per 718 patient-
years occurred. Compared with euthymia the incidence was
highest, over 120-fold, duringmixed states (765/1000 person-years
[95% confidence interval (CI) 461–1269]) and also very high in
MDEs, almost 60-fold (354/1000 [95%CI 277–451]). For risk of SAs
during MDEs, the duration of MDEs, severity of depression and
cluster C personality disorders were significant predictors.
Conclusions In this long-termstudy, the highest incidences of SAs
occurred in mixed phases and MDEs. The variations in incidence
rates between euthymia and illness phases were remarkably large,
suggesting that the question “when” rather than “who” may be
more relevant for suicide risk in BD. However, risk during MDEs
is likely also influenced by personality factors.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
O053
Cost-effectiveness of a specialised
medium secure personality disorder
service
R. Woodward ∗, R. Lingam , F. Papouli
Bamburgh Clinic-Northumberland Tyne and Wear-Newcastle upon
Tyne-UK, Forensic Personality Disorder Services, Newcastle upon
Tyne, United Kingdom
∗ Corresponding author.
Introduction The Oswin unit located in the North East of England
is commissioned primarily for offenders screened on the offender
personality disorder (OPD) pathway based on measures of per-
sonality disorder being linked to moderate to high risks to other
persons.
Objectives The Oswin Unit was re-designed in early 2014 meet-
ing commissioning specifications to meet objectives based on
access, measuring quality and reducing. The primary objective
of this pathway is to ensure personality Disorder offenders have
access to “community-to-community”, joint-up care and monitor-
ing of risks. The Oswin unit implemented a re-designed service
offering individuals formulation based assessments and risk man-
agement embedded in the OPD pathway. The overall objective of
this project is to evaluate the effectiveness and risk amelioration of
this hospital-based service.
Aim As part of a broader service development and evaluation
project, the cost-effectiveness of the current model of the unit was
compared to that of the unit prior to the redesign of the service.
Method Collection of data on number of admission and length of
stay and calculation of expenses per capita. Retrospective analysis
of costs of care.
Results Analysis of comparative figures post-implementation of
this new model of care found 41% more episodes of care. Cost-
analysis indicated a saving of £ 200,000.
Conclusion The new Oswin Model meets commissioning objec-
tives in offering access to hospital-based care and focused
treatments for prisoners ‘stuck’ in prison pathways. This finding
led to further investigation using thematic measures of qual-
ity of care to evaluate the effectiveness of this service and risk
amelioration.