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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S69–S105



Are volunteering and caregiving

associated with suicide risk? A

census-based longitudinal study

D. O’Reilly

1 ,

, M. Rosato


, A. Maguire



Queen’s University Belfast, Centre for Public Health, Belfast, United



Ulster University, Bamford Centre, Belfast, United Kingdom

Corresponding author.


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



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.


More intense caregiving was associated with worse

mental health (OR


= 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 (


= 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).


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.


Incidence and predictors of suicide

attempts in bipolar I and II disorders:

A five-year follow-up

S. Pallaskorpi

1 ,

, K. Suominen


, M. Ketokivi


, H. Valtonen



P. Arvilommi


, O. Mantere


, S. Leppämäki


, E. Isometsä



Finnish National Institute for Health and Welfare - THL, Psychiatric

and Substance Abuse Services, Helsinki, Finland


Helsinki City Department of Social Services and Healthcare,

Psychiatric and Substance Abuse Services, Helsinki, Finland


IE Business School, Operations and Technology Department,

Madrid, Spain


McGill University, Department of Psychiatry, Montreal, Canada


Helsinki University Central Hospital, Department of Psychiatry,

Helsinki, Finland


University of Helsinki, Department of Psychiatry, Helsinki, Finland

Corresponding author.


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.


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).


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



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.


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.


Cost-effectiveness of a specialised

medium secure personality disorder


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.


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



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.


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.


Collection of data on number of admission and length of

stay and calculation of expenses per capita. Retrospective analysis

of costs of care.


Analysis of comparative figures post-implementation of

this new model of care found 41% more episodes of care. Cost-

analysis indicated a saving of




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