Poster Index

Clinical and neurocognitive studies of suicidal behavior (17)  |  Clinical phenotyping of suicidal individuals (23)
Culture, ethnicity and spiritual approaches. New paradigms in suicidology (11)  |  Ethical and methodological challenges and solutions in suicide research (5)
Genetic, epigenetic and gene expression contributors to suicide risk (2)  |  Intervention research for prevention of suicidal behavior (30)
Lifespan differential aspects (from infancy to elderly) (7)  |  Miscellany (assisted suicide, minorities, legal aspects, etc.) (9)
Neurobiological underpinnings of suicidal behavior (3)  |  Novel monitoring strategies for detecting changes in risk over time (4)
Psychosocial variables: protective and risk factors. Resilience & vulnerability (38)  |  Testing the effectiveness of prevention strategies (6)




Clinical and neurocognitive studies of suicidal behavior


(126) PO-126. Factors associated with awareness of mental disorder

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Manuel Canal-Rivero . Universitat Autònoma de Barcelona/ Hospital Universitario Virgen del Rocío, Sevilla- Spain
- Jordi E Obiols Llandrich - Miguel Ruiz Veguilla -

 Introduction:
Theory of mind (ToM) impairment is common in patients with schizophrenia. ToM is "the ability to infer intentions, dispositions and beliefs of others". Poor insight has also been linked to poor outcome in schizophrenia. Clinical insight refers to one´s awareness of having a mental illness that requires treatment and includes dimensions of Awareness of Illness, Relabeling of Symptoms and Need for Treatment.
 Goals:
The objective of this study is analyze the factors associated with awareness of mental disorder.
 Methodology:
Sixty-five patients in their first episode of non-affective or affective psychosis participated in this study. Subjects were recruited during their first contact with any of the mental outpatient or inpatient health services. All patients were initially screened by phychiatrist for the presence of psychotic symptoms, and were subsequently diagnosed using an SCID structured interview. We excluded patients with a previous diagnosis of neurological disease or a history of head trauma with loss of consciousness. All the participants gave their written informed consent, and the research protocol was approved by local Ethics Committees. Scale of Unawareness of Mental Disorder (SUMD) was used to evaluate insight. This scale consists of three general items: awareness of mental disorder, awareness of the effects of medication and awareness of the social consequences of the disorder. Furthermore, the SUMD accounts for 17 items related to specific symptoms, which are divided into two subscales, awareness and attribution. Theory of mind was evaluated ussing Hiting task adapted for Corcoran et al. (1995). Five of the original ten vignettes were used. Each vignette described an interaction between two characters along with an extract of their dialogue and ended with one character dropping a hint to the other. Participants were required to state what the character really meant by their utterance. A correct response is therefore scored as 2 or 1 depending on when the response was given.
 Results:
Significant relationship (P?0.05) was found between impairment in ToM with awareness of mental disorder (r=0.28). No significant relationships were found between impairment in ToM and others dimensions of insight or total score.
 Conclusions:
These results suggested that treatments targeting mentalization abilities that contribute to representations of self and others may improve insight deficits associated with poor outcome in schizophrenia.
 References:
1. Ng R, Fish S, Granholm E. Insight and theory of mind in schizophrenia. Psychiatry Res. 2015;225(1-2):169?74.


(167) PO-167. Decision making under ambiguity and under risk in depressed suicide attempters, depressed non-attempters and healthy controls

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Eberhard A. Deisenhammer . Medical University of Innsbruck, Dep. of General and Social Psychiatry, Innsbruck - Austira
- Steffen K. Schmid - Georg Kemmler - Bernadette Moser - Margarethe Delazer -

 Introduction:
Decision making (DM) abilities are altered in a number of psychiatric disorders. With respect to depression study results are conflicting. Also regarding suicidal behavior, impaired abilities as well as no alteration have been reported before. However, most studies have focused on DM under ambiguity only and included patients with a lifetime history of suicide attempts.
 Goals:
In this study, we applied two instruments which assess different forms of DM and limited the time frame of suicide attempt history to six months.
 Methodology:
The study sample consisted of three groups. Group 1 (SA) were currently depressed inpatients (ICD-10: F3 or F43) having attempted suicide within the previous six months. Group 2 (NSA) consisted of depressed inpatients without a lifetime history of suicide attempts. Group 3 (CG) was a healthy control group. Besides depression severity, impulsiveness and suicidal intent (SA group only) DM patterns were investigated using the Iowa Gambling Task (IGT) for DM under ambiguity and the Game of Dice Task (GDT) for DM under risk.
 Results:
A total of 78 participants (SA group, n=21; NSA group, n=31; CG, n=26) were included into the study. Significant between group differences were found regarding marital status, current partnership, smoking status, depression score, impulsiveness score and family history of psychiatric disorders (all discriminating controls from patients but not between SA and NSA groups).
The three groups did not differ with regard to IGT scores. Concerning GDT, the SA group showed significantly lower scores compared to the two other groups, implying a readiness for more risky decisions in suicide attempters versus non-attempters and controls. No significant difference was found between the NSA and CG groups.
 Conclusions:
Suicide attempters appear to make more risky decisions compared to depressed non-attempters as well as healthy controls even if the DM under ambiguity patterns do not differ.


(182) PO-182. Implicit associations with death: First validation of the German version of the suicide Implicit Association Test

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Dajana Rath . Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen - Germany
- Nina Hallensleben - Lena Spangenberg - Heide Glaesmer - Tobias Teismann - Thomas Forkmann -

 Introduction:
Nock and colleagues [1] developed an implicit association test [2] measuring the implicit association between ‘self’ and ‘death’ (suicide-IAT) and demonstrated that psychiatric patients, who already attempted suicide, showed stronger implicit associations with ‘death’ than with ‘life’ (compared to patients without suicide attempt history).
 Goals:
The present study had two aims: (1) to provide a first validation of a new German version of the suicide-IAT and (2) to investigate how implicit associations (suicide-IAT) relate to suicidal ideation, suicidal behaviour, and the central concepts of the Interpersonal Theory of Suicide [3].
 Methodology:
The sample (n=32) consisted of 16 patients with a current Major Depression as well as 16 healthy controls (no prior or current mental disorders, matched for age, gender and education). The suicide-IAT [1] was translated into German according to the guidelines of the ISPOR Task Force for Translation and Cultural Adaption [4]. Implicit associations were computed as D-scores (positive D-scores representing stronger associations between self and death). Additionally, all participants completed the Suicide Behaviours Questionnaire-Revised [5], Beck Scale for Suicide Ideation [6], Interpersonal Needs Questionnaire [7], German Capability for Suicide Questionnaire [8], and Beck Hopelessness Scale [9].
 Results:
Patients showed less negative IAT-D scores than healthy controls. In the entire sample (n=32), positive correlation coefficients between IAT and SBQ-R and GCSQ were significant and higher than correlation coefficients between IAT and BSSI, thwarted belongingness and perceived burdensomeness (INQ), and BHS.
 Conclusions:
First, we found stronger self-death associations for patients than for healthy controls. Second, the stronger the implicit association between ‘self’ and ‘death’ the more suicidal behaviour (attempts in the past) and acquired capability was reported. Associations with less behaviour-oriented measures, e.g., suicidal ideation, thwarted belongingness, perceived burdensomeness, or hopelessness were small. Results corroborate the validity of the German suicide-IAT, however, replications in larger, sufficiently powered studies are needed.
 References:
[1] Nock MK, Park JM, Finn CT, Deliberto TL, Dour HJ, Banaji MR. Measuring the Suicidal Mind: Implicit Cognition Predicts Suicidal Behavior. Psychological Science. 2010;21(4):511-517. [2] Greenwald AG, Nosek BA, Banaji MR. Understanding and Using the Implicit Association Test: I. An Improved Scoring Algorithm. Journal of Personality and Social Psychology. 2003;85(2):197-216. [3] Joiner TE. Why people die by suicide. Cambridge, MA: Harvard University Press; 2005. [4] Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. VALUE IN HEALTH. 2005; 8(2):94-104. [5] Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX. The Suicidal behaviours questionnaire - revised (SBQ-R): Validation with clinical and nonclinical samples. ASSESSMENT. 2001;8(4):443-454. [6] Beck AT. Beck Scale for Suicide Ideation. The Psychological Corporation, San Antonio, TX; 1993. [7] Van Orden KA, Cukrowicz K, Witte TK, Joiner TE. Thwarted belongingness and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire. Psychological Assessment. 2012; 24:197-215. [8] Wachtel S, Vocks S, Edel M-A, Nyhuis P, Willutzki U, Teismann T. Validation and psychometric properties of the German Capability for Suicide Questionnaire. Comprehensive Psychiatry. 2014;55(5):1292-1302. [9] Beck AT, Steer RA. Manual for the Beck Hopelessness Scale. Psychological Corporation, San Antonio; 1993.


(186) PO-186. Suicide risk after self-harm - the impact of depression and severe suicidal ideation

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Åsa Lindh . Karolinska Institutet, Stockholm - Sweden
- Axel Haglund - Ellinor Salander Renberg - Margda Waern - Bo Runeson -

 Introduction:
It is often recommended that a structured risk assessment instrument should be used in suicide risk assessment, but the evidence for this recommendation is weak (1). The impact of a current depression on the risk for suicide attempt needs further investigation.
 Goals:
We aim to describe the prevalence of suicidal ideation of high severity and intensity in correlation to current depression in a patient cohort with suicide attempt and non-suicidal self-injury, and evaluate the impact of these characteristics of suicidal ideation on future suicide risk.
 Methodology:
Swedish multi-centre study of adults who have made a suicide attempt or a non-suicidal self-injury, presenting at a psychiatric emergency ward. These patients are interviewed with the Mini International Neuropsychiatric Interview and the Columbia Suicide Severity Rating Scale (C-SSRS) (2) and followed through review of medical records. Outcome is suicide attempt, lethal and non-lethal, within 6 months from the index attempt.
 Results:
Almost 800 participants have been included in the study. In the Stockholm subset, n = 479, the age span is 18 – 95, 69 % are women, 82 % have made a suicide attempt and 68.7% had a current depression at baseline. Baseline data indicates higher C-SSRS scores of both severity and intensity (frequency and duration) of suicidal ideation in the depressed group: high scores on frequency was found in 66 % of depressed patients but only in 17 % of patients without a current depression.
 Conclusions:
C-SSRS could be a valuable tool in characterising suicidal ideation in depressed suicide-attempters, thereby identifying potential risk factors for future suicide attempt.
 References:
1. SBU. Instrument för bedömning av suicidrisk. En systematisk litteraturöversikt. Stockholm: Statens beredning för medicinsk och social utvärdering, 2015 242. 2. Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. The American journal of psychiatry. 2011;168(12):1266-77.


(189) PO-189. Anorexia Nervosa, comorbidity and suicidal behaviour

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Irene Baños Martín . Santa Cristina University Hospital, Madrid, Spain
- Paula García Jorge - Tania Delgado Fernández - Natalia Sanz Velasco - Belén Velado Pulido - Enrique Gómez Guerra -

 Introduction:
Patient suffering from Eating Disorders have higher risk of suicide, which increases the added personality disorders, depressive disorder and traumatic events. In Anorexia Nervosa there is greater awareness of lethality, while in Bulimia Nervosa the methods are more violent, finding among the latter, greater number of attempts. There are a greater number of suicide attempts in patients with alexithymia, as suicidal behaviour may be a way of expressing discomfort.
 Goals:
Clinical case presentation to study the factors influencing the occurrence of suicidal behaviour: personality disorder, depressive symptoms and difficulties in emotional regulation.
 Methodology:
Literature review and clinical case exposure. Data collection through individual clinical interviews, family interviews and the administration of questionnaires.
 Results:
Female 32 years entered in Unit TCA H.U. Santa Cristina diagnosed with Anorexia Nervosa Mixed, Borderline Personality Disorder and pathological grief. Patient begins outpatient follow-up to 12 years for restrictive eating symptoms. With 26 years retakes outpatient follow due to depressive symptoms after the father's death. Since then multiple emergency department visits and miscellaneous income. Current illness: Patient has restrictive eating symptoms and compensatory behaviors: vomiting, laxatives and exercise. She presents difficulty in impulse control, episodes of agitation and externalizing attitude. Results scales: • Significant ratings for Obsessive Compulsive Disorder and Borderline Disorder (SCID-II). Schizoid, Limit and Avoidant Disorder (IPDE). • Severe depression with suicidal risk (Beck). • High levels in ineffectiveness, asceticism and social insecurity (EDI-2). Treatment: Group and family psychotherapeutic approach, psychopharmacological treatment, occupational therapy, nutrition education and nursing care.
 Conclusions:
The patient has suicidal risk in relation to their eating disorder, personality disorder and depressive symptoms for complicated grief. The problems of emotional management worsen their prognosis and cause difficulties in adherence to the therapeutic team.
 References:
1- Eunice Yu Chena, Milton Zebediah Brownb, Melanie Susanna Harnedc, and Marsha Marie Linehanc. A comparison of borderline personality disorder with and without eating disorders. Psychiatry Res. 2009 November 30; 170(1): 86–90. 2- Rosa Calvo Sagardoy, Gloria Solórzano, Carmen Morales, Mª Soledad Kassem, Rosana Codesal, Ascensión Blanco, Luis Tomás Gallego Morales. Procesamiento emocional en pacientes TCA adultas vs. adolescentes. Reconocimiento y regulación emocional. Clínica y Salud 25 (2014) 19-37 - Vol. 25 Núm.1 3- Cynthia M Bulk, P HD, Laura Thornton, P HD, Andréa Poyastro Pinheiro et al. Suicide Attempts in Anorexia Nervosa. Psychosomatic Medicine 70:378–383 (2008).


(197) PO-197. Impulsiveness and depression symptoms related to self hurting conducts in patients with bulimia nervosa: about one case

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Irene Baños Martín . Santa Cristina University Hospital, Madrid, Spain
- Natalia Sanz Velasco - Belén Velado Pulido - Tania Delgado Fernández - Paula García Jorge - Enrique Guerra Gómez -

 Introduction:
Eating behaviour disorders show the highest mortality index amongst all mental disorders, including deaths by suicide and those produced as a result of complications related to this disorders. Rate of suicide attempts is much higher in those patients diagnosed with bulimia nervosa. More specifically, suicide risk is more frequent, according to recent studies, in those cases showing a predominance of depressive and impulsive symptoms.
 Goals:
Studying the existent relationship between depressive symptoms, impulsiveness, and self-harm behaviour in people diagnosed with bulimia nervosa, and the comprehensive approach to them as a way to prevent suicide.
 Methodology:
Bibliographical review and exemplification through a 31 year old woman patient clinical case diagnosed with bulimia nervosa and its comorbidity, who is under intensive treatment in the Eating Behaviour Disorders Unit in Hospital Santa Cristina de Madrid, and clinical evolution study after psychotherapeutic (group, familiar and individual) and psychopharmacological (aripiprazol, topiramate and fluoxetine) approach, occupational theraphy, nutritional education and constant nursery care.
 Results:
Affective symptoms improvement was seen after 10 months of intensive and multidisciplinary treatment; besides, there was a reduction in impulsive conducts in eating behaviour (no binging or purging) and self-harm tendencies (no new self-harm actions detected ). However, family dysfunctional relationship and identification with the disorder still appear.
 Conclusions:
Comprehensive and intensive approach on those patients with bulimia nervosa with affective comorbidity and impulsive control problems often carries a remarkable improvement in clinical prognosis and prevention against self-harm behaviour.
 References:
Vaz-Leala, F.V. Rodríguez-Santos, L M. A García-Herráiza, C. A. Chimpén-Lópeza, L.Rojo-Morenob, L. Beato-Fernándezc, M.I. Ramos-Fuentesa. Papel de la depresión y la impulsividad en la psicopatología de la bulimia nerviosa. Revista de Psiquiatría y Salud Mental January–March 2014. Volume 7, Issue 1, Pp. 25–31 Corcos M, Taı¨eb O, Benoit-Lamy S, Paterniti S, Jeammet P, Flament MF. Suicide attempts in women with bulimia nervosa: frequency and characteristics. ActaPsychiatrScand 2002 :106: 381–38


(260) PO-260. Suicide in subjects with schizophrenia: more impulsive although not more aggresive

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Yolanda Morant . Hospital Arnau de Vilanova-Llíria, Valencia-España
- Eva María Barranco - Ángela Arcenegui - Mªcarmen Ruíz - Antonio Rico - Julio A. Guija - Lucas Giner -

 Introduction:
Entre un 4-5% de los sujetos con esquizofrenia muere por suicidio (1). Se estima un riesgo 8 veces mayor que en la población general (2). Los estudios de suicidios consumados indican que entre un 5-10% de los suicidios tienen diagnóstico de esquizofrenia (3,4). En el primer año tras el debut de la esquizofrenia se ha comunicado una incidencia del 11% de intentos de suicidio y entre el 0.3-2% de suicidio consumado (5).
 Goals:
Se pretende comparar los niveles de impulsividad y agresividad como rasgo en sujetos suicidados con esquizofrenia/T. esquizoafectivo (ESQ) en comparación con sujetos suicidados sin ESQ.
 Methodology:
Se estudian 316 suicidios mediante autopsia psicológica a través de los familiares. Se evalúa la impulsividad como rasgo mediante la Barrat Impulsivity Scale (BIS-11) y la agresividad por Brown-Goodwin Assessment for Lifetime History of Aggression.
 Results:
De los casos estudiados, 28 sujetos (8.9%) obtuvieron diagnóstico de ESQ. Al comparar con aquellos que no tenían este diagnóstico se observó que los ESQ tenían una edad media menor (42,32 DE: 12.89 vs 54,7639 DE: 19.58; t:-4.61; p<0.001), misma proporción de sexos. En cuanto a la impulsividad, los sujetos con ESQ presentaron mayor impulsividad y mayor agresividad. Impulsividad total: ESQ=61.44 (DE: 5.21) vs 48.91 (DE: 1.49). t=2.46; p=0.028). No hubo diferencias en niveles de agresividad de adolescente ni de adulto en ambas poblaciones.
 Conclusions:
El porcentaje de sujetos suicidados con diagnóstico de esquizofrenia o t. esquizoafectivo en España se encuentra en el mismo rango que en estudios previos internacionales La impulsividad como rasgo es mayor entre los sujetos con esquizofrenia o t. esquizoafectivo suicidados frente a otros sujetos suicidados con otros diagnósticos Son necesarios más estudios para comprobar esta relación así como estudios con muestras más amplias para poder describir factores propios del suicidio en esquizofrenia y trastorno esquizoafectivo.
 References:
1. Palmer BA, Pankratz VS, Bostwick JM. The lifetime risk of suicide in schizophrenia: a reexamination. Archives of General Psychiatry. 2005;62(3):247-53. 2. Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry. 1997;170:205-28. 3. Heila H, Isometsa ET, Henriksson MM, Heikkinen ME, Marttunen MJ, Lonnqvist JK. Suicide and schizophrenia: a nationwide psychological autopsy study on age- and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. American Journal of Psychiatry. 1997;154(9):1235-42. 4. McGirr A, Turecki G. What is specific to suicide in schizophrenia disorder? Demographic, clinical and behavioural dimensions. SchizophrRes. 2008;98(1-3):217-24. 5. Nordentoft M, Jeppesen P, Abel M, Kassow P, Petersen L, Thorup A, et al. OPUS study: suicidal behaviour, suicidal ideation and hopelessness among patients with first-episode psychosis. One-year follow-up of a randomised controlled trial. BrJ Psychiatry Suppl. 2002;43:s98-106.


(261) PO-261. The Suicide Ideation and Behavior Assessment Tool: Development of a Novel Measure of Suicidal Ideation and Behavior and Perceived Risk of Suicide

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Larry Alphs . Janssen Scientific Affairs, LLC, Titusville, NJ, USA
- Carla Canuso - Lian Mao - David Williamson - Sibat Consortium -

 Introduction:
Better tools are needed to permit identification of persons at risk for suicide and for assessment of change following treatment intervention. The Suicide Ideation and Behavior Assessment Tool (SIBAT) has been developed to address these needs.
 Goals:
The goal of this report is to describe the development of the SIBAT and provide results of its review by clinical psychiatrists and adolescent patients who were not involved with its development.
 Methodology:
The SIBAT Consortium, a group of about 30 clinical trial and academic experts in scale development, suicidology, and clinical management of suicidal patients, met regularly over 30 months and developed a modular instrument. Feedback from patients with a recent history of suicidal ideation and from an online patient community of individuals who self-identified as being at risk for suicide (PatientsLikeMe) was incorporated into the SIBAT and approved by the SIBAT Consortium. Thereafter, psychiatrists and adolescent patients not involved with the SIBAT’s development were interviewed regarding its strengths and weaknesses. Results of these reviews are presented.
 Results:
The SIBAT has been developed as a 10-module instrument for suicide identification and assessment of change with patient-report and clinician-rated sections. It has high face validity for assessment of suicidal ideation and behavior. It captures both patient and clinician estimates of short-term and long-term risk. Early work suggests that it is sensitive to changes in these estimates. Review of the SIBAT by clinicians and adolescents provide evidence of its acceptable burden and potential value to likely end-users.
 Conclusions:
Results from this validation program support the SIBAT’s use as an instrument that efficiently and comprehensively documents clinical severity and changes in imminent and long-term suicide risk.
 References:
Lindenmayer JP et al. Schizophr Res. 2003;63:161-170.


(263) PO-263. Using the Suicide Ideation and Behavior Assessment Tool (SIBAT) to Characterize Persons With Major Depressive Disorder at Imminent Risk for Suicide

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Larry Alphs . Janssen Scientific Affairs, LLC, Titusville, NJ, USA
- Carla Canuso - Rosanne Lane - Pilar Lim - Yun Zhang - Carol Jamieson -

 Introduction:
Worldwide, nearly 1 million people die by suicide each year. Approximately two-thirds of those who complete suicide have depressive symptoms at the time of their deaths. Better treatments are needed to reduce the risk for suicide, and better clinical scales are needed to identify those at risk for suicide and to document their response to treatment interventions.
 Goals:
The goal of this presentation is to demonstrate the value of the Suicide Ideation and Behavior Assessment Tool (SIBAT) for characterizing suicidality in persons with major depressive disorder (MDD) at imminent risk for suicide. In addition, it will demonstrate the facility of the SIBAT to capture change in response to treatment.
 Methodology:
The SIBAT was used to characterize subjects with MDD at imminent risk for suicide who had consented to treatment in a 25-day double-blind study comparing placebo plus treatment-as-usual (TAU) and esketamine plus TAU. Patients were treated for 4 weeks and then followed on TAU for an additional 56 days. Patients rated themselves on demographics, suicidal behaviors, risk/protective factors, current suicidal thinking, and self-assessment of risk. Clinicians provided ratings of suicide risk and optimal treatment management.
 Results:
The ratings of 68 subjects enrolled in this study were compared. At 4-hours post–initial dose and the following day (Day 2), changes in the SIBAT clinical global judgment of suicide risk were superior in the esketamine group compared with the placebo group. Changes in the component modules of the SIBAT were also evaluated.
 Conclusions:
This study supports the facility of the SIBAT for identifying persons at risk for suicide and for demonstrating rapid change in response to treatment interventions when it is used in patients with MDD at imminent risk for suicide.
 References:
Diaz-Granados N et al. J Clin Psychiatry. 2010;71:1605-1611.


(275) PO-275. Clinical management of suicide attempt in depressed inpatients

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Eleonora Gattoni . Department of Translational Medicine - University of Eastern Piedmont , Novara - Italy
- Paola Bergamasco - Alessandro Feggi - Carla Gramaglia - Debora Marangon - Isabella Coppola - Claudia Delicato - Sarah Di Marco - Fabrizio Bert - Patrizia Zeppegno -

 Introduction:
Psychiatric management of inpatients with suicidal behavior involves psychiatrists and psychiatric nurses. Specific precautions should be adopted: observation on a one to one basis with the cooperation of qualified nurses and accommodating the patient in a room close to the infirmary is usually recommended. An ongoing assessment of suicidal risk is warranted to check the response to treatment over time.
 Goals:
To compare the severity of depressive symptoms in depressed inpatients admitted after an attempted suicide and in depressed inpatients admitted for any other reason; to assess the severity of attempted suicide and the management of suicidal risk in the clinical setting.
 Methodology:
We divided the sample in two subgroups: patients with a diagnosis of depression admitted for a suicide attempt (SA) and depressed patients without current suicide attempt (NSA). Socio-demographic and clinical features were gathered; assessment included the Montgomery-Asberg Depression Rating Scale (MADRS) and the Nurses’ Global Assessment of Suicide Risk (NGASR).
 Results:
46 patients were eligible for our study: 20 were SA and 26 NSA. The multivariate analysis yielded a statistically significant correlation between the use of antidepressants and current suicide attempt. The occurrence of suicidal attempt was not significantly related to the severity of depressive symptoms. In the SA subgroup, NGASR suicide risk levels at discharge were significantly lower than those measured at admission. SA had a higher number of suicide attempts in their clinical history, compared to NSA.
 Conclusions:
We found no significant correlation among psychiatric diagnosis, severity of depressive symptoms and current suicide attempt. Antidepressant therapy was found to play the role of protective factor for suicide attempts. History of suicide attempts is one of the major predictor for reattempted suicide. A more thorough understanding of the complex phenomenon of suicide and of the reasons underlying suicidal behaviours is warranted.
 References:
APA, Practice guideline for the assessment and treatment of patients with suicidal behaviors. American Psychiatric Association, 2003 Cutcliffe J. R. & Barker P. The Nurses’ Global Assessment of Suicide Risk (NGASR): developing a tool for clinical practice. Journal of Psychiatric and Mental Health Nursing 11, 393–400 (2004) Zeppegno P, Gramaglia C, Castello LM, Bert F, Gualano MR, Ressico F, Coppola I, Avanzi GC, Siliquini R, Torre E. Suicide attempts and emergency room psychiatric consultation. BMC Psychiatry. 2015; 15: 13.


(307) PO-307. Description of a sample of suicide attempts in psychiatric emergency visited

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Victor Perez Sola . INAD, PARC DE SALUD MAR, Barcelona
- Carles Masip Montero - María Dolores Sánchez-Cabezudo - Itziar Ezquiaga - Gemma Sanchez - Montserrat Bernad - Jorge Coletas - María Teresa Campillo Sanz -

 Introduction:
From a total of 23,860 psychiatric emergencies attended between the two emergency services managed by our institution in two diferent nearby villages, 1579 emergencies were attended for suicidal attempts and another 1001 emergencies for suicidal ideation without attempt during the period of study (2012-2014).
 Goals:
To describe the clinical characteristics of the sample of suicidal attempts.
 Methodology:
All suicidal attempts attended at psychiatry emergency services (2012-2014) were registered. Clinical and demographic data were collected from the medical records.
 Results:
Suicidal attempts represented 6.6% of all psychiatric emergències during this period, with 77.7% of women and 22.3% of men. Mean age was 43 years (range 17-83). All attempts registered corresponded to 1326 patients, being 14.6% out of the whole 1579 emergencies registered repeated attempts. In 31% of cases non-syndromic diagnosis was made, the most frequent diagnosis was adjustment disorders (26.3%), followed by mood disorders (16.68%), personality disorders (14.73 %) (borderline and inespecífic the most) and substance use disorders (9.17%). This study is included in a follow-up study of suicidal attempts evaluated in our emergency psychiatry services during this period.
 Conclusions:
Further efforts to identify clinical risk variables in order to improve medical care for these patients should be conducted.
 References:
José L. Ayuso-Mateos , Enrique Baca-García, Julio Bobes, José Giner, Lucas Giner, Víctor Pérez , Pilar A. Sáiz , Jerónimo Saiz Ruizh Recomendaciones preventivas y manejo del comportamiento suicida en España (Recommendations for the prevention and management of suicidal behaviour) Revista de Psiquiatría y Salud Mental. 2012;5(1):8-23 Zeppegno et al. Suicide attempts and emergency room psychiatric consultation DOI 10.1186/s12888-015-0392-2 BMC Psychiatry (2015) 15:13


(314) PO-314. Characteristics of suicide attempts preceded by acute use of alcohol

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Virginija Adomaitiene . Psychiatry clinic of the Lithuanian University of Health Sciences , Kaunas- Lithuania
- Kristina Dambrauskiene - Rimantas Zalinkevicius - Vigintas Vilkas - Jariene Giedre - Dunderiene Loreta -

 Introduction:
Lithuania is the country where the prevalence of completed suicide among men is the highest in Europe (51 per 100,000 men in 2012) [1]. Many studies reported that a median of 37% of completed suicides and 40% of suicide attempts are preceded by acute use of alcohol [2]. Acute alcohol intake are known to increase the risk of impulsive suicide attempt even in non-depressed patients.
 Goals:
Goals: to assess the prevalence and factors associated with acute alcohol use among suicide attempters.
 Methodology:
Methodology: The current study included 148 patients hospitalized in Psychiatry Department of the Hospital of Lithuanian University of Health Sciences after a suicide attempt. Odd rates (OR) were estimated. The differences were statistically significant if p<0.05.
 Results:
Results indicated that 85 (57%) suicide attempts were committed with acute alcohol consumption. Acute alcohol ingestion posted 1.53 time (95%CI 1.37- 1.72, p=0.043) greater risk for suicide attempt. Alcohol consumption before suicide attempts was associated with middle age (the mean age was 38.5, SD12.95), more common among women (OR= 1.85, 95%CI 1.6-2.16, p=0.02), urban residents (n=63/85;74.1%), lonely persons (n=50/85;58.8%), persons with low (less than 325 €) month incomes (n=51/85;60.0%), less educated. Low-risk methods were used more often (n=71/83.5%). The men were at increased odd ratio of attempting suicide after acute alcohol consumption (OR=5.06, 95%CI 4.16-6.14, p<0.0001). Low body alcohol levels posted greater risk for suicide attempt among women (OR=21.78, 95%CI 17.18-27.63, p<0.0001).
 Conclusions:
Conclusion: A positive association was found between acute use of alcohol and suicide attempts. Findings suggest the importance of considering acute alcohol use when evaluating risk for suicide attempts. Female gender, loneliness, living in urban region, having low incomes, low education were associated with acute alcohol use among suicide attempters.
 References:
1. http://apps.who.int/gho/data/node.main.MHSUICIDE?lang=en 2. Cherpitel CJ, Borges GLG, Wilcox HC. Acute alcohol use and suicidal behavior: a review of the literature. Alcohol Clin Exp Res 2004;28(5S): 18S–28S.


(329) PO-329. Decision-Making and Suicidal Behaviour: Systematic Review

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Marco Antonio Rios . University of Glasgow , Glasgow - United Kigdom
- Rory O'connor - Jonathan Evans -

 Introduction:
Contemporary models of suicidal behaviour emphasize the multifactorial nature of suicide risk and have identified decision-making as an important component within the suicidal process. Although there is increasing evidence for a relationship between impaired decision-making and suicidal behaviour the nature of the relationship is unclear.
 Methodology:
In light of the mixed findings in the research literature, we conducted a systematic review which aimed to synthesize all studies of decision-making and suicidal behaviour, to determine the extent to which decision-making is associated with suicide risk in different populations. The following databases were systematically searched: Web of Science, EBSCO, and Ovid. Following application of inclusion and exclusion criteria, 32 papers reporting investigations of the relationship between decision-making and suicidal behavior were included. Synthesis of study results provides evidence of an association between performance on standardized measures of decision-making, problem solving, impulsivity and suicidal behaviour.
 Results:
The findings suggest that impaired decision-making plays a key role in the cognitive process that contributes to suicide vulnerability. The results stress the complex interactions among suicidal behaviour and impairments in the decision-making process.
 Conclusions:
The extent and nature of this link remains unclear, highlighting the need for further research to understand the mechanisms involved. A better understanding of this relationship may improve prevention and treatment interventions for suicidal behaviour.


(331) PO-331. Differences in cognitive and metacognitive variables in patients with recent onset psychosis with and without history of suicide attempts.

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:María Luisa Barrigon . Hospital Fundacion Jimenez Diaz, Madrid
- Sergio Sanchez-Alonso - Pedro Gutierrez Recacha - Raquel López-Carrilero - Susana Ochoa - Isabel Ruiz Delgado - Berta Moreno Küstner - Spanish Metacognition Study Group -

 Introduction:
Previous studies suggest that suicidality in psychotic disorders is not correlated with neurocognition unlike in mood disorders (1, 2)
 Goals:
To compare cognitive and metacognitive variables in patients with a psychosis of recent onset (first five years of their illness) with and without previous history of suicide attempts (SA)
 Methodology:
Patients included in this study were patients with psychosis of recent onset participating in a multicentric clinical trial on the efficacy of Metacognitive Training developed in Spain (data submitted for publication). For 120 of these patients, data on previous SA were available. In all of them we assessed sociodemographic and clinical variables and compared variables related with metacognition [Jumping to conclusions (Beads Task), Attributional Style (IPSAQ), Theory of Mind (Hinting Task), self-esteem (Rosenberg’s scale) and facial recognition] and neurocognition [Trail Making Test A and B, WAIS’ subtest digits, Wisconsin Card Sorting Test, Stroop and WAIS’ subtest vocabulary for estimate IC]
 Results:
In our sample, 97 patients had no history of SA and 23 have committed at least one SA. Concerning metacognitive variables, we found no differences in JTC, Hinting Task or facial recognition and found lower scores in external-personalizing bias of attributional style in non-SA patients (-0.56 vs.1.14; p=0.053) and lower scores in Rosenberg’s self-esteem scale (24.96 vs. 28.37; p=0.011). Concerning neurocognition, we found no differences between SA-patients and non-SA patient for any of the assessed variables.
 Conclusions:
Our findings confirm previous studies’ hypothesis on the absence of a relationship between neurocognition and suicidality in psychosis. Furthermore, patients with a previous suicide attempt showed low self-esteem.
 References:
1 .Huber, C. G., Schöttle, D., Lambert, M., Hottenrott, B., Agorastos, A., Naber, D., & Schroeder, K. (2012). Brief Psychiatric Rating Scale - Excited Component (BPRS-EC) and neuropsychological dysfunction predict aggression, suicidality, and involuntary treatment in first-episode psychosis. Schizophrenia Research, 134(2-3), 273–278. http://doi.org/10.1016/j.schres.2011.12.002 2. Potkin, S. G., Anand, R., Alphs, L., & Fleming, K. (2003). Neurocognitive performance does not correlate with suicidality in schizophrenic and schizoaffective patients at risk for suicide. Schizophrenia Research, 59(1), 59–66. http://doi.org/10.1016/S0920-9964(02)00159-7


(355) PO-355. Attentional Bias Toward Suicide-relevant Information in Suicide Attempters: A Cross-Sectional Study and a Meta-Analysis

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Stephane Richard-Devantoy . McGill Group for Suicide Studies, McGill University, Department of Psychiatry & Laboratoire de Psychologie des Pays de la Loire EA 4638, Université de Nantes et Angerse, Montréal & Nantes
- Yang Ding - Gustavo Turecki - Fabrice Jollant -

 Introduction:
Attentional Bias Toward Suicide-relevant Information in Suicide Attempters: A Cross-Sectional Study and a Meta-Analysis . Previous studies using a modified Stroop test suggested that suicide attempters, in contrast to depressed patients with no suicidal history, display a particular attentional bias toward suicide-related cues. However, negative results have also been reported.
 Goals:
In the present study, we collected new data and pooled them as part of a meta-analysis intended to shed further light on this question.
 Methodology:
We conducted 1) a cross-sectional study comparing performance on the modified Stroop task for suicide-related, positively-valenced and negatively-valenced words in 33 suicide attempters and 46 patient controls with a history of mood disorders; 2) a systematic review and a meta-analysis of studies comparing performance on the modified Stroop task among patients with vs. without a history of suicidal acts in mood disorders.

 Results:
The cross-sectional study showed no significant difference in interference scores for any type of words between suicide attempters and patient controls. A meta-analysis of four studies, including 233 suicide attempters and 768 patient controls, showed a significant but small attentional bias toward suicide-related words (Hedges’g=0.22, 95%CI [0.06 – 0.38], Z=2.73, p=0.006), but not negatively-valenced words (Hedges’g=0.06, 95%CI [-0.09 – 0.22], Z=0.77, p=0.4) in suicide attempters compared to patient controls.
 Conclusions:
Our data support a selective information-processing bias among suicide attempters. Indirect evidence suggests that this effect would be state-related and may be a cognitive component of the suicidal crisis. However, we could not conclude about the clinical utility of this Stroop version at this stage.
 References:
Richard-Devantoy S, Ding Y, Turecki G, Jollant F. Attentional Bias Toward Suicide-relevant Information in Suicide Attempters: A Cross-Sectional Study and a Meta-Analysis. Journal of Affective Disorders 2016 ;196:101-108.


(374) PO-374. Many people experience suicidal thoughts and images without acting on them

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:V. Hinze . ,
- K. Hawton - J. Holmes - D. Johnson - E. Chatburn - C. Crane - Bergljot Gjelsvik -

 Introduction:
Many people experience suicidal thoughts and images without acting on them. For some, suicidal thoughts feel comforting (Crane et al, 2013). For others, the thoughts are highly intrusive and the person might become preoccupied with suppressing them or ruminating about them. Such attempts to suppress or ruminate about the intrusive thoughts and images can backfire, exacerbating the suicidal impulses.One possible mechanism underlying the urge to suppress or ruminate about intrusions is the belief that intrusions have behavioural consequences, potentially exacerbating their aversive quality and thus the felt need to either get rid of them or ruminate over them. However, there is also evidence that some people are able to experience suicidal intrusions without trying to suppress or ruminate about them (Williams et al., in press).
 Goals:

 Methodology:
We will present data from an ongoing study comparing individuals with a history of recurrent suicidal depression with two non-suicidal control groups, examining the relationship between beliefs about intrusions, suppression, rumination and dispositional mindfulness.
 Results:
The degree to which these associations are specific to individuals with a history of suicidal depression will be examined.
 Conclusions:
Implications for clinical practice will be discussed.
 References:
Crane, C., Barnhofer, T., Duggan, D. S., Eames, C., Hepburn, S., Shah, D., & Williams, J. M. G. (2013). Comfort from suicidal cognition in recurrently depressed patients. Journal of Affective Disorders, 155, 241-246.
Williams, J. M. G., Duggan, D. S., Crane, C., Hepburn, S., Hargus, E., & Gjelsvik, B. (in press). Modes of mind and suicidal processes. In R. O’Connor, S. Platt and J. Gordon (Eds), International Handbook of Suicide Prevention. Research, Policy and Practice (2nd Ed.). London: Wiley-Blackwell.


(379) PO-379. Suicidal Behaviour and Related Factors in patients who visit emergency department of General Hospital in Cantabria (Spain)

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical and neurocognitive studies of suicidal behavior

Authors:Ana Isabel De Santiago-Díaz . Hospital Universitario Marqués de Valdecilla (Servicio Cántabro de Salud), Santander
- María Isabel Bolado-Alonso - Jesús Ángel Artal-Simón -

 Introduction:
Suicide attempts and suicidal ideation are common phenomena in general and psychiatric populations. Identifying factors associated with suicidal behaviour may contribute to the early identification, prevention and treatment of suicide.
 Goals:
The aim of this study is to describe the epidemiology of emergency department (ED) visits for attempted suicide and suicidal ideation to determine associated socio-demographic and clinical features in a naturalistic sample of General Hospital.
 Methodology:
An observational-descriptive study of patients admitted to the ED of Valdecilla University Hospital (Spain) during the 4-months period was conducted. 143 consecutive patients from March to June 2015 were assessed by the on-call Psychiatrist Unit (mean age=43,57; age range: 16-84; 61% women). Lifetime suicidal behaviour was assessed with routine outcome monitoring, including socio-demographic parameters, DSM-IV-R diagnosis, protective factors, number of previous suicide attempts, acute psychopathology and personality traits.
 Results:
Nearly half the patients were repeated attempters, 26% the first suicide-attempter, and 41% ED visits were suicidal ideation. Psychiatric diagnosis associated with suicide behaviour was found for Mood or Affective Disorders (62%) and Personality Disorders (26%). Suicide attempt was often impulsive (88%) and the most common method of injury was self-poisoning (69%). The fourth part of patients needed a Psychiatric admission (24% of suicide attempts and 27% of suicidal ideations).
 Conclusions:
ED visits for attempted suicide and suicidal behaviour are relatively common, at least two persons per day, most frequent among women. One of four of this suicidal behaviour need of psychiatric hospitalization. The high association of mood and personality disorders found suggests these issues should be considered during management and disposition. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients.
 References:
1. World Health Organization, 2014. Preventing suicide: a global imperative. ISBN 978 92 4 156477 9 (NLM classification: HV 6545) 2. Oquendo MA, Currier D, Mann JJ. Prospective studies of suicidal behavior in major depressive and bipolar disorders: What is the evidence for predictive risk factors? Acta Psychiatr Scand 2006; 114:151-158. 3. Doshi A1 & all. National study of US emergency department visits for attempted suicide and self-inflicted injury, 1997-2001. Ann Emerg Med 2005;46(4):369-75. 4. Alberdi-Sudupe J1 & all. Suicide attempts and related factors in patients admitted to a general hospital: a ten-year cross-sectional study (1997-2007). BMC Psychiatry 2011; 31:11-51.




Clinical phenotyping of suicidal individuals


(123) PO-123. Are there clinical and care differences between patients with or without history of suicide attempts who are treated in an outpatient clinic?

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Juan Valdes-Stauber . University of Ulm, Department of Psychiatry and Psychotherapy I, Ravensburg- Germany
-

 Introduction:
Epidemiological research regarding care needs, treatment intensity and costs is important for more accurate allocation of outpatient treatment resources in community.
 Goals:
First, to assess clinical, sociodemographic and treatment differences between patients with a history of suicide attempts and those without. Second, to assess the possible differences between the principal diagnostic groups.
 Methodology:
The sample consisted of 1,672 patients suffering from severe mental disorders attending a German rural outpatient clinic during a 1 year period. Differences were assessed using Chi-square tests and ANOVA tests. Associations were calculated using robust multivariate regression analyses.
 Results:
Patients with suicide attempt history were younger, lived more often alone, showed lower functionality (GAF) and higher impairments (CGI), more psychiatric as well as somatic comorbidity and had a longer illness history. All assessed treatment variables demonstrated more intensive care for this group: annual outpatient, hospitalization and psychopharmacological costs were higher as was the number of lifetime psychiatric hospitalizations. For the assessed one-year period, the number of contacts as well as the cumulative treatment time was larger. Living alone, having lower functionality, suffering from a personality disorder or having psychiatric comorbidity was associated with greater care intensity. Patients with a history of suicide attempts suffered more frequently from personality disorders and schizophrenia and less frequently form organic mental and psychosomatic disorders.
 Conclusions:
This investigation confirms results from the research literature regarding the after-discharge care needs of patients with a history of suicide attempts. Patients with a history of suicide attempts exhibit through all assessed variables a higher degree of impairment and outpatient care. These results reflect naturalistic care efforts that do not necessarily correspond to the real care needs.


(146) PO-146. The association between alcohol and patterns of self-harm during public holidays

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Eve Griffin . National Suicide Research Foundation, Cork, Ireland
-

 Introduction:
Temporal fluctuations in hospital-treated self-harm have previously been observed, with peaks emerging during holiday periods. Alcohol is frequently involved in self-harm presentations. However, research exploring alcohol as a contributory factor to seasonal variations in self-harm is limited. Thus, the aim of this study was to examine patterns of hospital-treated self-harm in Ireland during public holidays and associations with alcohol involvement.
Data on self-harm presentations to all emergency departments (EDs) from 2007-2013 were obtained from the National Self-Harm Registry Ireland. Descriptive and risk ratio analyses were used to explore the relationship between self-harm presentations and alcohol consumption on public holidays compared to all other days in the year.
Between January 2007 and December 2013, a total of 82,057 episodes of hospital-treated self-harm were recorded by the Registry. The mean number of self-harm presentations were 32 (±7) daily and 36 (±11) on public holidays. Overall, alcohol was involved in 40% of all self-harm presentations to hospital. More specifically, alcohol was involved in 46% of all self-harm presentations on bank holidays compared to 39% on all other days. Alcohol consumption in males increased on public holidays (51%) compared to all other days (45%). During public holidays, self-harm presentations had a 17% increase in risk of involving alcohol consumption compared to all other days (RR: 1.17, 95%CI: 1.12-1.21). Self-harm presentations to hospital on Christmas Eve, Christmas Day and New Year?s Day had a 34%, 36% and 32% increase in risk of involving alcohol consumption compared to all other days, respectively.
The results from this study indicate that self-harm presentations are elevated on public holidays and that alcohol consumption is more strongly associated with self-harm presentations on public holidays compared to all other days in the year. Therefore national strategies aiming at reducing alcohol consumption and misuse should be intensified before and during public holidays.


(163) PO-163. Is suicidal behavior related to higher severity in patients with Bipolar Disorder?

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Lorena De La Fuente-Tomás . Universidad de Oviedo, Oviedo - Spain
- Gemma Safont Lacal - Belén Arranz Martí - Pilar Sierra San Miguel - Mónica Sánchez - Leticia García-Álvarez - Mª Paz García-Portilla -

 Introduction:
Despite suicide attempts remain prevalent among patients with bipolar disorder (BD) [1, 2], there are no many research exploring suicidal behavior in BD understood as a systemic illness [3, 4] and its negative consequences.
 Goals:
To examine the differences in demographic, clinical (psychiatric and somatic), functioning and quality of life (QoL) variables according to history of suicidal attempts.
 Methodology:
Cross-sectional, naturalistic, multicenter study. Sample: 224 outpatients with BD (DSM IV-TR criteria). Patients were divided in the following 3 groups: nonattempters (NA), one suicidal attempt (OSA) and repeated suicidal attempters (more than 1 suicidal attempt) (RSA). Assessment: demographic and clinical information (bipolar illness characteristics, comorbidity (psychiatric and somatic); biological information: anthropometric and lab results; cognition: SCIP; functioning: FAST and GAF; and QoL: SF-36.
 Results:
Mean age 47.28 (SD=12.46); 65.3% females; 71.3% Bipolar I; CGI-S=3.63 (SD=1.41); length of illness 11.62 (SD=10.04). RSA significantly have greater number of manic episodes and worse functioning (FAST, GAF) than the other two groups. NA patients were less severe, took a small number of drugs, and were widowed/divorced, had a pension benefit and comorbid personality disorders in a lower proportion than the other two groups. RSA had greater clinical severity (number of: hospitalizations, depressive and mixed episodes), worse physical health (BMI, abdominal perimeter, insulin and calcium levels) and worse QoL (mental health) than NA.
 Conclusions:
- Patients with suicidal attempts (both OSA and RSA) have a more severe bipolar disorder and greater negative consequences.
- Repeated suicidal attempts are associated with worse level of functioning and greater number of manic episodes.
- Physical health and clinical characteristics of the BD differentiate between nonattempters and repeated suicidal attempters, while demographic characteristics, severity of the illness, and number of drugs prescribed distinguish between nonattempters and the other two groups.

 References:
1. Goffin, K.C., et al., Different characteristics associated with suicide attempts among bipolar I versus bipolar II disorder patients. J Psychiatr Res, 2016. 76: p. 94-100.
2. Jimenez, E., et al., Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder. Acta Psychiatr Scand, 2016. 133(4): p. 266-76.
3. Berk, M., et al., Does stage of illness impact treatment response in bipolar disorder? Empirical treatment data and their implication for the staging model and early intervention. Bipolar Disord, 2011. 13(1): p. 87-98.
4. Grande, I., et al., Mediators of allostasis and systemic toxicity in bipolar disorder. Physiol Behav, 2012. 106(1): p. 46-50.


(183) PO-183. Identifying risk factors for suicide according to clinical severity: retrospective and descriptive study in Sabadell (Spain)

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Marti Guinovart Julian . Corporacio Sanitaria Parc Tauli, Sabadell - Spain
- Eva Aguilar Morales - Isabel Parra Uribe - Diego Jose Palao Vidal -

 Introduction:
There is disparity when we analyze suicide attempts. The most severe attempts are those associated to a higher risk of completing suicide. Detecting patients with higher risk may help to prevent suicide.
 Goals:
To identify risk factors related to severe suicide attempts, as they often translate into a higher risk of completing suicide.
 Methodology:
We selected all cases of suicide attempts seen at the emergency room of the Sabadell Hospital between 2008 and 2013. Mild attemps required less than 24 hours of medical follow-up, moderate attempts between 24-48 hours and severe attempts more than 48 hours, surgery or admission in a medical unit.
 Results:
From 2501 attempts, 300 (11.6%) were severe. Compared to mild or moderate ones, severe attempts were more frequent in men (39.3% vs 31.6%) and older population (mean age 45.7 vs 39.9). The most prevalent diagnosis was depressive disorder, but its incidence was increased in severe attempts (33.8% vs 21.5%). Other axis I disorders were also more prevalent in severe attempts (psychotic disorder 13.9% vs 5.5%, bipolar disorder 7.4% vs 2.9%). Among severe attempts, 76% had an axis I disorder, whereas in mild and moderate attempts the proportion of axis I disorders was lower (44.9%) and higher in axis II disorders (42.6% vs 34.4%).
 Conclusions:
Most attempts were not severe. Severe ones were more prevalent in men and older population. In agreement with other authors, most patients suffered depressive disorder, but psychopathology was more important among severe suicide attempters. Identification of clinical and demographic features related to severe suicide attempts is essential to establish prevention strategies.
 References:
Mento C et al. Serious Suicide Attempts: Evidence on Variables for Manage and Prevent this Phenomenon. Community Ment Health J. 2015 Sep 23. Parra I et al. Attempted and completed suicide: Not what we expected? Journal of Affective Disorders 150 (2013) 840-846.


(187) PO-187. Profile of patients presenting to emergency departments with high-risk suicidal behaviour

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Jacklyn Mccarthy . National Suicide Research Foundation, Cork
-

 Introduction:
Self-harm is one of the strongest predictors of suicide. Individuals who have engaged in high-risk suicidal behaviour share similar characteristics to those who die by suicide. A limited number of studies have focused on high-risk suicidal behaviour, especially in an Irish context.
 Methodology:
As part of the larger SSIS-ACE study, presentations of high-risk suicidal behaviour were identified through the two Cork Emergency Departments from June 2014 to December 2015. A number of items were recorded including characteristics of the presentation and socio-demographic variables.
 Results:
During the 15-month period 113 eligible patients presented to the EDs following an episode of high-risk suicidal behaviour. The majority of participants were male (62%). The average age across both genders was 36 years. There was a peak in those aged 30-35 years. Half of the presentations involved self-poisoning. Other common methods of self-harm included hanging (19%) and serious self-cutting or stabbing (14%). Despite having engaged in high-risk suicidal behaviour only 5% scored high (10-14) on objective suicide intent. Patients who had engaged in more lethal methods of self-harm such as carbon monoxide poisoning, strangulation and hanging scored higher overall.
 Conclusions:
This study is one of the first to examine Irish presentations of high-risk suicidal behaviour. Our findings suggest important similarities (gender) and differences (methods) between this group and those who die by suicide. Suicide intent varied by method. Despite having engaged in high-risk suicidal behaviour the majority of patients showed no significant physical injuries. This is especially relevant considering the poor survival rates of individuals who engage in attempted hanging, which is a frequently used method of highly lethal self-harm.


(196) PO-196. Seasonality in three different profiles of suicidal adolescents

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Francisco Villar Cabeza . Servicio de Psiquiatría y Psicología del Hospital Materno-Infantil Sant Joan de Déu, Esplugues de Llobregat (Barcelona), España
- Carmina Castellano-Tejedor - Tania Prieto-Toribio - Tomás Blasco Blasco -

 Introduction:
Research on seasonal effects on suicide rates suggests that the prevalence of suicide is greatest during the late spring and early summer months[1] despite the common belief that suicide rates peak during the winter season. Additionally, it might be possible that seasonality could be related to different individuals with different suicidal behaviour trajectories. To clarify this, the three categories of adolescents who engage in suicidal behavior suggested by Fortune et al[2] will be considered, although they did not provide data on seasonality when proposing the classification.
 Goals:
To explore if suicide attempts are season-related in three different prototypic profiles of adolescents who engage in suicide behaviors[2].
 Methodology:
Longitudinal descriptive study. All admissions to a Specialized Suicide Unit in a Pediatric Hospital were registered by a clinical psychologist during two years (2014-2015). Each episode was classified according to Fortune et al[2] categories: Group I: longstanding difficulties which spanned the developmental domains of home, school and peers. Group II: Evidence of an established psychiatric disorder; subgroup I: individuals with a protracted suicidal process which lasted 5-9 years approx., subgroup II: those with a brief suicidal process lasting 1 year approx. Group III: emergence of suicidal process as an acute response to life events among people who appeared to have previously been functioning well, without apparent mental illness or known selfharm.
 Results:
Figures I-III show suicide rates for each group during two-year period. Globally, seasonality is observed in Group III with rates of suicide attempts notably increased during April and August compared to previous months and specifically, March, July and October. No seasonal pattern is observed for Groups I and II.
 Conclusions:
Contrary to previous research, groups I and II (90% of the sample) showed no seasonal pattern. Our preliminary results only showed a certain seasonal pattern for group III. The identification of a seasonal pattern would suggest the influence of an important environmental modulator that can reverberate to suicide prevention strategies. Further studies controlling interfering variables for this phenomenon would be needed.
 References:
[1] Christodoulou C, Douzenis A, Papadopoulos FC, Papadopoulos A, Bouras G, Gournellis, R, Lykouras L. Suicide and Seasonality. Acta Psychiatr Scand, 2012;125(2):127-46. [2] Fortune S, Stewart A, Yadav V, Hawton K. Suicide in adolescents: using life charts to understand the suicidal process. Journal of Affective Disorders, 2007;100:199-210.


(202) PO-202. Is lifetime history of suicide attempts related to worse physical health in patients with schizophrenia?

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Leticia García-Álvarez . Cibersam, Oviedo
- Julia Basteiro-Monje - Maria Paz García-Portilla - Juan Carlos Leza - Javier Rubén Caso - Leticia González-Blanco - Pilar Alejandra Saiz - Lorena De La Fuente-Tomás - Patricia Burón-Fernández - Julio Bobes -

 Introduction:
Suicide attempts had been associated with female gender, higher levels of education, substance abuse/dependence, depression, and childhood physical abuse in patients with schizophrenia (1, 2). Furthermore, many studies have shown a link between suicidal behavior and low lipid levels, especially cholesterol, in patients with schizophrenia (3).
 Goals:
To examine the differences in demographic, clinical (psychiatric and somatic, including inflammatory parameters), functioning and quality of life (QoL) variables according to history of suicide attempts.
 Methodology:
Cross-sectional, naturalistic study. Inclusion criteria: DSM-IV diagnosis of schizophrenia; age >17 years; and written informed consent given. Sample: 123 patients with schizophrenia (DSM IV-TR criteria). Patients were divided in the following 3 groups: nonattempters (NA), one suicide attempt (OSA) and repeated suicide attempters (more than 1 suicide attempt) (RSA). Assessment: demographic and clinical information (length of illness, comorbidity (psychiatric and somatic); biological information: anthropometric and lab results; cognition: SCIP; functioning: PSP and EEAG; and QoL: SF-36.
 Results:
Mean age 40.75 (10.37), 67.5% males. CGI-S=4.20 (SD=1.03); length of illness 13.85 (SD=10.88). Patients with OSA have greater levels of PGE2 (F=4.976, p=0.009), greater proportion of patients with high creatinine levels (Chi-square=11.971, p=0.018) and hypertension (Chi-square=13.273, p=0.010) than the other two groups. Patients with RSA have greater number of hospitalization (F=8.032, p=0.001) and have in a greater proportion low levels of cholesterol (Chi-square=9.543, p=0.049) and diagnosis of cancer (Chi-square=8.839, p=0.012), hepatitis C (Chi-square=22.374, p<0.0001) and bronchitis (Chi-square=13.370, p=0.001). Furthermore, they have low levels of calcium (F=6.529, p=0.002) and smoke a greater number of cigarettes per day (F=5.245, p=0.007) than those patients with OSA.
 Conclusions:
Low levels of cholesterol, higher number of hospitalizations and the diagnosis of severe somatic illnesses are associated with repeated suicide attempt. - Other lab results are significant but they need a deeper causal study.
 References:
1. Fuller-Thomson E, Hollister B. 2016. Schizophrenia and Suicide Attempts: Findings from a Representative Community-Based Canadian Sample. Schizophr Res Treatment, 3165243. doi: 10.1155/2016/3165243. 2. Hor K, Taylor M. 2010. Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol, 24 (4), 81–90. 3. Ainiyet B, Rybakowski JK. 2014. Suicidal behavior in schizophrenia may be related to low lipid levels. Med Sci Monit, 20, 1486-90.


(207) PO-207. Multicentre Study of Self-harm in England

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Galit Geulayov Geulayov . Department of Psychiatry, University of Oxford, Oxford
-

 Introduction:
Multicentre Study of Self-harm in England – rationale, methodology and results Self-harm (intentional self-poisoning and self-injury) is a major health problem in many countries. Individuals who self-harm have a markedly elevated risk of subsequent suicide and at least half of all persons who die by suicide have a history of self-harm, with a quarter having episodes in the year before death. Self-harm is also associated with increased risk of non-suicidal premature death and with poorer psychosocial outcomes and increased economic costs. Reliable and accurate data on self-harm presentations are important for understanding national trends and risk factors for self-harm and for informing potentially effective preventative measures. Systematic monitoring of self-harm in many countries, including England, has tended to be confined to single centres. However, these are limited in terms of generalizability of findings. We describe the rationale and methodology of the Multicentre Study of Self-harm in England which was developed as part of the National Suicide Prevention Strategy for England. This involves systematic and comprehensive data collection on self-harm presentations to five large general hospitals in three cities (Oxford, Manchester and Derby).
 Methodology:
We present findings from this 14-year (2000-2014) project (N persons=52,567, N episodes of self-harm=94,498), including trends in self-harm and how these relate to trends in suicide, the impact of the recent economic recession and the risk of suicide following self-harm. We also discuss key challenges pertaining to methods of data collection across centres.
 Conclusions:
This presentation will be relevant to those wishing to establish a systematic collection on self-harm, clinicians working with this population and policy makers interested in the importance of clinical services for self-harm patients in relation to suicide prevention.


(219) PO-219. Drugs used in international drug overdose: Finding from the National Registry of Self-Harm, Ireland.

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Caroline Daly . National Suicide Research Foundation, Cork-Ireland
- Eve Griffin - Darren Ashcroft - Roger Webb - Ella Arensman -

 Introduction:
Intentional Drug Overdose (IDO) is the most common form of hospital treated self-harm in Ireland [1]. To date there has been no detailed breakdown of individual drugs frequently used in self-harm in Ireland.
 Goals:
This research aims to examine the profile of persons who present following IDO, and to determine the drugs most frequently used in IDO acts.
 Methodology:
This research includes data from the national registry of self-harm, recording presentations involving drug overdoses (ICD-10 codes x60-64) to emergency departments in ireland, for the period 1st January 2012 to 31st December 2014. Drugs are classified according to the Anatomical Therapeutic Classification System.
 Results:
18,329 presentations involving IDO were recorded. the majority of these presentations were made by females (10767,59%), aged 15-24 (5195,28%), with alcohol involved in 41% (7446) of acts. half of presentations involved polydrug use (6961,53%) and 49% of acts, where quantity is known, involved the ingestion of >20 tablets (7217;49%). two thirds (12021,66%) of ido's involved nervous system drugs, mainly psycholeptics (4827.40%), including anxiolytics (2309) and hypnotics and sedatives (1736). antidepressants were involved in 14% (2492) of IDO's. illegal drugs were involved in 5% of acts, including mainly cocaine and heroin. Seven of the top 10 drugs used in ido were prescription, 4 were benzodiazepines (2916,16%). paracetamol was the most common drug used (2845,16%) followed by diazepam (1367,8%) and alprazolam (558,3%).
 Conclusions:
intentional drug overdose occurs more frequently in females, under 25 years and is often associated with alcohol. prescription drugs specifically psycholeptics and antidepressants are frequently used in overdose. paracetamol is the most commonly used drug in ido. there is a need for further research and also to review prescribing practices, adherence to prescription medications and also restrictions to accessing drugs frequently used in overdose.
 References:
[1] national self harm registry annual report ireland. cork: national suicide research foundation; 2014 p.5. Available: http://nsrf.ie/publications/reports/


(259) PO-259. Self-reported triggering events for suicide attempts in a representative community sample of adolescents and young adults in Germany

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Catharina Voss . Institute of Clinical Psychology and Psychotherapy, Behav. Epi., Technische Universität Dresden, Dresden - Germany
- Kerstin Diel - Eva Asselmann - Hans-ulrich Wittchen - Roselind Lieb - Katja Beesdo-Baum -

 Introduction:
Why suicide? Several theories have tried to understand the reasons for suicide attempts (O’Connor & Nock, 2014). Though, only a few studies have directly assessed reasons and triggering events for suicide attempts in subjects with previous attempts.
 Goals:
Therefore, the current analysis examines self-reported triggering events that led to the decision to commit suicide in adolescents and young adults.
 Methodology:
The Early Developmental Stages of Psychopathology Study (EDSP) interviewed a representative community sample of N=3,021 adolescents and young adults from Germany, at baseline (T0, age 14-24y) and in up to three follow-up assessments over 10 years (T1-T3). Diagnoses of mental disorders were assessed at each wave using the Munich Composite International Diagnostic Interview (M-CIDI). In addition, all participants were asked at T2 and T3 about lifetime suicide attempts including triggering events and other suicide characteristics. Triggering events were noted with written responses to the following item: Which event or events have led to the decision to commit suicide? Based on previous research, participants’ first answer was categorized by two independent raters into four main categories: interpersonal conflicts, intra-psychological conflicts, traumatic events, and socio-economic conditions (Cohen’s Kappa: .81-.92).
 Results:
Results indicated that 133 participants reported a lifetime suicide attempt (59.2% women); 115 participants provided information about triggering events. The most frequently reported triggering events were interpersonal conflicts (40.9%) followed by intra-psychological conflicts (35.0%), socio-economic conditions (14.3%) and traumatic events (8.3%). Associations between categories, socio-demographic variables and mental disorders were examined.
 Conclusions:
Results may be useful for targeted prevention and early intervention among subjects at increased risk for suicide. Further studies should examine differences in triggering events between individuals with suicidal ideations or plans compared to those with suicide attempts. These results could help to differentiate between individuals at higher and lower risk for a subsequent suicide attempt.
 References:
O'Connor, R.C., Nock, M.K. (2014). The Psychology of Suicidal Behaviour. Lancet Psychiatry, 1, 73-85.


(262) PO-262. Description of suicide attempts attended in a coastal community mental health unit during one year

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Maria Luisa Barrigón . Hospital Fundacion Jimenez Diaz, Madrid-Spain
- Margarita Guerrero Jiménez - Carmen Maura Carrillo De Albornoz Calahorro - Braulio Girela Serrano - Mercedes Méndez Santa Olalla - Antonio Rodríguez -

 Introduction:
Concurrent with the recent global economic crisis there is a rising concern about the effect of recession on suicide mortality rates. In our country, this crisis has hit in specially in touristic and agricultural areas such as the coastal area of Granada in Andalucia, biggest region in Spain. In this way, to study the profile of suicide attempts in this area could highlight this relationship.
 Goals:
To record patients treated urgently in Community Mental Health Unit of Motril, Granada(Spain) by attempted suicide.
 Methodology:
We conducted a descriptive study recording patients treated urgently in Motril Community Mental Health Unit who have done any suicide gesture from February 2015 until December of that year.
 Results:
In total 39 urgent assessments were recorded during the observational period. The month of highest incidence was November, with 6 visits followed by August and October (5). The most common method was voluntary drug intake (29 of the total of 39 patients) Origin: -23 out of 39 (59%) were remitted from the general hospital emergency department. -Critical care and emergency ambulatory devices: 1 -Primary Care: 10 -Another Specialist: 2 -Own initiative: 2 Discharge diagnosis: -14 of 39 (35.8%) individuals did not meet criteria for any mental disorder, although some of them were classified with V or Z diagnosis according to ICD-10 for making a reactive gesture to a emotional crisis, couple breakups or economic problems ... -11 Of them meet criteria for various anxiety disorders, obsessive compulsive and adaptative crisis.
 Conclusions:
Discussion: Primary and preventive care amongst psychiatric disorders is not as resolute as other specialties. Due to this deficiency, the patient attends the emergency room in hospital for help and guidance more frequently. Knowing some peculiar characteristics in suicidal populations as well as the most prevalent pathologies, it could be adapted both the profile of nurse attendance and the type of resources needed to ensure effective patient care. Conclusion Profile of patients attended for suicide attempt in an outpatient setting in a semi-rural coastal area is variated. It is worth to mention that one-third of this population did not meet criteria for any mental disorder.
 References:
• Vijayakumar, Lakshmi; Nagaraj, K.; Sujit Jhon. Suicide and suicide prevention in developing countries, Desease Control Priorities Project. Working Paper Nº 27, June 2004 • Meyer RE, Salzman C, Youngstrom EA, Clayton PJ, Goodwin FK, Mann JJ, et al. Suicidality and risk of suicide definition, drug safety concerns, and a necessary target for drug development: a consensus statement. J Clin Psychiatry. 2010;71(8):e1-e21.


(278) PO-278. Liaison Psychiatry - the experience of the Suicide Research and Prevention Unit

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Sandra Neves . Suicide Research and Prevention Unit ,Coimbra Hospital University Centre, Coimbra, Portugal
- Filipe Vieira - Sandra Silva - Nuno Madeira - Adelaide Craveiro - Francisco Alte Da Veiga - José Carlos Santos - Carlos Saraiva -

 Introduction:
A subgroup of patients in medical wards corresponds to those who had severe suicide attempts requiring hospitalization (1). These patients should be referred to liaison psychiatry during their hospitalization as a crucial step in order to achieve long-term stabilization (2). Since 2014 our Liaison Unit at a general university hospital has been providing that support, ensuring a quick (24h-48h) and targeted response.
 Goals:
This study aims to provide a comprehensive overview of sociodemographic and clinic profile of patients who attempted suicide and were subsequently hospitalization.
 Methodology:
All Liaison patients referred to our Suicide Research and Prevention Unit in Coimbra Hospital University Centre, since January 2014 to March 2016, were included. Data were collected using electronic and paper medical records. Statistical analysis was performed with SPSS.
 Results:
Females were the majority (59%) of the sample and the average age was around 51 years. The most frequent suicide method in women was drug poisoning (87,5%), while men preferred violent methods such as defenestration, hanging or firearms. Respecting to violent methods, only 19% of the women (compared to 81% of men) had chosen them, with a highly significant association (p = 0.001).
 Conclusions:
Our findings were in agreement with literature, yet sample size is relatively small. Further studies could provide a more comprehensive approach, optimizing suicidal behavior recurrence. Patients seem to have benefited from an earlier referral to our Liaison support, leading to better psychiatric care during admission and discharge planning, with potential benefits in the long-term.
 References:
(1) Alberdi-Sudupe J, Pita-Fernández S, Gómez-Pardiñas SM, et al. Suicide attempts and related factors in patients admitted to a general hospital: a ten-year cross-sectional study (1997-2007). BMC Psychiatry. 2011;11:51. (2) Royal College of Psychiatrists. Position Statement PS3/2010. Self-harm, suicide and risk: a summary. London, England: Royal College of Psychiatrists; 2010.


(285) PO-285. Suicidal behavior: Methods and personality traits.

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Filipe Vieira . Centro Hospitalar e Universitário de Coimbra, Coimbra-Portugal
- Sandra Neves - Sandra Silva - Nuno Madeira - Francisco Alte Da Veiga - Adelaide Craveiro - José Carlos Santos - Carlos Braz Saraiva -

 Introduction:
Accurate information about preferred suicide methods is important for devising strategies and programs for suicide prevention. Our knowledge of the methods used and their variation across personality traits is limited (1).
 Goals:
The aim of this study was to provide the first comprehensive overview of personality trait patterns of suicide methods.
 Methodology:
All patients referred to the Suicide Research and Prevention Unit in Coimbra Hospital University Centre from 1994 until 2016, following a suicidal behavior, were included in the study. The instrument used to collect information was the Suicidal Behavior Assessment Interview – EACOS (2). Statistical analysis was performed with SPSS.
 Results:
After excluding patients due to missing data, the final sample consisted of 444 patients with a mean age of 29 years. 28% were males and 72% females. Most patients (69,1%) used drug poisoning as their suicide method. Moreover, 12,6% used other toxins, 9,7% used phlebotomy and 8,6% other methods (such as drowning or hanging) as suicide method. The use of drug poisoning was positively associated with histrionic personality traits (p<0,001) and the use of other methods was negatively associated with such personality traits (p<0,006). The use of other toxins as a suicide method was positively associated with antisocial (p<0,024) and impulsive (p<0,002) personality traits. Phlebotomy as a suicide method was positively associated with borderline (p<0,002) and avoidant (p<0.009) personality traits.
 Conclusions:
Understanding the choice of suicide methods and its relationship with personality can provide more effective and personalized suicide prevention strategies.
 References:
(1) Lester D. Choice of Method for Suicide and Personality: A Study of Suicide Notes. Omega (Westport). 1971; 2:76-80 (2) Saraiva CB. Entrevista de Avaliação dos Comportamentos Suicidários (EACOS). Psiquiatria Clínica. 1998; 19(4): 251-274.


(286) PO-286. The relationship between suicide behavior and personality traits with physical and sexual abuse in childhood

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Filipe Vieira . Centro Hospitalar e Universitário de Coimbra, Coimbra-Portugal
- Sandra Neves - Sandra Silva - Nuno Madeira - Francisco Alte Da Veiga - Adelaide Craveiro - José Carlos Santos - Carlos Braz Saraiva -

 Introduction:
Physical and sexual abuses during childhood are major public health problems worldwide (1). They can cause permanent neurobiological and neuroendocrine changes that lead to increased vulnerability in the development of psychopathology throughout life.
 Goals:
This study aims to find an eventual association between physical and sexual abuse in childhood with personality traits in a population of adults with suicidal behavior.
 Methodology:
All patients referred to the Suicide Research and Prevention Unit in Coimbra Hospital University Centre from 1994 until 2016, following a suicidal behavior, were included in the study. The instrument used to collect information was the Suicidal Behavior Assessment Interview – EACOS (2). Statistical analysis was performed with SPSS.
 Results:
Our final sample consisted of 418 patients: mean age of 29 years; 27% were males and 73% females. 14,6% and 35,4% of patients suffered from sexual and physical abuse, respectively. The most frequent personality traits in adults with suicidal behavior exposed to childhood sexual and physical abuse were borderline traits (25,9% and 26,2%, respectively). In adults with suicidal behavior, the presence of sexual abuse during childhood was positively associated with borderline traits (p<0.048); physical abuse during childhood was negatively associated with obsessive-compulsive traits (p<0.017).
 Conclusions:
There is a correlation between sexual abuse during childhood and borderline personality traits in adults with suicidal behavior. It is crucial to further understand this relationship, given its role in mental health promotion in adulthood. Early intervention, at a biopsychosocial level and focusing on children and their families, is of key importance.
 References:
(1) Hillis SD, Mercy JA, Saul JR. The enduring impact of violence against children. Psychol Health Med. 2016 Mar 16:1-13. (2) Saraiva CB. Entrevista de Avaliação dos Comportamentos Suicidários (EACOS). Psiquiatria Clínica. 1998; 19(4): 251-274.


(287) PO-287. Suicide attempters admitted to a Psychiatric Ward Versus ones with others psychiatric consultation outcomes in an Emergency Room

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Claudia Delicato . Department of Traslational Medicine - University of Eastern Piedmont, Novara - Italy
- Carla Gramaglia - Isabella Coppola - Eleonora Gattoni - Sarah Di Marco - Luigi Girardi - Gian Carlo Avanzi - Luigi Castello - Fabrizio Bert - Patrizia Zeppegno -

 Introduction:
Many people who attempt suicide require medical attention. The contact with health services may be an opportunity for suicide risk detection and referral for specialized treatment. This is particularly relevant in emergency settings, where a significant percentage of suicide attempters receives first care aid. However, the approach regarding the psychiatric assessment of suicide attempters can vary considerably from one emergency room (ER) to another.
 Goals:
To compare suicide attempters admitted to a psychiatric ward after the ER referral and attempters with different psychiatric consultation outcomes.
 Methodology:
We recruited consecutive patients referring to the ER of the “Maggiore della Carità” Hospital in Novara during the period 2009–2014. No exclusion criteria were applied: all patients aged >16 years referring to the ER and requiring a psychiatric evaluation were taken into consideration. The psychiatric assessment of patients was performed by experienced psychiatrists with a clinical interview, including the assessment of suicidal intent, suicidal behaviours and attempts. For each patient, a data sheet was filled in by the psychiatrist, in order to gather demographic features, type of referral to the ER, psychiatric history and present clinical issues, type of acute intervention delivered to patient, and psychiatric admission rates.
 Results:
Less than half of suicide attempters was discharged while about one third of them was hospitalized. The remaining percentage was admitted, almost in equal proportion, were admitted to the Short Stay Unit, referred to a Day Hospital or an outpatient service. Only a small percentage was either hospitalized in other specialized Wards or self-discharged.
 Conclusions:
Implications will be discussed.
 References:
Fleischmann A, Bertolote JM, Wasserman D, De Leo D, Bolhari J, Botega NJ, De Silva D, Phillips M, Vijayakumar L, Värnik A, Schlebusch L, Thanh HT. Effectiveness of brief intervention and contact for suicide attempters: A randomixed controlled trial in five countries. Bull World Health Organ. 2008 Sep;86(9):703-9. Jo SJ, Lee MS, Yim HW, Kim HJ, Lee K, Chung HS, Cho J, Choi SP, Seo YM. Factors associated with referral to mental health services among suicide attempters visiting emergency centers of general hospitals in Korea: Does history of suicide attempts predict referral? Gen Hosp Psychiatry. 2011 May-Jun;33(3):294-9. Baraff LJ, Janowicz N, Asarnow, JR. (2006). Survey of California emergency departments about practices for management of suicidal patients and resources available for their care. Ann Emerg Med. 2006 Oct;48(4):452-8, 458.e1-2. Zeppegno P, Gramaglia C, Castello LM, Bert F, Gualano MR, Ressico F, Coppola I, Avanzi GC, Siliquini R, Torre E. Suicide attempts and emergency room psychiatric consultation. BMC Psychiatry. 2015 Feb 5;15:13.


(291) PO-291. Suicidal behavior and no satisfaction towards survival

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Sandra Silva . Centro Hospitalar e Universitário de Coimbra, Coimbra - Portugal
- Filipe Vieira - Sandra Neves - Nuno Madeira - Francisco Alte Da Veiga - Adelaide Craveiro - José Carlos Santos - Carlos Braz Saraiva -

 Introduction:
The greater the magnitude and persistence of suicidal thoughts, the greater the risk of suicide. Some authors have hypothesized that death awareness precipitates withdrawal from a goal of continuing life when it is experienced as dissatisfying and hope for the future is grim (1). Hence, satisfaction with survival after a suicide attempt is an interesting and useful parameter to consider in assessing the risk of recurrence of suicidal behavior.
 Goals:
This study aims to describe the sociodemographic profile of patients who are not satisfied with survival after a suicide attempt and finding an eventual association with the methods used.
 Methodology:
All patients referred to the Suicide Research and Prevention Unit in Coimbra Hospital University Centre from 1994 until 2016, following a suicidal behavior, were included in the study. The instrument used to collect information was the Suicidal Behavior Assessment Interview – EACOS (2). Statistical analysis was performed with SPSS.
 Results:
After excluding patients due to missing data, the final sample consisted of 184 patients who were not satisfied with survival. Females were the majority (73%) and average age stood at 32 years old. Most (48%) are single or married (39%). About half lived in urban areas. Besides, 87% had an occupation (job or students) and 13% were unemployed or retired. No satisfaction towards survival is positively associated with drug poisoning as suicide method (p< 0,003) and negatively associated with other toxins (p< 0,001).
 Conclusions:
In order to better evaluate patients and reducing the recurrence of suicidal behavior, there is a need for a qualitative approach, enhancing patient's narrative, far beyond the symptoms.
 References:
1. Hayes J, Ward CL, McGregor I. Why bother? Death, failure, and fatalistic withdrawal from life. J Pers Soc Psychol. 2016 Jan;110(1):96-115. 2. Saraiva CB. Entrevista de Avaliação dos Comportamentos Suicidários (EACOS). Psiquiatria Clínica. 1998;19(4):251-274.


(335) PO-335. Characterization of suicide attempts using high lethal methods

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:João Fonseca . Hospital Senhora da Oliveira Guimarães, Portugal
- Nélson Almeida - Rosa Rodrigues -

 Introduction:
Suicidal behavior is considered a major health problem, given the social and economic burden it brings for the communities. Suicide attempt (SA) is defined as a non-fatal, self-directed potentially injurious behavior, being considered the single most important risk factor for death by suicide in the general population. Therefore, it is important to identify the suicidal patterns inside the communities in order to designed more effective prevention strategies.
 Goals:
To characterize the patients observed in the ER of Hospital Senhora da Oliveira (Guimarães, Portugal) for attempted suicide using a high lethal method.
 Methodology:
We retrospectively collected the records of all SA medically assisted in our hospital between January 2010 and December 2015. 81 out of 840 cases were included because of the use of methods considered more lethal. A statistical descriptive analysis was conducted regarding patients’ sociodemographic and clinical data.
 Results:
Serious SA corresponded to 9.6% of all the registered cases during the five-year period considered. The majority of the patients was male (54.3%) with a mean age of 44.8 years, married (55.6%), professionally non-active (60.5%). 39.5% had a history of prior SA. When it comes to the methods used, self-poisoning by pesticides/insecticides was the most used (52 patients), followed by association of methods (8), hanging (5), drowning (4), self-poisoning by caustic alkali (4), phlebotomy (4), jumping from a high place (3) and self-harm by sharp object (1). The most prevalent clinical diagnoses were Mood Disorders (40.7%), Personality Disorders and Alcoholism (21%, each). Family and marital conflicts were the most pointed precipitating factors pointed out by the patients in 34.6% and 22.2%, respectively.
 Conclusions:
Self-poisoning by pesticides/insecticides is still a prevalent suicide method, probably given the rural way of life of some hospital catchment areas. A middle aged, non-working male suffering from a mood disorder seems to be at a higher risk of attempting suicide in this community.
 References:
Carlos Braz Saraiva, Bessa Peixoto, Daniel Sampaio. Suicídio e Comportamentos Autolesivos. Lisboa: Lidel; 2014. Portuguese World Health Organization. Preventing suicide: A global imperative, 2014. Avaiable from: http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/


(349) PO-349. Analysis of completed suicides in Pleven county for 6 year period

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Vladimir Nakov . National Center of Public Health and Analyses, Sofia, Bulgaria
- Kaloyan Stoychev - Liudmil Tumbev - Krasimir Ivanov - Dancho Dekov -

 Introduction:
Suicide is a growing public health problem worldwide: approximately one million people die by suicide each year. In 2002 suicide was ranked as the 14-th leading cause of death globally and with its projected increase it is expected to move to 12-th position in this list by year 2030. Factors associated with acute and chronic suicide risk are still poorly understood.
 Goals:
To identify potential socio-demographic and clinical suicide risk factors in a sample of patients with psychiatric diagnosis who have completed suicide.
 Methodology:
Our study covers a 6 year period /2009-2014/. All known cases of suicide passed through the Forensic Medicine department in Pleven were studied (a total of 198 individuals) and subjects with medical records for mental illness were extracted and analyzed using documentary and historical method. Relevant socio-demographic and clinical data were elicited by a specially designed information form.
 Results:
Of all 198 suicide completers for the studied period 41 (25 men, 16 women) had an ICD-10 mental disorder (20.7%). Leading diagnoses were Schizophrenia (18 cases) and Depressive disorders (14 cases), 4 patients had alcohol dependence and 4 had other psychiatric disorder. The mean age of suicide victims is 54.69 years (52.5 for males and 58.2 for females), significantly lower for patients with schizophrenia (42.75 years) and higher for those with depressive disorders (68 years)
 Conclusions:
Preliminary data (information is still being processed) show that chronic mental disorders significantly increase suicide risk. Schizophrenia seems to be associated with higher suicide risk than all other psychiatric disorders especially in younger patients.
 References:
American Foundation for Suicide Prevention www.asfp.org Hawton, K., Casanas, C., Haw, C., & Saunders, K. (2013). Risk factors for suicide in individuals with depression. Journal of Affective Disorders, 147, 17-28. Khan, A., Khan, S., Kolts, R., & Brown, W. A. (2003). Suicide rates in clinical trials of SSRIs, other antidepressants, and placebo: analysis of FDA reports. American Journal of Psychiatry, 160 (40), 790-792. Mathers, C.D. & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e. 442 Ruiz, P. (2014). Global epidemiology of suicide. In: S.H. Koslow, P. Ruiz & C.B. Nemeroff (eds): A Concise Guide to Understanding Suicide. Cambridge University Press; pp. 13-16)


(372) PO-372. Analyze the number of emergency care and the reasons

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Laura Montes Reula . Servicio Navarro de salud- Osasunbidea, Pamplona, Spain
- Almudena Portilla Fernández - Rebeca Elorza Pardo - Patricia Macaya Aranguren - Lucía Janda Galán - Adriana Goñi Sarriés -

 Introduction:
For years suicide is considered a major public health problem worldwide. It is a medical and social interest to study of factors surrounding this event.
 Goals:
Observe how many times the patients attending an emergency department of psychiatry, the motives and if they repeated suicide attempts.
 Methodology:
A total of 440 patients were included in the study, recruited in the emergency department of the Hospital of Navarra and the Reina Sofía Hospital of Tudela in period between January and October 2015. Cases are patients who were attending in emergency room for attempted suicide, and controls, who received psychiatric care for a different reason of autolytic attempt. Of all patients is being carried out follow-up six months after the first emergency care. It has chosen a monitoring group until January 31, 2016 with a sample size of 295 patients with 150 cases and 145 controls.
 Results:
It is observed that 35% of the follow-up sample repeated at least once emergency care, the most common reason was anxiety. Some of them repeat until seven times without differences between cases and controls. 16% of the cases achieve again an attempt autolytic, that the most common method was triggered by drug use.
 Conclusions:
It is observed that patients with mental illness often come to the emergency services, the most frequent causes are anxiety, demand for treatment and psychopathological decompensation. The method of making an autolytic attempt most frequent, as described literature, the drug use.
 References:
Andoni Ansean Ramos. Suicidios, Manual de Prevención, Intervención y Postvención de la conducta Suicida.2ª ed revisada. Madrid: Fundación Salud Mental España; 2015


(376) PO-376. Can Suicide be prevented in Cancer Patients?

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Martha Cristina Cancino Botello . Consorcio Hospital General Universitario de Valencia , Valencia, Spain
- Miler Andrés Cuéllar Rivas - Juan Miguel Hernández Sánchez - Fernanda Molina López -

 Introduction:
Cancer diagnosis provokes physical and psychological suffering. The emotional impact intensity and the resulting behavior (adaptive or maladaptive as in the case of suicide), has been related to different factors. According to this, authors indicate that suicide may be twice as prevalent among patients with cancer compared to general population. We present the case of a >65 year-old man with bladder neoplasm, who at the moment of diagnose had pulmonary metastatic lesions. Before the onset of any oncological treatment, the patient decided to commit suicide.
 Goals:
We aim to identify possible risk factors associated to suicide in patients with cancer.
 Methodology:
We searched articles in English and Spanish on PubMed database, using the following keywords: neoplasm, suicide, and malignancy.
 Results:
The available literature describes that suicide risk in patients with cancer is highest during the first three year since diagnose, and suicide ideation among this population has been associated with depressive disorders and hopelessness feelings. The most related entities with higher suicide rates are pulmonary, oropharyngeal, breast and pancreatic cancer. In the case of genitourinary cancer (as in this case) there is not sufficient data. Given the emotional distress provoked by these pathologies, it has been proposed some guidelines (like the one of the National Comprehensive Cancer Network) addressed to identify risk factors on cancer patients that can be useful for clinicians.
 Conclusions:
All clinicians should be aware of risk factors for suicide in these patients, specifically for those older than 60 years old, unmarried status and advanced disease at diagnose, so once identified can be implemented appropriate intervention with a multidisciplinary approach.
 References:
National Comprehensive Cancer Network. Distress management. Clinical practice guidelines. J Natl Compr Canc Netw. 2003;1:344-374. Klaassen Z, Jen RP, DiBianco JM, Reinstatler L, Li Q, Madi R, Lewis RW, Smith AM, Neal Jr DE, Moses KA, Terris MK. Factors Associated With Suicide in Patients With Genitourinary Malignancies. Cancer. 2015 Jun; 121:1864-1872 Fang F, Fall K, Mittleman MA et al. Suicide and cardiovascular death after a cancer diagnosis. N Engl J Med 2012;366(14):1310–1318. Valverde JJ, Gómez M, Navarrete A. Guía Clínica de Comunicación en oncología. 1st ed. Desclée de Brouwer, S.A; 2014


(394) PO-394. Love Till the End? A Longitudinal Dyadic Study on Suicidal Ideation among Former Prisoners of Wars and their Wives

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Yossi Levi-Belz . Ruppin Academic Center, Israel
-

 Introduction:
War captivity is one of the most severe human-inflicted traumatic experiences with wide and substantial long-term negative effects. However, only one retrospective study examined suicidal ideation (SI) among ex-prisoners of war (ex-POWs). Several studies have revealed the toll of war captivity on secondary traumatization' (ST) of ex-POWs' wives.
 Goals:
This study aimed to prospectively assess SI among ex-POWs and its associations with posttraumatic stress disorder (PTSD) symptoms over a 17-years period. Moreover, is also aimed to assess SI among ex-POWs' wives and the longitudinal associations with their husbands' PTSD and their own ST.
 Methodology:
A sample of 233 Israeli couples (142 ex-POW couples and a comparison group of 91 veteran couples) completed self-report measures of PTSD symptoms, SI and depression at two time points: T1 (2003) and T2 (2008), 30 and 37 years after the 1973 Yom Kippur War.
 Results:
Latent growth curve modeling (LGM) results showed that ex-POWs reported higher levels of SI at T2 and T3 and a pattern of increase in SI levels trajectory over time, compared to control veterans. Furthermore, among ex-POWs, PTSD symptoms at T1 contributed to the increase in rate of change in SI overtime. In related to the wives, among controls' wives, but not among ex-POWs' wives' the more ST symptoms wives reported, the higher their level of SI. Furthermore, for both research groups, PTSD and ST were positively associated with their own levels of SI. Surprisingly, an Actor-Partner Interdependence Modeling (APIM) analysis revealed that only among ex-POWs' couples, the more the husband suffered from PTSD and SI, the more moderate the increase of the wife's SI between T1 and T2.
 Conclusions:
Clinical implications of these findings for the relations between captivity trauma and suicidality as well as for veteran's couples are discussed.


(430) PO-430. Social anxiety and suicidal (anti-vital) behavior

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Olga Sagalakova . Altai State University, Barnaul, Russian Federation,
- Dmitry Truevtsev -

 Introduction:
The high frequency of suicidal and anti-vital behaviors among adolescents (in the example of Altay territory) shows that significant needs of this age group frustrated. The reason for this is both dysfunctional environment does not provide the strategies and techniques of constructive self-realization. The needs of adolescents are associated with social activity. They need recognition, success, approval, love and acceptance in the group. To achieve these goals, it is important to have social skills, social courage, to be able to mediate in situations of anxiety assessment and respond to failure. When unformed these competences increasing social anxiety, which is difficult to regulate and mediate. We saw an increase in dissatisfaction with the teenager, helplessness, hopelessness and anti-vital experiences, actions, suicide risk.

 Goals:
Identify the relationship of social anxiety and anti-vital experiences, behaviors, and suicide risk in adolescence / early adulthood. Identify markers of SA to prove a violation of the targeted action regulation in evaluation situations. Show that features of the selectivity and distribution, focus (focus mental activity) leads to disruption of activities, reducing its effectiveness, violation of mastering emotions and behavior as SA, to the accumulation of negative affect and stress in the mind due to the accumulation of unmediated affect and pathology of the dynamical system regulation in its various phases
 Methodology:
The sample of subjects. The sample of subjects consisted of 981 adolescents (2015) and 1163 young people (in 2014 - the preliminary research phase). The test was attended by students from different areas of the Altai Territory. The analysis of cases of completed suicides among adolescents and para suicide (2013-2015, in the report - data 2015). Formed map of suicides in the province. 25 teenagers participated in an experiment to study the characteristics of vigilance and selective attention in social anxiety with pronounced anti-vital experiences.
Research methods and procedures. To assess SA used validated questionnaire “Social Anxiety and social phobia” (29 points, the questions focused on the main symptoms of social anxiety in typical social situations) and to assess the viability, anti-vital and suicide risk used a validated questionnaire “Viability and Anti-vitality ” (72 points and blank test - 6 survey points about family situation, age, gender) (Sagalakova, Truevtsev, 2013-2015) . Used eye-tracker (SMI mobile). We research the properties of visual attention (focus mental activity): motivational bias, allocation, concentration, switch. Empirical indicators: fixation and saccades, the analysis of interest areas. Groups of teenagers are divided into groups by the level of SA (high, low, intermediate values ​​were also evaluated, but not presented in the report). Methods of statistical data analysis: analysis of variance, correlation analysis, cluster analysis, nonparametric measure differences. The data is processed in the program SPSS 22, STATISTICA 10.

 Conclusions:
1. Social anxiety highly significant in all experiments connected with anti-vital experiences, actions and suicide risk in adolescents. Social anxiety - a marker of significant frustration for the crisis of adolescence needs.

2. Both verbal and non-verbal stimuli, causing a threat to the social or emotional risk assessment, with high SA perceived more disorganized (attention is focused not only on target, but irrelevant stimuli).

3. Correlation between social anxiety and post-situational rumination shows that dysregulation is not only at the stage of its course, but also in the phase of completion. Accumulated dynamic tension indicates prolonged circulation of the regulatory system (circle drive), formed by social problems. This is the result that the phase of system shutdown does not occur, the person continues to be recorded on a "mental image" of how he/she was perceived by others in the situation. Long-term accumulation of negative affect leads to the disruption of activities, resource depletion psyche, mental stress buildup and anti-vital and / or suicidal behavior.

4. It’s not correct to oppose these particulars of attention (vigilance or avoid). We see a specific fix (selective focus) and large amplitude saccades in adolescents with high levels of anxiety and the presence of anti-vital experiences. Areas of interest in these adolescents are more concerned with negative implications, associated with emotional stress. Zones of interest significantly more vigilant attention is expressed in several ways (fluctuations of attention). This reduces the efficiency of the situation task (the priority tasks performed worse). The duration of saccades (both in terms of stimulus segments, and as a whole), and amplitude of saccades during the perception of evaluation situations is higher in subjects with high SA than low. This constitutes a violation of the activity target regulation in a situation assessment. This trend we have observed in all the experiments with different stimuli.

5. The average duration and frequency of fixations do not differ in groups. The differences were significant in the parameter amplitude saccades in all conditions. Fixation, the area of interest and saccades with low SA do not depend on the type of stimulus (facial expressions). At high SA saccadic amplitude is very high. The maximum amplitude provided the angry and frightened expression.


(431) PO-431. Conceptual models of social anxiety and social anxiety disorder in a study of anti-vital behavior (suicidal and parasuicidal)

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Clinical phenotyping of suicidal individuals

Authors:Olga Sagalakova . tai State University, Barnaul, Russian Federation,
- Dmitry Truevtsev - Anatoly Sagalakov -

 Introduction:
The basic model of social anxiety (SA) and social anxiety disorder (SAD) distinguished mechanisms of cognitive and metacognitive disorders that lead to changes in behavior and consolidation strategy of avoidance.
The authors presented one of the most developed and empirically proven SAD concepts - the cognitive-behavioral SAD model, based on attention disturbance as a factor in the generation and maintenance of anxiety in social-evaluative situations. The authors describe the “self-focused” position, typical for anxious individuals (Hope, Gansler, Heimberg, 1989). A person with SAD being in a social situation, constructs a mental image of what he looks like in the eyes of others and then begins to behave as if he were under the close supervision of other people.

 Goals:
Develop a conceptual model of SA and SAD on the basis of cultural and active methodology. Identify SA syndrome (primary, secondary and derivatives violations of mental activity). Show that the primary syndrome acts constitute a violation of the regulation of activities in situations of evaluation, which leads to disorganization and failure. Secondary infringement - bias in the motivational system and the accumulation of contradictions, tensions. Demonstrate a methodical diagnostic decision determining syndromic features of SA. Relate data pilot patho-psychological examination of the results of the study questionnaires and selective focus using an eye tracker.

 Methodology:
The sample of subjects. The sample of subjects consisted of 981 adolescents (2015) and 1163 young people (in 2014 - the preliminary research phase). 25 participated in an experiment to study the characteristics of SA.
Research methods and procedures. At this stage, we studied the prevalence of SA among young people, the most common situations that cause anxiety, and feelings of anxiety for the effects of the psyche and personality of the individual with unformed strategies of mediation and regulation of emotions in situations of evaluation.
To assess SA used validated questionnaire “Social Anxiety and social phobia” (29 points, the questions focused on the main symptoms of social anxiety in typical social situations) and Experimental methods of diagnosis patho-psychological «Social evaluation situations sorting test» (Sagalakova, Truevtsev, 2013-2015) .
Used eye-tracker (SMI mobile). We research the properties of visual attention (focus mental activity): motivational bias, allocation, concentration, switch. Empirical indicators: fixation and saccades, the analysis of interest areas. Groups of teenagers are divided into groups by the level of SA (high, low, intermediate values ​​were also evaluated, but not presented in the report). Methods of statistical data analysis: analysis of variance, correlation analysis, cluster analysis, others. The data is processed in the program SPSS 22, STATISTICA 10.

 Results:
Our testing consistent with those of studies of the orientation and distribution of attention (the mental activity as a whole) using the eye tracker. Determine the specific dysregulation (emotions prevail over cognitive mediation of anxiety), semantic motivational priorities and contradictions. To achieve the goals and motives are sought the most appropriate means. All mental activity is organized and aimed at this goal. At SA we see bias of attention not only to the target, but do not target stimulus situation (violation of focus and allocation of attention - multitasking), the shift selectivity in the target regulation (disorganization). The regulation is broken. The primary factor in forming the syndrome of SA and transition to SAD acts violating the regulation of target activities. Disruption due to regulatory violations in the system causes a fluctuation of attention (fixing multitasking, characterized by large amplitude saccades). The activity becomes ineffective. Further, there is an accumulation of negative experiences. Formed relative stability of SA mental map of the world (fixation on negative semantics as a potential threat). The shift to a secondary meaning motives in the situation (as the voice of what I look like in the eyes of others, someone laughed, and so forth.). Multitasking becomes an end in itself forced.
 Conclusions:

Based on psycho-pathological SAD model, the authors argue that the main psychological techniques related to the disorganized assessment affect, as well as to the formation of adaptive and flexible regulation of mental activity, are the following:
1) The introduction of sign-symbolic mediation of cognitive-communicative, perceptual activity in speaking to the audience and other situations are more effective regulators than direct willpower (via self-instruction, inner speech and inner action planning, the introduction of assistance tools, having direct response, the introduction of mediation-based "rules" of the decision-taking);
2) Formation of a flexible goal-setting system (the psychological distance between the immediate and long-term purposes);
3) Stabilization of self-esteem regardless of situational success / failure, forming the semantically integrated and adaptive image of success and failure, formation of positive experience in the application of adaptive tactics related to activity structuring.
4) Informing of the anxiety mechanisms and training mental activity regulation along with goal priority retention, allocation of attention in the social assessment situations.




Culture, ethnicity and spiritual approaches. New paradigms in suicidology


(119) PO-119. Mental health service changes, organizational factors, and patient suicide in England 1997 to 2012

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Nav Kapur . Centre for Suicide Prevention, University of Manchester, Manchester
-

 Introduction:
Research investigating which aspects of mental health service provision are most effective in preventing suicide is relatively sparse.
 Goals:
We examined the association between service changes, organizational factors, and suicide rates in a national sample.
 Methodology:
We did a before-and-after analysis of service delivery data and an ecological analysis of organizational characteristics in relation to suicide rates in mental health providers in England. We also investigated whether the impact of service changes varied according to markers of organizational functioning.
 Results:
Overall, 19,248 individuals who died by suicide within 12 months of contact with mental health services were included (1997-2012). A number of service changes related to ward safety, improved community services, staff training, and implementation of policy and guidance were associated with a lower suicide rate after their introduction (IRRs ranged from 0·71-0·79, p<0·01). Some wider organizational factors (non-medical staff turnover and incident reporting) were also related to suicide rates (Spearman's: 0·34 (p=0·01) and 0.46 (p<0·01) respectively) but others (such as staff sickness and patient satisfaction) were not. Service changes had more impact in organizations which had low rates of staff turnover but high rates of overall event reporting.
 Conclusions:
Aspects of mental health service provision may have an impact on suicide rates in clinical populations but the wider organizational context in which service changes are made are likely to be important too. System-wide change implemented across the patient care pathway could be a key strategy for improving patient safety in mental health care.


(158) PO-158. The timing of general population and patient suicide in England, 1997-2012

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Saied Ibrahim . University of Manchester, United Kingdom
-

 Introduction:
There have been conflicting findings on temporal variation in suicide risk and few have examined the phenomenon in clinical populations. This study investigated seasonal and other temporal patterns using national data.
 Methodology:
Data on 73,591 general population and 19,318 patient suicide deaths in England between 1997 and 2012 were collected through the National Confidential Inquiry into Suicide examining suicide rates in relation to month of the year, day of the week, and individual days of national or religious significance. We selected several days in the calendar year based on their prominence and impact on social activities, such as Christmas, Easter, New Year?s Eve, New Year?s Day, Valentine?s Day, Mother?s Day and Father?s Day. To identify potential mechanisms we examined the temporal variations in suicide by socio-demographic and clinical subgroups (sex, age, living circumstances, diagnosis).
 Results:
Suicide incidence fell over successive months of the year and there was evidence of an overall spring peak. Monday was associated with the highest suicide rates in the general population, 20% higher than observed for Sunday (IRR = 1.20, 95% CI = 1.17-1.23, p < 0.001). The effect was similar in the patient population but appeared to be more pronounced in those aged over 50, or those who lived alone. Suicide risk was significantly lower during Christmas, particularly for women. There was a peak in suicide on New Year?s Day in the general population. Other ?special days? were not associated with a change in suicide incidence.
 Conclusions:
There is substantial seasonal and temporal variation in suicide deaths, and there appears to be some evidence in the clinical as well as the general population in England. Clinical services should be aware of the risk of suicide just after the weekend, especially in people who live alone, and the potential need for closer supervision during this period.


(174) PO-174. Cultural risk factors in young mexican adults.

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Teresita Morfín-López . ITESO University, México
-

 Introduction:
The Ministry of Health in Mexico estimates that every year about forty thousand suicides attempts occur (1)
Death caused by suicide in Mexico has steadily increased over the last 40 years (2).
In 2013 just under six thousand suicides in Mexico were presented, with the highest number of suicides between 15 and 24 years old (1)
 Goals:
The aim of this study was to identify the semantic structure and cultural knowledge of young adults about suicidal behavior.
 Methodology:
The method used in this study was the cultural consensus, by analyzing data collected through semi -structured young adults, with and without suicide attempt, interviews. They involved 34 people with recent suicide attempt, contacted at the a) Municipal Medical Services in Guadalajara, b) Jalisco Institute of Mental Health, c) Psychiatric Hospital San Juan de Dios. In addition, 33 people participated without a history of attempted suicide.
 Results:
Cultural consensus was observed in both groups, with similar semantic structure and only some small differences. Regarding the causes of the suicide attempt, family conflict was the most important; also sadness had more mentions as feeling before the suicide attempt; the individual?s thoughts were not to live. In relation of what they did, planning suicide was the most mentioned action and about the prevention, psychological counseling had the greatest relevance.
 Conclusions:
The results of this research suggest a shared knowledge about suicide. It can be concluded that showing the relevance found on these socio- cultural factors in suicidal phenomenon in Mexico may be useful to carry out protective measures.
 References:
(1)Mexican Ministry of Health, (2014, 2015)
(2) Borges, G., Orozco, R., Benjet, C., & Medina-Mora, M. E. (2010). Suicide and suicidal behavior in Mexico: retrospective and current situation. Public Health of Mexico, 52 (4), 292-304.
(3 )Romney, K.S. Weller, S.C. y Batchelder, H. (1986). Culture as consensus: a theory of culture and informant accuracy. American anthropologist; 81 (2): 313-338.


(180) PO-180. Theme Analysis of Suicide Prevention Comics in Taiwan

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Ya-hsing Yeh . John Tung Foundation, Taipei City-Taiwan
-

 
 Goals:
Prepare to understand the differences in ideas expressed within 4 koma comics within the past 10 years. The comics from ten years ago are analyzed and used as the reference for recent works and as the foundation to compare future comics with.
 Methodology:
Hosted a 4 koma competition from November 2004 to January 2015. A total of 3256 comic works received and were grouped into 4 categories by contestants’ age: Primary School, Middle School, High School, and Adult Category. A theme analysis was conducted on these comic works.
 Results:
1. People believed that the most common cause of suicide were “Poor Grades and Academic Pressure”. 2. The most common method of suicide found within the comics is jumping off a building. 3. If given a chance to speak to those who wanted to suicide, people are most likely to offer words of encouragement and persuasion . 4. Most people believed that suicidal people can stop thinking about suicide “by themselves” through changing the way they think. 5. Primary School and High School students are more likely to believe suicidal behavior is induced by Poor Grades and Academic pressure; Middle school students are more likely to believe suicide induced by relationship problem. The adults are more inclined to place “other reasons” as the most common cause for suicide. 6. Primary School students are more inclined than other categories to believe the support of family will be more effective in preventing suicide;
 Conclusions:
Middle School and High School Students are more likely to think that the support of their friends can prevent suicide, while the majority of adults believe that the most effective way to prevent suicide is through a change in personal conviction and values.


(198) PO-198. Human values and socio-economic variables in relation to suicide. A longitudinal analysis of regional suicide rates in 11 European countries.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Alexandre Reynders . KU Leuven - Odisee, Brussels - Belgium
- Toon Kuppens - Geert Molenberghs - Chantal Van Audenhove -

 Introduction:
Although suicide seems to be an individual act, studies have shown that suicide rates can vary substantially between and within countries (Korosec Jagodic, Agius, & Pregelj, 2012). In explaining these differences between suicide rates, the majority of studies are inspired by the social integration theory of Durkheim. Already in the late 1800's, Durkheim argued that modern societies are characterized by social disintegration and deregulation. This results in high levels of Individualism and anomie which caused suicide rates to increase (Durkheim, 1951). Social integration contains different dimensions such as economic and religious integration and social fragmentation. Until today, these dimensions are often operationalized in terms of unemployment rates, secularization, fertility rates, educational attainment, social capital, etc. Although many studies have found associations between these societal indices and regional or national suicide rates, only few studies have investigated the cultural values underlying Durkheims' theory (Lenzi, Colucci, & Minas, 2012) and none have done so in a longitudinal design. Schwarz defined human values as beliefs that refer to desirable goals beyond specific actions and situations and which serve, according to their relative importance, as standards for action (Schwarz, 2012). human values evolve to recognize, respond and cope with societal problems.
 Goals:
The aim of this study is to investigate the effect of Schwartz's value dimensions on suicide rates at a regional level by estimating a single growth model. This is the first longitudinal study of human values and suicide rates. Indicators of social integration were included in the analysis to determine the strength of the associations between suicide rates and Schwartz’ human value dimensions over and above known correlates of suicide rates. Furthermore, to forestall the bias caused by misclassified suicides, we decide to include the most important concurrent cause of death category 'self-harm of which the intent is undetermined' (UI) into the analysis (Reynders, Scheerder, & Van Audenhove, 2010).
 Methodology:
Method: The dependent variables were suicide rates and the rate of self-harm of which the intent was undetermined. The socio-economic variables were religiousness, unemployment, education, fertility, social contact and social capital. Data were collected from the European Social Survey and Eurostat. Data were gathered for 87 regions of 11 European countries and analyzed by means of descriptive statistics and correlations. and multilevel, longitudinal analysis for the period 2005-2010. Next, we estimated a single growth model using multilevel modeling (Singer & Willett, 2003) in which variables measured at T1 predicted the change in suicide from T1 to T2 and T3. In this multilevel model the suicide rates for T1 (2005-06) to T2 (2007-08) and T3 (2009-10) were nested within regions, and regions were nested within countries. The model included (1) a linear effect of time, which was coded with values 0, 1, and 2, (2) a quadratic effect of time, (3) a random intercept for region, that is, a region-specific deviation from the overall mean suicide rate, (4) a random slope for time, that is, a region-specific deviation from the change in suicide rate over time, (5) a random intercept for country, that is, a country-specific deviation from the overall suicide rate, to control for the non-independence of regions from the same country, and (6) the 2006 scores of all predictors. The latter estimate the effect of all predictors on T1 values for suicide. Crucially, however, we also added (7) the interactions between time and all predictors, testing whether the 2006 score on a particular predictor was related to the (linear) change in suicide from T1 to T2 and T3.
 Results:
Surprisingly, socio-economic variables had no robust effects in our longitudinal models, and this finding raises doubts about causal interpretations of previous cross-sectional analyses. While research has frequently found that unemployment rate is positively associated with regional suicide rates, this relation was not observed in our longitudinal study. In other words, despite the 2008 economic crisis, no effect of unemployment on regional suicide rates was found. Social contact and social capital neither predict suicide rates in any of the four models. In regions with higher proportions of low educated people, suicide rates tend to be higher among women, but this effect diminishes after including the Human Values into the model. Higher fertility rates predict only higher regional suicide rates among women. Although not consistently, this finding contradicts the assumption that familial integration in terms of fertility, is a protective factor of suicide on a regional level. Overall, we can conclude that socio-economic variables have no predictive effect on male suicide rates and only a limited and inconsistent effect on female suicide rates. This suggests that associations found by previous, mainly cross-sectional studies, should probably not be interpreted as causal relations. The human value dimension Autonomy vs. Embeddedness was the single consistent predictor of regional suicide rates. In Regions where people gave more priority to values reflecting autonomy, suicide rates were lower in the years following. For example, a change from the lowest to the highest regional level of Autonomy at T1 corresponds with an 11 percent lower suicide rate in T2. In other words, at the regional level Autonomy appears to be a protective factor for suicide. No other variable had a consistently significant effect on the change in suicide.
 Conclusions:
Limitations: we were restricted to those countries and variables for which data were available. Conclusions: Human values are associated with regional suicide rates after controlling for socio-economic variables. Autonomy as a value at a regional level seems to have a protective effect toward suicide. . What then could explain the protective effect of Autonomy values with respect to suicide rates in non-traditional or individualistic countries? Lenzi et al. (2012) argue that in modern societies, were people become increasingly free to choose their own identity and social roles, giving priority to values such as being adventurous, taking risks, develop abilities etc. increases the possibilities for people to become more socially integrated. Furthermore, the pursuit of personal goals and needs as an important value, is related to a more individualistic culture in which personal control or internal locus of control is more prevalent (Stocks, April, & Lynton, 2012). Research found that nations with higher levels of internal locus had lower suicide rates (Lester, Castromayor, & Içli, 1991). Thus, in contemporary Europe, people are assumed to form their own identity and take their own social position. Values that are in line with increasingly Individualistic countries, therefore have a positive influence on social regulation and integration in post-modern societies.
 References:
Allik, J., Realo, A. Psychological and cultural mechanisms of suicide. Trames. 1997; 1: 306-321. Durkheim, E. Suicide: A study in sociology. New York: Free Press. 1951 ESS Round 5: European Social Survey Round 5 Data (2010). Data file edition 3.1. (Publication. Retrieved 15/12/2014, from Norwegian Social Science Data Services, Norway – Data Archive and distributor of ESS data. Eurostat.com Regional statistics (Publication. Retrieved 15/12/2014, from European Commission: http://ec.europa.eu/eurostat/web/regions/data/database. 2014 Korosec Jagodic, H., Agius, M., Pregelj, M. Inter-regional variations in suicide rates. Psychiatria Danubina. 2012; 12: Suppl 1, 82-85. Lenzi, M., Colucci, E., Minas, H. Suicide, culture, and Society from a cross-national perspective. Cross-Cult Res. 2012; 46: 50-71. Lester, D. Individualism and suicide. Psychol Rep. 2005; 97: 576. Reynders, A., Scheerder, G., & Van Audenhove, C. (2010). The reliability of suicide rates: An analysis of railway suicides from two sources in fifteen European countries. J Affect Disorders. 2010; 131: 120-127. Schwartz, S. An overview of the Schwartz Theory of Basic Values. Online Readings in Psychology and Culture, 2. http://dx.doi.org/10.9707/2307-0919.1116. 2012. Stocks, A., April, K., Lynton, N. Locus of control and subjective well-being – a cross-cultural study. Problems and Perspectives in Management. 2012;10: 17-25.


(238) PO-238. A systematic review of relationships between substance use and suicide in low- and middle-income countries

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Elsie Breet . Department of Psychology, Stellenbosch University, Cape Town - South Africa
-

 Introduction:
People who abuse substances are at increased risk of engaging in suicidal ideation and behaviour (SIB). Epidemiological literature from high income countries demonstrates that substance abuse correlates with suicidal behaviour, less is known about the psychosocial context in which substance abuse is associated with fatal and non-fatal self-injurious behaviour in low and middle income countries (LMICs).
 Methodology:
Electronic databases were searched in February 2016. PubMed, CINAHL, Web of science, DARE, PsychINFO, and article reference lists were searched for eligible studies. Epidemiological studies reporting on the association between acute and chronic alcohol or drug use and SIB were retrieved.
 Results:
We identified 1600 articles published between 2006 and 2016, of which 104 met our inclusion criteria. Acute or chronic substance use among people who engage in SIB is a significant problem in LMICs. Several psychosocial factors mediated the association between acute or chronic substance use and SIB.
 Conclusions:
The current evidence suggests that prevention and intervention initiatives in LMICs should consider the psychosocial context in which acute or chronic alcohol and drug use is associated with SIB. The findings from this review are limited by study design and quality; therefore more sophisticated studies with larger samples are needed.


(267) PO-267. Making suicide nonsensical. The way in which the concepts of potential /suicidal/ patient and disability do it.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Tamas Ervin Barnabas . Self-employed, mentally disabled self-advocate, Budapest-Hungary
-

 Introduction:
The concepts of potential patient and disability, the role of theory in suicide research, a new dimension in mental health promotion training and education."
 Goals:
This presentation highlights the possibilities in which these concepts are utilizable in suicide pre/inter/vention, post/inter/vention and mental health promotion training for professional groups and their interdisciplinary partners that is a powerful tool towards the end of making suicide nonsensical and the improvement of suicidal consumers' quality of life.
 Methodology:
Analytical, comparative.
 Results:
How do the pros and cons of the issues of euthanasia effect the 21st century anti-suicide crusades and action takings? This is a quintessential question of suicidology, concerning the contemporary enterprises of euthanasiology. The scholars of suicidology and euthanasiology are challenged to make suicide nonsensical and euthanasia sensical in an updated, renewed fashion. In 2009, I invented the concepts of potential patient and disability. This approximately six minute long briefing-presentation demonstrates how the concepts of potential /suicidal/ patient and disability are useable to overcome the gap between the healthy, able professional groups and the unfit, disabled, potentially healthy suicidal consumers. This presentation helps to discern unhealthy, not well-being, disabled states of mind as part of human condition, embedded in social stratums and to describe suicidal phenomenons in extra details and to understand the role of theory in suicide research better.
 Conclusions:
A train of thought in regard to the kew aspects of a self-image with potential suicidal illness and/or disability and the ways in which they facilitate a new dimension in education of scholars of suicidology and euthanasiology.


(277) PO-277. Psychiatric consultation for Suicide attempts in migrants in the Emergency Room: Comparison with the native population. Data from a 7-years period.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Sarah Di Marco . Department of Translational Medicine - University of Eastern Piedmont , Novara-Italy
- Eleonora Gambaro - Claudia Delicato - Eleonora Gattoni - Isabella Coppola - Elisa Di Tullio - Camilla Vecchi - Fabrizio Bert - Luigi Mario Castello - Patrizia Zeppegno -

 Introduction:
Immigration is a very important issue in Europe, also as far as health policies are concerned. Because of its position, Italy became a disembarkation country for migrants sailing from North Africa across the Mediterranean Sea, as well as a destination for people from Eastern Europe. At the end of year 2014, 5 million out of the 60.8 million inhabitants in Italy (8.2%) had a foreign citizenship. Non-EU foreigners holding a residence permit in Italy on 1st January 2015 were 3,929,916, with the following being the most represented Countries of origin: Morocco, Albania, China , Ukraine and Philippines. Istat data report an approximately 63% increase of the migrant population in Italy from 2008 to 2015 (from 3 millions to 4.9 millions). This increase was almost 50% in Piedmont (from 284.191 in 2008 to 425.523 in 2014) and a similar trend was observed in the province of Novara (from 25.088 = 6.9% of the total population in 2008 to 37.453=10.1% in 2014). The largest migrant communities were the Moroccan, Albanian, Romanian and Ukrainian ones.
 Goals:
Describing the features of migrants referring to Emergency Room (ER) psychiatric consultation after a suicide attempt and assessing the possible differences in socio-demographic, clinical and treatment variables between migrants and natives as far as suicidal behaviors are concerned.
 Methodology:
We recruited consecutive patients referring to the ER of the Maggiore della Carità Hospital from 1st March 2008 and 31st March 2015. Socio-demographic, clinical and consultation features were recorded and compared in natives and migrants.
 Results:
Preliminary data show that migrants were more frequently referred to ER psychiatric consultation for self-injury behaviours compared to natives. Suicide attempts were more frequent in the migrant group than in the native one. Further Analyses are still ongoing.
 Conclusions:
Implications will be discussed.
 References:
1. Istituto nazionale di statistica (2015). Istat.it. http://www.istat.it/it/immigrati (2015). 2. Gramaglia C, Gambaro E, Rossi A, Toso A, Feggi A, Cattaneo CI, Castignoli G, Mainini P, Tarricone I, Torre E, Zeppegno P. Migrants' Pathways to Outpatient Mental Health: Are there Differences with the Italian Population? J Immigr Minor Health. 2015; 1-8. 3. Gaddini A, Franco F, Biscaglia L, Di Lallo D. An urban Italian study on emergency room utilisation by migrants suffering from mental disorders in Rome, 2000-2004. Eur.Psych 2008; 23(2): 118-124. 4. Zeppegno P, Gramaglia C, Castello LM, Bert F, Gualano, MR, Ressico F, Coppola I, Avanzi GC, Siliquini R, Torre E. Suicide attempts and emergency room psychiatric consultation. Bio Med Centr 2015;15:13.


(365) PO-365. Patients attending the psychiatric emergency room for a reason of suicide attempt compared to those attending with no suicidal behaviour: Are there any differences regarding the follow-up? A case-control study

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Almudena Portilla Fernández . Complejo Hospitalario de Navarra, Pamplona-Spain
- Patricia Macaya Aranguren - Lucía Janda Galán - Rebeca Elorza Pardo - Laura Montes Reula - José Javier López Goñi -

 Introduction:
Suicidal behavior is one of the most significant issues we have in Mental Health. Lots of studies in this area have been developed, aiming to increase our knowledge on it and try to offer an effective prevention, intervention and postvention of suicide.
 Goals:
This is a multicenter case-control study carried out by mental health professionals in Navarra. The aim of this study is to track patients after they attend the Emergency Room seeking for urgent psychiatric attention, comparing the paths they follow through the mental health net after committing a suicide attempt to those attending the psychiatric ER because of any other reason
 Methodology:
Data of all patients attending psychiatric ER were collected during 10 months (from January to October 2015). Patients were divided into two groups: the cases were those attending because of having committed suicide attempt; and the controls were those attending because of any other psychiatric reason. We compared the ways that cases and controls had followed after the urgent attention, during 6 months.
 Results:
A sample of 295 patients was obtained with a 6-month follow-up, after requesting for urgent psychiatric attendance in the ER. It was observed that in the urgent attention, a pharmacological adjustment was made more often for the controls group than for the cases (99 controls vs 61 cases underwent a treatment modification in the ER). The control group had a higher number of consultations with psychiatrist than the group of cases during the 6 months. Same number of cases and controls required hospitalization in the psychiatry service after the ER attention. All this differences showed statistical significance.
 References:
-Suicidios. Manual de prevención, intervención y postvención de la conducta suicida. Andoni Anseán -Self-impalement after thoracic stab wound. An unusual method of suicide in psychotic symptomatology. Reuhl J, Schuster R, Weiler G. Arch Kriminol. 2000 May-Jun;205(5-6):152-61. - Geoffroy MC, Turecki G. The developmental course of suicidal ideation in first-episode psychosis. Lancet Psychiatry. 2016 Mar 2


(392) PO-392. The peer specialist: Possibilities for the recovery of suicidal care consumers

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Diana Van Bergen . Groningen University, Groningen, the Netherlands
- Annemiek Huisman -

 Introduction:
Following the initiative of care consumers who felt that their voice regarding the care they received was not heard in mental health services, a recovery-focused approach to mental health problems emerged, advocating for a person-centered, integrated mental healthcare delivery model. The emergence and availability of peer specialists with a history of suicidality (suicide attempts and/or suicidal ideation) who work with suicidal care consumers is a more recent phenomenon in this context. The Suicide Attempt Survivor Movement was launched within the American Association of Suicidology in 2014, aimed at the improvement of care provided to suicidal care consumers and at helping fellow care consumers with their recovery from suicidality.
 Goals:
We will answer the following question: What unique value and potential risks for the recovery process of suicidal care consumers can be derived from the literature about the integration of peer specialists with a history of suicidality?
 Methodology:
1. A systematic literature search of the role of peer specialists with a history of suicidality in mental health care; 2. An outline of the theoretically plausible value of peer specialists with a history of suicidality, based on general literature of peer specialists in mental health care.
 Results:
The unique contribution of peer specialists in suicide prevention is expected to emerge as a result of their shared experiences with suicidality and shared adversities in life, recognition of stigma, and shared challenges of communicating with healthcare staff and family or friends about suicidality. Due to their own recovery process, peer specialists can be a role model for suicidal care consumers.
 Conclusions:
The literature suggests that peer specialists have the potential to fulfill a groundbreaking role for suicide prevention, providing support to suicidal peers, inspiring empowerment and recovery, and breaking the taboo.


(419) PO-419. Could some common mental diseases have evolved to prevent suicide? - a theoretical enquiry

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Culture, ethnicity and spiritual approaches. New paradigms in suicidology

Authors:Cas Soper . University of Gloucestershire, Gloucestershire
-

 Introduction:
Multiple lines of evidence converge to suggest that depression, generalised anxiety, addictions and many other common metal ‘disorders’ (‘CMDs’) may have evolved in the human species to avert suicide. Several clinicians and researchers (eg, Hundert, 1992) have commented on the anti-suicide properties of CMDs: depression, for example, has been described as a loss of vitality that impairs the individual’s ability to act out on suicidal thoughts, while psychotic delusions may function to buffer the individual from a suicidogenic reality.
 Methodology:
The methodology is a theoretical enquiry, based on formal evolutionary theory and assessing CMDs for evidence of purposeful biological design (Williams 1966).

 Results:
The necessity for some adaptive countermeasures to have evolved to suppress suicide is supported by an evolutionary account of suicide’s likely origins as a by-product of human cognition combined with the experience of emotional pain. Reactive defences, triggered by the onset of emotional pain among adolescents and adults, would be expected to reduce suicide risk while allowing the individual to function in a cognitively attenuated capacity. A set of institutional suicide prevention interventions, such as restraint and medication, may point to a corresponding suite of analogous and often co-occurring instinctive mechanisms (depression, addiction etc) that mobilise to deal with the same problem in nature.

 Conclusions:
It is concluded that a CMDs may operate as crisis defences as part of a wider system of protections against suicide. A general therapeutic implication is noted, alongside the potential for a new, comprehensive theoretical framework in psychology and psychopathology based on suicide avoidance.

 References:
HUNDERT, E. M. 1992. The brain’s capacity to form delusions as an evolutionary strategy for survival. In: SPITZER, M., UEHLEIN, F., SCHWARTZ, M. A. & MUNDT, C. (eds.) Phenomenology, Language & Schizophrenia. New York: Springer.

WILLIAMS, G. 1966. Adaptation and Natural Selection: A Critique of some Current Evolutionary Thought. Princeton: Princeton University Press.
TOOBY, J. & COSMIDES, L. 2005. Conceptual foundations of evolutionary psychology. In: BUSS, D. M. (ed.) The handbook of evolutionary psychology. Hoboken, NJ: John Wiley & Sons.




Ethical and methodological challenges and solutions in suicide research


(8) PO-8. Misdiagnosing non-suicidal and suicidal behavior

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Ethical and methodological challenges and solutions in suicide research

Authors:Tobias Teismann . Department of Clinical Psychology & Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
- Jan Cwik -

 Introduction:
Inconsistent nomenclature and classification of suicidal behavior has plagued the field of suicidology for a long time. To enhance interpretability of self-directed violence within pediatric antidepressant trial data the Columbia Classification Algorithm of Suicide Assessment (C-CASA; Posner et al., 2007), a classification system that utilizes definitions of self-injurious events rooted in consensus recommendations and empirical findings on the phenomenology of non-suicidal and suicidal behaviour, was developed.
 Goals:
Aim of the current study was to determine the extent of misdiagnosed acts of self-directed violence according to the C-CASA classification system ? controlling for the level of expertise in psychology/psychotherapy. Additionally, the effect of gender and diagnosis on misclassifications was assessed.
 Methodology:
426 participants (laypersons, psychology students, psychotherapists-in-training, licensed psychotherapists) were presented with 15 case vignettes describing different acts of self-injurious behavior (e.g., non-suicidal self-injury, suicide attempt, suicide ideation) and were asked to make a classification. Gender and given diagnosis (Major Depression vs. Borderline Personality Disorder) were varied systematically in two vignettes.
 Results:
Overall 51.6% of the cases were misclassified (Range: 0.5% to 71.6%). The level of expertise was almost unrelated to classification correctness. Yet, psychotherapists were more confident about their judgments. Female gender of the character described in the vignette and an ascribed diagnosis of Borderline Personality Disorder were associated with higher misclassification rates.
 Conclusions:
The results highlight the importance of more methodological and diagnostic training of psychologists regarding suicidal issues. This is even more relevant considering the potentially severe consequences of misclassifications for patients as well as their therapists.
 References:
Posner, K., Oquendo, M., Gould, M., Stanley, B., Davies, M., 2007. Columbia classification algorithm of suicide assessment (C-CASA): Classification of suicidal events in the FDA´s pediatric suicidal risk analysis of antidepressants. Am. J. Psychiatry 164, 1035?1043.


(113) PO-113. The Web-Based Assessment of Suicidal and Suicide-Related Symptoms: Factors Associated with Disclosing Identifying Information to Receive Study Compensation

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Ethical and methodological challenges and solutions in suicide research

Authors:Melanie Hom . Florida State University, Tallahassee, FL - United States
- Ian Stanley - Thomas Joiner -

 Introduction:
With the increasing utilization of web-based surveys for suicide and suicide-related research, it is critical to understand factors that impact participants? decision to request study compensation (and thus potentially reveal their identity) or remain anonymous.
 Goals:
This study evaluated differences in demographics, suicidal symptoms, and suicide-related constructs between participants electing and declining to provide identifying information to receive study compensation.
 Methodology:
A sample of 931 firefighters (91.5% male) participated in a web-based mental health survey; upon survey completion, individuals had the option to provide contact information to receive a $10 gift card. Logistic regression analyses were employed to investigate differences between those who did and did not provide this information.
 Results:
Overall, 82.8% provided identifying information, with younger individuals significantly more likely to do so. Participants reporting more severe suicidal symptoms and greater levels of suicide-related constructs appeared equally, and in some cases, significantly more, willing to provide identifying information.
 Conclusions:
Findings indicate that individuals reporting more sensitive or stigmatizing experiences may not systematically opt-out of receiving study compensation to remain anonymous on web-based surveys. Additional research is warranted to replicate these findings in more representative samples and further delineate personality and other factors influencing the disclosure of contact information to receive study compensation.
 References:
1. American Psychological Association [APA]. Ethical principles of psychologists and code of conduct. American Psychological Association, editor. Washington, D.C.; 2010.
2. Podlogar MC, Rogers ML, Chiurliza B, Hom MA, Tzoneva M, Joiner TE. Who are we missing? Non-disclosure in online suicide risk screening questionnaires. Psychol Assess. 2015.


(327) PO-327. Attitudes towards euthanasia among relatives in psychiatry

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Ethical and methodological challenges and solutions in suicide research

Authors:August G. Wang . Centre of Suicide Prevention, Copenhagen University Hospital, Copenhagen, Denmark
- Titia Lahoz -

 Introduction:
Assisted suicide and euthanasia are often topics in public debate, but not so often in psychiatric congresses or journals. However, the trend in some countries indicate that the movement for the "right to die" or a "dignified death" also will reach psychiatric patients. Some studies or surveys about the attitude towards assisted suicide and euthanasia are often conducted in general public, and thus do not reveal the attitude in populations that are patients or relatives to patients where death or suicide is a real potential option.
 Goals:
We want to elucidate the attitude among relatives to elderly psychiatric patients, which is a group of people that may consider death and suicide as a solution.
 Methodology:
Psychiatric patients 65 or older are asked for permission to interview one relative. The relatives are interviewed about: Age, sex, relation to the patient, at work or pensioneer, percieved burden of care, attitude toward influence on and involvement in patients´ treatment, attitude towards a law legalising assisted suicide and/or euthanasia.
 Results:
So far we have only some few results, but we intend to present results about relatives´ attitude towards assisted suicide and/or euthanasia, possible related to age, sex and relation to patient, burden of care, influence and involvement in treatment.
 Conclusions:
Results will be discussed for relatives that have patients that potentially could ask for assisted suicide or for euthanasia. Also how relatives´ own age, sex, relation to patient and influence on and involvement in treatment possible can influence the attitude.
 References:
Stutzki R1, Weber M, Reiter-Theil S, Simmen U, Borasio GD, Jox RJ. Attitudes towards hastened death in ALS: a prospective study of patients and family caregivers. Amyotroph Lateral Scler Frontotemporal Degener. 2014 Mar;15(1-2):68-76.


(364) PO-364. Surveillance of Youth Self-Directed Violent Behavior in Hospital Settings

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Ethical and methodological challenges and solutions in suicide research

Authors:Thomas Delaney . University of Vermont, Burlington, USA
- Laurin Kasehagen - Barbara Carroll -

 Introduction:
youth self-directed violence (sdv) is believed to be prevalent and may be increasing, but systematic data on sdv are lacking.1 Effective sdv prevention requires identification of populations and individuals who experience different types of sdv. using hospital discharge data, we identified youth self-directed violent behaviors and estimated corresponding population rates of suicidal ideation, suicidal and undetermined sdv, and medicinal poisonings.
 Goals:
identify a common set of billing codes for identifying specific sdv behaviors, and estimate population rates of undetermined and suicidal sdv in young people.
 Methodology:
we used external cause-of-injury international classification of diseases, ninth revision, clinical modification (icd-9) codes for suicidal ideation, undetermined and intentional injuries, medicinal poisonings, and mental health conditions to define a common set of codes relevant to youth with suicidal ideation and self-directed violent behaviors.2 we then analyzed data from the vermont uniform hospital discharge data sets to estimate and describe population rates of suicidal ideation and sdv.
 Results:
analysis included 6008 2010-2014 emergency departments visits for ages 10-24 with icd-9 codes for suicidal ideation, suicidal and undetermined sdv, and medicinal poisonings. Crude rates of ideation, sdv, and medicinal poisonings increased – 23.7 to 29.0, 22.8 to 32.3, and 13.3 to 16.4, per 10,000 population, respectively. disparities were observed among youth and hospital visit characteristics by episode type.
 Conclusions:
icd 9 coding for self-directed violence in youth can be used to estimate specific sdv behaviors, and examine changes of these behaviors over time. youth sdv appears to have increased since 2010.
 References:
1. patrick ar, miller m, barber cw, et al. identification of hospitalizations for intentional self-harm when e-codes are incompletely recorded. pharmacoepidemiol drug saf. 2010;19:1263-1275. 2. crosby ae, ortega l, melanson c. self-directed violence surveillance: uniform definitions and recommended data elements, version 1.0. atlanta (ga): centers for disease control and prevention, national center for injury prevention and control; 2011


(373) PO-373. Practices and difficulties of health professionals towards suicidal patients

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Ethical and methodological challenges and solutions in suicide research

Authors:Ines Rothes . Faculty of Psychology and Educational Sciences of Porto University, Portugal , Porto
-

 
 Goals:
The study describes the current practices and difficulties of psychologists, psychiatrists and general physician facing a suicidal patient and tests differences according to socio-professional variables as training in suicide prevention.
 Methodology:
242 health professionals filled out self-report questionnaires: the ISBQ - Intervention Strategies towards Suicidal Behaviours Questionnaire and the DSBQ - Difficulties in Suicidal Behaviors Intervention Questionnaire. Exploratory principal components and variance analyses were used.
 Results:
Five intervention components emerged: comprehensive assessment; protocols; family; psychotherapy; and hospitalization and medical treatment; and four types of difficulties were found: technical; emotional; relational and communicational; and family-approaching and logistic difficulties. Psychotherapy is the modality of treatment most likely to be advised; health professionals rated the support to the family, the hospitalization and medical treatment, including pharmacological therapy with moderate probability to be counselled. The use of protocols is unlikely even if more probable by psychologists. The comparison of psychologists, psychiatrists and GPs revealed moderate to large differences in practices and difficulties. Psychiatrists reported as more likely to engage in risk detection and assessment than psychologists and GPs. The professionals who have specific training on suicide intervention tend to score higher in the assessment practices and in the involvement of the family and tend to achieve lower scores in difficulties. The specific experience with suicidal behaviours in clinical practice also influences the assessment practices and technical and emotional difficulties: the more experience with suicidal patients the greater the likelihood to perform a comprehensive evaluation and to feel fewer difficulties.
 Conclusions:
Health professionals’ practices can benefit from specific training namely using case base learning and other experiential and active methodologies.




Genetic, epigenetic and gene expression contributors to suicide risk


(386) PO-386. Are Single Nucleotide Polymorphisms within SKA2, OPRM1 and KOR genes linked to suicidal behavior?

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Genetic, epigenetic and gene expression contributors to suicide risk

Authors:Bénédicte Nobile . Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, Montpellier - France
-

 Introduction:
Suicide is a major public health problem and news therapeutics target and genetic markers could help to improve the care of patients. Opioidergic system seems to be implicated in the physiopathology of suicide but mechanisms are still unclear.
 Goals:
The aim of our study is firstly to find genetic markers of suicidal behavior and secondly to find a link between single nucleotide polymorphisms of those genes and response to treatment.
 Methodology:
This is a retrospective study on a cohort of 3771 patients with a major depressive episode according to the DSM-IV criteria. Those patients were treated with Tianeptine during six weeks. They were screened on suicidal thoughts and behaviors. They were also screened on depressive symptomatology and impulsivity (MADRS, HAD scale and Plutchik questionnary, both hetero and self evaluation at zero and six weeks and another self evaluation at two and four weeks). For genotyping we used genomic DNA purified from blood patients. We did a qPCR with Taqman® technical and analysed scatter plot for results.
 Results:
Assays pending
 Conclusions:
We expect a positive correlation between suicidal behavior and some single nucleotide polymorphisms of those genes.
 References:
1. AB Niculescu, DF Levey, PL Phalen, H Le-Niculescu1, HD Dainton, N Jain, E Belanger, A James, S George, H Weber, DL Graham, R Schweitzer, TB Ladd, R Learman, EM Niculescu, NP Vanipenta, FN Khan, J Mullen, G Shankar, S Cook, C Humbert, A Ballew, M Yard, T Gelbart, A Shekhar, NJ Schork, SM Kurian, GE Sandusky and DR Salomon; Understanding and predicting suicidality using a combined genomic and clinical risk assessment approach; Molecular Psychiatry (2015) 20, 1266–1285; doi:10.1038/mp.2015.112; published online 18 August 2015
2. Mark A. Ilgen, Amy S. B. Bohnert, Dara Ganoczy, Matthew J. Bair, John F. McCarthy, Frederic C. Blow; Opioid dose and risk of suicide; PAIN Publish Ahead of Print DOI: 10.1097/j.pain.0000000000000484


(388) PO-388. Genes and risk of suicide: A systematic review of studies.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Genetic, epigenetic and gene expression contributors to suicide risk

Authors:Laura Rubio Rodriguez . Hospital de Jove/ Hospital de Cabueñes, Gijón - Spain
- Miguel Maldonado Fernandez - Jorge Antolin Suarez - Danny Francisco Frias Ortiz -

 Introduction:
Suicide is a major preventable health problem that can have prolonged harmful effects on individuals, families, and communities. The main object of suicide prevention is to remove the risk factors. The number of genetic variations that have been related to an increased risk of suicide is continuously increasing.
 Goals:
To summarize in a systematic way the current evidence on the genetic variations related to an increased risk of suicidal behaviour, understood as suicide attempts or consummated suicide.
 Methodology:
A systematic review of studies on genetic alterations related with risk of suicidal behaviour.
 Results:
We found 240 articles our primary search. We selected 196 articles that looked into the role of genes in an increased risk of suicidal behaviour.
 Conclusions:
We carried out a comprehensive systematic review to resume the current situation of genetic disorders related to suicidal behaviour. We expect this review to be a useful tool to summarize the evidence on this subject.
 References:
1. Centers for Disease Control and Prevention. Suicide Prevention. Available online at [http://www.cdc.gov/violenceprevention/suicide/]. 2. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from http://handbook.cochrane.org.




Intervention research for prevention of suicidal behavior


(42) PO-42. Suicide First Aid Guidelines for Sri Lanka

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Erminia Colucci . Centre for Psychiatry, Queen Mary University of London, London
-

 Introduction:
Sri Lanka has one of the highest suicide rates in the world. Gatekeepers programs aimed at specific target groups are a promising strategy to prevent suicide. The aim of this study was to develop guidelines that help members of the public to provide first aid to someone at risk of suicide in Sri Lanka. The Delphi-consensus method was used to elicit consensus among Sri Lankan mental health and/or suicide experts on potential helping statements to include in the guidelines.
The outcome of the three Delphi rounds was a set of agreed statements that were then used to develop the Suicide First Aid Guidelines for Sri Lanka, which will be presented and discussed during the session.
The guidelines may serve as a basis for developing training for members of the public to provide mental health first aid to persons at risk of suicide as part of Sri Lanka's suicide prevention strategy. This project was a collaboration between The University of Melbourne and Mental Health First Aid.


(82) PO-82. North Atlantic Treaty Organization (NATO) Research Task Group on Military Suicide: Brief Report of Findings

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Marjan Ghahramanlou-Holloway . Uniformed Services University of the Health Sciences, Bethesda - Maryland
-

 Introduction:
Military suicide remains a significant public health problem across many nations. To date, there have been no systematic collaborative efforts across North Atlantic Treaty Organization (NATO) member and non-member (e.g., Partnership for Peace) nations to best understand suicide-related behaviors among military personnel and to identify best practices most suitable for this highly vulnerable group. Given the public health problem of suicide among the Armed Forces, representatives from 17 nations participated in the Human Factors and Medicine (HFM), Research Task Group (RTG) on military suicide, from 2010-2015. This presentation will provide a brief outline of findings from the soon-to-be released technical report. The main objectives of the RTG have been to: (1) to produce a technical report on military suicide for NATO; (2) to administer a survey to NATO member and non-member nations in order to enhance our understanding of current military suicide prevention efforts, best practices, and potential gaps; (3) to create a web-based platform to organize and make available materials pertaining to military suicide across several countries; (4) to prepare a series of white papers covering key topics on military suicide prevention relevant to NATO leadership and members; and (5) to disseminate the RTG findings at international scientific professional conference(s). Future efforts to advance this preliminary work in the area of military suicide prevention for NATO countries will be delineated.


(98) PO-98. Masculinity and suicidal thinking

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Jane Pirkis Pirkis . University of Melbourne, Melbourne, Australia
-

 Introduction:
Males feature prominently in suicide statistics, but relatively little work has been done to date to explore whether conformity to ?dominant? masculinity norms heighten the risk of or are protective against suicidal thinking.
 Goals:
To explore whether particular elements of ?dominant? masculinity heighten the risk of or are protective against suicidal thinking.
 Methodology:
We used data from 13,884 men (aged 18-55) in the Australian Longitudinal Study on Male Health (Ten to Men) cohort. These men filled in self-complete questionnaires in 2013/14 which covered a range of topics, including conformity to ?dominant? masculinity norms and suicidal thinking. We conducted logistic regression analyses to estimate the strength of association between these two variables.
 Results:
After controlling for other key predictors of suicidal thinking, one key masculine characteristic ? self-reliance ? stood out as a risk factor for suicidal thinking (AOR = 1.34; 95%CI = 1.26-1.43).
 Conclusions:
It is easy to see how self-reliance might confer risk for suicidality. Men who are self-reliant may believe that they should be strong in the face of any adversity, consider that feeling down is a sign of weakness, and be unlikely to reach out to friends, family or professional sources for help. We need to ensure that clinical and population-based suicide prevention activities that men actively address self-reliance, and promote broader definitions of masculinity at a societal level.


(106) PO-106. A programme for the prevention of suicide reattempts with telemedicine techniques

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Andrea Gabilondo . Osakidetza, San Sebastián
- Edurne Aristegi - Jose Martin Zurimendi - Iñaki Zorrilla - Ana González Pinto - Raquel Roca - Álvaro Iruin Sanz -

 Introduction:
There is ample evidence showing that the prevention of suicide is possible and there are different approaches proven to be effective. Although the use of telemedicine in suicide prevention is relatively recent this is one of the most promising approaches today.
 Goals:
To evaluate the efficacy, feasibility and cost of a brief telephone follow-up program for the prevention of suicide in patients with a recent history of attempted suicide.
 Methodology:
This is a prospective, multicenter, controlled non randomized study. Patients with a recent history of suicide attempt were included in a brief standardized telephone follow up programme, lasting 6 months which was added to their usual treatment. Telephone calls were made by nurses, they lasted no more tan 10 min and were intended to 1) assess the risk of suicide; 2) Improve adherence to usual treatment and 3) provide general psychoeducation. Patients in the control group only received usual treatment.
 Results:
Preliminary results (includes only the intervention group): 1 month before recruitment ends 198 attempts have been identified. 63% of patients agreed to participate and have been included in the program. 69.2% are women and the average age is 41.5 years. A total of 303 phone calls (2.5 per patient) have been made. 42% of patients have completed all the calls within the programme. 4% of patients have reattempted suicide. The anual rate of reattempt is 5.6, and the average delay between attempts is of 72.5 days. No major adverse effects have been identified.
 Conclusions:
Preliminary results show reattempt rates which are similar to previos studies in the literature. Attrition rates are in line with other techniques. As a conclusión, preliminary data show promising results and give support to the use of this approach in the prevention of suicide.
 References:
Luxton D, June JD, and Comtois KA. Can Postdischarge Follow-Up Contacts Prevent Suicide and Suicidal Behavior? A Review of the Evidence. Crisis 2013; Vol. 34(1):32?41


(107) PO-107. Feasibility study and implementation of the EAAD model in a región of Gipuzkoa (Spain)

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Andrea Gabilondo Cuellar . Osakidetza, San Sebastián
- Marian Bernaras Aguirrezabala - Ana Alustiza García - Eider Tapia - Álvaro Iruin Sanz -

 Introduction:
The suicide prevention program of the European Alliance Against Depression (EAAD; www.eaad.net ) has been implemented in 17 European countries. The introduction of the model in a new region requires a preliminary work of cultural adaptation and a a feasibility study in order to maximize its potential for success.
 Goals:
To assess the feasibility and results of the pilot implementation of the EAAD model in a region of Gipuzkoa. To propose the changes necessary to maximize it?s adaptations to the region.

 Methodology:
The EAAD program was implemented in 2 regions of Gipuzkoa (175,000 inhabitants). 4 different interventions (1 to 4, see next section) were developed.
 Results:
1. Psychological first aid training for social workers: 72 professionals were trained in 3 workshops. The evaluation indicated high satisfaction and a 10% increase in the level of knowledge.
2. Depression awareness campaign for the general population. Leaflets and posters were distributed in strategic locations. Additional dissemination of key messages was made by the local media.
3. Media training and sensitization workshops. 75 professionals and university students took part in 3 workshops. The evaluation indicated satisfaction and interest.
4. Program for improving the care of those with recent history of suicide attempt by the health system. Including training of professionals, renewed coordination mechanisms between professionals, improvements in information systems and a specific follow up program for high risk patients based on techniques of telemedicine. Reattempt rates were similar to those reported in the literature. Professional satisfaction was high.

 Conclusions:
The multidisciplinary approach to the risk of suicide increases the complexity and the resources needed. Having strategic partners outside the health system is a key factor of success. However the potential benefits seem to outweigh this initial disadvantages.
 References:
Hegerl U, Wittenburg L; European Alliance Against Depression Consortium.Focus on mental health care reforms in Europe: the European alliance against depression: a multilevel approach to the prevention of suicidal behavior. Psychiatr Serv. 2009 May;60(5):596-9.


(115) PO-115. Discussing firearm ownership and access as part of suicide risk assessment and prevention: Means safety versus means restriction?

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Ian Stanley . Florida State University, Tallahassee, FL USA
- Melanie Hom - Megan Rogers - Michael Anestis - Thomas Joiner -

 Introduction:
In 2014, an estimated 21,334 individuals in the United States died by an intentional self-inflicted gunshot wound, accounting for approximately 50% of all suicide deaths that year. Indeed, the assessment and management of firearm ownership and access is a key component of suicide prevention efforts. The prevailing terminology surrounding the management of firearms for a patient at risk for self-harm or harm to others is ?means restriction.? However, use of the term ?restriction? may suggest to a patient absolute limits on his or her firearm ownership.
 Goals:
This study aimed to describe the relative utility of the terms ?means safety? versus ?means restriction? in counseling individuals to limit their access to firearms in the context of a mock suicide risk assessment.
 Methodology:
Overall, 370 participants (Mage=19.35y, SD=1.77y; 71.9% female; 73.0% White) were randomized to read one of two vignettes depicting a clinical scenario in which managing firearm ownership and access was discussed either using the term ?means safety? or ?means restriction.? Participants then rated their intention to disclose firearm ownership and access to a clinician and adhere to clinician recommendations, as well as the relative acceptability and preferability of each term.
 Results:
Overall, participants rated the term ?means safety? as significantly more acceptable (t[369]=14.006, p<.001) and preferable (t[369]=16.781, p<.001) as compared to ?means restriction.? Across vignette groups, no significant differences emerged with respect to participants? reported willingness to disclose firearm ownership and access. However, participants randomized to the ?means safety? condition were significantly more likely to report intentions to adhere to clinicians? recommendations to limit access to a firearm for safety purposes (F[1,367]=7.393, p=.007, ?p2=.020).
 Conclusions:
Findings suggest that the term ?means safety? may be more clinically advantageous than ?means restriction,? resulting in greater adherence to clinician recommendations. Future research is needed to replicate these findings among more diverse samples in clinical settings.
 References:
1. Anestis MD, Anestis JC. Suicide rates and state laws regulating access and exposure to handguns. Am J Public Health. 2015 Oct;105(10):2049?58.
2. Chu C, Klein KM, Buchman-Schmitt JM, Hom MA, Hagan CR, Joiner TE. Routinized assessment of suicide risk in clinical practice: An empirically informed update. J Clin Psychol. 2015 Dec;71(12):1186?200.


(124) PO-124. Previous suicide attempts at first episode of psychosis

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Manuel Canal-Rivero . Universitat Autònoma de Barcelona/ Hospital Universitario Virgen del Rocío, Sevilla- Spain
- María Isabel Calvo-Rubiales - Jordi E. Obiols Llandrich - Miguel Ruiz-Veguilla -

 Introduction:
Suicide has been shown to be the single major cause of premature death among patients with schizophrenia spectrum disorders. It has been suggested that history of attempts of suicide are one of the principal predictor of suicidal behavior. This study examined the influence of premorbid adjustment in attempts of suicide occurred before of first episode of psychosis (FEP). Little is known about premorbid functioning like risk factor for suicide attempts. The current study examined the association of premorbid functioning and previous attempts of suicide of FEP.
 Goals:
The objective of this study is analyses the influence of premorbid adjustment in previous suicide attempts at first episode of psychosis.
 Methodology:
Sixty-five first-episode patients participated in this study. Baseline demographic clinical data and information about suicide attempts previous at FEP were collected in the first contact with mental health services. Sociodemographic and clinical data were collected from information provided by the patients and their relatives. We used Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to screen for psychotic symptoms which were then used for diagnosis. Information about suicide attempts previous at FEP was collected using Schedules for Clinical Assessment in Neuropsychyatry SCAN. This clinical interview contains a question about attempted suicide. Premorbid Adjustment Scale (PAS) comprises 36 items describing levels of functioning before the onset of psychosis during four periods in life: childhood (up to 11 years), early adolescence (12-15 years), late adolescence (16-18 years) and adulthood (19 years and beyond).
 Results:
Poor premorbid adjustment in early adolescence was significantly associated with prior attempts of suicide at FEP (OR= 1.13, 95% CI= 1.00-1.26). The others premorbid adjustment didn´t predicted attempts of suicide before FEP


 Conclusions:
Few studies have investigated risk factors of priors? attempts of suicide at FEP. The knowledge about those risk factors could help clinicians to identify high-risk patients. In this study poor premorbid adjustment in early adolescence is associated with attempts of suicide previous at FEP. Greater attention to person with poor premorbid adjustment in early adolescence may form the basis for early interventions aimed towards reducing the risk for subsequent suicide attempts.
 References:
1. Barrett EA, Sundet K, Faerden A, Nesvåg R, Agartz I, Fosse R, et al. Suicidality before and in the early phases of first episode psychosis. Schizophr Res. 2010;119(1-3):11?7.
2. Bakst S, Rabinowitz J, Bromet EJ. Is poor premorbid functioning a risk factor for suicide attempts in first-admission psychosis? Schizophr Res. 2010;116(2-3):210?6.


(136) PO-136. Can case management and psychoeducation interventions contribute to the prevent recurrent suicidal behavior? Data from PsyMAC Study

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Susana Al-Halabí . CIBERSAM - Área de Psiquiatría, Universidad de Oviedo, Oviedo
- Sergio Fernández-Artamendi - Patricia Burón - Julia Rodriguez - Marlen Garrido - Leticia González-Blanco - Leticia García-Álvarez - M. Paz García-Portilla - Pilar A. Saiz - Julio Bobes -

 Introduction:
The greatest risk factor for later suicide attempts is having made a previous attempt [1]. It is essential to develop preventive strategies. One of the most frequently used is case management, although no strong data is available yet as to its efficacy. An alternative strategy which has yielded promising results in many mental health contexts is psychoeducation. However, its application in this field is practically non-existent in comparison to other psychosocial interventions.
 Goals:
This study evaluated the differential effectiveness of the combination of several strategies to prevent repetition of suicide attempts [2].
 Methodology:
Sample: patients who entered the Emergency Department of the Hospital Universitario Central de Asturias (HUCA) after a suicide attempt (SA). A total of 163 participants [68.1% males, mean age (SD)=41.39 (12.91)] met the inclusion criteria and were spread across three groups: (1) passive strategy consisting of leaflets with information oriented towards suicide prevention; (2) the passive strategy combined with an active component of case management (MAC); (3) the passive strategy, case management and a psychoeducational programme (PSyMAC).The study included psychopathological assessments at the beginning of the study, and follow-ups every 6 months up to 30 months.
 Results:
There were no significant differences between the three groups in the number of SA nor in the number of patients with more than one SA. The cumulative curve of suicide events also confirms a lack of differences in the number of SA per group. Additionally, both the presence of SA prior to joining the study and the stated intention to repeat them proved to be predictor variables of a greater risk of suicidal behaviours during the period covered by the study. However, a positive trend was found for case management.
 Conclusions:
The present study showed that the use of psychoeducation is a promising strategy to prevent the repetition of SA, although more research is still needed.
 References:
Oquendo MA, Currier D, Mann JJ. Prospective studies of suicidal behavior in major depressive and bipolar disorders: what is the evidence for predictive risk factors? Acta Psychiatr Scand. 2006;114:151-158. doi: 10.1111/j.1600-0447.2006.00829.x

Sáiz PA, Rodríguez-Revuelta J, González-Blanco L, Burón P, Al-Halabi S, Garrido M et al. Study protocol of a prevention of recurrent suicidal behaviour program based on case management (PSyMAC)Rev Psiquiatr Salud Ment. 2014;7:131-138. doi: 10.1016/j.rpsm.2014.01.001.


(138) PO-138. Suicide rates under the microscope: A fine-scale analysis of a 1.8 million-inhabitants city

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Viktoria Zeilinger . Department of Basic Psychological Research and Research Methods, School of Psychology, University of, Vienna
-

 Introduction:
The geography of suicide prevalence is a well-established topic within suicidology, documenting substantial differences in suicide rates between world regions and countries. As for one example, there is evidence that national suicide rates across Europe differ by more than one order of magnitude, with the lowest rates found in Southeast Europe (Balkans, Mediterranean area) and the highest in Northeast Europe (Belarus, Baltic countries) [1]. Although geographic analyses have been extended to the intranational (i.e., regional or state level of analysis), owing to a dearth of appropriate data such analyses have rarely been conducted on more fine-scale levels. Here, we took the opportunity to examine the district-level suicide rates within the 1.8 million-inhabitants city of Vienna, the capital city of Austria and second-largest city of German-speaking Central Europe
 Goals:
By international comparisons, Austria?s suicide rate historically has ranked above average, but presently is mid-field (12.8/100,000 inhabitants per yr.; 2007-11 average) in European Rankings [2]. Our findings might be helpful for identifying catchment areas to reduce this even further.
 Methodology:
From district-level suicide statistics and population figures, obtained from Statistics Austria for all 23 districts of Vienna for the 10-yr. period 2003-12, we calculated annualized (2003-12 average) sex-specific suicide rates for analysis. In order to identify possible risk factors and potentially problematic districts, we entered district-level indicators (e.g., proportion of public green area, migrant proportion, income) in a correlational analysis vis-à-vis the districts? suicide rates.
 Results:
We found nontrivial differences in suicide rates between men (ranging from 14 to 26) and women (ranging from 5 to 13). Moreover we identified regional distinctions: most committed male suicides were located for the 5th district (26), whereas the highest female suicide rate (13) is reported for the 8th district.
 Conclusions:
These findings might be useful for planning district-specific outreach activities for suicide prevention and informative for existing extramural psychosocial service facilities.
 References:
[1] WHO. (10. 12 2015). http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/. Von http://apps.who.int/iris/bitstream/10665/131056/1/9789241564779_eng.pdf?ua=1&ua=1 abgerufen
[2]WHO. (27. Dezember 2015). Preventing suicide. A global imperative. Von http://www.who.int/en/: http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/ abgerufen


(145) PO-145. Evaluation of benefit to patients of training mental health professionals in suicide guidelines: cluster randomised trial

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Derek De Beurs . Netherlands Institute for Health Services Research (NIVEL), Amsterdam The Netherlands
-

 Introduction:
Background
Randomised studies examining the effect on patients of
training professionals in adherence to suicide guidelines are
scarce.
Aims
To assess whether patients benefited from the training of
professionals in adherence to suicide guidelines.
Method
In total 45 psychiatric departments were randomised (Dutch
trial register: NTR3092). In the intervention condition, all
staff in the departments were trained with an e-learning
supported train-the-trainer programme. After the intervention,
patients were assessed at admission and at 3-month
follow-up. Primary outcome was change in suicide ideation,
assessed with the Beck Scale for Suicide Ideation.
Results
For the total group of 566 patients with a positive score on
the Beck Scale for Suicide Ideation at baseline, intention-totreat
analysis showed no effects of the intervention on
patient outcomes at 3-month follow-up. Patients who were
suicidal with a DSM-IV diagnosis of depression (n = 154)
showed a significant decrease in suicide ideation when
treated in the intervention group. Patients in the intervention
group more often reported that suicidality was discussed
during treatment.
Conclusions
Overall, no effect of our intervention on patients was found.
However, we did find a beneficial effect of the training of
professionals on patients with depression.


(161) PO-161. Combining biological and psychological approaches in the prediction of suicidal behaviour

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Abel D Fernández-Peláez . Department of Psychiatry, University of Oviedo - CIBERSAM, Oviedo, Spain
- Patricia Burón - Elena Riesco - Susana Al-Halabí - Leticia García-Alvarez - Lorena De La Fuente Tomás - Lars-hakan Thorell - María Paz García-Portilla - Pilar A Saiz - Julio Bobes -

 Introduction:
Suicidal behavior (SB) is a major public health concern. Predicting SB is matter of particular interest for behavioral scientists. However, when studying complex behaviours such us SB, it is anticipate that only biomarkers of small size will be in play. Recently, it has been suggested that the combination of biological factors with other variables (clinical, psychological) associated with SB may be a good strategy to improve the predictive capacity of explanatory models. Data suggest that the Short Personality and Life Events (S-PLE) scale discriminates between past suicide and past non-suicide attempters with high sensitivity and specificity. On the other hand, electrodermal hyporeactivity has been suggested as a trait marker for suicidal propensity in depression.
 Goals:
The aim of this study is to check the predictive value of combination models requiring positive results on more than one test or requiring a positive result on either one or two of the above described tests.
 Methodology:
We included 144 depressed outpatients [males=94 (65.3%), mean age (SD)=54.36 (9.72)] from Oviedo (Spain). All patients were assessed using the S-PLE (Artieda-Urrutia et al., 2015) and electrodermal reactivity was measured by the EDOR test (Emotra AB).
 Results:
Forty eight patients (33.3%) have personal history of SB. No differences in gender, age, civil status, education level or socioeconomic status were found between those with previous history of SB and depressed patients without SB. The prediction model that requires both S-PLE (> 1.70) and EDOR hyporeactivity results in 35.4% sensitivity, 87.5% specificity, and has a positive predictive value of 58.6%. The prediction model that requires either S-PLE or EDOR hyporeactivity to be positive has a sensitivity of 85.4%, specificity of 22.3%, and positive predictive value of 35.6%.
 Conclusions:
Due to the different performance of these models, prospective data are needed in other to establish their real clinical utility in the prediction of SB.
 References:
Artieda-Urrutia P, Delgado-Gómez D, Ruiz-Hernández D, García-Vega JM, Berenguer N, Oquendo MA, Blasco-Fontecilla H. Short Personality and Life Event scale for detection of suicide attempters. Rev Psiquiatr Salud Ment. 2015; 8(4):199-206. doi: 10.1016/j.rpsm.2015.02.004.
Mann JJ, Currier D, Stanley B, Oquendo MA, Amsel LV, Ellis SP. Can biological tests assist prediction of suicide in mood disorders? Int J Neuropsychopharmacol. 2006; 9(4):465-74.
Thorell LH, Wolfersdorf M, Straub R, Steyer J, Hodgkinson S, Kaschka WP, Jandl M. Electrodermal hyporeactivity as a trait marker for suicidal propensity in uni- and bipolar depression. J Psychiatr Res. 2013; 47(12):1925-31. doi: 0.1016/j.jpsychires.2013.08.017.


(165) PO-165. The Clinical Utility and Reliability of the Assessment of Suicide Intent using Becks Suicide Intent Scale

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Aislinne Freeman . Univeristy of Leipzig, Germany
-

 Introduction:
High scores of suicide intent at the time of self-harm is associated with an elevated risk of suicide. Assessing suicide intent in hospital settings is of clinical importance, and has been strongly endorsed in the evaluation of future suicide risk. The Becks Suicide Intent Scale (SIS) is the most commonly used tool for measuring suicide intent, however, uncertainties over its suitability as a reliable measure of suicide intent within clinical settings has motivated the current study.
 Goals:
Thus, the aim of the current study was to assess the utility and inter-rater reliability of the objective component of the Suicide Intent Scale in order to evaluate its utility and appropriateness in clinical settings.
 Methodology:
Individuals who were consecutively admitted to the emergency department in Cork City between January and May 2015, for self-harming were included in the study (n=94). Information from the self-harm patients was recorded by a crisis nurse using the Biopsychosocial assessment measure. In order to explore the inter-rater reliability of Becks Suicide Intent Scale, data on suicide intent was inferred from the Biopsychosocial assessment and the crisis nurses? case notes, and translated into a SIS score by two independent raters. Cohen?s Kappa coefficient was calculated in order to rate the inter-rater reliability of the objective component of Beck?s Suicide Intent Scale,
 Results:
Cohen?s kappa was calculated with this data and found to reflect a low-level of inter-rater agreement (kappa = 0.25). Disagreement was consistent across all items on the scale.
 Conclusions:
The relatively low agreement across all items of the scale implies that there is much uncertainty surrounding the interpretation of the scale and that caution should be exercised when using this scale in a clinical setting.


(176) PO-176. Assessment of medical and non-medical student?s stigmatizing attitudes toward suicide

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Pirlog Mihail Cristian . University of Medicine and Pharmacy of Craiova, Craiova - Romania
- Gheorman Victor - Udristoiu Ion - Cazacu Sorin - Niculescu Mariana - Alexandru Dragos Ovidiu -

 Introduction:
Understanding attitudes toward suicide may help building new strategies for its prevention. Previous research showed that people with any kind of connection with suicidal behavior have more permissive attitudes toward suicide (Limbacher & Domino, 1985?86), and the attitudes of medical professional towards this phenomenon affect their provision of care to suicidal patients (Bagley & Ramsay, 1989).
 Goals:
Our study aimed to find out if there are differences between attitudes toward suicide among medical students from University of Medicine and Pharmacy of Craiova (UMF), Romania, and students from other study programmes (literature and agriculture) of University of Craiova (UCV).
 Methodology:
Attitudes were measured using Stigma of Suicide Scale (SOSS) (Batterham, Calear & Christensen, 2012) on two samples including 129 UMF students, respectively 81 UCV students, and were approved by local IRB.
 Results:
Higher scores on the three SOSS subscales indicated higher stigma, greater attribution to isolation/depression, and greater normalisation/glorification. For medical students, the average scores were 3.00 (Standard Deviation - SD 0.52), 3.76 (SD 0.49), and glorification 2.15 (SD 0.67), while for UCV students the scores were 2.89 (SD 0.59), 3.28 (SD 0.72), and glorification 2.45 (SD 0.64). These results highlighted significant differences between those two categories of students, for isolation and glorification (p student <0.01). Also, connections with persons with suicidal behavior lead to significant differences for stigma and glorification (p<0.05), respectively isolation (p<0.01), while the female gender was also influenced by glorification attitudes (p<0.05).
 Conclusions:
The data obtained showed that medical students have more stigmatizing attitudes toward suicidal individuals, while glorification of suicidal behavior is more frequent in other category of students, and exposure to suicidal people is a factor for more restrictive attitudes. In this respect, it becomes important to intervene at this level in order to reduce stigmatizing attitudes and limit the glorification of suicide.
 References:
Limbacher, M. & Domino, G. (1985?86) Attitudes toward suicide among attempters, contemplators and non-attempters. Omega: Journal of Death and Dying, 16, 325?334.
Bagley, C.h. & Ramsay, R. (1989) Attitudes toward suicide, religious values and suicidal behaviour: Evidence from a community survey. In Suicide and its Prevention: The Role of Attitude and Limitation (eds. R.F.W. Diekstra, R. Maris, S. Platt, A. Schmidtke & G. Sonneck). Leiden: E.J. Brill.
Batterham PJ, Calear AL and Christensen H. The Stigma of Suicide Scale. Psychometric properties and correlates of the stigma of suicide. Crisis 2013; 34: 13?21.


(193) PO-193. The role of Danish clergies in preventing of suicidal behavior among vulnerable groups

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Agnieszka Konieczna . Centre for Suicide Research, Odense C - Denmark
- Anne Bundgaard Hansen -

 Introduction:
Clergies have extensive contact with suicidal people and their relatives, but a lack of knowledge and understanding of suicidal thoughts and behaviour can be stressful for the prevention of suicide attempts and suicides. Among working clergies there is often a great uncertainty how suicidal thoughts and behavior should be managed and prevented. The clergies have different opinions on whether or not it is sinful and wrong to commit suicide. A big discussion among clergies is whether we are obliged to live, or whether we have the right to die.
 Goals:
The goal of this project is to reduce the vulnerable groups’ suicidal thoughts and behavior by increasing preventional work among clergies.
 Methodology:
A quantitative and qualitative approach was used for evaluating the data collected. Calculations were done by multiple logistic regression analysis to control for gender, age, experience and region.
 Results:
A total of 914 clergies completed a questionnaire and 47 clergies were interviewed. The clergies displayed inadequate knowledge of suicidal behavior. Most clergies were of the opinion that life is God's gift, and therefore people do not have the right to choose the circumstances of their own death. Male clergies agreed the most that suicide is a sin against God and against other people, but that it can be forgiven. More men than women also disagreed that life and not death has an ethical value and life's dignity does not depend on quality of life.
 Conclusions:
The current results showed that the suicide prevention can be a challenge for clergies and therefore as a part of the project we are currently working on an educational material aimed for mainly clergies. The material will be containing primarily information on how to prevent suicides among vulnerable groups.


(222) PO-222. The Self-help Online against Suicidal thoughts (SOS) trial - a Danish randomized controlled trial

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Charlotte Mühlmann . Mental Health Centre Copenhagen, Copenhagen -Denmark
-

 Introduction:
Background: Denmark is, to our knowledge, the only country in the world with specialized out-patient Clinics for Suicide Prevention where people at risk of suicide can get psychotherapeutic help free of charge. Still, the suicide rate has remained fairly stable over recent years and additional suicide preventive efforts are needed. A Dutch online self-help program has been found to be effective and cost-effective in terms of reducing suicide thoughts.
 Goals:
This study aims to examine the effectiveness of the Danish version of the online self-help program, Self-help Online against Suicidal thoughts, in Denmark.
 Methodology:
A total of 450 people with suicide thoughts will be recruited from the Danish suicide hotline “The Lifeline” and randomly allocated to the intervention (N=250) or a waiting list (N=250). Participants assigned to the intervention will be offered a self-help cognitive behavioural therapy program for six weeks via the Internet. The control group will be assigned to a waiting position for 32 weeks. The primary outcome is frequency and intensity of suicidal ideation. Secondary outcomes include depressive symptoms, hopelessness, worrying, quality of life, negative effects of the intervention as well as costs related to health care utilisation and productivity loss. Follow-ups will be conducted at 6 and 32 weeks after inclusion.
 Results:
The pilot study is scheduled to be completed by August 2016.
 Conclusions:
If the intervention is found to be linked to reductions in suicidal ideation, this will strengthen the evidence that online self-help interventions might be a relevant tool for people with at risk of suicide.


(234) PO-234. Involuntary hospital admission as preventive intervention after suicidal behavior? A 2-year case records in an acute psychiatric unitin a general hospital in Gijón (Spain).

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Danny Francisco Frías Ortiz . SESPA, Area Gestion Clinica V , Asturias - Spain
- Juan José Fernández Miranda - Omar Walid Muquebil Ali Al Shaban Rodriguez - Laura Rubio Rodriguez - Aida González Fernández - Elena Pérez Fernández - Susana Pereira - Manuela Valle Neila -

 Introduction:
Commitment proceedings often follow a period of emergency hospitalization, during which an individual with acute psychiatric symptoms is confined for a relatively short duration in a treatment facility for evaluation and stabilization by mental health professionals. Patients with a plan, access to lethal means, recent social stressors and symptoms suggestive of a psychiatric disorder should be hospitalized immediately; sometimes involuntary hospital admission is used by the specialist to avoid a suicidal behaviour, taking into account that after a suicide attempt 25% of people repeat attempt and 10% die by suicide.
 Goals:
The aim of this study was to know hospital admission due to suicide attempts, and which of them were involuntary.
 Methodology:
A 2-year retrospective study (2014-2015) of all cases admitted after suicidal behaviour in an acute psychiatric ward in a general hospital in Gijón (Spain). Reasons for hospital admission were registered, including suicide attempts, and also if they were involuntary.
 Results:
The total number of admissions to the psychiatric unit in 2014-2015 was Admissions due to suicide attempts were 427; 300 of them were involuntary admissions. There were a total of 347 involuntary admissions these two years; among them, due to suicide attempt: 300.
 Conclusions:
Although criteria for involuntary admission sometimes has no clinical considerations, emergency room is a vital setting for suicide prevention, and hospital admission is indicated until patient’s condition has been stabilized, in many cases involuntary. In fact, most of involuntary admissions in the psychiatric unit of the hospital studied followed a suicide attempt. Prevention of suicidal behaviour; Obvious high risk of repeat suicide attempt generates an urgency to make an accurate assessment and create a safe treatment plan and determine to retain suicidal patients
 References:
1.- Sáiz PA, Bobes J. Prevención del suicidio en España: una necesidad clínica no resuelta. Rev Psiquiatr Salud Ment. 2014;7:1---4. 2.- Mittendorfer-Rutz E, Schmidtke A. Suicide attempts in Europe. En: Wasserman D, Wasserman C, editores. Oxford textbook of suicidology and suicide prevention. Oxford: Oxford University, Press; 2009. p. 123---6. 3.- Jimenez-Trevino L, Sáiz PA, Corcoran P, García-Portilla MP, Burón, P, Garrido M, et al. The incidence of hospital-treated attempted suicide in Oviedo, Spain. Crisis. 2012;33:46---53. 4.-Ayuso-Mateos JL, Baca-Garcia E, Bobes J, Giner J, Giner L, Perez V, et al. Recomendaciones preventivas y manejo del comportamiento suicida en Espa˜na. Rev Psiquiatr Salud Ment. 2012;5:8---23.


(248) PO-248. Reconnecting AFTer deliberate self-harm (RAFT): a pilot study of SMS brief intervention

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Fiona Shand . Black Dog Institute, University of New South Wales, Sydney, Australia
-

 
 Goals:
Engaging patients following hospital-treated self-harm presents a number of challenges for both health systems and patients. Our previous research identified high levels of dissatisfaction with health system responses to self-harm, including failure to follow-up. One potential response is to test low-intensity follow-up which is easy to implement through hospital emergency departments. Several agencies are exploring the use of technology-based brief interventions as an extension to postcard, letter, and green card interventions. Using SMS allows the inclusion of links to additional material, and patients have the option to engage or not with this material. This paper describes the design and piloting of the RAFT intervention which combines brief contact text messages with links to therapeutic content.
 Methodology:
Following a review of research on effective follow-up interventions, RAFT was co-designed with consumers and suicide prevention experts. The intervention combines brief messages with links to brief therapeutic content targeting proximal risk factors. These messages are delivered at specified intervals over a 12 month period, beginning within 24-hours of leaving hospital. Based on feedback from consumers, easy-to-use content is delivered first to allow for the still-difficult feelings which may still be present for some patients.
 Results:
The feasibility of the intervention will be tested at two Australian hospitals, one urban and one regional. This pilot study aims to recruit 50 participants in order to test the feasibility and acceptability of the prototype, and to establish the parameters for a larger trial. Ethics approvals are in place to commence the pilot study, and baseline results will be presented.
 Conclusions:
If successful, RAFT has potential to reduce repeat episodes by approximately one-third, based on data for offline brief interventions. Using mobile phone technology is likely to be more acceptable to a younger population, and offers the opportunity to scale up to national and international settings.


(250) PO-250. Compare the paper version of the safety plan with a new-developed safety plan app in reducing suicide ideation and other symptoms

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Kate Andreasson . Psychiatric Research Unit, Psychoatric Centre North Zealand,, Denmark
- Merete Nordentoft - Annette Erlangsen -

 Introduction:
A recent report from the World health Organization estimates that approximately 800.000 individuals die by suicide each year, and there are twenty times more suicide attempts (WHO 2014). Previous studies have shown that a safety plan will assist patients with suicide ideation in providing instant support and help seeking professional assistance (Stanley et al. 2012).
 Goals:
The aim of the trial is to compare the paper version of the safety plan with a new-developed safety plan app in reducing suicide ideation and other symptoms, as an add-on to the supportive psychotherapy delivered in the clinics.
 Methodology:
The trial is designed as a 2-arm observer-blinded parallel group randomized clinical superiority trial, where participants will either receive: 1) Experimental intervention: the safety plan provided as the app MYPLAN, or 2) Treatment as Usual: the safety plan in the original paper format. Based on a power calculation,, a total of 560 participants. They will be recruited from national suicide preventive clinics. Both intervention groups will also receive standard psychosocial therapeutic care, up to 8-10 sessions of supportive psychotherapy. Follow-ups will be conducted at 3, 6, 9, and 12 months after date of inclusion. Participants, inclusion and exclusion criteria: All participants will be recruited from the suicide preventive clinics in Denmark. There are no age restriction on participation in the study and participants must have a smartphone. Exclusion criteria: alcohol or substance abuse disorder (DSM-V), Primary outcome is suicide ideation measured by Becks suicide ideation scale. Secondary outcomes are: suicide intensity, hopelessness, depressive symptoms, quality of life, Statistics: Data analyses will be based on intention-to-treat principle. We will use repeated measurement in mixed model with unstructed variance, and missing data will be handled with multiple imputations.
 Results:
The patient recruitment will start in November 2016 and finish November 2017. Analyses and results are expected in 2018.
 References:
1.World Health Organization WHO, Preventing suicide: A global imperative. Luxembourg, WHO cataloguing-in publication data; 2014. 2. Stanley B, Brown GK. Safety planning Intervention: A brief intervention to mitigate suicide risk. Cognitive and beheavorial practice 2012;19:256-64.


(294) PO-294. The Collaborative Assessment and Management of Suicidality project in Denmark (CAMS-DK)

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Bent Rosenbaum . Psychiatric Center Copenhagen, Capital Region, Copenhagen, Denmark
- Malene Grundahl - Hanne Frandsen - Lone Fogholm - August Wang - Jan-henrik Winsløv -

 Introduction:
The Competence Center for Suicide Prevention in the Capital Region of Denmark (ESSSP-CRD) has since 2009 provided psychotherapeutic help for people at risk of suicide under the premise that early intervention will help reduce risk of suicide and prevent future suicidal attempts. Since 2006 the CAMS approach (Jobes 2006, 2012) has been applied randomly all over the country of Denmark, and lately an RCT has demonstrated that CAMS is equally effective as Dialectic Behavior Therapy for persons with traits of Borderline Personality Disorder (Andreasson 2015, Andreasson et al. 2016). However, little is known as to which elements of CAMS facilitate the positive effect.
 Goals:
The goal of this sub-study of CAMS is to investigate in depth each of the specific elements of CAMS and evaluate their strengths and weaknesses from the patient-perspective as well as the therapist perspective.
 Methodology:
Successively included persons referred to ESSSP-CRD and treated with CAMS due to suicidal thoughts and/or suicide behavior are interviewed with a semi-qualitative approach. Essential elements of the CAMS therapy are studied in depth, and the subjectively experienced short-term supportive and curing capacities are systematized. Statements of therapists of different theoretical orientations are also included in the evaluation of positive and negative aspects of the CAMS approach.
 Results:
The presentation will describe the initial results of a pilot project with interviews from 20 patients. Pre-post therapy measures of psychache, stress, perturbation, hopelessness, self-hate, changes in reasons for living and reasons for dying, core-self evaluation as well as quality of life, will, in addition to the empirical material for the interviews, be taken into consideration.
 Conclusions:
The necessity for knowing more details about the qualitatively effective element of any suicide prevention therapy is usually underestimated. This lack of knowledge is mended in an ongoing large-scale, prospective, exploratory project with follow-up on the CAMS approach.
 References:
Andreasson, K.T. (2015). Suicide prevention and borderline personality disorder - the DiaS trial. Copenhagen University, Faculty of Health and Medical Sciences, Ph.D. thesis. Andreasson, K.T., Krogh, J., Wenneberg, C., Jessen, H.K.L., Krakauer, K., Gluud, C., Thomsen, R.R., Randers, L., Nordentoft, M. (2016). Effectiveness of Dialectical Behaviour Therapy versus Collaborative Assessment and Management of Suicidality treatment for reduction of self-harm in adults with vorderline personality traits and disorder - A randomized observer-blinded clinical trial. Depression and Andreasson, KT. Suicide prevention and borderline personality disorder - the DiaS trial. Copenhagen University, Faculty of Health and Medical Sciences, Ph.D. thesis, 2015 Andreasson, KT, et al. Effectiveness of Dialectical Behaviour Therapy versus Collaborative Assessment and Management of Suicidality treatment for reduction of self-harm in adults with vorderline personality traits and disorder - A randomized observer-blinded clinical trial. Depression and Anxiety, 2016, (online february): 1–11 Colleen Nielsen, A, Alberdi, F, Rosenbaum, B. Collaborative Assessement and Management of Suicidality method shows effect. Danish Medical Bulletin, 2011;58/8: 1-5 Jobes, DA. Managing suicidal risk. New York: Guilford Press, 2006 Jobes, D.The Collaborative Assessment and Management of Suicidality (CAMS): An Evolving Evidence- Based Clinical Approach to Suicidal Risk. Journal of Suicide and Life-Threatening Behavior, 2012; 42(6):640-53


(298) PO-298. The association between suicidal behaviour and antidepressant medication

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Nikita Vancayseele . Ghent University, Ghent-Belgium
- Gwendolyn Portzky - Kees Van Heeringen -

 Introduction:
The association between suicidal behaviour and antidepressant medication is a matter of debate. While clinical trials of antidepressants report increased rates of (non-fatal) suicidal behaviour, particularly in young people, pharmaco-epidemiological studies show a protective effect of antidepressants on suicide rates, particularly in the elderly. Pharmaco-epidemiological studies of the relationship between antidepressant and attempted suicide are scarce.
 Goals:
To investigate the relationship between the occurrence of attempted suicide and antidepressant prescriptions in Flanders, Belgium.
 Methodology:
By means of a standardized monitoring form, information on all attempted suicide episodes involving deliberate self-poisoning presented at A&E departments was collected in general hospitals in the 5 provinces of Flanders between January 2010 and December 2013. We analyzed data on 8.143 patients. Data on prescriptions of antidepressants at a provincial level in Flanders for 2010-2013 were available from health insurance funds. Pearson correlations were used to explore the direction and magnitude of associations, and the poisson regression model was used to relate numbers of antidepressant prescriptions to the attempted suicide rates.
 Results:
There was a negative correlation between rates of attempted suicide and the numbers of antidepressant prescriptions in Flanders. The number of prescriptions of antidepressants increased by 3.5%, while the rate of attempted suicides decreased by 5.6% during the study period. There was an effect of province on this overall correlation. An inverse correlation between rates of attempted suicide, and the number of prescriptions of antidepressants was observed in two of the five provinces in Flanders while in the three other provinces there was a significant positive correlation.
 Conclusions:
There was a significant negative correlation between rates of attempted suicide and numbers of antidepressant prescriptions in Flanders, with an effect of province. The effect of age and gender needs to be taken into account in further study.
 References:
Gusmão R, Quintão S, McDaid D, Arensman E, Van Audenhove C, Coffey C, et al. Antidepressant utilization and suicide in Europe: An ecological multi-national study. Plos One. 2013 June. 8(6). Gibbons RD, Hur K, Bhaumik DK, Mann JJ. The relationship between antidepressant prescription rates and rate of early adolescent suicide. Am J Psychiatry. 2006 November, 163 (11): 1898-1904. Corcoran P, Heavey B, Griffin E, Perry IJ, Arensman E. Psychotropic medication involved in intentional drug overdose: Implications for treatment. Neuropsychiatry. 2013, 3(3): 285-293. Reseland S, Bray I, Gunnell D. Relationship between antidepressant sales and secular trends in suicide rates in the Nordic countries. British journal of psychiatry. 2006, 188: 354-358. Isacsson G, Bergman U, Rich CL. Epidemiological data suggest antidepressants reduce suicide risk among depressives. Journal of affective disorders. 1996, 41: 1-8. Olfson M, Shaffer D, Marcus SC, Greenberg T. Relationship between antidepressant medication treatment and suicide in adolescents. Arch gen psychiatry. October 2003, 60: 978-982.


(304) PO-304. Raising Media Awareness in French-speaking Switzerland: Best Practices and a new study

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Irina Inostroza . STOP SUICIDE, Switzerland
-

 Introduction:
At STOP SUICIDE, we think that appropriate ways to inform about suicide can help preventing suicide among youth people. Through on going funding from one of the Swiss federal states, STOP SUICIDE has worked since 2011 to improve the suicide-protective effect of the media and limit its copycat effect. We work closely with media to promote sensitive and appropriate reporting of suicide. STOP SUICIDE’s “Media program” leads three main activities: media observation, briefing editorial staff and journalism students’ training. Our oral presentation will provide a brief overview of the best practices we identified during the four past years of working with media outlets and journalists. We have developed an innovative and pragmatic approach that media appreciate. Beginning with monitoring the press and writing letters to the press, STOP SUICIDE followed the Swiss experience of Konrad Michel and all (Michel, Frey, Wyss & Valach, 2000) and started to implement a proactive and preventative strategy. STOP SUICIDE offers in-house briefings and has fostered sustainable and interpersonal relationships with newspaper titles. We also work together with schools of journalism and youth medias. Raising awareness amongst the journalists of the future is crucial to change practices. According to one student, “if we don’t have enough time to report carefully about suicide, I’d rather not poke this issue.”
 Goals:
STOP SUICIDE aims to prevent youth suicide in the French-speaking part of Switzerland. www.stopsuicide.ch/site/medias
 Methodology:
In January 2016, we started a qualitative study among Swiss French-Speaking journalists in order to evaluate and develop our strategy towards media outlets and to face the new challenges of online media.
 Results:
The results will be presented in June in Switzerland and it would be nice to present them in September in Oviedo!


(311) PO-311. Feasibility of a suicide mortality review mechanism: A trial in New Zealand

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Sunny Collings . Otago Univeristy, Wellington, New Zealand
- Gabrielle Jenkin - Sarah Mckenzie - Debbie Peterson - June Atkinson -

 Introduction:
Suicide is a major cause of death in New Zealand. While there is publication of suicide data through various government agencies, there has been no systematic review of suicide deaths. In 2014 the Suicide Mortality Review Committee (SuMRC) was established on a trial basis to determine the feasibility of setting up a permanent suicide mortality review mechanism.
 Goals:
The aim of the SuMRC feasibility study was to investigate contributing factors and patterns of suicidal behaviour in NZ and identify points for suicide prevention.
 Methodology:
Files and data from a wide range of government agencies and services were requested for three priority population groups (indigenous Māori youth, males aged 25-64 and those who had recently accessed mental health services) who had died by suicide in a five year period (between 1 January 2007 and 31 December 2011). A tiered approach was used to explore a variety of quantitative and qualitative research methods and analyses for the subgroups. These included: demographic overviews and more specific overviews on the lives of the subgroups, paper-based systems review for the mental health service users and qualitative story-based inquiry (family suicide stories) for the Māori youth subgroup.
 Results:
The study cohort was 1797 people who died by suicide between 1 January 2007 and 31 December 2011. Data retrieved from 16 government agencies and services found that a large number of these were known to Government agencies. The study found a number of potential intervention points for suicide reduction.
 Conclusions:
The SuMRC feasibility study demonstrated that mortality review for suicide in New Zealand is possible and that an ongoing SuMRC could exhaustively analyse existing data, in conjunction with other agencies and in ways that are not currently possible to inform future suicide prevention work.
 References:
Ministry of Health. 2015. Suicide facts: Deaths and intentional self-harm hospitalisations 2012. Wellington: Ministry of Health. Associate Minister of Health. 2006. The New Zealand suicide prevention strategy 2006–2016. Wellington: Ministry of Health.


(340) PO-340. The treatment in the Danish Suicide Prevention Clinics: A qualitative description.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Titia Lahoz . Suicide Prevention Clinic, Copenhagen University Hospital, Copenhagen
- August Garbriel Wang - Winsløv Jan-Henrik - Krogh Søren - Christiansen Helle - Lykkeskov Hanne - Rass Dorte - Kirketerp Marlene - Bjørnkjær Loft Dianna - Erlangsen Annette -

 Introduction:
Since 1992 psychosocial therapy for people at risk of suicide has been offered in specialised clinics in Denmark. The intervention was at first only available in two cities but became more widespread over time. In 2007 the Danish National Board of Health was possibly the first authority in the world to implement the psychosocial therapy intervention nationally and suicide prevention clinics continue to emerge reaching 19 clinics in 2016 covering all regions of Denmark. The generally lower risk of suicidal behaviour demonstrated for suicide attempters receiving treatment within one of such suicide clinics provides a basis for interest and the point of departure for a more detailed description of the treatment in the Danish suicide prevention clinics.
 Goals:
The aim of this study is to describe the psychosocial intervention offered to people at risk of suicide in out-patient settings in Denmark.
 Methodology:
A qualitative study is applied to describe the psychosocial therapy from the perspective of the clinician. Data were collected through 10 semi-structured interviews with therapists. A purposive sampling strategy was selected with respect to educational backgrounds and geographical locations, i.e. across all five regions in Denmark. All interviews were transcribed verbatim and analyzed using phenomenologic condensation of meaning according to Kvale and Brinkmann aiming to identify central themes of suicide prevention therapy regarding stages of treatment: initial, intermediate and final.
 Results:
The study is expected to provide a detailed description of the suicide prevention therapy, normally categorized as a psychosocial or a rapid and active outreach intervention.
 Conclusions:
The study aims to conclude upon themes that characterize the psychosocial intervention as it currently takes place at the suicide prevention clinics in Denmark, 2016.
 References:
Erlangsen A, Lind BD, Stuart EA, Qin P, Stenager E, Larsen KJ, et al. Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: A register-based, nationwide multicentre study using propensity score matching, Lancet 2015: 49-58. Acknowledgements: Mette Riis Søgaard, Hanne Frandsen, Mikkel Christoffer Berg Arendt, Berdel Dam Lind.


(342) PO-342. How to implement a clinical guideline for suicide prevention: Development of an e-learning website

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Saskia Aerts . Flemish Centre for Suicide Prevention (VLESP), Ghent - Belgium
-

 Introduction:
In 2017 the first multidisciplinary clinical guideline on detection and treatment of suicidal patients in Flanders will be implemented in different health care settings. The success of this guideline will depend on the dissemination and implementation in daily health care practice.
 Goals:
To support this implementation, the Flemish Centre for Suicide Prevention (VLESP) is developing an online e-learning platform for health professionals.
 Methodology:
To improve the accessibility and usability of the guideline’s recommendations, an online e-learning platform for health professionals will be created.
 Results:
The guideline addresses five clinical questions: • How to detect and discuss suicidal behavior? • How to treat suicidal patients? • How to act after a patient suicide attempt? • How to act after a patient suicide? • How to develop a suicide prevention policy? The guideline contains evidence-based recommendations for health care professionals of different disciplines (e.g. general practitioners, psychologists, psychiatrists, nurses, …).
 Conclusions:
This platform will be integrated in Zelfmoord1813.be, the online suicide prevention portal of Flanders. On this website, the health professional will be able to browse the content of the guideline through video animations, interviews with experts, infographics and different tools like a custom-made safety plan and checklists that can be put directly into practice.


(360) PO-360. Chronic Suicidality and Its Treatment: A Case Series and Review of the Literature

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Alejandra Cabello . Universidad Autónoma de Nuevo León Departamento de Psiquiatría, Monterrey México
- María Eugenia Corral -

 Introduction:
Evidence-based guidance on how best to treat chronic suicidality is limited. The statistics show that over 3.5% of the general population experienced suicidal thoughts, albeit there is no evidence about people with chronic suicidality
 Goals:
Elucidate the evidence for chronic suicidality treatment. A case series of 3 patients and review of the literature was performed.
 Methodology:
In order to illustrate the complexities of chronic suicidality, we selected a case series of 3 young patients with chronic suicidality. We assessed clinical and personality features, cognition, family history and pharmacological response with clinical interviews and psychological collaborative assessment with the WAIS IV and Rorschach Test. Bibliographic reference searches for suicidality, suicide and chronic were performed in PubMed and Science-Direct search engines with language restriction for English and Spanish from January 1st, 2006, to January 1st, 2016. The sensitive keywords suicidality and suicide were crossed with keywords chronic, recurrent and treatment and were searched in the title
 Results:
All patients have a long history of suicidal ideation, self/injurious behavior and suicide attempts. Also, they have early onset of depressive mood symptoms and meeting DSM5 criteria for MDD and Personality Disorders. Likewise, all patients were unemployed and there is evidence that the risk is greater in the first five years for unemployment and history of violence prevails in their family and personal development. This was observed in spite of 3 different IQ score ranges: extremely low, average and high average. The review identified 17 eligible studies, out of 224.
 Conclusions:
Because there is no guidance in the treatment of chronic suicidality, the work with these patients is challenging, at the end, the physician appeals to his decision making process and clinical judgement. The common history of family violence is concerning since literature supports that friends and family are considered the first line in providing assistance in suicidal crisis.
 References:
1. Cooper SL, Lezotte D, Jacobellis J, Diguiseppi C. Does availability of mental health resources prevent recurrent suicidal behavior? An ecological analysis. Suicide Life Threat Behav [Internet]. 2006 Aug [cited 2016 Feb 17];36(4):409–17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16978095 2. Chesin MS, Jeglic EL. Factors Associated with Recurrent Suicidal Ideation among Racially and Ethnically Diverse College Students with a History of Suicide Attempt: The Role of Mindfulness. Arch Suicide Res [Internet]. Jan [cited 2016 Feb 17];20(1):29–44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26212484 3. Pompili M, Lester D, Tatarelli R, Girardi P. Incomplete oedipism and chronic suicidality in psychotic depression with paranoid delusions related to eyes. Ann Gen Psychiatry [Internet]. 2006;5:18. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1661590&tool=pmcentrez&rendertype=abstract 4. Bergmans Y, Links PS. Reducing potential risk factors for suicide-related behavior with a group intervention for clients with recurrent suicide-related behavior. Ann Clin Psychiatry [Internet]. Jan [cited 2016 Feb 17];21(1):17–25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19239829 5. Bryan CJ, Clemans TA, Leeson B, Rudd MD. Acute vs. chronic stressors, multiple suicide attempts, and persistent suicide ideation in US soldiers. J Nerv Ment Dis [Internet]. 2015 Jan [cited 2016 Feb 17];203(1):48–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25503959 6. Williams JMG, Crane C, Barnhofer T, Van der Does AJW, Segal Z V. Recurrence of suicidal ideation across depressive episodes. J Affect Disord [Internet]. 2006 Apr [cited 2016 Jan 5];91(2-3):189–94. Available from: http://www.sciencedirect.com/science/article/pii/S0165032706000036 7. De Gioannis A, De Leo D. Oral ketamine augmentation for chronic suicidality in treatment-resistant depression. Aust N Z J Psychiatry [Internet]. 2014 Jul [cited 2016 Feb 17];48(7):686. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24452289 8. Dugas EN, Low NC, O’Loughlin EK, O’Loughlin JL. Recurrent suicidal ideation in young adults. Can J public Heal = Rev Can santé publique [Internet]. Jan [cited 2016 Feb 9];106(5):e303–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26451992 9. Fishbain DA, Bruns D, Bruns A, Gao J, Lewis JE, Meyer LJ, et al. The Perception of Being a Burden in Acute and Chronic Pain Patients is Associated with Affirmation of Different Types of Suicidality. Pain Med [Internet]. 2015 Sep 1 [cited 2016 Feb 17]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/26332796 10. Mousavi SG, Bateni S, Maracy MR, Mardanian F, Mousavi SH. Recurrent suicide attempt and female hormones. Adv Biomed Res [Internet]. 2014 Jan [cited 2016 Feb 17];3:201. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4202501&tool=pmcentrez&rendertype=abstract 11. Sáiz PA, Rodríguez-Revuelta J, González-Blanco L, Burón P, Al-Halabí S, Garrido M, et al. [Study protocol of a prevention of recurrent suicidal behaviour program based on case management (PSyMAC)]. Rev Psiquiatr y salud Ment [Internet]. Jan [cited 2016 Jan 29];7(3):131–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24656762 12. Sockalingam S, Flett H, Bergmans Y. A pilot study in suicide intervention training using a group intervention for patients with recurrent suicide attempts. Acad Psychiatry [Internet]. Jan [cited 2016 Feb 17];34(2):132–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20224024 13. Angelica MD, Fong Y. NIH Public Access. October. 2008;141(4):520–9. 14. Lopez-Castroman J, Cerrato L, Beziat S, Jaussent I, Guillaume S, Courtet P. Heavy tobacco dependence in suicide attempters making recurrent and medically serious attempts. Drug Alcohol Depend [Internet]. Elsevier Ireland Ltd; 2016;1–6. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0376871616000284


(366) PO-366. Gender differences in triggers of suicidal behavior and other risk factors in adolescents

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Tania Prieto Toribio . Sant Joan de Déu University Hospital. UB, Barcelona- Spain
- Sandra Yazmín Valdez Amaral - Bernardo Sánchez Fernández - Carmina Castellano Tejedor - Francisco Villar Cabeza -

 Introduction:
Adolescent suicide attempts are a major public health problem. Although rates of completed suicide are higher for male adolescents, rates of suicide attempt are 2-3 times greater for female adolescents[1]. Thus, to identify risk factors and gender-related variables related to greater risk of suicide attempts becomes crucial[2].
 Goals:
To assess gender differences in relation to triggers of suicidal behavior and other selected risk factors (specifically, bullying, family history of suicidal behavior, history of childhood sexual abuse and self-harm)
 Methodology:
Patients evaluated in a psychiatric emergency unit of a Pediatric Hospital were included in a cross-sectional study during 2014-2015
 Results:
526 episodes of 402 patients were registered (82.08% females and 17.91% males). More than 50% of the suicidal behaviors registered were preceded by relationship conflicts. Specifically, family relationship problems were main triggers in both genders (34% females, 35% males), followed by sentimental breakups (11% females, 14% males) and conflicts with peers (7% females, 4% males). Emotional dysregulation was the second most mentioned trigger in both genders (29% females, 18% males). When considering the selected risk factors, 11% of the treated patients said that they had suffered bullying and 12% had a family history of suicidal behavior, with no significant differences between genders. Significant differences between genders were found in patients with a history of childhood sexual abuse (11% males, 4% females; p <0.05) and with a history of self-harm (40% females, 18% males; p <0.001).
 Conclusions:
No relevant differences between genders were found regarding possible triggers of suicidal behavior. Considering that relationship conflicts represent more than 50% of the mentioned triggers, suicidal behaviors in populations at risk could be expected to be reduced by intensifying the interventions aimed to reduce family conflicts, emotional management and solving interpersonal conflicts in adolescents of both genders. Further research is needed to validate these results.
 References:
1) Lewinsohn PM, Rohde P, Seeley JR, Baldwin CL. Gender Differences in Suicide Attempts From Adolescence to Young Adulthood. J Am Acad Child Adolesc Psychiatry. 2001 April; 40 (4): 427-434. 2)Qin P, Agerbo E, Westergård-Nielsen N, Eriksson T, Mortensen PB. Gender differences in risk factors for suicide in Denmark. Br J Psychiatry. 2000 Dec;177:546-50.


(375) PO-375. Treating high suicidal patients with Asperger syndrome (DSM-IV-RT) with DBT principles

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Shu Chin Chen . Suicide Prevention Center, MacKay Memorial Hospital, Taipei, Taiwan
-

 Introduction:
DBT is an effective treatment for BPD clients. Some researchers report that BPD and Asperger syndrome (DSM-IV-TR) are sometimes confused. Yet, there is no research mention about treating suicidal patients with Asperger.
 Goals:
This report tries to modify DBT for high sundial patients with AS syndrome.
 Methodology:
The therapist finished intensive DBT training, is on DBT team for 8 years. She used DBT principles to treat two clients in this report. They are both female, around 20, drop out from collage, had suicide attempts and threats. They also have significant AS traits, Autism-spectrum Quotient Chinese Version total score > 30. It means that they have more difficulties in social skills, more rigid behavior, and easy to focus on details not very fit the context. Case A finished one year standard DBT. Case B received DBT individual therapy for one year. But because of her serious interrupted behavior, such as threaten to burn clinic, rejected diary card record and blamed therapist all the time. Therapist used 8 months to prepare case B to get into a skills training group, and it only left 4 months.
 Results:
Their suicidal behaviors and threats decreased after one year treatment. Their life worth living goals are extending. Case A changed her major and back to college in 0.5 years after treatment. Case B back to school in 3 months during treatment. Both of them stayed in their school work. Their interpersonal conflicts decreased. These two cases see therapist one or two times per month continually.
 Conclusions:
This is not a strict study, yet showed some effect of modified DBT treating suicidal clients with Asperger symptoms. Individual help especially needed while applied DBT skills to real life. If the client had tremendous dysregulated behavior, these behaviors need to decrease to certain level before she got into a group.


(391) PO-391. Predictors of suicide attempt with violent methods compared with poisoning

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Per Sverre Persett . Oslo University Hospital, Oslo - Norway
-

 Introduction:
In Norway about 550 suicides are recorded each year (Statistics Norway). Probably, the number of suicide attempts is 10-15 times higher (Hawton). Suicide is one of the most common causes of death among those aged 15-44 years. In Norway, research om suicide attempt caused by self-poisoning is fairly widespread, suicide attempt by violent method has not been studied.
 Goals:
1: The main objective of this study was to describe patients who admitted to somatic hospital after attempted suicide using violent methods (hanging, drowning, jumping from heights, using firearms, cutting or others). 2: An additional objective of the study was to compare patients after attempted suicide using violent methods with non-violent methods.
 Methodology:
A prospective cohort study included patients (>18 years), 80 patients admitted by violent method (median age 42 years, male=63%) and 81 admitted by other methods (median age 41 years, male 47%). Its designed to examine psychological and somatic outcomes of patients admitted to somatic hospital in Norway after suicide attempt, and to compare patients with suicide attempt using violent methods with suicide attempt by other methods. Their demographics and previous health background was examined.
 Results:
159 patients was attending the Emergency Room with suicide attempt by violent method during 2011 to 2014. The methods used in violation was cutting (34%),, jumping from heights (32%), hanging (14%), different (10%), firearms (7%) and drowning (4%). Patients admitted with violent methods had a more widespread history with psychosis than patients admitted with self-poisoning. Patients admitted with self-poisoning were previously more frequent of anxiety and affective disorders. Patients with violent method used health services infrequently before suicide attempt, but more reported suicide thoughts when attending health service.
 Conclusions:
From the 159 patients admitted the hospital by violent methods were more men than women. They had a severe damage and longer hospital stay than patients. The incidence of hospitalized suicide attempt by violent methods in Oslo University Hospital was 159, with a not equal sex distribution. One in ten patients died during the hospital stay and 14 suffered a cerebral damage. The in-hospital mortality was 11%. Method by firearms had highest mortality. Compared to the outcome of suicide by poisoning (Lund. 2012) this patient group is in serious dangerous conditions after a suicide attempt.
 References:
Hawton, K., & Harriss, L. (2008). How often does deliberate self-harm occur relative to each suicide? A study of variations by gender and age. Suicide and Life-Threatening Behavior, 38(6), 650-660. doi:10.1521/suli.2008.38.6.650 Lund, C., Drottning, P., Stiksrud, B., Vahabi, J., Lyngra, M., Ekeberg, I., . . . Hovda, K. E. (2012). A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae. Scand J Trauma Resusc Emerg Med, 20, 49. doi:10.1186/1757-7241-20-49 Nordentoft, M. (2007). Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Danish Medical Bulletin, 54(4), 306-369. Statistic Norway


(399) PO-399. Evaluation of the Implementation of the Project Integrated Care for Suicide Attempters in 44 General Hospitals in Flanders, Belgium

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Peter Beks . Integrated Care for Suicide Attempters, DAGG vzw, Lommel, Belgium
- Marie Van Broeckhoven - Anneleen Depaire -

 Introduction:
In 2005 we started to focus on the high risk group of suicide attempters (SA) in Flanders. In the last ten years we managed to develop a set of tools and instruments to support caregivers in their work with suicide attempters. In 2015 approximately 80% of the general hospitals in flanders use our instruments.These participating hospitals are evaluated biennially.
 Goals:
The evaluation's main goals is to detect problems en discuss solutions concerning the implementation of our tools and instruments (IPEO, KIPEO, Toolkit On Track Again and leaflets). Further we detect the needs of workers in the care of SA and promote a professional attitude, support and referral (adequate risk assessment, continuity of care, communication between hospital and general practitioners)
 Methodology:
Evaluation: a standard questionnaire following a semi-structured interview with key persons in the hospital, carried out by suicide prevention workers.
 Results:
More than 50% of the hospitals had a standard procedure developed by a planning group. In 43.2% of the hospitals a standard procedure is guaranteed 24/7. About 40% of the hospitals say to use the IPEO tool for ‘all’ patients and 22.7% for ‘almost all’ patients. In 65.9% of the cases the patient leaflet is used. In 70.5% of the cases the GP is informed and involved in the follow-up care. Hospitals report a change of attitude, improved knowledge and understanding, improved assessment and care, improved cooperation between caretakers and optimized care for patients.
 Conclusions:
The introduction of good practices for suicide attempters, has been well received by the participating hospitals. The training and the use of the instrument promote knowledge and positive attitudes towards SA. The introduced good practices need to be constantly promoted to render them permanent. In-service-trainings, repeated trainings for hospital staff and evaluations are ways to do this.


(417) PO-417. Suicide Survivors in Lithuania: I have to cope with it on my own

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Intervention research for prevention of suicidal behavior

Authors:Odeta Geležėlytė . Vilnius University ,
- Vaiva Klimaitė - Danutė Gailienė -

 Introduction:
Every suicide leaves 10 to 15 suffering people. Bereaved by suicide face emotional, somatic and social difficulties (Pitman et al., 2014). As a result, they are often in need of help (Dyregrov, 2011). Lithuania is a country with one of the highest suicide rates in the world, but suicide prevention and postvention system is very poor. We believe, this situation has a significant effect on the bereaved.
 Goals:
As part of a larger study, the objective of this presentation is to analyze and describe professional help-seeking difficulties of those bereaved by suicide in Lithuania.
 Methodology:
23 suicide survivors (20 female, 3 male, average age 42 y.), who lost a close relative (parent, child, sibling or spouse) from 1 to 2 years before, were interviewed (average duration 67 min.). Thematic analysis was used for the data examination. 2429 citations, 299 themes, 44 subcategories and 15 categories were discovered.
 Results:
Results revealed that the bereaved didn’t get help needed. They often felt confused about what kind of help they could ask. Survivors avoided participating or initiating helpful activities (eg. self-help groups), although expressed the need for it. As a result, they felt they have to cope with extensive difficulties on their own and accept it as it is in the nature of the case. The study also revealed interviewees‘ mistrust in public health care and other institutions. Suicide stigma played an important role too. Results showed beliefs about inappropriateness, sinfulness of suicide that discouraged the bereaved from seeking help, stimulated avoidance and withdrawal.
 Conclusions:
These results suggest that lack of help offered, mistrust, isolation and suicide stigma play an important role that bereaved by suicide don’t get help needed in Lithuania. Systematic essential changes are necessary to change the situation.
 References:
Dyregrov, K. (2011). What do we know about needs for help after suicide in different parts of the world? A phenomenological perspective. Crisis, 32 (6), 310-318.
Pitman, A., Osborn, D., King, M., & Erlangsen, A. (2014). Effects of suicide bereavement on mental health and suicide risk. Lancet Psyciatry. doi:10.1016/S2215-0366(14)70224-X




Lifespan differential aspects (from infancy to elderly)


(169) PO-169. Postpartum psychosis and suicide attempt

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Antonio España Osuna . Complejo Hospitalario de Jaen, Jaen
- Mercedes Valverde Barea - Francisca Cartas Moreno -

 Introduction:
Postpartum psychiatric complications include sadness, depression and psychosis. In the last two cases the risk of suicide is increased so that the intervention should be early, energetic and often requires hospitalization and social and family intervention.
 Goals:
Autolytic provide an example of a serious complication in the postpartum psychotic disorder.
 Methodology:
Present illness: The patient gave birth two weeks before the onset of symptoms. Since then he has made several attempts autolytic knife and attempted strangulation. Shows perplexity, self-referentiality, delusional and psychomotor retardation.
Psychopathological exploration: psychomotor slowing, stiffness and facial blankness in puzzlement. Inattentive. Hypothymic affection, personnel and underestimation ambivalent about the actual suicide attempts and suicidal ideation. Imperative auditory hallucinations. Delusional interpretations of their environment and labor. Self-referentiality and contriving jealousy for her husband. Insomnia. Decreased appetite. Partial insight. Scale Edinburgh on postpartum depression (EPDS) score: 21.
Diagnosis: Puerperal psychoses without specification.
 Results:
The patient had an adequate response to hospitalization and establishment of antipsychotic treatment with Olanzapine gradually decreasing alterations in sensory perception, mood and thought content. Drug dosage was titrated to 15 mg a day. During her internment she was accompanied at all times by her husband and not staged any autolytic act. Significantly, the beneficial effect on the progressive and she had protected exposure to newborns in an attempt to establish an early bonding child. There was a multidisciplinary strategy that were involved psychiatrist, psychologist, social worker and family physician established.
 Conclusions:
1. Postpartum mood disorders are very common and range from sadness, depression and psychosis.
2. The severity and frequency together with the involvement of the newborn and the rest of the family in question make a real public health problem. To this is added a higher incidence of suicide and extended staff.
3. Antipsychotic treatment, along with supportive psychotherapy, family and social intervention are the therapeutic pillars.
 References:
1. Medina-Serdán E. Diferencias entre la depresión postparto, la psicosis postparto y la tristeza postparto. Perinatol Reprod Hum 2013; 27 (3): 185-193.
2. Oviedo GF, Jordán V. Trastornos afectivos posparto. Universitas Médica. 2006; 47: 131-40.


(270) PO-270. After the suicide of a relative or a friend: The grief experiences of adolescents

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Karl Andriessen . School of Psychiatry, University of New South Wales, Randwick 2031 NSW, Australia
- Brian Draper - Michael Dudley - Elizabeth A. Lobb - Jane Mowll - Philip B. Mitchell -

 
 Goals:
The grief experiences of adolescents are not well understood. The impact of the loss should be studied within a broad context including risk factors for maladaptive outcomes, as well as protective factors. The study aims to explore the grief experience of adolescents including (1) pre-loss features related to personal and/or family history of mental health, family life, suicidal behaviour, kinship and psychological closeness of relationship; (2) cause of death and; (3) post-loss issues, e.g., how the death was communicated, and quality of remaining relationships. Phase one of the study involves a semi-structured telephone interview with adolescents who have lost a relative/friend by suicide or other type of death when they were aged between 12 and 18 years old, and experienced the loss between six months and ten years ago. Phase two will be informed by the interviews and involve a survey regarding psychiatric morbidity, grief, suicide risk and protective factors, kinship and closeness of relationship. Preliminary results show that the loss may have a lasting impact, irrespective of the cause of death. The familial context, the mental health of the bereaved adolescent, the meaning attributed to the relationship with the deceased person, and the quality of remaining relationships appear to be important in the grief experience and coping with the loss.
 Results:
The study findings will inform guidelines and recommendations for clinicians, community service providers and school counsellors on how to better support bereaved adolescents.


(313) PO-313. Suicide in Children and Young People in England

Day: 10 | Time: 10:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Pauline Turnbull . The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Manchester - England
-

 Introduction:
Suicide is one of the main causes of mortality in young people, and the impact on families can be extremely distressing. Suicide rates are linked to age, and increase markedly from mid-teens to early twenties. Investigating young deaths would help to explore what happens as children age to increase their suicide risk.
 Goals:
We aimed to examine the antecedents of suicide in children and young people.
 Methodology:
National suicide data were obtained for individuals aged 10 to 19 who died by suicide between January 2014 and April 2015. Data were collected from investigations by official bodies in England, including but not restricted to coroner’s inquests, local authority investigations, and NHS investigations. If an issue was not present in a data source, it was recorded as absent. Pearson’s chi square tests examined associations between the groups.
 Results:
We were notified of 145 suicides by young people, and we obtained data on 130 of these. There were more males than females, and the number of deaths increased into the late teens. Hanging was the most common method of death (92, 63%). The second most common method was jumping from a height or in front of a moving vehicle (31, 21%). Sixty-nine (57%) were in education at the time of death, and many of those were experiencing educational pressures. Bullying was mentioned in 26 cases (20%). Face-to-face bullying was more common than cyber-bullying. Thirty-six (28%) had been bereaved, 17 of those (47%) by suicide. Physical illness was common (47, 36%), mostly dermatological and respiratory problems.
 Conclusions:
Children and young people who die by suicide are a complex group with many risk factors. There is an escalation of suicide in later teen years. Areas of particular concern are age and gender differences, academic pressures, bereavement, and physical illness.


(333) PO-333. Self-injurious thoghts and behaviors as risk factors of suicide attempts and completed suicide in adolescence and young adulthood: A systematic review and meta-analysis

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Pere Castellvi . Fundacio IMIM Hospital del Mar, Barcelona - Spain
-

 Introduction:
Previous self-injurious thoughts and behaviors (SITB) are the strongest risk factor of future suicidal behaviors. No meta-analyses have been conducted for a comprehensive set of SITB among the general youth population.
 Goals:
We assessed the association and magnitude of the effect of a variety of previous SITB with subsequent suicide attempt and completed suicide in adolescence and young adulthood.
 Methodology:
We searched 6 major international databases and grey literature until June 2015. Inclusion criteria were: 1. Assessment of any type of SITB as risk factor of suicide attempt or completed suicide: a) suicidal behavior (ideation; plan; attempt); b) non-suicidal behavior (non-suicidal self-injury; self-injury thoughts); c) self-harm; and d) suicide threat; 2. Case-control or cohort studies; 3. Subjects aged 12-26 years old. Random models were used. (Reg: CRD42013005775).
 Results:
From 23,682 potentially eligible articles, 29 were included in the meta-analysis (1,122,054 individuals). A history of any previous SITB was significantly associated with suicide attempts in adolescence/youth (OR = 3.48, 95%CI = 2.73-4.44; I2 = 88), the risk for previous suicidal behaviors was higher (OR = 3.88, 95%CI = 2.91-5.17; I2 = 87%) than for previous non-suicidal behaviors (OR = 2.26, 95%CI= 1.26-4.07; I2 = 75%). For completed suicide, any previous SITB were very strongly associated (OR = 22.3, 95%CI = 18.7-27.19; I2 = 0%).
 Conclusions:
All types of early SITB entail a risk of future suicide attempts and, particularly, suicide death in adolescence and young adulthood. Effective programs to outreach this population are needed to reduce recurrent suicidal behaviors.
 References:
FUNDING: ISCIII- FEDER (PI13/00343), CIBER (CB06/02/0046); MSSSI-PNSD (Exp. 2015I015); AGAUR (2014 SGR 748).


(384) PO-384. Suicidal feelings in 85-year-olds: A birth cohort comparison study

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Margda Waern . University of Gothenburg, Gothenburg, Sweden
-

 
 Goals:
Over the past decades, there have been significant changes in general health and overall living situation for older adults. Octogenarians of today are better educated, have better health, less disability and better cognitive function compared to those who were in their eighties several decades ago. We hypothesized that we would find reduced rates of suicidal feelings, as well. The aim of this study was to compare the prevalence of suicidal feelings in two birth cohorts of 85-year-olds, born in 1901-02 and 1923-24.
 Methodology:
Data were derived from the multidisciplinary H85 study, a gerontological and geriatric population study in Gothenburg, Sweden. Participants were systematically selected from the population register. The 1901 cohort included 345 persons and the 1923 cohort 431 persons. Participants took part in a psychiatric examination that included the Paykel questions about suicide feelings (weariness of life, death wishes, suicidal thoughts and attempts). Symptoms were rated by the Comprehensive Psychopathological Rating Scale.
 Results:
We noted a reduction of past month suicidal feelings in the later-born cohort. Suicidal feelings were observed in 15.9% in those born in 1901 and 8.1% of those born in 1923 (p=0.001). The difference was driven, however by a significant decrease in women (18.7% vs 10.2%, p=0.007). Women in the latter-born cohort were less likely to report milder suicidal feelings (weariness of life, death wishes). There was a trend for depressed men in the later-born cohort to report serious suicidal feelings, including attempts, to a larger degree than depressed men in the earlier born cohort.
 Conclusions:
We observed a secular change with decreasing rates of suicidal feelings in 85- year-olds, but this was due to a reduction of suicide feelings in women only. Findings have implications for public health, highlighting the need for suicide prevention programs tailored to older men.


(423) PO-423. Childhood adversities and Suicide Attempts

Day: 10 | Time: 10:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Anna Plaza . Crisis Intervention and Suicide Prevention Unit, Barcelona
- David Closas - Roser Blanqué - Carmen Pinedo - Luis De Ángel -

 Introduction:
Research to date indicates that a history of childhood abuse is associated with suicidal behaviour, but little research has examined the unique contributions of specific types of childhood adversities (CAs) and specific characteristics of those CAs (perpetrator, frequency, age).
 Goals:
To examine the association between a history of Childhood Adversities (childhood physical, emotional and sexual abuse, parental substance abuse, witnesses of familial violence, parental death, and parental separation or divorce) and the presence of suicide attempts (SA) as well as the number of previous SA.
 Methodology:
A sample of twenty patients (N=20) who have made at least one suicide attempt and a sample of twenty patients (N=20) who have not, were selected to participate in the study. The subjects were recruited from a Unit of Crisis Intervention and Suicide Prevention (UCI-SP). Socio-demographic variables and other variables related to the suicide attempts (number of previous suicide attempts, severity, level of rescue and method) were selected from the usual protocol of the UCI-SP. The presence of a history of CAs and its characteristics was evaluated by the ETI-SF and ETI-SR (Bremner et al., 2007). Chi square analyses, Student’s t-test, and the Mann-Whitney U test, as well as Pearson and Spearman Rho were carried out. Binary logistical regression was done with the presence of SA as dependent variable.
 Results:
The presence of suicide attempts was not significantly associated with any of the socio-demographic variables, and within the CAs, only the presence of childhood physical abuse (p≤0.011) was associated with the presence of SA. Within the patients who had suffered emotional abuse, the variable “age when abuse occurred” was significantly associated with the presence of SA (p≤0.016). Parental substance abuse was associated with more previous SAs (p≤.0.042). The scale of physical abuse also correlated with the number of SAs (r=. 434; p≤0.021). Binary Logistical regression showed that the presence of physical abuse is the only variable that remains in the model (OR: 2.903 (1.22-7.508); p≤ 0.28).
 Conclusions:
A history of childhood abuse, especially physical abuse, must be evaluated in those patients admitted to Crisis Intervention Units to help identify suicide risks.


(426) PO-426. Prevention of Suicide Among Adolescents in Kazakhstan: Evidences from Kyzylorda Oblast

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Lifespan differential aspects (from infancy to elderly)

Authors:Saylybayev Bakytzhan . Educational Department, Kyzylorda Oblast
- Askarov Syrym - Abdrakhmanova Symbat - Ertashova Dina - Makhataeva Zhuldyz - Aigul Kadirova - Amanova Zhanna - Miriam Iosue - Vladimir Carli - Marco Sarchiapone -

 Introduction:
According to the World Health Organization (WHO), Kazakhstan is among the countries with the highest suicide rates in the world. Furthermore, Kazakhstan is one of the countries that are experiencing the greatest level of mortality among adolescents (15-19 years) and young adults (20-24 years).
Several suicide prevention programs have been developed and there are evidences that school represents the best setting for these programs. For this reason, recently UNICEF Kazakhstan promoted the project "Prevention of suicide among minors".
 Methodology:
This large suicide prevention program tries to combine different approaches in order to maximize their effects. It includes a mental health awareness program for the adolescents, a gatekeeper training for the school staff and a screening program. Moreover, mental health professionals and general practitioners were specifically trained in order to improve their skills in treating adolescents with mental health problems and suicidal behavior.
In November 2015, a questionnaire, also including well validated scales (Depression Anxiety Stress Scale, Paykel Suicide Scale, etc.), has been administered to 33,069 adolescents. According to the cut-off scores of the different scales, 1,128 adolescents were identified as at risk. This group underwent a semi-structured interview in which 974 children were identified as at high risk. All the children were referred to a mental health service.

 Results:
Preliminary results of the suicide prevention program will be discussed in the poster.




Miscellany (assisted suicide, minorities, legal aspects, etc.)


(78) PO-78. Globalisation, anomie and farmers suicide in India: a macro-sociological approach

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Pravati Dalua . Assistant Professor, Deptt. of Sociology, KNC , University of Delhi, New Delhi, India
-

 Introduction:
Abstract:
Suicide among the farming communities in regional provinces of India have been in rise for the last couple of years. Most official reports, studies and testimonials considered indebtedness and the burdens of debt defaulting to be the primal reasons for such adversity. Indebtedness is far from being a mere economic condition rather it represents a social condition of living which has been accentuated by the capitalization of societies. This paper seeks to understand the nature of suicide among Indian farmers in the post liberalization era. It argues that the package of a liberal regime, unbundled in 1991 at the national and state levels, has adverse impact on Indian peasantry by creating anomic condition of living. Anomie is a state of lack of regulation and greater social isolation typical of the capitalistic societies according to Durkheim, a French sociologist. The paper concludes that anomic condition laid by huge gap between aspirations and achievement of Indian farmers in post liberalization era serves as a fundamental basis for understanding farmers? suicide in India.

Key words: Globalization, Suicide, Anomie, Farmers


(134) PO-134. Publications on suicide and prevention: Adolescents, statistics, and general knowledge

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Trine Banke Dandrade . Centre for Suicide Research, Denmark
-

 Introduction:
The Centre for Suicide Research in Denmark conducts research into suicidal behaviour and prevention. The Centre publishes findings and results at three levels aimed at the general population, professionals, and decision makers.
 Goals:
The purpose is to determine which topics and which publications are the most in demand.
 Methodology:
Website statistics.
 Results:
From 2011 to 2014, the most popular publications for professionals have focused on prevention for adolescents. Data for 2015 is generated differently and is incomparable to data gathered in 2011-2014. However, reports for professionals on prevention for adolescents remain the most popular publications. New booklets targeted at the general population focusing on a single theme, e.g. the confidentiality of the clergy, or guidelines to the media professionals were also among the most sought out publications in 2015. Older booklets focusing on e.g. being bereaved, the suicide process, or signals of suicidal behaviour have remained popular since 2011.

Updated results will be presented at the ESSSB16.
 Conclusions:
The Centre for Suicide Research meets the most pressing demands, as we continuously publish on adolescents, statistics and general knowledge. Future publications may focus on or aim at vulnerable groups such as bereaved or those affected by suicide and suicidal behaviour.


(154) PO-154. The Register for Suicide Attempts - Methods and rates in relation to age, gender and demographic variation?

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Christina Petrea Larsen . Centre for Suicide Research , Denmark
- Anne Katrine Thrue Mikkelsen -

 Introduction:
Knowledge of the extent of attempted suicides in Denmark can be found in the Register for Suicide Attempts?. The register has existed since 1989 covering the former County of Funen. An extension of the register was initiated in 2011. The aim is that in time The Register for Suicide Attempts will be a nationwide register.
 Goals:
The goal is that The Register for Suicide Attempts will i.a. illuminate the association between suicide attempts and circumstances, methods, age and gender, and demographic variation.
 Methodology:
We received transcripts of all civil registration numbers that had been in contact with an emergency ward (somatic and psychiatric) due to a suicide attempt. From each patient?s medical journal, we recorded the following variables: Age, gender, place of registration, code for cause of contact, method, medicine, circumstances in relation to the attempt: proximal- and distal factors.
 Results:
The results are based on data collection from years 2012-2014 in two out of five Regions of Denmark. At the time of writing, we are collecting the data which will be presented at the conference. The results will focus on methods and rates in relation to age, gender and demographic variation.
 Conclusions:
Previous results [1, 2] are consistent with existing research on this field. The number of attempted suicides is a minimum figure as not all suicide attempters have subsequent contact with either somatic- or psychiatric emergency wards. The information in the patient?s medical journal depends on what information the attending doctor is able to gather.
 References:
1) Larsen CP, Mikkelsen AKT: Register for Selvmordsforsøg 2012, 2013 & 2014. Center for Selvmordsforskning. 2015.
2) Egeskov CP, Ejdesgaard BA, Konieczna A: Udvidelse af Register for Selvmordsforsøg, -Hvorfor forsøger mennesker at begå selvmord? Center for Selvmordsforskning. 2013.


(156) PO-156. Register for Suicide Attempts - Why do people try to commit suicide? - Circumstances

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Anne Katrine Thrue Mikkelsen . Centre for Suicide Research, Denmark
- Christina Petrea Larsen -

 Introduction:
Knowledge of the extent of attempted suicides in Denmark can be found in the Register for Suicide Attempts. The study is based on registered suicide attempts during 2012-2014 collected from two Regions of Denmark. Results of the study define the most frequent proximal and distal circumstances in relation to registered suicide attempts by gender in 2012-2014.
 Goals:
The aim of this study is to gain greater knowledge of the potential triggering and underlying factors for the individuals suicide attempt that allows us to elucidate why people try to commit suicide.
 Methodology:
We received transcripts of all civil registration numbers that had been in contact with an emergency ward (somatic) due to a suicide attempt in 2012-2014. From each registered patient?s medical record, we registered the following variables: time, date, age, gender, place of registration, code for cause of contact, method, circumstances in relation to the attempt: proximal- and distal factors defined in various triggering and underlying causes.
 Results:
Results of this study will include the most and second most frequent proximal and distal circumstances in relation to registered suicide attempts in 2012-2014 [1,2]. Results will be presented at the poster session.
 Conclusions:
The reasons why people try to commit suicide is often complex. The number of registered attempted suicides is only the tip of the iceberg, as not all suicide attempters have subsequent contact with somatic emergency wards. The information in the patient?s medical record depends on the information the attending doctor is able to gather, which affects the results of this study.
 References:
1) Larsen CP, Mikkelsen AKT: Register for Selvmordsforsøg 2012, 2013 & 2014. Center for Selvmordsforskning. 2015.
2) Egeskov CP, Ejdesgaard BA, Konieczna A: Udvidelse af Register for Selvmordsforsøg, -Hvorfor forsøger mennesker at begå selvmord? Center for Selvmordsforskning. 2013.


(213) PO-213. Social demography characteristics and method use in suicide attempts in VII Area Principado de Asturias.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Covadonga Huergo Lora . uhp hospital alvarez buylla, spain
- Sergio Ocio Leon - Manuel Gomez Simon - Mario Javier Hernandez Gonzalez - Omar Walid Muquebil Ali Al Shabanl Rodriguez - Jaime Lopez Fernandez -

 Introduction:
Suicide is an act or a voluntary omission in which a person kills his own life. It includes action which finalizes in dead, also all acts in which don't end in dead and attempts which its goal is to gain attention for help.
 Goals:
To study the social-demografic factors in suicide attemps (age, sex, racial classification, marital status and number of children) and method used.
 Methodology:
The study design included 36 patients, was descriptive, transversal and retrospective and it last one year.
 Results:
Females occures more often (58,3%), and the mean age of the study is 43,53 (DT 14,58), where Mens do suicide at the mean age 49,47 (DT 14,86) and women at 39,29 (DT 13,11) (probabilty 0,037). White people is the most frequency race. The most frequency marital status is marriage (52.8%), and number of children is from 0 to 5 with a medium of 1 The 47,7% are suffering from physical illness, which 11,1% of those are suffering fibromyalgia in female. Neoplasia rate is similar between sexs. Most methods used are pharmacy intoxication (61,1%), self injured (19,4%), hanging (5,6%), jumping (8,3%), carbon-monoxide poisoning (5,6 %)
 Conclusions:
The profile of suicide study is woman, 40 age-old, married and medium number of children of 1 . Men try to suicide when they are older than women. Nearly half of cases are suffering of physical illness (female mainly), in which the most illness are fibromyalgia and neoplasia. Most methods used are pharmacy intoxication with medications like Antidepressants and/or anxiety.
 References:
Isaac Sakinofsky, MD, FRCPC, FRC Psych. Treatment Suicidality in Depressive Illness. The Canadian Journal of Psychiatry 2007 june;52(1):71-102.


(214) PO-214. Suicide Attempt assessment in Area VII of SM

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Covadonga Huergo Lora . uhp hospital alvarez buylla, spain
- Sergio Ocio Leon - Manuel Gomez Simon - Mario Javier Hernandez Gonzalez - Omar Walid Muquebil Ali Al Shaban Rodriguez - Jaime Lopez Fernandez -

 Introduction:
Suicide is a health public problem, because it's the fourth cause in the list of the causes of lost age's potential life.
 Goals:
To determine suicide intentionality in area VII mainly studying: existence of impulsiveness in the attempts, the goal of suicide attempts and the possibility of pleading help
 Methodology:
The study uses sampling with 36 patients who had did a suicide attempt and were given the Beck Scale for Suicide Ideation to fill (the goal is evaluate suicide attempt characteristics, keeping in mind the seriousness of attempt and assessment the subsequent risk of new attempts. The Beck Scale is a 20-question multiple-choice self-report inventory. Each question has a set of at least three possible responses, ranging in intensity. The more punctuation, more seriousness In this study, its going to be assessment the next items of the Beck Scale: the loneliness in the moment of the attempt, the goal of the attempt and premeditation degree.
 Results:
First, the pacients loneliness in the moment of the suicide attempt: 83% had somebody else, some near the pacient or any change of contact somebody. Second, in the goal of the attempt: 61,1% the goal was tried to change the medium which rounds them or change the medium and get out of the way. Last but no least, the premeditation degree: 83,3% was impulsive, 16,7% was planned in attempt and 8,3% had a period of thinking it over before attempt.
 Conclusions:
In this study, like others (Lozatno et al, 2000), the pacient had any way to plead help, and the most of them wanted to change the medium, being the premeditation degree impulsive in the most cases.
 References:
1. Bobes García J, Sáiz Martínez PA, García-Portilla González MP, Bascarán Fdez MT, Bousoño García M. Comportamientos suicidas, prevención y tratamiento. 1ªedición. Barcelona: Ars Medica; 2004


(247) PO-247. Suicidal behaviour: Anthropological dichotomies at the border between life and death

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Juan Valdes-Stauber . University of Ulm (Germany)-Zentrum für Psychiatrie Südwürttemberg, Ravensburg-Germany
-

 Introduction:
Life and death are inexorably entwined with each other, the latter giving substance to the former (G. Simmel), but death also represents a break of communication (T.H. Macho). Suicide may arise from tedium vitae (Aulo Gelio) and may be viewed as a specific human ability to demonstrate autonomy and to control unacceptable life conditions (J. Baechler).
 Goals:
To establish the historical and anthropological relevance of suicide as a manifestation of human freedom and dignity or, alternatively, as the loss of freedom because of a mental disorder. Finally, we consider whether suicide is in fact a yearning for ontological truth.
 Results:
The first dichotomy is the risk of suicide from depersonalisation and loss of reality control or by the breakdown of self-esteem. The second dichotomy is between the anger to die and anger to keep alive. The third dichotomy is the emotional spectrum between aggressiveness and escapism. The fourth dichotomy denotes a death antinomy: the will to die and will to keep in permanence. The fifth dichotomy designates the tension between an autonomous person with dignity and free will and a person entangled in their mental disorder. The sixth and final dichotomy is between the mute of suicide and the absence of dialogue for the surviving relatives and friends.
 Conclusions:
Attempting suicide appears to reflect a basic anthropological constant and issues related to mourning are in the fabric of human life (R. Andrés). It reflects not only despair but also hopelessness (Laín-Entralgo) and the breakdown of personal project of life (J. Marías). There is also a relevant anthropological question to be answered about the importance of mental disorders or of changing social conditions in the process of suicide.


(380) PO-380. Suicide risks in same-sex and opposite-sex couples in Denmark and Sweden, 1989-2013

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Annette Erlangsen . Research Unit, Mental Health Centre Copenhagen, Copenhagen - Denmark
- Sven Drefahl - Ann Haas - Charlotte Björkenstam - Merete Nordentoft - Gunnar Andersson -

 Introduction:
Sexual minority, or generally preferred, lesbian, gay, bisexual and transgendered (LGBT) populations, are emphasized as an underserved high risk group with respect to suicide prevention. As the first country in the world, Denmark introduced same-sex partnerships in 1989 and Sweden followed suit in 1995.
 Goals:
The aim of the current study was to assess suicide rates in same-sex and opposite-sex marriages in Denmark and Sweden.
 Methodology:
A prospective cohort study design was applied to study longitudinal, individual-level register data covering all individuals living in Denmark (since 1989) and Sweden (since 1995) through 2013. Changes in civil status were updated with monthly precision based on data from the civil registries. The outcome of interest was defined as suicides (ICD-10: X60-X84) and likely suicides (ICD-10: X60-X84; Y10-Y34). We calculated suicide rates of married as well as divorced/widowed for same-sex and opposite-sex couples.
 Results:
In Denmark and Sweden, a total of 124,850 and 43,061 person-years were observed for same-sex marriages, respectively. The corresponding numbers of opposite-sex marriages were 16,130,696 and xx person-years for Denmark and Sweden. In all, 51 suicides and 55 likely suicides were observed among persons who had entered a same-sex union in Denmark while 14 suicides and 19 likely suicides were recorded in Sweden.
 Conclusions:
The suicide risk appeared to be about three times as high for those living in same-sex unions when compared to opposite-sex unions.


(418) PO-418. Pathways to Suicide Attempts among Adult Gay and Bisexual Men: A Mediation Analysis

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Miscellany (assisted suicide, minorities, legal aspects, etc.)

Authors:Travis Hottes Salway . University of Toronto. Community-Based Research Centre for Gay Men's Health., Toronto
- Dionne Gesink - Anne Rhodes - David Brennan - Olivier Ferlatte - Rick Marchand - Terry Trussler -

 Introduction:
Gay and bisexual men (GBM) are more likely to attempt suicide than heterosexual men. This disparity is commonly interpreted using minority stress theory; however, specific pathways from antigay stigma to suicidal behavior are poorly understood.
 Goals:
The objective of this study is to measure the relationship between distinct minority stress constructs and suicide attempts among GBM, as mediated by specific psychosocial challenges.
 Methodology:
Data were drawn from a Canadian community-based survey of adult GBM (N=8037). Structural equation modeling was used to compare associations between three latent constructs—enacted stigma (e.g., discrimination, harassment), anticipated prejudice, and concealment of sexuality—and suicide attempts in the last 12 months. Factor analysis was used to generate a measurement model for latent constructs. Path analysis was used to estimate coefficients for direct, indirect/mediation, and total (sum of direct and indirect) pathways, evaluated based on magnitude and statistical significance.
 Results:
279 respondents (3.5%) reported a recent suicide attempt. The largest total effect was observed for enacted stigma (0.250, 95% CI 0.162, 0.338), and this association was partially mediated by depression (0.084, 95% CI 0.055, 0.113) and drug/alcohol use (0.028, 95%CI 0.001, 0.055). The total effect of anticipated prejudice was relatively smaller (0.022, 95% CI -0.051, 0.095) and mediated by depression (0.021, 95% CI 0.003, 0.039) and social isolation (0.015, 95% CI 0.005, 0.025). Concealment had an inverse association with suicide attempts as mediated by depression (-0.018, 95% CI -0.032, -0.004) but was also positively associated with suicide attempts when mediated through social isolation (0.045, 95% CI 0.020, 0.070). That is, concealment increased social isolation, which in turn increased suicide attempts.
 Conclusions:
Enacted stigma, anticipated prejudice, and concealment of sexuality were all associated with adult suicide attempts; however, mediating pathways differed by construct, suggesting that a combination of strategies is required to prevent suicide in adult GBM.




Neurobiological underpinnings of suicidal behavior


(90) PO-90. Trait impulsivity and interactions between phenylalanine/tyrosine ratio and Toxoplasma gondii seropositivity in healthy adults

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Neurobiological underpinnings of suicidal behavior

Authors:Nadine Postolache . Department of Psychiatry, University of Maryland-Baltimore School of Medicine, Baltimore, MD, USA, Austria
- Thomas B. Cook - Lisa A. Brenner - Lena Brundin - Ashwin J. Matthai - Ina Giegling - Bettina Konte - Dietmar Fuchs - Dan Rujescu - Teodor T. Postolache -

 Introduction:
Suicidal behavior has been linked to Toxoplasma gondii (T. gondii) seropositivity (Pedersen et al., 2012). We previously found that T. gondii positive had higher scores of trait impulsivity (an intermediate phenotype for suicidal behavior (Mann et al., 2009) than T. gondii negative males (Cook et al., 2015). Impulsivity has been previously associated to dopamine function (Norbury and Husain, 2015); T. gondii is genetically endowed to synthesize dopamine (Gaskell et al., 2009), and the ratio of phenylalanine/ tyrosine (Phe/Tyr, precursors of dopamine) is affected by immune activation (necessary to keep T. gondii in check)
 Goals:
We sought to determine interactions between plasma levels of precursors of dopamine (phenylalanine and tyrosine) and T. gondii seropositivity in association to impulsivity.
 Methodology:
1,000 individuals with no psychiatric conditions by SCID for DSM-IV (510 men, 490 women, mean age 53.6 ± 15.8) self-rated impulsivity using the Zuckerman?s Sensation Seeking Scale (SSS-V). Plasma IgG antibodies to T. gondii were measured using ELISA and dopamine precursors with HPLC.
 Results:
Only among T. gondii positive males higher Phe:Tyr ratios were associated with increased impulsivity. Specifically, among IgG-positive males, compared to the lowest quartile of Phe:Tyr, males in upper quartile of Phe:Tyr scored higher (p = .006) on impulsivity. By contrast, higher Phe:Tyr ratios were not related to impulsivity in females or T.gondii-negative males.
 Conclusions:
Gender-specific interactions between metabolic changes in dopamine precursors, often altered by inflammation, and T. gondii seropositivity, could improve stratification of risk, and identify intersections of modifiable risk factors and lead to novel treatment targets for impulsivity and self-directed violence.
 References:
Pedersen M, et al. Toxoplasma gondii infection and self-directed violence in mothers. JAMA Psychiatry. 2012; 69: 1123-1130.
Mann J, et al. Candidate endophenotypes for genetic studies of suicidal behavior. Biol Psychiatry. 2009; 65: 556-563
Cook T, et al. Latent infection with Toxoplasma gondii: Association with trait aggression and impulsivity in healthy adults. J Psychiatr Res. 2015; 60: 87-94.
Norbury A, Husain M. Sensation-seeking: Dopaminergic modulation and risk for psychopathology. Behav Brain Res. 2015; 288: 79-93
Gaskell EA, et al. A unique dual activity amino acid hydroxylase in Toxoplasma gondii. PLoS One. 2009; 4:e4801


(323) PO-323. Inflammatory and metabolic biomarkers and history of suicide attempts in patients with schizophrenia

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Neurobiological underpinnings of suicidal behavior

Authors:Leticia González-Blanco . Department of Psychiatry, University of Oviedo - Servicio de Salud del Principado de Asturias, Oviedo - SPAIN
- María Paz García-Portilla - Leticia García-Álvarez - Celso Iglesias - Lorena De La Fuente-Tomás - Pilar Alejandra Saiz - Ana Coto - Julio Bobes -

 Introduction:
Low lipid levels related to suicidality have been reported(1), and specifically in patients with schizophrenia(2). Pro-inflammatory and oxidative stress biomarkers have been described in suicidal patients as well(3,4).
 Goals:
To determinate potential inflammatory/metabolic biomarkers in patients with schizophrenia who have a history of suicide attempts (SA).
 Methodology:
Sample: 73 outpatients with schizophrenia, lenght of illness <11 years, under stable maintenance treatment [mean age(32.16), males(63.9%)] Evaluation: PANSS, Clinical Assessment Interview for Negative Symptoms (CAINS), Calgary Depression Scale (CDS). Biomarkers: C-Reactive Protein (CRP), Homocysteine, Lipoperoxidation subproducts, Glucose, Insulin, Cholesterol, HDL, LDL, Triglycerids, TSH.
 Results:
Partial correlations, after controlling BMI (28.8 kg/m2) and smoking (47.9%-smokers), found significant relationship (p<0.05) between number of SA and age (r=0.26), PANSS Total (r=0.28), Positive (r=0.46) and General (r=0.30) subscales and CDS (r=0.42) scores, HDL-cholesterol (r=0.29) and Insulin (r= -0.32). No inflammatory or oxidative biomarker showed any significant correlation. Subgroup analyses were performed [(a) patients taken Olanzapine, Clozapine or Quetiapine vs (b) other antipsychotics]: (a) correlation with HDL-cholesterol (r=0.29,p=0.062), Triglycerids (r=-0.38,p=0.066) and Insulin (r=-0.46,p=0.043); and (b) correlation with HDL-cholesterol (r=0.29,p=0.062) and TSH (r=0.37,p=0.017) were found. We performed a MANCOVA (Multivariate analysis of Covariate) to determinate differences in these parameters between patients with a history of SA (n=15; 20.5%) and patients without SA. PANSS Total, Positive and General Subscales, and CDS showed significantly higher scores in SA group (p<0.05). Insulin presented lower levels in SA group [10.2 vs 18.1mg/dl; F=4.60(p=0.036)]. No significant differences in age, HDL, Triglycerids and TSH between groups were found.
 Conclusions:
1. No inflammatory or oxidative biomarker was associated with a history of SA in patients with schizophrenia in our sample. 2. Lower Insulin concentrations was associated with a history of SA, but not lipid levels. However, HDL-Cholesterol had a positive relationship with number of SA.
 References:
(1) Wu S, Ding Y, Wu F, Xie G, Hou J, Mao P. Serum lipid levels and suicidality: a meta-analysis of 65 epidemiological studies. Journal of Psychiatry & Neuroscience. 2016; 41(1): 56–69. (2) Ainiyet B, Rybakowski JK. Suicidal Behavior in Schizophrenia may be Related to Low Lipid Levels. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2014; 20: 1486–1490. (3) Miná V, Lacerda-Pinheiro SF, Maia LC, Pinheiro R, Meireles CB, et al. The influence of inflammatory cytokines in physiopathology of suicidal behavior. Journal of Affective Disorders. 2015; 172: 219-230. (4) Vargas H, Vargas SO, Pizzo de Castro M, Bortolasci C, Barbosa D, Morimoto H, et al. Oxidative stress and lowered total antioxidant status are associated with a history of suicide attempts. Journal of Affective Disorders. 2016; 150(3): 923–930.


(352) PO-352. Relationship between inflammatory markers and sensitivity to social exclusion in vulnerability to depression and suicide

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Neurobiological underpinnings of suicidal behavior

Authors:Ismael Conejero . Department of Emergency Psychiatry and Post Acute Care, Hôpital Lapeyronie, CHU Montpellier, Montpellier- France
- Emilie Olié -

 Introduction:
By the year 2020, depression is projected to reach the second place in the ranking of disability. Depression is highly associated with suicidal issue. On the one hand, evidence has reported a possible relationship between inflammatory processes, depression and suicide. On the other hand, social exclusion, frequent trigger of suicidal act, has been associated with inflammatory responses and prefrontal cerebral activations in healthy subjects.
 Goals:
The primary aim of our study is to measure the association between cerebral activations during social exclusion and levels of inflammatory markers in a clinical sample with vulnerability to depression while taking into account suicidal history.
 Methodology:
116 euthymic females aged 18 to 50 were included and clustered into 3 groups : 45 having a history of depression and suicide attempt, 43 having a history of depression without suicide attempt and 28 healthy subjects. During functional MRI, they performed Cyberball game, a validated social exclusion task . Blood levels of cytokines IL-1B, IL-6,TNFa and CRP were measured prior to MRI.
 Results:
We expect a positive correlation between levels of peripheral inflammatory markers and activations of anterior cingulate cortex and anterior insula in subjects with history of depressive disorder and suicide attempts.
 Conclusions:
Our results may help to better understand the role of inflammation in social stress and its role in emergence of depression and suicidal act.
 References:
1. Eisenberger NI. The pain of social disconnection: examining the shared neural underpinnings of physical and social pain. Nat Rev Neurosci [Internet]. 3 mai 2012 [cité 11 avr 2016]; Disponible sur: http://www.nature.com/doifinder/10.1038/nrn3231
2. Bowlby J. Attachment and loss: Retrospect and prospect. Am J Orthopsychiatry. 1982;52(4):664‑78.




Novel monitoring strategies for detecting changes in risk over time


(306) PO-306. In search of the internal structure of the Columbia-Suicide Severity Rating Scale (C-SSRS): A confirmatory factor analysis approach

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:Susana Al-Halabi . Centro de Investigación Biomédica en Salud Mental, CIBERSAM. Psiquiatría - Universidad de Oviedo, Oviedo - Spain
- Abel D. Fernández-Peláez - Patricia Burón - Elena Riesco - Julia Rodríguez-Revuelta - Kelly Posner - María Oquendo - M. Paz García-Portilla - Pilar A. Saiz - Julio Bobes -

 Introduction:
Suicide is a major public health issue, and reduction or prevention depends on accurate identification of at-risk patients. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a semi-structured interview that captures the severity of ideation (with a subscale that reflects five types of ideation), the intensity of ideation (with a subscale comprising five items), the suicidal behaviour and the suicidal behaviour lethality1. The C-SSRS has been validated in Spanish (Sp-C-SSRS)2.
 Goals:
To perform a replication study to identify the underlying internal structure of both Sp-C-SSRS Severity and Intensity subscales.
 Methodology:
The sample comprised a total of 150 outpatients (35.33% with a history of suicide attempt) with unipolar or bipolar depression according to ICD-10 criteria [34% males; mean age (SD)=53.90 years (9.78)]. Data Analysis: For analysing the dimensional structure of the Sp-C-SSRS Severity and Intensity subscales, we used the principal component analysis (PCA) with Varimax rotation. The criteria employed to determine the number of components to extract were the Kaiser rule, the screen plot, and the interpretation of the components.
 Results:
The KMO’s measure of sampling adequacy was 0.763 (Severity subscale) and 0.874 (Intensity subscale), indicating that the data was suitable for factor analysis. The Bartlett´s Test of Sphericity was significant (p < 0.000) in both analyses, confirming that the variables were inert-correlated and therefore suitable for factoring. In both Severity and Intensity subscales, the principal component analysis identified two components that explain 87.98% (Severity) and 86.15% (Intensity) of the total variance. In both subscales, the first component included the first three items and explained 44.04% (Severity) and 64.24% (Intensity) of the total variance. In both subscales, the second component included items number 4 and 5 and explained 43.93% (Severity) and 21.91% (Intensity) of the total variance.
 Conclusions:
The principal component analysis performed in this sample confirms the existence of two components in both Sp-C-SSRS Severity and Intensity subscales. These results suggest the need for further research on the structure of the C-CCSR subscales.
 References:
1. Posner K, Brown GK, Stanley B et al. The Columbia-suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168:1266-77.
2. Al-Halabí S, Sáiz PA, Burón P, Garrido M, Benabarre A, Jiménez E, Cervilla J, Navarrete MI, Díaz-Mesa EM, García-Álvarez L, Muñiz J, Posner K, Oquendo MA, García-Portilla MP, Bobes J. Validation of a Spanish version of the Columbia-Suicide Severity Rating Scale (C-SSRS). Revista de Psiquiatría y Salud Mental (2016, in press).


(371) PO-371. Monitoring of treatment of patients at risk of achieving a suicidal attempt

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:Laura Montes Reula . Servicio Navarro de salud- Osasunbidea, Pamplona, Spain
- Rebeca Elorza Pardo - Patricia Macaya Aranguren - Lucía Janda Galán - Almudena Portilla Fernández - Leyre Azcárate Jiménez -

 Introduction:
For years suicide is considered a major public health problem worldwide. It is in our interest to analyze what factors surrounding this event, to identify populations at risk and intervene to achieve a reduction.
 Goals:
Determine whether patients treated at a psychiatric emergency department were previously treated and if subsequently were derived to network of Mental Health.
 Methodology:
A total of 440 patients were included in the study, they were recruited in the emergency department of the Hospital of Navarra and the Hospital Reina Sofia of Tudela. They are about of 207 cases (attempted suicide) and 233 controls (attention for a different reason of an attempt autolytic) in the period between January and October 2015. Of all patients is being carried out follow-up six months after the first emergency care. It has chosen a monitoring group until January 31, 2016 with a sample size of 295 patients with 150 cases and 145 controls.
 Results:
It is observed in the beginning sample (N = 295) to 38.6% of patients were not receiving care at a mental health center, being slightly higher in cases compared to controls. Half of the patients had specialized follow-up, but was higher in controls (60%) to cases (42.8%). These differences are statistically significant. In follow-up after six months, there was a loss of 27 patients. Five of them (1.7%) died by suicide, two controls, and three cases. A number of seven patients were discharged of therapeutic cause.
 Conclusions:
The results in the beginning seem contrary to what is expected, so we should ask ourselves whether we are doing a good screening from primary care services. We need to devise new strategies for the management of suicidal patients. Also it appears that less serious diseases are the most frequent users of mental health centers. Draws attention to the number of autolytic fait events that have occurred in six month follow-up sample.
 References:
Patients hospitalized for suicidal ideation and suicide attempt in a Mental Health Hospital: Clinicodemographical features and 6-month follow-up. Teti GL, Rebok F, Grendas LN, Rodante D, Fógola A, Daray FM. Vertex. 2014 May-Jun;25(115):203-12.


(389) PO-389. Improved risk assessment after suicide attempts in the emergency departments of general hospitals with psychiatric unit in the Region of Murcia.

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:María Loreto Medina Garrido . Servicio Murciano de Salud. Subdirección de Salud Mental, Spain
- Jose Martínez Serrano - Laura Belinchon - Francisco Sánchez Yago - Mª Angeles De Haro - Juan Francisco Martínez Inglés - Miguel Santiuste -

 Introduction:
Throughout the year 2014, and within the Mental Health Strategy of the National Health System, a series of projects that seek to identify concrete actions and interventions that can help the Autonomous Communities (CCAA) to implement will be performed some of the priority objectives of the national Strategy. Specifically in the project in which we find it is called "EARLY DETECTION, TREATMENT AND PREVENTION OF RECURRENCE SUICIDE ATTEMPTS".
 Goals:
Improved risk assessment after attempts at emergency departments of general hospitals with psychiatric unit of the reference areas of our community. • On the one hand with a brief clinical interview which includes the most important risk factors for suicide, • Furthermore, the introduction of a scale of assessment of suicide risk. • Incorporation into the computer systems of the community (SELENE) Improved continuity of care between the emergency services and outpatient mental health services. Suicide risk assessment and incorporation of a scale of assessment of suicide risk in mental health centers.
 Methodology:
As a working group working on the realization of a basic protocol assessment of suicidal behavior in emergencies and that it be recorded in computer-readable format. This protocol is not intended to carry out an investigation but based clinical practices and good performances determine our further action.
 Results:
The protocol where appropriate psychopathological and social assessment is carried out and will be discussed include: 1) the evaluation of psychological and contextual factors that explain the suicidal behavior. 2) the characteristics of suicidal behavior with which seeks to identify the elements that could predict recurrence.
 Conclusions:
Model unified action protocol to suicidal patients. minimum quality rating recorded in reports. Interview training in clinical suicide risk, criteria for admission / discharge unified in the region. Scale standardized assessment.
 References:
1. Working Group of the Clinical Practice Guidelines for the Prevention and Treatment of Suicidal Behavior. Guide to Clinical Practice Prevention and Treatment of Suicidal Behavior. Quality plan for the National Health System of the Ministry of Health, Social Policy and Equality. Technology Assessment Agency Health of Galicia (Avalia-t); 2012. Clinical Practice Guidelines in the NHS: Avalia-t 2010/02 2. Pilar A. Sáiz ∗ y Julio Bobes. Suicide prevention in Spain: An uncovered clinical need. Rev Psiquiatr Salud Ment (Barc.). 2014;7(1):1---4


(424) PO-424. Assessing suicide risk: The Firestone Assessment of Self-Destructive Thoughts (FAST)

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:Marjan Ghahramanlou-Holloway . Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Lisa Firestone -

 Introduction:
The Firestone Assessment of Self-Destructive Thoughts (FAST) is based on Separation Theory and Voice Therapy methodology, a comprehensive approach to psychopathology and the corresponding model of mental health. The theoretical approach, as it relates to suicide, focuses on internalized negative thought processes. The FAST was derived from 20 years of clinical research into self-attacking attitudes, or introjects, that restrict or impair an individual’s psychological development. The authors of the scale believed that it was logical to use these negative thought patterns to predict increasingly aggressive cognition and affect toward the self that are closely related to self-destructive behavior and actual suicide. The FAST covers a wide range of self-destructive behaviors- from self-denial, to extreme self-hate, addictions, self-mutilation, and, at the very end, to suicide. The FAST can be used for risk assessment, treatment planning, targeting intervention and outcome evaluation. , will present data from both inpatient and outpatients samples of individuals diagnosed with psychiatric disorders most associated with suicide risk. In addition, data from a high risk military sample will be presented and explained.




Psychosocial variables: protective and risk factors. Resilience & vulnerability


(27) PO-27. Suicide reporting in the NZ news media: Impact of releasing information on methods

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Sunny Collings . University of Otago, New Zealand
- Ben Slim - James Stanley - Gabrielle Jenkin -

 Introduction:

Aim: In August 2010 the Chief Coroner released to the press, suicide statistics including details of the methods used. This was a high profile and controversial action contradicting best practice media guidelines on suicide reporting. We aimed to see if this action had an impact on the nature and extent of suicide reporting in the New Zealand newsprint media.
Method: The Factiva database was searched for news items on cases of suicide before and after the Chief Coroner?s action. The news items were counted and the nature of suicide reporting assessed by examining the frequency at which key variables were reported.
Results: There were fewer reports of individual cases of suicide in the year after the Chief Coroner?s action (n=62) than before (n=94) and this difference was statistically significant. Considered relative to the number of suicides occurring in these periods this represented a 28% reduction in the rate of reporting of suicide per actual death. Due to the small number of cases in each period no major conclusions could be drawn about any changes to the nature of suicide reporting.
Conclusion: The Chief Coroner's actions appear to have done no harm and in fact the frequency of suicide reporting in the New Zealand newsprint media declined.


(111) PO-111. Suicide in the over 60s in Northern Ireland

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Siobhan Oneill . Ulster University, Londonderry
-

 Introduction:
Northern Ireland (NI) currently has the highest rate of suicide in the British Isles and the suicide death rate for those aged over 60 years has shown a consistent increase over the past 10 years.
 Methodology:
This paper presents and analysis of over 1600 suicides in NI; 165 of whom were individuals aged over 60 years (51 women and 142 men). The data is based on the information contained within coronial files on deaths with a verdict of suicide and also cases where the cause of death is undetermined, but is likely to be suicide. The sources of evidence include police records, witness statements at the time of the death and medical and toxicology reports.
 Results:
The over 60 age group were less likely to have died by hanging than the other groups and less likely to have taken alcohol at the time of death. The over 60 age group were also less likely than the other age groups to have had prior attempts or communications regarding suicide. A thematic analysis of the personal circumstances and life events prior to death revealed that in addition to recorded mental illness, concerns about transitions in care, death or illness of a loved one and physical health conditions or concerns were common.
 Conclusions:
The results are discussed in the context of the theories of suicide and the implications for the care and treatment of older people with mental and physical illnesses are elucidated. The findings raise questions about the effects of the current societal debates about assisted dying and how we can foster connectedness and reduce burdensomeness in this group.


(116) PO-116. Resiliency to suicide ideation and behavior: The relative importance of various protective factors

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Paula Siegmann . Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
- Tobias Teismann - Jürgen Margraf -

 Introduction:
Worldwide about one million people die by suicide each year. While substantial efforts have been made to understand which risk factors contribute to suicide ideation and suicidal behavior, far less attention has been paid to factors that buffer individuals against the development of suicide ideation and behavior.
 Goals:
The present study investigated resilience factors associated with suicide ideation and attempts in a sample of German students.
 Methodology:
A total of 601 students (68 % female; age: 18 - 52 years) were assessed. Social support, satisfaction with life, resilience, self-efficacy and positive mental health were considered as predictors of suicide ideation and suicide attempts ? controlling for gender, age and symptom severity.
 Results:
21 % of the students reported suicide ideation in the last 12 month and 4.3 % reported lifetime suicide attempts. Social support and positive mental health emerged as predictors of lowered suicide ideation. Social support, satisfaction with life and self-efficacy were predictive of less lifetime suicide attempts ? controlling for age, gender and symptom severity in both analyses.
 Conclusions:
Various factors seem to buffer against suicide ideation and suicide attempts. As in previous studies, social support emerged as a protective factor of special relevance. In terms of clinical implications, these findings suggest that protective factors should be a key consideration when assessing clients? risk of suicide, as these factors may attenuate the influence of risk factors.


(127) PO-127. Psychosocial disability after suicide attempts

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Manuel Canal-Rivero . Universitat Autònoma de Barcelona/ Hospital Universitario Virgen del Rocío, Sevilla- Spain
- Jordi E Obiols Llandrich - Miguel Ruiz Veguilla -

 Introduction:
The adverse impact of attempts of suicide on psychosocial functioning and symptomatic remission hasn´t been well documented. However, the determinants and levels of psychosocial functioning and symptomatic remission remain poorly understood in people experiencing FEP. This study aimed to study the effects of attempts of suicide after first episode of psychosis on psychosocial functioning and symptomatic remission one year after first episode of psychosis.
 Goals:
The aim of this stusy is analyze the effects of suicide attempts on psychosocial functioning
 Methodology:
Sixty-five first-episode patients participated in this study. Baseline demographic clinical data and information about suicide attempts previous at FEP were collected in the first contact with mental health services. Sociodemographic and clinical data were collected from information provided by the patients and their relatives. We used Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to screen for psychotic symptoms which were then used for diagnosis. Information about suicide attempts previous at FEP was collected using Schedules for Clinical Assessment in Neuropsychyatry SCAN. This clinical interview contains a question about attempted suicide. At 12 months after first episode of psychosis WHO-DAS-S was used to assess psychosocial functioning. Is a semi-structured interview to screen psychosocial functioning in four dimensions: personal care, occupation, family and household and broader social context. This interview is recommended by OMS to evaluate difficulties caused for physical and mental problems. We defined remission according to PANSS operational criteria set up by the Remission in Schizophrenia Working Group. The symptomatic criterion includes eight core PANSS items (delusion, unusual thought content, hallucinatory behaviour, conceptual disorganization, mannerism/posturing, blunted affect, social withdrawal, lack of spontaneity) with a score ? 3.The duration criterion is symptomatic remission maintenance over 6 consecutive months.
 Results:
Significant correlation (P<0.001) was found between disability in personal care and number of attempts of suicide after first episode of psychosis (r=0.52). Disability in family and household correlated significantly (P<0.005) with number of attempts after first episode of psychosis (r=0.29). Multivariable analysis were done to analyse the relationship between disability in personal care and family and household with number of attempts of suicide. In the linear regression we included covariates. These covariates were: age, gender and diagnosis. Number of attempts of suicide explaining 20% of the variance in the disability of personal care and 14% of the variance in the disability of family and household.
 Conclusions:
Suicide attempts impacted negatively on personal care and family and household disability. These findings have significant implications for early, targeted interventions for this vulnerable group.
 References:
1. Evert H, Harvey C, Trauer T, Herrman H. The relationship between social networks and occupational and self-care functioning in people with psychosis. Soc Psychiatry Psychiatr Epidemiol. 2003;38(4):180?8.
2. Marwaha S, Johnson S. Schizophrenia and employment - a review. Soc Psychiatry Psychiatr Epidemiol [Internet]. 2004;39(5):337?49. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15133589
3. Jaracz K, Górna K, Kiejda J, Grabowska-Fudala B, Jaracz J, Suwalska A, et al. Psychosocial functioning in relation to symptomatic remission: A longitudinal study of first episode schizophrenia. Eur Psychiatry [Internet]. 2015 Nov [cited 2016 Jan 14];30(8):907?13. Available from: http://www.sciencedirect.com/science/article/pii/S0924933815001479


(131) PO-131. Suicide and sociodemographic factors

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Esther Torío . Mental Health Services. SESPA Area IV. , Oviedo, Spain.
- Javier Caballer - Marino Montes - Inmaculada Serrano - Pilar Saiz - Julio Bobes - Luis Jiménez-Treviño -

 Introduction:
Many factors have been analyzed in relation to suicide: biological, genetic, mental disorders, or sociodemographic factors1. Of the above mentioned, different hypothesis exist about the relation between suicide rates and sociodemographic factors such as sex, age, education, income, unemployment, even latitude is directly related to variation in suicide rates2.
 Goals:
To realize an analysis of sociodemographic factors related to suicide from a global perspective and provide information to improve suicide prevention strategies.
 Methodology:
Departing from official databases (WHO, World Bank, US Government) of every country, we analyze the relation between the different variables and suicide rates. Analysis of correlation and linear regression has been used with the statistical program SPSS v15.0.
 Results:
A positive correlation (Pearson) exists between suicide rates and: mean age (Pearson: 0,414 P=0,002), alcohol consumption (Pearson: 0,669 P=0,000) and latitude (Pearson:0,512 P=0,000). Suicide rates increase with age, alcohol consumption and latitude of the country.
There is no significant correlation between suicide rates and socioeconomic level (Pearson:-0.006 P=0,963). In the later linear regression analysis, only alcohol consumption is a predictor variable with a suicide rate increase of 1.637 for every liter of alcohol per capita (Anova P=0,000).
As for the correlation between suicide rates and religion, the result is not statistically significant (Anova P=0,090).
 Conclusions:
The results of the study indicate that exists a relation between the suicide rates and sociodemographic factors such as age, latitude, and consumption of alcohol, but not with socioeconomic level of countries
Alcohol consumption, in addition, predicts an increase in suicide risk.
There seems to be a trend so that Muslim countries have lower suicide rates than non- religious countries.
 References:
1.García Resa E, Braquehais D, Blasco H, Ramírez A, Jiménez L, Díaz-Sastre C, Baca-García E, Sáiz J. Aspectos sociodemográficos de los intentos de suicidio. Actas Esp Psiquiatr 2002; 30 (2): 112-119.
2.Prevalence and risk factors for suicide ideation, plans and attempts in the WHO. World Mental Health Surveys. J Clin Psychiatry 2010; 71 (12): 1617-1628


(132) PO-132. Risk factors for smoking in European adolescents: Results of the SEYLE study

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Christian Haring . State Hospital Hall in Tyrol/tirol-kliniken, Hall, Austria
-

 Introduction:
AIMS: Tobacco smoking among adolescents is still a major public health problem and a global concern. Early onset and long-term smoking are associated with physical and psychological health problems. The aim of the presented analysis was to investigate risk and influencing factors for occasional and daily cigarette smoking in European adolescents.
METHODS: In the context of the Europe-wide ?Saving and Empowering Young Lives in Europe? (SEYLE) study we surveyed 12,328 adolescents at the age of 13 to 17 from eleven countries. The survey took place in a school-based context using a questionnaire. Questions from the Global School-Based Student Health Survey (GSHS) were applied to determine nicotine consumption and other risk behaviors like substance consumption and family problems. Behavioral criteria like conduct problems, and hyperactivity as well as emotional symptoms were investigated using the Strenghts and Difficulties Questionaire (SDQ). Psychological issues like suicidal behavior, direct self-injurious behavior and anxiety were ascertained using the Paykel Suicide Scale (PSS), a shortened version of the Deliberate Self-Harm Inventory (DSHI) and the Zung Self-Rating Anxiety Scale (SAS), respectively.
RESULTS: On average 30.9% of adolescents reported daily smoking and 58% reported the onset of smoking under the age of 14 already. Multinomial logistic regression model showed significant correlations between adolescent smoking and psychological issues (anxiety, emotional symptoms, previous suicide attempts, D-SIB), family problems (parental smoking, family drunkenness, living in single parent households), behavioral criteria (conduct problems, hyperactivity) and substance consumption (excessive alcohol use, illegal drug use).
CONCLUSIONS: Our data show that adolescent smoking is associated with psychiatric problems as well as behavioral criteria and substance use. Further, smoking and psychosocial factors, especially family setting and parental behaviors, are highly correlated. Therefore, early preventive measures are necessary and essential not only for adolescents but also for their parents.


(141) PO-141. Suicide in the Workplace: Impact, Experiences and Responses of Colleagues

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Evelyn Gordon . Dublin City University, Dublin Ireland
- Briege Casey -

 Introduction:
The impact of suicide is far reaching. There is a growing body of theoretical and research literature regarding the experiences and needs of those bereaved by suicide, indicating that bereavement by suicide entails some unique features (Hunt & Hertlein 2015); hence the response needs to be tailored to meet these needs (Gordon et al., 2015). The prevalence of suicide in the workplace is increasing worldwide (Cullen 2014) and while awareness concerning incidence, possible contributing factors and the effectiveness of prevention strategies is developing, little is known about the lived experience of workplace suicide for mangers and co-workers. Suicide in the workplace can evoke powerful emotional responses among colleagues such as anger, fear and distress (Kinder & Cooper 2009) yet this is a vastly under researched area.
 Methodology:
This paper describes the findings of a study, which used an Interpretive Phenomenological Analysis (IPA) method, to explore the experiences and responses of workplace colleagues - managers and co-workers.
 Conclusions:
The impact of worker suicide on the organisation as a whole will also be discussed.
 References:
Cullen J. G. (2014) Towards an organisational suicidology, Culture and Organization, 20:1, 40-52
Gordon, E., McElvaney, R., MacGabhann, L., Farrelly, M., Casey, B. & Pulcherio, I. (2015) Responding to the Suicide Bereaved: The Mayo model ? Full Report, Dublin: Dublin City University.

Kinder A. & Cooper C. L. (2009) The Costs of Suicide and Sudden Death Within an Organization, Death Studies, 33:5, 411-419
Hunt Q. A. & Hertlein K. M. (2015) Conceptualizing Suicide Bereavement From an Attachment Lens, The American Journal of Family Therapy, 43:1, 16-27,


(144) PO-144. Trends in suicidal behaviour in Dutch general practice 1983-2013: A retrospective observational study

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Derek De Beurs . Netherlands Institute for Health Services Research (NIVEL), Amsterdam The Neterlands
-

 Introduction:
Objectives:

To analyze trends in suicidal behaviour as reported by Dutch sentinel general practices from 1983-2013. Second, to examine the relationship between suicidal behaviour and several patient characteristics. Finally, to compare the relationship between suicidal behaviour and patient characteristics before (1983-2007) and after (2008-2013) the start of the crisis.

Setting
40 general practices in the Netherlands during the period 1983-2013

Participants

Patients with an ICPC code of P77 (suicide attempt)


Primary and secondary outcomes


Primary outcomes were age-adjusted and gender-specific trends in reported suicides (342) and suicide attempts (1614). Secondary outcomes were the relationship between suicidal behaviour and age, household composition, history of depression, recognition of suicide ideation, treatment before the suicidal behaviour and contact within the last month before suicidal behaviour for the period 1983-2013. Additionally, separate frequencies for the periods 1983-2007 and 2008-2013 were presented.


Results

Join-point analyses revealed a significant rise in male suicides from 2008 (b = 0.32, SE = 0.1, p = 0.008), and an increase in male suicide attempts since 2009 (b = 0.19, SE = 0.04, P < 0.001). Female suicidal behaviour showed a steady decrease from 1989-2013(b = -0.03, SE = 0.007, p < 0.0001 for female suicide, b = -0.02, SE = 0.002, p < 0.001 for female attempts). Before 2007, a history of depression was reported in 65% (168/257) of the suicides. After the start of the recession, a depression was recognized in 44% (22/50) of the patients that died by suicide.




Conclusions

Since 2008, there was a rise in the male suicide rate while female suicide behaviour has continued to decline. GPs less often reported a history of depression within patients that died due to suicide after 2007 than before. Training in the early recognition of suicide ideation in depressive patients might improve suicide prevention in primary care.


(150) PO-150. The area of residence influences female suicide

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Jon García Ormaza . SERVICIO VASCO DE SALUD, BARAKALDO (VIZCAYA)
- Marta Diez Gabas - Aníbal Arrillaga Trueba - Aida Sánchez Palacio - Iñaki Eguiluz Uruchurtu - Rafael Segarra Echebarria -

 Introduction:
Suicide is responsible for at least one million deaths annually in the world. Suicide is the result of the complex interaction of multiple factors, which include psychiatric and medical aspects and genetic and environmental factors. No factor has been shown necessary nor sufficient, or what is the same, suicide never occurs in response to a single cause. Epidemiologically, individual factors are not sufficient to explain the risk of suicide, making it necessary to take into account contextual factors of the area of residence.
 Goals:
Analyze the distribution of suicides based on the residence of the deceased in Districts of unequal socioeconomic level in Barakaldo, Spanish city of 100,000 inhabitants.
 Methodology:
The study includes 31 cases of suicide recognized by the Basque Institute of Legal Medicine during the period from 1 January 2010 to 31 December 2014. To ensure an objective approach to poverty, socio-economic deprivation indicator MEDEA (acronym for Mortality in Spanish small areas and Socioeconomic and Environmental Inequalities) was used. MEDEA is constructed from the analysis of five economic indicators: unemployment, inadequate education, insufficient instruction in youth, manual workers and temporary employees. This indicator distinguishes five quintiles, representing Q1 the lowest, and Q5 the highest level of deprivation.
 Results:
Differences among suicide rates of nine different districts are not statistically significant (p=0,680), but all cases of female suicide occurred in the most disadvantaged neighborhoods (those districts represented Q4 and Q5).
 Conclusions:
Since our results show an excess of female suicide in the economically depressed areas, we suggest implementing specific suicide prevention programs in these disadvantaged neighborhoods.
 References:
Ministerio de Fomento. Análisis Urbanístico de Barrios Vulnerables: Barakaldo. Madrid: Gobierno de España; 2010.

Distribución del índice de privación socioeconómica en las secciones censales de la CAPV. Euskadi: Osakidetza-Servicio Vasco de Salud; 2013. Available from: http://www.osakidetza.euskadi.eus/


(162) PO-162. Violent relationships and self-harm among young adolescents in Denmark

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Sarah Jensen . Centre for Suicide Research, Odense - Denmark
- Anne Clausen -

 Introduction:
This study is part of the on-going project called The CASE Study (Childhood and Adolescent Self-harm in Europe). The study examines the prevalence of vulnerability, self-harm, and suicidal behaviour among adolescents aged 13-19 years in Denmark. Furthermore, factors that decrease or increase the risk of self-harm and suicidal behaviour are identified.
 Goals:
The goal is to raise awareness of violent teenage relationships and how much it affects adolescents. With this information preventive actions can be taken.
 Methodology:
Data is collected through a questionnaire administered to schools in Denmark. The questionnaire is web-based and includes 42 questions in 2015. Seven questions concern violence (psychologically, physically or sexually). Calculations were done by multiple regression analysis to control for gender, age and household differences.
 Results:
In total, 4,721 adolescents aged 13-19 years from 52 different schools completed the questionnaire.
2775 adolescents (59%) had experienced at least one kind of violence, whereof most had experienced psychological violence. 133 of these adolescents (5%) had experienced violence from a partner during or after a relationship. Results showed that adolescents who experienced violence from other people than their partner nearly had a 5 times higher risk of carrying out self-harm than those who had not experienced violence (OR 4.5 p<0.0001). Meanwhile, adolescents who experienced violence from a partner had a 9 times higher risk of carrying out self-harm than those who had not experienced violence (OR 8.8 p<0.0001).

 Conclusions:
Violence from a partner is far more damaging than violence from other people like family, friends, or strangers.


(168) PO-168. Hospitalization in suicidal behavior

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Antonio España Osuna . Complejo Hospitalario de Jaen, Jaen
- Mercedes Valverde Barea - Francisca Cartas Moreno -

 Introduction:
There are varied reasons for admission in Mental Health Hospitalization Units. Among them, there are of great importance both self-injurious thoughts and attempts suicide by their great impact on society. In recent decades, the suicide rate has increased coming to be among the leading causes of death worldwide, so establishing the relationship between the different stressors to which people are exposed and the appearance of self-injurious ideas is very important to establish possible risk factors as protectors and thus be able to better prevention of suicidal behaviors.


 Goals:
The aim is to analyze the prevalence over a year of patients requiring hospitalization for self-injurious thoughts and self-injurious gestures to total revenue in the mental health unit, as well as different socio-demographic factors that may be related to his appearance.
 Methodology:
Descriptive study, with a sample of 134 patients who required hospitalization in Mental Health Hospitalization Units.
Collected socio-demographic variables: sex, age, marital status and reason for admission.
 Results:
We obtain a sample of 134. From all of them 72 are men and 62 women. The average age of the sample stands at 44 years for those with self-harm ideation and 42 years for suicide attempts. We have a population ranging from 19 years to 83 years. Considering the re-entries of autolytic ideation and suicide attempts, the most frequency of occurrence are in the age group of 36-50 years and most are married.
 Conclusions:
Autolytic revenue ideation and suicide attempts are of great importance in our population, reaching a fifth of total revenue. The number is being greater in males. As autolytic ideation, most cases are female
The average age of life is the stage where most self-injurious ideation and suicide attempts are situated.
Considering marital status, we have observed that married situation can be considered a risk factor for suicide.
 References:
Kim JL, Kim JM, Choi Y, Lee TH, Park EC. Effect of Socioeconomic Status on the Linkage Between Suicidal Ideation and Suicide Attempts. Suicide Life Threat Behav. 2016 Mar 17.

Wierzbi?ski P, Ka?mierczak W, Zdanowicz A, Zboralski K. Causes of suicide attempts in patients undergoing psychiatric hospitalization--a preliminary study. Pol Merkur Lekarski. 2015 Oct; 39 (232):209-13.


(170) PO-170. Dual pathology and suicide

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Antonio España Osuna . Complejo Hospitalario de Jaen, Jaen
- Mercedes Valverde Barea - Francisca Cartas Moreno -

 Introduction:
The so-called "drunkorexia", anorexia and alcoholism, is increasing among young people. When you join an addiction in a patient with eating disorder increases the risk of suicide. a case where, in addition, consumption was both members of the couple with what the chances of relapse are higher exposed.

 Goals:
Provide an example of autolytic complication in a box dual pathology.
 Methodology:
Reason for consultation: alcohol abuse, and autolytic hyporexia gesture with a knife.
Current disease: The patient injured herself in the abdomen with a knife after worsen their mood by family and labor problems in the context of excessive alcohol consumption and continued a couple. Access to voluntary admission.
Personal history: Gastralgia by NSAIDS. alcohol abuse.
Family history: Grandfather maternal alcoholism and suicide by hanging. Two maternal aunts suffer from depression.
Psychopathological exploration: extreme thinness (BMI: 15.8495 kg / m2). Conscious, alert and oriented. Euthymic without current autolytic ideation. Body image distortion with partial criticism. Decreased appetite. Dream preserved. Recognizes alcohol abuse, along with her husband.
Investigations:
Blood tests and urine normocytic anemia. Slight decrease glucose, albumin and cholesterol. Slight increase in GGT and VSG. No electrolyte disturbances. Triage to negative toxic.
Abdominal ultrasound: intravesical polyp 3 mm.
Hamilton Depression Scale: score below the cutoff for depression.
Diagnostics: ICD-10: F50.0 Anorexia nervosa restrictive purgative mixed type. F10.1 harmful alcohol consumption.
Treatment: Mirtazapine 30 mg: 0-0-1, diazepam 5 mg: 1-1-0, B1B6B12: 1-1-1, folic acid 5 mg: 1-0-0.
 Results:
The patient had an adequate response to hospitalization and establishment of antidepressant, anxiolytic and multivitamin treatment and prevention of abstinence and relapse of alcohol consumption.
 Conclusions:
1. Consumption of toxic worsens any Axis I psychiatric disorder and makes it more difficult to control. It also increases the risk of suicide.
2. The withdrawal of toxic, nutritional recovery, family intervention and drug therapy are the mainstay of treatment.
 References:
Cucchi A, Ryan D, Konstantakopoulos G, Stroumpa S, Kaçar A?, Renshaw S, Landau S, Kravariti E. Lifetime prevalence of non-suicidal self-injury in patients with eating disorders: a systematic review and meta-analysis. Psychol Med. 2016 Mar 8:1-14

Eisenberg MH, Fitz CC." Drunkorexia": exploring the who and why of a disturbing trend in college students eating and drinking behaviors. J Am Coll Health. 2014; 62 (8):570-7.


(185) PO-185. Suicide in Taiwan 1905-1940 and 1959-2012: A time trend analysis

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Shu-sen Chang . National Taiwan University, Taiwan
- Yi-han Chang -

 Introduction:
Previous studies of long-term trends in suicide are restricted to Western countries.
 Goals:
To investigate trends in suicide in Taiwan during the Japanese colonial period (1905-1940) and the post-war period (1959-2012).
 Methodology:
Data for suicide were obtained from the Statistical Reports of Taiwan Governor’s Office (1905-1940), Vital Statistics (1959-1970) and computerized cause-of-death mortality files (1971-2012). Annual sex-, age-, and method-specific suicide rates were calculated. We examined Pearson’s correlation between suicide and economic indicators using de-trended data (year-on-year differences).
 Results:
In 1905-1940, male suicide rates of all age groups increased, whilst young and older females showed divergent trends, with females aged 20-29 years showing a more than 50% reduction and those aged 50+ years showing a more than two-fold increase in rates. In 1959-2012, male and female rates showed generally similar trends whilst there were two to six-fold differences in age-specific rates over time. Male-to-female rate ratio increased markedly in those aged below 40; for example, in 20-29-year-olds, it increased from 0.5 in 1905 to 1.6 in 2012, indicating a reverse in sex pattern. Hanging was the major method for suicide in 1905-1940, whilst poisoning became the most common method in the early part of the post-war period until it was replaced by hanging in the 1990s. The use of gassing for suicide increased markedly in the 2000s and a smaller increase was seen for suicide by drowning and falling from the 1990s. Economic downturns were correlated with a rise in suicide, particularly in men – in 1905-1940 male suicide rate was inversely correlated with GDP growth (r=-0.36, p=0.035) and in 1959-2012 it was positively correlated with unemployment rate (r=0.50, p=0.0001).
 Conclusions:
Suicide trends and patterns changed markedly in Taiwan over the past 100 years. Suicide rates rose with economic downturns and increased unemployment rates. Our findings contribute to suicide prevention strategies.


(205) PO-205. Relapse risk factors for suicide attempts in adolescents

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Francisco Villar Cabeza . Servicio de Psiquiatría y Psicología del Hospital Materno-Infantil Sant Joan de Déu, Esplugues de Llobregat (Barcelona), España
- Carmina Castellano-Tejedor - Bernardo Sánchez Fernández - Tomás Blasco Blasco -

 Introduction:
Every year, suicide claims the lives of tens of thousands of young people worldwide. Prior suicide-related behaviors are an important indicator of current risk[1]. Despite its high prevalence, suicidality in high risk samples is still undetected in many cases. Therefore, early identification of suicide risk factors may be an important method of mitigating this public health crisis[2].
 Goals:
To analyze risk factors for suicide attempt relapse in a sample of adolescents with previous suicide related behaviors.
 Methodology:
The total sample consisted of 526 suicidal attempts in a sample of 402 adolescents age between 8 and 17 years of age (M=14.76, SD=1.56). Variables considered for the analysis were: gender, age, current comorbidity, previous psychopathological disorders, previous suicide-related behaviors and family previous suicide-related behaviors. Data was collected by the attending clinical psychologist. Longitudinal design with logistical regression models, Odds ratios (OR) with 95% confidence intervals (CI) were used.
 Results:
A significant logistic regression model was obtained (2(3, N=402)=25.317; p<.001)) including gender (OR=.285, p=.045, IC95%=.084-.971), age (OR=.389, p=.023, IC95%=.172-.879) and comorbidity (OR=.267, p<.001, IC95%=.137-.521).
 Conclusions:
Females under 16 years old with comorbidity are at greater risk of committing successive suicide attempts after an episode. Targeted suicide screening may be the most effective way to recognize and prevent suicide-related behaviors in high risk samples. Thus, more research is needed to increase the knowledge on empirically based risk factors to design accurate suicide prevention protocols or early intervention plans.
 References:
[1] Miranda R, Scott M, Hicks R, Wilcox HC, Harris-Munfakh JL & Shaffer D. Suicide attempt characteristics, diagnoses, and future attempts: Comparing multiple attempters to single attempters and ideators. Journal of the American Academy of Child and Adolescent Psychiatry, 2008;47(1):32–40. [2] Instituto Nacional de estadística. Defunciones según la causa de muerte en 2013. Available at: www.ine.es


(226) PO-226. Prevalence and factors associated with suicidality: A longitudinal study in a nationally representative sample from Spain

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Kaloyan Kamenov . Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid-Spain
- Francisco Félix Caballero - Marta Miret - Marco Bennardi - María Cabello - Beatriz Olaya - Josep María Haro - Ella Arensman - José Luis Ayuso-Mateos -

 Introduction:
It is still unknown whether the rates of suicidal ideation and attempts have changed after the 2012 healthcare and social expenditure cuts in Spain (1). Furthermore, to date no longitudinal studies have been carried out in nationally representative samples of the general population in Spain to analyse the prevalence trends and factors longitudinally associated with suicidality.
 Goals:
To estimate the prevalence of non-fatal suicidal behaviour in Spain and to analyse potential factors longitudinally associated with suicidal ideation in the previous 12 months.
 Methodology:
A nationally representative sample of non-institutionalised adults (n=4375) was interviewed in Spain within the COURAGE in Europe project in 2011-2012. The present study was focused on 2528 participants who were re-evaluated in 2014-2015. The presence of suicidal ideation, suicide planning and attempts in the previous 12 months was evaluated using the Composite International Diagnostic Interview. Socio-demographics, socio-economic variables, tobacco and alcohol consumption, physical activity, obesity, loneliness, affect, depression and disability at baseline were considered as potential factors related to suicidal ideation. A logistic regression model with a penalised likelihood method was employed. Rates were calculated using the direct method of age standardisation to the 2010 European Standard Population.
 Results:
The prevalence estimates of 12-month outcomes in the follow-up were 1.41% for suicidal ideation, 0.23% for suicide planning, and 0.11% for suicide attempt. After controlling for suicidal ideation at baseline, heavy alcohol consumption (OR=4.92, p=0.027), depression (OR=3.04, p=0.027) and low positive affect (OR=0.64, p=0.005) were significantly associated with suicidal ideation in the previous 12 months.
 Conclusions:
Compared to results from 2011-2012, there was a slight but not statistically significant increase in suicidal ideation and no increase in suicidal planning (2). Suicide prevention programmes should focus on early detection, prevention of depression and heavy drinking, and improved care of those affected.
 References:
1. Legido-Quigley H, Otero L, la Parra D, Alvarez-Dardet C, Martin-Moreno JM, McKee M. Will austerity cuts dismantle the Spanish healthcare system?. Bmj. 2013 Jun 13;346. 2. Miret M, Caballero FF, Huerta-Ramírez R, Moneta MV, Olaya B, Chatterji S, Haro JM, Ayuso-Mateos JL. Factors associated with suicidal ideation and attempts in Spain for different age groups. Prevalence before and after the onset of the economic crisis. Journal of affective disorders. 2014 Jul 31;163:1-9.


(233) PO-233. Self-reported sucidal ideation in Latvia: Associations with gender, age and self-rated health

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Santa Japenina . Centre for Disease Prevention and Control of Latvia, Riga, Latvia
- Toms Pulmanis - Lauma Springe - Biruta Velika - Iveta Pudule - Daiga Grinberga - Iveta Gavare -

 Introduction:
Suicide rate in Latvian population is the 3rd highest among the Member States of the EU (1, 2). Suicide is a complex process that involves series of mechanisms from initiation of ideation, to planning, and finally, to attempting suicide (3, 4). Suicidal ideation is often associated with the risk of completed suicide (4, 5, 6).
 Goals:
To determine the last year prevalence of self-reported suicidal ideation in Latvian 15-64 year old population and associations between suicidal ideation, age, gender and self-rated health.
 Methodology:
Data from Health Behaviour among Latvian Adult Population survey (2014) with nationally representative sample of 15 – 64 year old respondents (n=3010) were analysed. Adjusted regression model with self-reported suicidal ideation in last 12 months as dependent variable and gender, age and self-rated health as factor variables was performed. Statistical significance was based on 95% confidence intervals.
 Results:
3.1% (95% CI=2.5-3.7) of respondents reported suicidal ideation in the last 12 months. Those who reported poor self-rated health had 11 times higher odds (OR=11.3 95% CI=6.0-21.2) of suicidal ideation in the last 12 months compared with those who rated their health as good after adjusting for age and gender. 15-34 year old respondents had two times higher odds (OR=2.0 95%CI=1.1-3.8) of suicidal ideation in the last 12 months compared with 55-64 year olds respondents after adjusting for other variables in the model.
 Conclusions:
Younger respondents and those with poor self-rated health had higher odds of suicidal ideation. Further research is needed to identify additional risk factors for suicidal ideation and other forms of suicidal behaviour in Latvia.
 References:
1. World Health Organization Regional Office for Europe. European Detailed Mortality database; 2014 (updated December 2015; cited February 2016). Available from: http://data.euro.who.int/dmdb/ 2. Paykel ES, Myers JK, Lindenthal JJ, Tanner J. Suicidal feelings in the general population: a prevalence study. Br J Psychiatry. 1974;124:460–469. 3. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al. Suicide prevention strategies: A systematic review. J Formos Med Assoc. 2005;294(16):2064-2074. 4. Casey PR, Dunn G, Kelly BD, Birkbeck G, Dalgard AS, Lehtinen V, et al. Factors associated with suicidal ideation in the general population: five-centre analysis from the ODIN study. Br J Psychiatry. 2006;189:410-415. 5. Lee JI, Lee MB, Liao SC, Chang CM, Sung SC, Chiang HC, et al. Prevalence of suicidal ideation and associated risk factors in the general population. J Formos Med Assoc. 2010;109(2):139. 6. Suominen K, Isometa E, Suokas J, Haukka J, Achte K, Lonnqvist J.. Completed suicide after a suicide attempt: a 37-year follow-up study. AM J Psychiatry 2004;161:562-563.


(252) PO-252. The effect of psychological resilience in buffering the impact of substance use on suicidal ideation in young adults.

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Patricia Gooding . University of Manchester, UK
-

 Introduction:
Introduction: Substance use is a considerable public health concern in young people. There are strong links between substance use and suicidal thoughts and behaviours in this population. This means that suicide prevention strategies should focus on factors which weaken this link. Psychological resilience describes mechanisms which buffer individuals from the consequences of negative events and stressors. Hence, building and nurturing psychological resilience is an important clinical target. The goal of the current study was to examine the extent to which psychological resilience would buffer young individuals from the effects of alcohol and drug use on suicidal thoughts. Methods: A cross-sectional questionnaire design was used. The outcome variable was suicidal ideation. Predictor variables were drug and alcohol use, and resilience was the moderator variable (total scores, and three sub-scale scores of emotional control, social support, and problem solving). Depression was controlled for in all analyses. An opportunity sample of young people from Manchester, UK, were recruited. Inclusion criteria were being over the age of 18 and under the age of 25, and being fluent in the English language. Results: Psychological resilience was protective in reducing the association between substance use and suicidal ideation. This is a particularly important result because levels of depression were controlled for in the analysis. Depression and substance use have been reported to be highly correlated, including in young people. This means that the positive effects of resilience factors on suicidal thoughts and behaviours were not due to lower depressive symptoms. Discussion: From a theoretical perspective, the components of inter-personal problem solving which confer resilience deserve further scrutiny in the context of developing psychological models of resilience to suicidality. Our findings have potentially important clinical implications for developing interventions which counter the amplifying interactions between substance use and suicidal thoughts and behaviours in young adults.


(255) PO-255. The effect of psychiatric symptoms in the pathways to suicidal thoughts and behaviour in psychiatric in-patients.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Patricia Gooding . University of Manchester, UK
-

 Introduction:
Co-Authors:Awenat,Y., Davies,L., Emsley,R., Peters,S., Pratt,D., Haddock,G. Introduction: People who are psychiatric in-patients experience a range of severe mental illnesses. Consequently, they are at an increased risk of experiencing suicidal thoughts and/or behaviours. Contemporary psychological models of suicidality posit that defeat, entrapment, and hopelessness are key in the pathways to suicidality. Initial findings with suicidal prisoners point to an interactive role of psychiatric symptoms in such pathways. The goal of the current study was to build on this work, and to examine the ways in which psychiatric symptoms affect pathways to suicidility by affecting relationships between defeat, entrapment, hopelessness, and suicide probability. Method: This was a cross-sectional design. Participants were recruited from acute psychiatric wards from NHS trusts in the North West of England, UK, as part of a single blind randomised controlled trial with two arms, namely, treatment as usual (TAU) or cognitive therapy for suicide plus TAU. Inclusion criteria comprised being between the ages of 18-65 years, able to provide informed consent, having experienced suicidal thoughts or behaviours within the three months prior to admission, and having sufficient English language capacity to complete measures. A questionnaire battery included measures of suicide probability, hopelessness, defeat, entrapment, psychiatric symptoms, and depression. Mediation and moderated mediation analyses were applied to the data. Results: A mediation model was supported in which defeat led to suicide probability directly, and indirectly via entrapment, but not hopelessness. Furthermore, high levels of general psychiatric symptoms strengthened the relationship between defeat and suicide probability. However, entrapment was a predictor of suicide probability only when psychiatric symptom levels were low. Discussion and conclusions: These findings emphasise differential effects of defeat and entrapment on suicidality when considered in tandem with general psychiatric symptoms. Clinically, interventions to reduce perceptions of defeat and entrapment should consider interactive effects of psychiatric symptoms.


(257) PO-257. Factors which can contribute towards the potential for suicidal risk in young people

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Megan Gaffney . Trinity College Dublin, Dublin, Ireland
- Dr. Paul Surgenor - Barbara Hannigan - Dr. Tim Trimble -

 Introduction:
Both national and international research have identified factors which can contribute towards the potential for suicidal risk in young people. Based on clinician experience and factors identified in the literature, a tool to measure both risk and resilience factors for suicidality in adolescents and young people was created.
 Goals:
The study aims to develop a practical tool for use in a variety of settings to identify adolescents and young people prior to or early on in the onset of a suicidal crisis.
 Methodology:
The Riskres tool, a 46-item self report scale was piloted initially with an ‘at risk’ population. 66 young people between the ages of 12 and 21 completed the Riskres as part of their assessment at a community based suicide and self harm service in Ireland. The participants also completed a brief screener for depression (PHQ-9) (Spitzer et al., 1999) and a brief standardised measure for suicidal behaviour (SBQ-R) (Osman et al., 2001). Demographic information was also collected. Test administrators were asked to log any queries about items from the participants for future refining of the language of items.
 Results:
Based on preliminary exploratory factor analysis, the Riskres tool looks at 15 factors: connection, hopelessness, impulsivity, anxiety, optimism, coping difficulties, isolation, self efficacy, worry, painful history, avoidance, school connection, sexuality, shame, and depression total. Also based on preliminary analysis, a binary logistic regression showed that the following 5 factors were significant in predicting one of the suicide ideation screening items. These factors are: hopelessness, anxiety, coping difficulties, school connection, and depression total.
 Conclusions:
Due to the relatively small sample size in the pilot study, further administration and validation with a larger sample is recommended, based on the provisional findings. The overall research aim is to develop a tool which is non-pathologising, strength identifying, and can guide intervention with young people.
 References:
Osman, A. C. L. Bagge, P. M. Gutierrez, L. C. Konick, B. A. Kopper, F. X. Barrios. The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001 December; 8(4): 443–454. Spitzer, R.L. K. Kroenke, J. B. Williams. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999 November 10; 282(18): 1737–1744.


(273) PO-273. Regional and Demographic Differences in Suicide Attempts

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Kathrine Aarøe Jørgensen . Centre for Suicide Research, Denmark
-

 Introduction:
The expansion of the Register for Suicide Attempts in Denmark has shown demographic differences nationwide. Data has been collected in several of the Danish regions from 2012-2014, and the distribution of suicide attempts differs significantly - both regarding the quantity of suicide attempts and the age.
 Goals:
The aim of the project is to approach an understanding of the link between regional differences on the one hand, and demographical patterns of suicide attempts on the other hand. Attention will especially be paid to the social relations in the local communities in order to explore whether there is a pattern that links the social relations with the geographic and demographic distribution of suicide attempts.
 Methodology:
By first mapping out geographical, social, and cultural features in the two Danish regions selected for the project, patterns in the suicide attempts are explored. With statistical data from the Register of Suicide Attempts, The CASE Study (Child and Adolescent Self-harm in Europe) and data containing information on health and social relations, the project examines whether there is a connection that can help explain the regional differences.
 Results:
Preliminary results indicate a connection between parameters such as distance from a bigger city, population density and age distribution on the one hand and rates of suicide attempts on the other hand. Furthermore, data from The CASE Study indicates that rates of suicide attempts among the younger population is lower in regions that report e.g. higher family support and lesser loneliness, which points to a connection between suicide attempts and social relations.
 Conclusions:
Comparison between two Danish regions indicates geographical differences in suicide attempts, but in order to conclude more thoroughly on the impact of the demographic and social parameters, further analysis is required.


(276) PO-276. How economic crisis influences suicidal behavior: A study in the province of Novara

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Debora Marangon . Department of Translational Medicine - University of Eastern Piedmont, Novara - Italy
- Carla Gramaglia - Isabella Coppola - Claudia Delicato - Sarah Di Marco - Eleonora Gattoni - Alessandra Venesia - Luigi Castello - Fabrizio Bert - Patrizia Zeppegno -

 Introduction:
Since 2009 in Europe, it was observed an increase in the suicide rates, which could be related with the economical crisis and the condition of unemployment. In accordance to Durkheim’s theory, the number of suicide attempts increases during periods of economic changes and decreases again when stability is achieved, due to the social integration in the community guaranteed by occupational status. Moreover unemployment is considered a risk factor for suicide, despite that it was observed an increase in suicide rates among Italian employed men during the last years, probably related to the specific economic scenario and to emerging difficulties in keeping an income to adequately maintain one’s own family standard of living
 Goals:
To examine the impact of Italian economical crisis on suicide behaviour, especially on suicide attempts, in the province of Novara.
 Methodology:
Patients aged>16 years admitted for psychiatric symptoms in the Emergency Room of the AOU Maggiore della Carità Hospital, Novara, Italy, were studied prospectively from 2008 to 2015. Each patient was assessed by an experienced psychiatrist with a clinical interview; socio-demographic and clinical features were gathered. Data were compare to socio-demographic characteristics of the general population in the province of Novara. Statistical significance was set at p≤0.05.
 Results:
The study describes the complex correlation among socio-demographic variables (especially socio-economic characteristics), psychiatric symptoms and suicide attempts. Preliminary results suggest an increase in suicide attempts according to the rise of the unemployment rate in Novara. Moreover we highlight that employment does not reflect the whole socio-economic situation, but considering other variables is necessary.
 Conclusions:
Data collection and statistical analyses are still ongoing. Implications for clinical practice will be discussed.
 References:
Wasserman D, Rihmer Z, Rujescu D, Sarchiapone M, Sokolowski M, Titelman D, Zalsman G, Zemishlany Z, Carli V, European Psychiatric Associaton: The European Psychiatric Association (EPA) guidance on suicide treatment and prevention. Eur Psychiatry (2012) 27:129-41. Zeppegno P, Gramaglia C, Castello LM, Bert F, Gualano MR, Ressico F, Coppola I, Avanzi GC, Siliquini R, Torre E. Suicide attempts and emergency room psychiatric consultation. BMC Psychiatry (2015) 15: 13.


(279) PO-279. ATTEMPTED SUICIDE AND DEPRESSION: ELECTRODERMAL ACTIVITY, RESILIENCE, COPING AND PERSONALITY TRAITS

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Isabella Coppola . Department of Translational Medicine - University of Eastern Piedmont, Novara - Italy
- Carla Gramaglia - Eleonora Gattoni - Sarah Di Marco - Claudia Delicato - Lars-hakan Thorell - Marco Sarchiapone - Debora Marangon - Patrizia Zeppegno -

 Introduction:
It was estimated that suicide attempts were reported by 6.6% of patients with past-year major depressive disorders. Low electrodermal activity in depressed patients was first described more than 100 years ago. The literature suggests that a history of suicide attempts is significantly related to electrodermal hyporeactivity. The outcome of the disease and the impact of depressive symptoms on suicidal ideation may be moderated by resilience which refers to the ability to maintain or regain mental health despite experiencing adversity. Resilience may be influenced by innate characteristics, such as personality traits, gender, race, or by the subject’s character development over time, for example social attachment and relationship, coping strategies and adaptability.
 Goals:
To compare electrodermal hyporeactive subjects and reactive ones in a sample of depressed patients, in order to assess the possible correlations among attempted suicide, electrodermal activity and personal characteristics of resilience, coping strategies, perceived quality of life and personality features.
 Methodology:
We recruited patients with Bipolar or Unipolar Depressive Disorders. Patients filled in the Resilience Scale for Adult, the Brief Cope Scale, the Short Form Health Survey and the Temperament and Character Inventory test. For each patient we performed the EDORTM test in order to assess electrodermal activity and we collected data about socio-demographic, clinical features and history of suicide attempts.
 Results:
Data collection is still ongoing. According to the Literature, we expect to find no clinical differences between hyporeactive and reactive patients as regards gender and clinical severity of depressive episode. However, we hypothesize that suicide attempts in the group of hyporeactive patients would be characterized by planning and greater severity. Moreover, we expect lower levels of resilience in those patients who are hyporeactive and attempted suicide.
 Conclusions:
Clinical implications will be discussed.
 References:
1. Zeppegno P, Gramaglia C, Castello LM, Bert F, Gualano MR, Ressico F, Coppola I, Avanzi GC, Siliquini R, Torre E. Suicide attempts and emergency room psychiatric consultation. BMC Psychiatry 2015 Feb 5;15:13. 2. Thorell LH, Wolfersdorf M, Straub R, Steyer J, Hodgkinson S, Kaschka WP, Jandl M. Electrodermal hyporeactivity as a trait marker for suicidal propensity in uni- and bipolar depression. J Psychiatr Res 2013 Dec;47(12):1925-31. 3. Deegan PE. The importance of personal medicine: A qualitative study of resilience in people with psychiatric disabilities. Scand J Public Health Suppl 2005 Oct;66:29-35. 4. Patel V, Goodman A. Researching protective and promotive factors in mental health. Int J Epidemiol 2007 Aug;36(4):703-7.


(284) PO-284. Mental Health Service Utilization of Individuals at Risk for Suicide: The role of family support

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Dana Alonzo . Fordham University, NY-USA
-

 Introduction:
Up to 60% of attempters fail to attend treatment one week after discharge from an emergency room. Suicidal individuals demonstrate cognitive impairments such as poor problem-solving skills and impairments in decision-making abilities. These deficits prevent them from forming accurate representations of problems and from making effective decisions about how to address these problems. This may be why it is difficult for suicide attempters to engage in treatment. They may not consider treatment a potential solution to their problems, or, they may not be motivated to attend treatment when they are unable to recognize that a positive outcome may result.
 Goals:
The current study examines correlates of mental health service utilization among clients at high risk for suicide receiving treatment in an outpatient mental health center.
 Methodology:
We conducted a systematic chart review of 44 clients to examine clinical (i.e., diagnosis, length of time in treatment, number of prior attempts, severity of symptomatology) and sociodemographic (i.e., age, gender, ethnicity, level of education, social supports) correlates of mental health service utilization. We conducted an ANOVA to determine which, if any, of these factors was related to mental health service utilization.
 Results:
Individuals reporting a having family support were significantly less likely (p=<.05) to attend treatment than those who did not report having family support 69% vs 80%, respectively).
 Conclusions:
Findings suggest that even though individuals may struggle with suicidal thoughts and behaviors, they are less likely to adhere to treatment when they feel they receive family support. This speaks to the importance of involving family members in the treatment process in order to bolster the client’s adherence to outpatient treatment. Family can be in a unique position to meaningfully encourage clients to attend sessions and to reinforce why attending treatment is important and how it can be benefical.


(296) PO-296. Protective factors for familial transmission of suicidal behaviour

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Lilian Zoellner . Centre for Suicide Research, Denmark, Odense - Denmark
-

 Introduction:
Protective factors for familial transmission of suicidal behaviour Lillian Zoellner, director of Centre for Suicide Research, Denmark, Ph.D. Introduction Several studies show that attempted and/or committed suicides among the immediate family (i.e. parents, siblings or children) constitute a risk factor for the bereaved. Some studies show that genetic risk factors cause familial transmission of suicidal behaviour, others show that environmental factors often are related to risk factors that are heritable. The risk factors are well known whereas research into protective factors for familial transmission of suicidal behaviour is sparse.
 Goals:
This study focuses on circumstances that may contribute to changing the view of life among persons who have experienced suicide of one of their nearest relations. Goals The goal of the study is to identify protective factors for serious suicidal ideation and suicidal behaviour among person bereaved by suicide within the immediate family.
 Methodology:
Data is collected through personal interviews with 20 women and 2 men aged 23 to 65 years. Every interview lasted approximately 2 hours. The interviews have been analysed subsequently.
 Results:
Several of the interviewees have experienced more than one suicide in the immediate family (grandparents, parents, siblings or children). Only very few of the interviewees suffer from suicidal ideation or have attempted suicide themselves. Protective factors for both men and women are ethical considerations about responsibility, i.e. responsibility for life, themselves or the immediate family. Another significant protective factor is having very close friends to confide in. Many state that getting outside into nature is of great importance. Furthermore, some tell that faith, religion, philosophy of life and/or spirituality protect against both suicidal ideation and suicidal behaviour.
 Conclusions:
This research project gives us new knowledge of protective factors for suicidal ideation and suicidal behaviour among persons who have experienced suicide within the immediate family.


(309) PO-309. Substance and internet abuse: What are the effects on suicidal ideation and well-being of adolescents?

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Matilde Bousoño . Universidad de Oviedo, Oviedo- Spain
- Susana Al-Halabi - Patricia Burón - Vladimir Carli - Marco Sarchiapone - Danuta Wasserman - Paz García-Portilla - Celso Iglesias - Pilar Alejandra Sáiz - Julio Bobes -

 Introduction:
Substance and Internet addictions, psychopathology and suicidal ideation appear to be related.
 Goals:
The aim of this study is to investigate the association between addictive behavior, suicidal ideation and other psychopathological symptoms within adolescent population.
 Methodology:
The present study was carried out under the Saving and Empowering Young Lives in Europe (SEYLE) project, funded by the European Union: The sample is composed of 1026 adolescents aged between 14 and 16 years from 12 public schools in Asturias (530 men and 496 women).
 Results:
In the present study we have obtained the following consumption rates: a) alcohol 11.89% in males and 7.86% in women; b) tobacco: 4.15% and 5.44 in men and women respectively; c) other drugs: 6.98% in males and 4.44% in women; d) maladaptive or pathological use of internet: 14.53% and 20.77% in males and females respectively. We observed a positive association of the presence of suicidal ideation with the following psychopathological variables and substance or behavioral addictions: previous suicide attempts (OR = 10.26), depression (OR = 7.69), maladaptive Internet use (OR = 7.39), peer problems (OR = 3.74), alcohol consumption (OR = 2.78) and emotional symptoms (OR = 2.51).
 Conclusions:
The data suggests that the implementation of policies aimed at restricting maladaptive substance addiction and Internet use could have benefits for public health.
 References:
Carli V, Hoven, CW, Wasserman C, Chiesa F, Guffanti G, Sarchiapone M et al. A newly identified group of adolescents at "invisible" risk for psychopathology and suicidal behavior: findings from the SEYLE study. World Psychiatry. 2014;13:78-86. Kaess M, Durkee T, Brunner R, Carli V, Parzer P, Wasserman C et al. Pathological Internet use among European adolescents: psychopathology and self-destructive behaviours. Eur Child Adolesc Psychiatry. 2014; 23:1093-1102. Wasserman D, Carli V, Wasserman C, Apter A, Balazs J , Bobes J et al. Saving and empowering young lives in Europe (SEYLE): a randomized controlled trial. BMC Public Health. 2010;10: 192.


(310) PO-310. Profile of patients with suicidal behavior history attending a mental health center

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Elsa Arrua Duarte . Hospital Fundación Jimnez Díaz, Madrid- España
- A. Sedano Capdevila - F. Cegla Schvartzman - M. Migoya Borja - N. Palomar Ciria - M.l. Barrigon Estevez - L. Villoria - E. Baca-Garcia - Hospital Universitario Fundación Jiménez Díaz Memind Study Group Psychiatry Department -

 Introduction:
Suicidal behavior includes a range a behaviors, from suicidal ideation to consumed suicide1 and it is one of the most serious psychiatric emergencies2. The study describes risk factors associated with suicidal behavior in patients treated at the Psychiatric Department of Fundación Jiménez Díaz Hospital, by comparing patients with suicide behavior (SA patients) with patients without it (non-SA patients).
 Methodology:
13811 outpatients were recruited from May-2014 to May- 2015, aged 18 to 64, and a descriptive study was made based on suicidal behavior. Sociodemographic variables, clinical global impression scale, stressful life eventsand suicidal thoughts and behavior were collected by the MEmind web application, a data base that continuously collects information of patients in real-time.
 Results:
1181 individuals (8.55%) reported asuicide attempt. When compared by groups, SA patients were significantly younger (44.3vs 47.5; p=0.000),less frequently married (39.8% vs 60.2%; p=0.000 and were more frequently unemployed than non-SA patients (63.1% vs 36.9%; p=0.000). There were no differences according sex (35.7% men vs 38.2% men; p=0.1). SA patients presented amoderate-severe illness more frequently than non-SA patients (68.2% vs 42.8%; p=0.000). Traumatic life events were more frequently described in SA patients (67.6% vs 48.6%; p=0,000). SA patients had more often mental and behavioral disorders such as substance use disorders (SUD), mood and personality disorders than non-SA patients (17.3%, 35.1% and 34.3% respectively vs 6.8%, 10.1% and 22.4%; p=0.000). Neurotic disorders were less frequent in SA patients (34.5% vs 50.5%; p=0,000). We found no differences in schizophrenia and related disorders(11.4% SA patients vs 12% non-SA patients; p=0.563).
 Conclusions:
Patients with suicidal attempts history were younger, unmarried, non-active, had a serious illness and suffered a stressful life event.SUD, affective and personality disorders were more frequent among patients with SA history.
 References:
1.Vallejo J. Introducción a la psiquiatría y a la psicopatología. Ed Masson. España. 2011. 2.Schreiber J, Culpepper L. Suicidal ideation and behavior in adults. UpToDate. 2016


(322) PO-322. The Influence of Bullying on Suicide Responses.

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Martha Cristina Cancino Botello . Consorcio Hospital General Universitario de Valencia , Valencia, Spain
- Juan Miguel Hernández Sánchez - Fernanda Molina López -

 Introduction:
Bullying is a form of aggression in which someone is intentionally intimidated, harassed or harmed. During the last years with the development of new technologies and its accessibility to youth, it has developed a new type of aggression that involves electronic media, also known as cyberbullying. These forms of intimidation may be the cause of mental disturbances, especially anxiety and depression that, in the worst cases, could lead to death. This is why over the last decade there has been increased attention to the association between any bullying involvement and suicidal ideation or behaviors.
 Goals:
Our aim is to determine the relationship between cyber or physical bullying involvement (victim, perpetrator or both) and suicidal behaviors.
 Methodology:
We searched articles in English and Spanish on PubMed database, using the following keywords: Bullying, suicide, children, and adolescent
 Results:
By definition bullying (physical, psychological or electronic media) involves behaviors that must occur repeatedly and systematically against an individual who fails or is unable to defend him/herself. It includes harm, humiliation, suffering, fear and despair for the individual who is the target of aggression. On the other hand, electronic media implies free expression without social control, which have probably influenced the extension of cyberbullying. As a consequence, those who had been involved in any kind of intimidation reported significantly more health and social problems, such as anxiety and depression. Suicidal ideation and suicidal behaviors are frequent outcomes, whether it was a victim or a perpetrator.
 Conclusions:
Victimization or perpetration of bullying in youth is increasing more and more especially by electronic media. It is a vulnerable population to the development of mental disorders or even suicide. It is needed to work hardly on primary prevention and Internet services, and also to create more strict social policies that can diminish this kind of aggression.
 References:
Lemstra ME, Nielsen G, Rogers MR, Thompson AT, Moraros JS. Risk indicators and outcomes associated with bullying in youth aged 9-15 years. Can J Public Health. 2012 Jan-Feb;103(1):9-13. Holt MK, M. Vivolo-Kantor A, Polanin JR, Holland KM, DeGue S, Matjasko JL, Wolfe M, Reid G. Bullying and Suicidal Ideation and Behaviors: A Meta-Analysis. Pediatrics. 2015 Feb; 135(2): 496-511 Borges Bottino, SM Bottino C, Gomez Regina C, Villa Lobo Correia A, Silva Ribeiro W. Cyberbullying and adolescent mental health: systematic review. Cad. Saúde Pública. 2015. Mar; 31(3): 463-475


(324) PO-324. Shame experiences in bereaved by suicide

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Tânia Pinto . Criap , Portugal
-

 Introduction:
One of the most prominent aspects of the reactions of mourning for suicide is the presence of high levels of shame. Shame has a mediator role of vulnerability to psychopathology. As a result of this, the risk of suicide is seen as a strategy to deal with the intense psychological pain and it maximizes the magnitude of the important and serious worldwide public health problem – suicidal behavior.
 Goals:
Systematize and clarify, by revision of literature, the role of shame experiences in the process of mourning for suicide.
 Methodology:
Revision of the literature that is in the database Pubmed, Psychology and Behavioral Sciences Collection, PsycARTICLES and Redalyc. Using the key words: “shame on suicide survivors”; “exposed to suicide and shame”; “affected by suicide”, “suicide-bereaved-short term and shame”, “suicide-bereaved-long term and shame”.
 Results:
Shame is a warning sign. It is not generating positive affection in the minds of others. There is the risk of rejection experiences and social exclusion that complicate the process of mourning. Social restrictions, due to vast social repercussions (stigma and social prejudice), increase the feelings of shame, guilt and rejection. Shame reveals itself primordial in the process of understanding suicide and it contributes to explain suicide with its circular effect. The experiences of shame and stigma can promote the disinvestment of the risk of suicide in those bereaved by suicide because of its vigorous moral component.
 Conclusions:
Recent studies show that feelings of shame should be evaluated and they should also have specific intervention. These studies also show that shame is the cause of the difficulties felt in the psychotherapeutic intervention and they refer that we should have prevention programs in order to improve mental health literacy and reduce stigma.
 References:
Wiklander, M., Wilczek, A., Jokinen, J., Nilsonne, A., Rylander, G., Samuelsson, M., Asber, M. (2012). Shame-proneness in attempted suicide patients. BMC Psychiatry, 12, 1-9. Wu A, Wang J-Y, Jia C-X (2015) Religion and Completed Suicide: a Meta-Analysis. Plos one,10(6), e0131715. doi:10.1371/journal.pone.0131715


(326) PO-326. Is the Internet a cause, a consequence or a preventive tool for suicide/self-harm behavior?

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Martha Cristina Cancino Botello . Consorcio Hospital General Universitario de Valencia , valencia, Spain
- Fernanda Molina López - Juan Miguel Hernández Sánchez - María De Los Ángeles Canseco Navarro -

 Introduction:
The Internet has brought new forms of social interaction, activities, and communication. People are able to share a variety of information that may have no control. This explains the existence of websites, which are easily accessed online, that encourages and facilitates suicide. Likewise, there are sites with supportive information and advice about self-harm and suicide feelings. Nonetheless, given that youth has such an easy and rapid Internet access, how this amount of contradictory information can affect behavior of this population?
 Goals:
Our aim is to determine the degree in which Internet has influenced youth behavior related to self-harm practice and suicide.
 Methodology:
We searched articles in English and Spanish on PubMed database, using the following keywords: suicide, youth, Internet.
 Results:
The use of Internet in young adults in order to search information related to self-harm or suicide is more frequent on those with suicidal thoughts, suicidal plans, history of self-harm and history of mental illness (especially anxiety, mood or personality disorders). While a smaller proportion of this group of population appear to be more likely to access help sites. The easy access to Internet makes youth very vulnerable to be exposed to this material. It has been described that up to 1% of youth, have visited a website which encourages self-harm or suicide. At the same time, those who have made these kind of searches are 7 to 11 times more likely to have thought about hurting themselves.
 Conclusions:
The use of Internet may be a potentially key factor to assess those individuals with death thoughts, self-harm practices or depressive symptomatology, in order to provide a proper treatment. Policies of Internet service should work hardly to control the access to websites that encourages suicide and self-harm and to facilitate and promote access to helpful and supportive sites.
 References:
Mars B, Heron J, Biddle L, Donovan JL, Holley R, Piper M, Potokar J, Wyllie C, Gunnell D. Exposure to, and searching for, information about suicide and self-harm on the Internet: Prevalence and predictors in a population based cohort of young adults. J. Affect. Disord. 2015 Jun; 185: 239-245. Mitchell KJ, Wells M, Priebe G, Ybarra ML. Exposure to websites that encourage self-harm and suicide: Prevalence rates and association with actual thoughts of self-harm and thoughts of suicide in the United States. Journal of Adolescence. 2014 Oct; 37: 1335-1344. Lewis SP, Baker TG, The possible risks of self-injury web sites: a content analysis. Arch. Suicide Res. 2011. 15: 390–396.


(337) PO-337. Investigating the association between sleep problems and self-harm in Scottish adolescents

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Kirsten Russell . University of Strathclyde, Glasgow-Scotland
- Susan Rasmussen - Simon C Hunter -

 Introduction:
Suicidal and self-harming behaviours (SSHBs) represent a major public health concern, particularly during adolescence(1). There is a need to identify risk factors for the development of these behaviours in young people. Research has repeatedly highlighted a significant link between sleep problems and SSHBs(2). However, the majority of these studies have relied upon brief measures of global sleep that do not tap into the complexity of poor sleep. The distinctiveness of sleep disturbance subtypes, and their associated treatments, justifies a need to evaluate each of these subtypes in relation to SSHBs.
 Goals:
This investigation aimed to: 1. Evaluate whether distinctive subtypes of sleep disturbance can be identified within a sample of adolescents. 2. Assess the nature of the association between subtypes of sleep disturbance and SSHBs.
 Methodology:
15 and 16 year olds (n=1046) from Scottish secondary schools completed a questionnaire battery including questions measuring self –reported self-harm (with and without suicidal intent), demographics, and sleep. More specifically, questions assessed sleep patterns (bed-time, rise-time and sleep duration on school-days and weekends) and sleep quality (weekly sleep loss, insomnia and nightmares).
 Results:
K-means cluster analysis identified three distinct subgroups of sleep disturbance: 1)consistently good sleepers (60.8%), 2)consistently poor sleepers (8.7%), and 3)poorer weekday/better weekend sleepers (30.45%). Rates of self-harm were highest in individuals who were consistently poor sleepers (42.2%). This was also the case with regards to suicide-attempts (18.9%).
 Conclusions:
These findings provide novel insights into the relationship between sleep and SSHBs by examining how specific presentations of sleep disturbance could contribute to risk in adolescents. Future research in this area could inform the development of specific sleep interventions to combat SSHBs.
 References:
O’Connor RC,Rasmussen S,Miles J,Hawton K.Self-harm in adolescents:self-report survey in schools in Scotland.The British Journal of Psychiatry.2009Jan 1;194(1):68-72. Pigeon WR,Pinquart M,Conner K.Meta-analysis of sleep disturbance and suicidal thoughts and behaviors.The Journal of clinical psychiatry.2012 Sep 15;73(9):1-478.


(341) PO-341. Mental wellbeing as a potential protective factor for suicidal and self-harming behaviours

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Kirsten Russell . University of Strathclyde, Glasgow-Scotland
- Susan Rasmussen - Simon C Hunter -

 Introduction:
Suicidal and self-harming behaviours (SSHBs) represent significant public health concerns, particularly during adolescence. There is a pressing need to increase understanding regarding the development of these behaviours in order to enhance prevention efforts. There is a body of research focussing on risk factors associated with SSHBs. However, protective factors have received less attention within the literature. There is increasing interest in the concept of positive mental health (mental wellbeing) and its contribution to a range of life outcomes(1). However, to our knowledge, no research has examined the relationship between mental wellbeing and SSHBs.
 Goals:
This investigation set out to examine the nature of the relationship between mental wellbeing and SSHBs, within an adolescent population, in order to determine if increased mental wellbeing could represent a potential protective factor for these behaviours.
 Methodology:
15 and 16 year old volunteers (n=1046) from Scottish secondary schools completed a questionnaire battery including questions measuring self-reported self-harm (with and without suicidal intent), mental wellbeing, and demographics. Mental wellbeing was assessed using the short version of the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) which has been validated for adolescents(2).
 Results:
Increased levels of mental wellbeing were associated with lower odds of suicidal (OR: 0.788, 95% CI 0.737-0.842, p<.001) and self-harming behaviour (OR: 0.810, 95% CI 0.775-0.847, p<.001). These associations remained significant when controlling for age and gender.
 Conclusions:
These findings provide novel insights into positive mental well-being as a factor that could potentially protect against the development of SSHBs. Mental wellbeing can be improved and, therefore, may offer a potential modifiable target for interventions seeking to tackle SSHBs.
 References:
1)Herrman H,Saxena S,Moodie R.Promoting mental health:concepts,emerging evidence,practice:a report of the World Health Organization.World Health Organization;2005. 2)Clarke A,Friede T,Putz R,Ashdown J,Martin S,Blake A, et al. Warwick-Edinburgh Mental Well-being Scale (WEMWBS):validated for teenage school students in England and Scotland. BMC Public Health.2011 Jun 21;11(1):487.


(344) PO-344. Examining levels of defeat and entrapment in first-time and repeat episode self-harm

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Kirsten Russell . University of Strathclyde, Glasgow-Scotland
- Susan Rasmussen - Simon C Hunter -

 Introduction:
Defeat and entrapment are predictors of suicidal behaviour. Research grounded within the Integrated Motivational-Volitional Model of Suicidal Behaviour demonstrated that levels of defeat and entrapment do not distinguish between adolescents who have seriously considered self-harm but have not acted on these thoughts and adolescents who have actually engaged in self-harm(1). However, it is unclear whether levels of defeat and entrapment differ between adolescents who report first time and repeat episode self-harm
 Goals:
This investigation aimed to examine whether levels of defeat and entrapment differed between adolescents who had 1)never self-harmed (controls), 2)had self-harmed once only or 3)had a history of repeated self-harm. Previous research demonstrated that adults reporting first-time and repeat episode self-harm differ on levels of defeat and entrapment(2). Young people are particularly vulnerable to self-harm. Therefore, investigating this research question specifically in adolescents is justified.
 Methodology:
15 and 16 year olds (n=1046) from Scottish secondary schools completed a questionnaire battery including questions measuring self-reported self-harm (with and without suicidal intent), entrapment, defeat and demographics.
 Results:
All three participant groups were found to differ significantly in terms of defeat and entrapment. Further analysis revealed that both self-harm groups were significantly higher than controls on both measures. In addition, adolescents reporting repeated episodes of self-harm demonstrated higher levels of defeat and entrapment than those who had harmed themselves on one occasion.
 Conclusions:
These findings extend knowledge and understanding regarding adolescent self-harm and reinforce evidence from previous research highlighting differences in defeat and entrapment between individuals endorsing first-time and repeat episode self-harm.
 References:
1) O'Connor RC,Rasmussen S,Hawton K.Distinguishing adolescents who think about self-harm from those who engage in self-harm.The British Journal of Psychiatry.2012 Apr1;200(4):330-5. 2)Rasmussen SA,Fraser L,Gotz M,MacHale S,Mackie R,Masterton G et al.Elaborating the cry of pain model of suicidality:testing a psychological model in a sample of first‐time and repeat self‐harm patients.British Journal of Clinical Psychology.2010 Mar1;49(1):15-30.


(347) PO-347. Associations between physical behaviour patterns and levels of anxiety and depressive symptoms in middle-aged adults.

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Christina Dillon . NATIONAL SUICIDE RESEARCH FOUNDATION, CORK
-

 Introduction:
Physical activity has been identified as a protective factor against many adverse health outcomes including depression and anxiety.
 Goals:
The aim of this paper is to examine the compositional effects of physical behaviour on mental health.
 Methodology:
Participants were 475 (59.7, SD: 5.5 years) middle-aged adults. Participants wore the wrist GENEActiv accelerometer for 7-consecutive days. Data were summarised into 60s epochs and activity intensity categorised as sedentary behaviour, light or moderate-to-vigorous physical activity (MVPA) based on validated thresholds. Levels of depressive and anxiety symptoms were assessed using the Centre for Epidemiologic Studies Depression (CESD) scale and the Hospital Anxiety and Depression Scale (HADS) respectively. Single, partition and isotemporal substitution models were analysed. Isotemporal substitution examined the associations between replacing 10 minutes/day of sedentary behaviour with equal amounts of light activity and MVPA on levels of depressive and anxiety symptoms.
 Results:
In single model analysis, light activity was negatively associated with levels of anxiety (B=-0.06; 95% Confidence Interval (CI), -0.12 to -0.0002) and depressive symptoms (B=-0.17; 95%CI, -0.34 to -0.006). No significant associations were observed for sedentary behaviour and MVPA (P>0.05). Results of both partition and isotemperol models showed significant negative associations with levels of anxiety when 10 minutes of sedentary behaviour were substituted with 10 minutes of light activity (B=-0.08; 95%CI, -0.16to-0.006 and B=-0.09; 95%CI, -0.16 to -0.009 respectively). No statistically significant associations were observed when sedentary behaviour was replaced with MVPA (P>0.05).
 Conclusions:
Substituting light activity for sedentary behaviour may have positive effects on depressive and anxiety symptoms among middle-aged adults.


(351) PO-351. Demographic and clinical characteristics of the patients treated in psychiatric consult a general hospital for attempted suicide

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Rafael Ángel Baena Mures . Hospital Universitario Clínico San Carlos, Madrid-Spain
- Yolanda Lázaro Pascual - Luis Olivares Gerechter - Diana Gimeno Alvarez - Julia Del Río Vega - Lluis Niell Galmes -

 Introduction:
Introduction Suicide attempt with high lethality have been interacting with certain clinical and demographic factors such as age, sex, psychopathology and adverse events, among others. Patients treated at the psychiatric consult the Clinical Hospital San Carlos de Madrid after an attempt to provide a good sample for the study of these factors. Describe and analyze demographic and clinical characteristics associated with serious suicide attempts as well as the methods used
 Goals:
Describe and analyze demographic and clinical characteristics associated with serious suicide attempts as well as the methods used.
 Methodology:
Naturalistic observational study, descriptive and retrospective cohort on 23 patients admitted during 2014 in various medical or surgical services of a general hospital as a result of injuries from a suicide attempt
 Results:
Total 23 patients, 61% male, mean age 54.1; 60% required ICU; the most common method consisted of multiple drug intake 40%, 30% associated with toxic, mostly alcohol. Predominant summer and diagnosis of adaptive tables (Acute Stress Reaction and T. Adaptive)
 Conclusions:
As is the case with suicides prevails male and summer. As to the most common method has been from medication, both men and women. We were surprised diagnosis of the most common reactions to stress. We conclude that the findings could guide a progressive change in the presuicidal pathology.
 References:
1.Kumar CT, Mohan R, Ranhit G, Chandrasekaran R: Characteristics of high intent suicide attempters admited to a general hospital J Affect Disord 2006, 91(1):77-81 2.Moscicki E: Epidemiology of suicide. In suicide prevention and intervenction: summary of a workshop. Edited by Goldsmith S. Healt IoMoBaB: National Academy Press; 2001


(356) PO-356. Slapping as a parental disciplinary practice, warm parenting, and bullying involvement in early adolescence: a longitudinal cohort study

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Shinya Fujikawa . Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo - Japan
- Shuntaro Ando - Atsushi Nishida - Kiyoto Kasai -

 Introduction:
Bullying involvement causes severe mental health problems such as suicidality (1–3). Risk factors for bullying in early adolescence, when the prevalence of bullying dramatically increases (4), should be identified to potentially prevent or reduce the incidence of bullying. Although certain parenting styles are known to be associated with bullying (5), the association of slapping as a parental disciplinary practice with early adolescent bullying considering warm parenting (WP) is not sufficiently understood. Using data obtained from a cross-sectional survey (the Tokyo Teen Cohort[TTC]-10) of the general population of 10-year-olds, we have found that the slapping was associated with increased odds of early adolescent bullying, regardless of whether WP was present. Then we have obtained data from prospective cohort study of general population of 12-year-olds (TTC-12) subsequent to the baseline survey (TTC-10).
 Goals:
In this study, using the data from TTC, we aimed to investigate the causality between slapping and early adolescent bullying, while considering how WP affected this association.
 Methodology:
The longitudinal data is composed of TTC-10 data and TTC-12 data (n=1,221, boys [51.8%]). The data were collected from both children and their primary parent using self-administered questionnaires and interviews. Categories of involvement with bullying were characterized as pure victims, pure bullies, and bully-victims. Logistic regression analyses were conducted to explore the association of 10-year-olds’ experience of slapping with 12-year-olds’ bullying considering WP.
 Results:
Slapping at 10-year-olds was associated with increased odds of being pure victims (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.04 to 2.02) or bully-victims (OR, 1.9; 95%CI, 1.13 to 3.07) at 12-year-olds, even after adjusting for WP.
 Conclusions:
Slapping as a parental disciplinary practice predicted later bullying experience in early adolescence. Our study suggests that avoiding parental slapping, regardless of WP, would be helpful for bullying prevention in early adolescence.
 References:
1. Klomek AB, Sourander A, Niemelä S, Kumpulainen K, Piha J, Tamminen T, et al. Childhood bullying behaviors as a risk for suicide attempts and completed suicides: a population-based birth cohort study. J Am Acad Child Adolesc Psychiatry. 2009;48:254–61. 2. Winsper C, Lereya T, Zanarini M, Wolke D. Involvement in bullying and suicide-related behavior at 11 years: a prospective birth cohort study. J Am Acad Child Adolesc Psychiatry. 2012;51:271-82. 3. Herba CM, Ferdinand RF, Stijnen T, Veenstra R, Oldehinkel AJ, Ormel J, et al. Victimisation and suicide ideation in the TRAILS study: specific vulnerabilities of victims. J Child Psychol Psychiatry Allied Discip. 2008;49:867–76. 4. Finkelhor D, Ormrod RK, Turner HA. The developmental epidemiology of childhood victimization. J Interpers Violence. 2009;24(5):711–31. 5. Lereya ST, Samara M, Wolke D. Parenting behavior and the risk of becoming a victim and a bully/victim: a meta-analysis study. Child Abus Negl. 2013;37(12):1091–108.


(396) PO-396. No Way Out: The interaction of Entrapment and stress as a Facilitator of Suicide Ideation among Military Personnel

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Yossi Levi-Belz . Ruppin Academic Center, Israel
- Lea Shelef - Eyal Fruchter -

 Introduction:
Suicide is a leading and growing cause of death in the military during peacetime. In recent years, a dramatic rise in suicide and suicidal behavior in several militaries have been reported. However, despite significant efforts in the area only scant knowledge is available regarding the processes and facilitator mechanisms by which military service impacts suicide risk.
 Goals:
The purpose of the present study, which is the first in this field addressing a military service population, was to shed light on the contribution of entrapment as an underlying factor influencing and enabling suicidal thoughts in young adult soldiers, beyond the experience of stress, and beyond known protective factors (problem-solving abilities and social support). Understanding of psychological mechanisms and processes experienced by soldiers prior to developing suicidal thoughts can help mental health professional evaluate the risk of suicidal ideation more accurately and assist in developing appropriate suicide-prevention initiatives in the military setting.
 Methodology:
One hundred sixty-eight soldiers (aged 18-21) comprised three groups: suicide attempters (n = 58); those receiving treatment by a mental health professional, reporting no suicidal behavior (n = 58); and controls (n = 50). all of the participants filled our questionnires tapping the research variables of entrapment, stress, Problem-Solving, Social Support and Suicide ideation.
 Results:
In general, the suicidal group scored higher than the two other groups on stress levels and entrapment, while lower than the other two groups in perceived problem-solving abilities and perceived social support. Moreover, the interaction of stress and entrapment predict suicide ideation beyond stress, protective factors, and entrapment alone.
 Conclusions:
Entrapment is an important predictor of suicide ideation and can serve as a moderator, in that its presence may exacerbate the harsh situation of subjective stress within the military context and intensify it into a suicide risk.


(427) PO-427. Hypocholesterolemia as risk factor of high suicide rate in ICU patients of the Central University Hospital of Asturias

Day: 10 | Time: 13:30 | Room: Poster hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Aitana M. González Álvarez . Área Sanitaria VIII, Langreo, Asturias, Spain
- Lucía Viña Soria - Esther Torío Ojeda -

 Introduction:
Several studies suggest the possibility that the lowering of serum cholesterol concentration could predispose individuals to suicide. The variation of the serum cholesterol concentration could alter the fluidity, viscosity, and function of the neuronal membranes; these changes could be relevant for neurotransmitters like serotonin. Plasma cholesterol could be a sign of suicide behavior predisposition, as its study is available and easy to find in Spanish health centres.
 Goals:
Plan the hypothesis on the relation between the low serum cholesterol concentration and the high-lethality suicide attempts that require hospitalization and ICU medical care.
 Methodology:
Patients who were hospitalized in the Intensive Care Unit of the Central University Hospital of Asturias after a serious suicide attempt and, who accepted through delegation their participation, were included into the study. Sociodemographic clinic data were collected and the evaluation of the suicide behavior using the Lethality Rating Scale and Method attempt coding. A sample of either vein or arterial blood was taken from each patient during the first 24 hours after being checked in in order to measure levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglyceride in the biochemical clinic of CUHA.
 Results:
2 Cases of high-lethality suicide attempts are described (method 5-drawning- and method 7 –defenestration-, with lethality level of 08 and 07, respectively) with a low serum cholesterol count (less than 150 mg/dl).
 Conclusions:
Remarkable data of low serum cholesterol count were found in the initial selection of high-lethality suicide attempts patients, however it is necessary to accurately determine its predictive capacity.


(429) PO-429. Alexithymia as a suicide risk factor among college students: A pilot study

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Psychosocial variables: protective and risk factors. Resilience & vulnerability

Authors:Mark Loftis . Tennessee Technological University, USA
- Derrick L. Edwards -

 Introduction:
Suicide is one of the leading causes of death in college students in the United States. Alexithymia has been associated with increased risk of suicide in clinical populations. Few studies have examined the possible relationship between Alexithymia and suicide risk in nonclinical populations, specifically among college students.
 Methodology:
A sample of 114 college students from a public university in Southeastern United States participated in the study via a web-based survey. The Suicide Behaviors Questionnaire – Revised SBQ-R), the Toronto Alexithymia Scale – 20, (TAS-20), the Adverse Childhood Experiences Scale (ACES), and the Ego Resilience Scale (ERS) were used in the study.
 Results:
The majority of the participants were females (68.4%) and Caucasian (85%). Average age of participants across gender classification was 20.7 (SD = 4.7) years. Past suicidal behaviors including planning (n = 20), disclosing a suicide plan (n = 24), and actual suicide attempts (n = 6), were reported by the participants. Using the SBQ-R, 37% (n = 48) of participants were considered at risk for suicidal behaviors. Average alexithymia scores of the current sample (M = 47.44) were consistent with the validation sample and are within the “non-alexithymia” range. Also, ego-resiliency scores (M = 41.86) indicated the current sample had high resiliency traits. As expected, a positive correlation was found between alexithymia and suicide risk. Alexithymia was also significantly, yet negatively correlated, with ego-resiliency. Additionally, no relationship was found between alexithymia and adverse childhood experiences. Ego-resiliency was negatively correlated with adverse childhood experiences, but not a significant predictor of suicide-risk. However, adverse childhood experiences were a significantly correlated with suicide risk. Lastly, when loaded into a regression model, alexithymia and adverse childhood experiences account for 25% of suicide risk variance.
 Conclusions:
The preliminary results of the current study are promising and support further inquiry. Understanding the historical and emotional factors that help predict suicide risk could identify individuals in need of intervention prior to a suicide attempt. Screening for alexithymia and adverse childhood experiences should become standard practice when assessing for risk of suicide.
 References:
Centers for Disease Control and Prevention (2007). Web-based injury statistics query reporting system (WISQARS). Retrieved from www.cdc.gov/injury/wisqars/pdf/ Death_by_age_2007-BW-a.pdf.

Evren, C. & Evren B. (2006). The relationship of suicide attempt history with childhood
abuse, neglect, alexithymia and temperament and character dimensions of
personality in substance dependence. NORD Journal of Psychiatry, 60, 263-269.
doi10.1080/08039480600790051.




Testing the effectiveness of prevention strategies


(83) PO-83. Inpatient Programs for the Prevention of Suicide: Brief Review of Scientific Literature & Recommendations

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Testing the effectiveness of prevention strategies

Authors:Marjan Ghahramanlou-Holloway . Uniformed Services University of the Health Sciences, Bethesda - Maryland
-

 Introduction:
Psychiatric hospitalizations, in many countries, are a standard approach in managing suicidal patients identified to be at imminent risk for suicide. Most often, the hospitalization setting may provide a
safe and supportive environment for specialty acute care services and stabilization of a suicidal patient. Yet to date, the majority of interventions that are delivered to suicidal patients during this sensitive
timeframe, within the United States, do not directly target suicide risk. This presentation will provide a brief review of inpatient-based scientific literature in order to best highlight evidence-based or evidence-informed strategies for suicide prevention. Interventions including Post Admission Cognitive Therapy (PACT), Collaborative Assessment and Management of Suicidality at Menninger (CAMS-M), Safety Planning, and Teachable Moment Brief Intervention (TMBI) will be very briefly described to highlight innovative strategies for targeting the needs of psychiatrically hospitalized suicidal individuals. We hope that this presentation will allow an opportunity for further dialogue about psychiatric inpatient care for suicidal patients across various countries and some of the best practices for reducing the recurrence of suicidal behaviors post hospital discharge.


(147) PO-147. Suicide rates among 200 patients with severe schizophrenia undergoing community based treatment for 7 years in Spain.

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Testing the effectiveness of prevention strategies

Authors:Juan J. Fernandez-Miranda . AGC SM -V-SESPA, Gijon-Spain
- Silvia Diaz-Fernandez -

 Introduction:
Adherence to treatment of people with severe schizophrenia is important to reach clinical and rehabilitation goals and to prevent suicidal behaviour.
 Goals:
The purpose of this study was to know the retention in treatment (and reasons for discharge) of people with severe schizophrenia enrolled in a specific programme for them, and also suicide rates.
 Methodology:
A 7-year prospective, observational, open-label and not randomized study of patients with severe schizophrenia (CIE 10: F 20; CGI>=5) undergoing specific severe mental illness program, community based. The study was conducted from September 2008 to September 2015 in Gijón (Spain). (N=200; average age=43.1+/-10.6 years old; 58% men and 42% women). Assessment included the Clinical Global Impression severity scale (CGI-S) and the WHO Disability Assessment Schedule (WHO-DAS). Time in treatment and reasons of discharge were measured, including deaths by suicide.
 Results:
CGI-S at baseline was 5.86+/-0.7. After seven years 46% of patients continued under treatment (CGI-S= 4.2 (0.9); p<0.01); 33% were medical discharged (CGI=3.5 (1.5); p<0.001) and continued non intensive treatment in mental health units; DAS also decreased in the four areas (self-care and employment p<0.01; family and social p<0.005); 7% had moved to other places, continuing treatment there; 10% were voluntary discharges. Ten patients dead during the follow up; four of them committed suicide (2%).
 Conclusions:
Retention of patients with severe schizophrenia in a specific programme, comprehensive and community based, was really high and seemed to be useful to decrease the high rates of suicide among them.
 References:
Brown S et al. 25 year mortality of a community cohort with schizophrenia. Br J Psychiatry 2010. 196: 116-121.
Palmer BA, Pankratz VS, Bostwick JM. The lifetime risk of suicide in schizophrenia: a reexamination. Arch Gen Psychiatry 2005. 62: 247-253.


(152) PO-152. In Reflection Workshops impact on high schoolers? attitudes towards people with mental disorders

Day: 10 | Time: 13:30 | Room: Poster Hall

Topic: Testing the effectiveness of prevention strategies

Authors:Sasa Kocijancic . Medical faculty, University of Ljubljana, Ljubljana, Slovenia
- Anja Plot - Peter Pregelj - Vesna Svab -

 Introduction:
Project named In reflection is a non-profit non-governmental project of Slovenian medical student organisation ? SloMSIC Ljubljana. Its workshops are conducted by medical students and are designed to address and reduce taboos and stigma attached to mental disorders, self-harm and suicide among high schoolers.
 Goals:
The goal was to evaluate the effect of the workshop on high schoolers? attitudes towards mental disorders. Improvement of attitudes towards reduced discrimination scores was expected.
 Methodology:
Workshops of the project In reflection are conducted by two medical students in classrooms of approx. 30 high schoolers and last 2 school hours. Peer to peer method is being used to educate participants on the topic of stigma and mental disorders. We handed out a questionnaire to determine their level of acceptance and negative attitudes towards mental disorders (created by Wolff G.) before and after the workshop in 6 different high schools in Slovenia (539 high schoolers participated, aged between 14?19 in the course of 6 months). Standard paired T-test was used.
 Results:
A total of 486 out of 539 high schoolers responded (90% response rate) before and 425 after the workshop (78,9%). Two age groups were analysed separately: high schoolers aged from 14?16 and from 17?19. The younger groups? attitudes changed positively in 8 out of 10 questions, out of which in 5 questions there was a significant difference (P<0.05). The older groups attitudes changed positively in 8 out of 10 questions, out of which 5 had a significant difference (P<0.05).
 Conclusions:
In reflection workshops of SloMSIC improved attitudes of high schoolers towards people with mental disorders. There was no variation between age groups, the effect was the same in both.
 References:
Wolff G, Pathare S, Craig T, Leff J. Community knowledge of mental illness and reaction to mentally ill people. The British Journal of Psychiatry. 1996 Feb;168(2):191?198.
Pinfold V, Toulmin H, Thornicroft G, et al. Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools. The British Journal of Psychiatry. 2003 Apr;182(4):342?346.
Yoshioka K, Reavley NJ, MacKinnon AJ, Jorm AF. Stigmatising attitudes towards people with mental disorders: results from a survey of Japanese high school students. Psychiatry Res. 2014 Jan;215(1):229?36.
Serra M, Lai A, Buizza C, et al. Beliefs and attitudes among Italian high school students toward people with severe mental disorders. J Nerv Ment Dis. 2013 Apr;201(4):311?8.


(179) PO-179. The suicide and depression prevention strategies in Taiwan

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Testing the effectiveness of prevention strategies

Authors:Ya-hsing Yeh . John Tung Foundation, Taipei City-Taiwan
- Chia-chen Chan - I-chun Tai - Li-ting Li - Bing-ting Hsieh - Ming-chieh Lin -

 Introduction:
To introduce the prevention strategies and current situation regarding suicide and depression prevention in Taiwan.
 Goals:
To explain the correlation between suicide prevention and depression prevention through the promotion of suicide prevention strategy and the data information of Taiwan’s suicide population, and introduce different ways of promoting the suicide prevention and their influences.
 Methodology:
By means of using keywords and electronic media database to collect research data.
 Results:
1. In 2014, there were 3,546 deaths by suicide in Taiwan; the suicide rate of male is higher than that of female. In addition, the suicide rate increased along with ages. 2. In Taiwan, there are around 1.245 million people suffering from emotional problems, and 13.2% of them had attempted suicide. 3. There are over 60 organizations in Taiwan engaging in suicide prevention together with mental health promotion. To remind the public to be aware of their and other’s own emotions, and to face it in positive attitude. 4. The suicide rate in Taiwan has been gradually decreasing since 2007, and it dropped out from the top ten leading causes of death in Taiwan for five years in a row since 2010.
 Conclusions:
1. Depression has a high correlation with suicidal behaviors. 2. To promote the public to consider suicide prevention as a basic knowledge.


(343) PO-343. Connecting with the suicidal mind. Finding the right words in crisis calls.

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Testing the effectiveness of prevention strategies

Authors:Nanouschka Verhamme . ,
- Ekke Muijzers -

 Introduction:
Started in 1979 with a suicide prevention helpline, the Flemish Centre for Suicide Prevention gained solid experience handling crisis calls. Each year the centre answers thousands of crisis calls from individuals considering suicide. Reaching a state of calmness and installing safety can be challenging in these calls with high suicidal intent. Key is to balance between showing empathy and compassion on the one hand and addressing the reasons for living on the other. In crisis calls this is often walking a fine line.
 Goals:
Based on literature and experience, a model has been established in order to train volunteers in answering crisis calls.
 Results:
The model, involving the importance of basic attitudes, risk assessment, the meaning and ambivalence of the suicide, reasons for living and coping will briefly be discussed. By use of fictional transcripts it will be illustrated how to connect to the suicidal ‘mindset’. It will be shown how crisis conversations with seemingly little perspective can be approached by using the right words to find the right tone of voice.
 Conclusions:
Focus lays on small instructions to gain more confidence in handling crisis conversations.


(377) PO-377. Analysis of the role of bullying as a suicide risk factor

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Testing the effectiveness of prevention strategies

Authors:Nuria Machin . Skylark Health Research Ltd, Halesworth - United Kingdom
-

 Introduction:
The aim of this study is to present an analysis of the role of bullying as a suicide risk factor, based on the data obtained from results from an EC Funded Project (SUPREME) which included suicide prevention intervention studies in Estonia, Italy, Hungary, Lithuania, Spain, Sweden and UK
 Goals:
To explore the Supreme dataset obtained from the SUPREME European partners respondents involved in bullying as a victim and as an aggressor, -To analyse the cross sectional data and to use the longitudinal data to explore the impact of the Supreme intervention of those being bullied / those who bully
 Methodology:
A randomised controlled trial was designed to test a web-based suicide prevention intervention which communicated information and sources of support. The intervention was conducted over six months ending in 2013. A questionnaire was designed to identify suicidal ideation, anxiety, stress and depression levels, (DASS-42) and Paykel Suicide Scale. Data from all countries’ participants (n=2286) from the baseline database, and (n=1575) from the longitudinal study database was collected to examine relationships based on sociodemographic characteristics , risky behaviours (drugs, substance abuse, involvement in bullying )and internet use
 Results:
Preliminary findings suggest adolescents who and those who are bullied or bully others are at an increased risk of suffering mental health problems and suicidal ideation in most countries. study has been used to investigate associations between bullying, being bullied and other risk factors associated with suicidal behaviour. Adolescents who are being bullied are at an increased risk of feelings of depression, anxiety and stress (p<0.001) and suicidal thoughts (p <0.001) and a high suicide risk in some countries
 Conclusions:
Preliminary results suggest consistency with research findings(1,2,3,). Adolescents who are involved in bullying are at a heightened risk of suicide. The role of depression is also discussed, as a mediator as some studies (4) show stress indicates strong association as a mediator between bullying/victimization and suicide attempts, but differently for males and females
 References:
(1) Espelage DL, Holt MK, Suicidal Ideation and School Bullying Experiences After Controlling for Depression and Deliquency, Journal of Adolescent Health, Journal of Adolescent Health 53 (2013) S27eS31 (2)Borowsky IW et al, Suicidal Thinking and Behavior Among Youth Involved in Verbal and Social Bullying: Risk and Protective Factors, Journal of Adolescent Health 53 (2013) S4eS12, http://dx.doi.org/10.1016/j.jadohealth.2012.10.280 (3) Bauman S1, Toomey RB, Walker JL.Associations among bullying, cyberbulling and suicide in high school students, Journal of Adolescence2013 Apr;36(2):341-50. doi: 10.1016/j.adolescence.2012.12.001. Epub 2013 Jan 16.