Systemic sclerosis (SSc) is a chronic, multisystem disease of unknown etiology characterized by autoimmune inflammation, abnormalities in small blood vessels, and progressive fibrosis of the skin and visceral organs. Mental disorders (MD), especially depression, occur quite often with SSc. The influence of childhood experience, relations’ traumatic events with SSc and MD, and MD's clinical specific have not investigated carefully still. The investigation has been realized in accordance with the interdisciplinary program “stress factors and mental disorders in auto-immune inflammatory rheumatic diseases”.

Sixty SSc patients (4 male and 56 female mean age 49.9 ± 13.5) were included. ICD-10 criteria were used for MD semi-structured interview. The stress factors were analyzed with the specially elaborated scale. The cognitive disorders and their severity were diagnosed by neuropsychology tests.

Early traumatic childhood experiences (parental deprivation mainly) observed in 90% cases. The significant stress factors were preceded SSc symptoms in 80% and MD in 70% cases. Most patients self-reported connection between stressful life events and exacerbation of SSc. MD preceded SSc in 76.6% cases. MD were diagnosed in 48 (80%) SSc patients: depressive episode (mild, moderate) − 26.6%, recurrent depressive disorder − 16.6%, dysthymia – 23.3%, adjustment disorder − 6.6% and schizotypal disorder – 40%. The mild or moderate cognitive impairments were diagnosed in all MD cases.

Individual history of stressful life events is important factor for the predisposition and provocation of the rheumatic disease and MD in SSc patients. Depressive, schizotypal and cognitive disorders are the common MD in SSc patients.

The authors have not supplied their declaration of competing interest.

Germany has always been an important host country for traumatized refugees and asylum seekers. Although, recently an increasing number of investigations about mental health of individual migrant groups have been published in Germany, there is a paucity of research concerning mental health of asylum seekers and refugees.

To investigate socio-demographic and clinical characteristics of traumatized refugees-asylum seekers who were applied to an outpatient psychiatry clinic in Germany.

A standardized data collection form (socio-demographics, diagnosis, suicidality, etc.) was filled by therapists for each traumatized refugee-asylum seeker who was applied to outpatient clinic of Klinikum Wahrendorff-Centre of Transcultural Psychiatry between April 2013 and October 2015.

Fifty-eight traumatized refugees-asylum seekers (F/M = 27/31, age: 34.7 ± 1.4) were assessed. 53 (91.4%) of them were assessed via interpreters. Thirty (51.7%) of them were staying in refugee-dormitories, 25 (43.1%) of them were living alone. They’ve been living in Germany for 19.9 ± 16 months (min: 1–max: 82). Psychiatric symptoms appeared before 29.9 ± 19 months. Time to reach to psychiatric care in Germany was 14.2 ± 11 months. Psychiatric diagnoses were posttraumatic stress disorder (PTSD): 12 (21%), depression + PTSD: 44 (76%), depression: 2 (3%). Fifty-three (91.4%) of them had suicidal ideation and 16 (27.6%) of them had at least one suicide attempt before.

Traumatized refugees in this study have high rates of suicidal ideation and suicide attempts and it takes months to years for them to reach a psychiatric care. Therefore, strategies should be developed for early detection of PTSD symptoms in traumatized refugees and access barriers to reach a psychiatric care should be overcome.

The authors have not supplied their declaration of competing interest.

Sleep paralysis (SP) is relatively frequent condition, occurring either at sleep onset or sleep offset. It occurs at least once in a lifetime in 40–50% of normal subjects. During SP, the patient experiences gross motor paralysis, while the sensory system is clear. Hypnogogic and hypnopompic hallucinations are common. This experience might be interpreted as a spiritual phenomenon in several cultures, each one with different interpretations and attributions.

The authors revisit the clinical presentation of sleep paralysis and how this sleep disorder is seen from a cultural perspective.

To describe several cultural interpretations of SP.

A literature review of the theme is shortly surveyed.

It is very common during an episode of SP sensing the presence of menacing intruders in one's bedroom. Supernatural accounts of this hallucinated intruder are common across cultures. It has been traditionally labeled “ghost oppression” among the Chinese. In the Abruzzo region (Italy), the supernatural interpretation of the phenomena is called the Pandafeche attack. One study found that nearly half (48%) of the participants from the general Egyptian population believed their SP to be caused by the Jinn, a spirit-like creature. In Southwest Nigeria, Ogun Oru is a traditional explanation for nocturnal neuropsychiatric disturbances. The characteristics of the ‘a dead body climbed on top of me’ phenomenon suggest that is identical to sleep paralysis and a frequent experience among Mexican adolescents.

Depending on the etiological interpretations of SP, which is largely culturally determined, patients react to the event in specific ways.

The authors have not supplied their declaration of competing interest.

To determine the frequency of marital adjustment in patients with depression.

Depressed patients, who were aged between 15–65 were included. Patients who had documented co morbid of substance use or any unstable serious general medical condition were excluded. The severity of depression was evaluated by using Urdu validated Hamilton Depression Rating Scale. Marital adjustment is determined by using Urdu validated version of Kansas Marital Satisfaction Scale.

Only 8.6% were well adjusted in their marital life, and all were females. The association of marital adjustment and severity of depression and difference in both genders on KANSAS was insignificant. The longer duration of illness was positively interrelated to the marital adjustment with odd ratio of 7.6. Being employed and above 30 years of age were inversely related to marital satisfaction with odd ratio of 6.1 and 5.4 respectively. However, the correlation between other independent variables and marital adjustment were insignificant in both genders.

This study confirms the presence of high frequency i.e. 91.4% of marital dissatisfaction in depression in both male and females, irrespective of their severity of depression.

The author has not supplied their declaration of competing interest.

Psychotic symptoms in the Egyptian community have always been mixed up with supernatural phenomena. This makes patients and their families seek help from traditional healers who can abuse them physically, financially and sexually.

The aim of the study was to assess the impact of the traditional healers on the psychotic patients in the Egyptian community.

To measure the percentage of patients going to traditional healers and how much they pay and for how long.

The study was conducted on a total of 555 psychotic patients. Four hundred and fifty-five psychotic patients from the Mamoura Mental state Hospital and 100 psychotic patients from a private hospital in Alexandria in duration of three months in 2006. A special questionnaire was designed and was run for all patients and their families.

A total of 67.4% of male patients consulted healers while 88.4% of the females consulted healers. Only 9.4% of the females who went to the healers were highly educated compared to 19.7% of the male patients. The majority of the patients who improved were illiterate or can only read and write. Lower socioeconomic groups tend to have a higher percentage in consulting healers and a longer duration of staying in treatment with them. Although therapy at the first session tended to be for free, from the second session forward patients pay more than they would pay seeing a psychiatrist.

Traditional healers have a negative impact on the psychiatry practice and are sources of patient's abuse in Egypt.

The author has not supplied their declaration of competing interest.

There is a lack of evidence regarding which kind of psychotherapy that is the most effective when treating traumatized refugees. Studies on the effect of psychotherapy among other patient groups with PTSD suggest a good effect using cognitive behavioural therapy (CBT). The competence center for transcultural psychiatry (CTP) has specialized in the treatment of traumatized refugees. The objectives were to study the effect of CBT with a focus on either stress management or cognitive restructuring in a clinical sample of traumatized refugees with PTSD and to identify predictors for the treatment effect.

All patients (n = 143) referred to CTP from June 2011–March 2012 and fulfilling the inclusion criteria were offered to participate in the study. Participants were offered combined treatment with a psychiatrist (psycho-education and psychopharmacological treatment when needed) and a psychologist (CBT). The duration of the treatment was 6–7 months. The participants were randomized to either CBT with a focus on stress management or cbt with focus on cognitive restructuring. The primary outcome was PTSD measured by the Harvard Trauma Questionnaire.

The results are presently being analyzed and will be presented at the congress.

Both research results and the clinical experience at CTP suggest, that cognitive restructuring is not always a useful tool and that stress reducing techniques could be more useful. This hypothesis was tested in the present study.

The authors have not supplied their declaration of competing interest.

Today we lack sufficient evidence to conclude which type of treatment approach that is most efficient when it comes to trauma-affected refugees. That is a problem for both patients and doctors as well as for society. Also there is a lack of studies, which examine the relation between psychosocial resources and treatment efficiency, in order to find reliable predictors of treatment outcome. This study therefore aims to produce new evidence within this field in order to optimise treatment for trauma-affected refugees with complex PTSD.

The study included 207 patients referred to Competence Centre for Transcultural Psychiatry between April 2012 and September 2013. Patients were randomised into one of the two treatment groups: a sertraline group (n = 109) or a venlafaxine group (n = 98). Patients in both groups received the same manual based cognitive behavioural therapy, specially adapted to this group of patients. The trial endpoints were PTSD-and depression symptoms and social functioning, all measured on validated ratings scales. Furthermore the study examined the relation between expected outcome of treatment from a range of predictors and the relation to the treatment results for the individual patient.

Data are presently being analysed and results will be ready for the conference.

The study is among the largest randomised studies ever conducted on pharmacological treatment among traumatised refugees. It is expected to bring forward new knowledge about clinical evaluation and medical treatment of traumatised refugees.

The authors have not supplied their declaration of competing interest.

Stigma and discrimination experienced by persons suffering from mental illness, unlike other medical conditions, recognized as a barrier in countries rich and poor, and in countries with well-developed mental health services and those with limited services. It was hypothesized that depression may affect patients’ attitude towards mental illness “public stigma” as well as self-stigmatization and that there will be a difference between Egyptians and Germans.

This study sets out to identify and compare public–and self-stigma among depressed women in two different communities.

To test findings from transcultural comparative study of two patient groups of depressed women from two different communities. Participants were 50 adult females diagnosed with depression from Egypt and Germany.

Participants completed after clinical interviewing and diagnosis with depression two questionnaires: the inventory of attitude towards mental illness (Shokeer, 2002) and the explanatory model interview catalogue EMIC (Weis et al., 2001).

Analysis indicates that positive attitudes towards mental illness were more for the German respondents than for the Egyptians. There were significant differences between the two groups in the causal attributions of mental illness. Psychotherapy was widely accepted in the two groups as a helpful method for treatment of mental illness.

It was concluded that the traditional beliefs affect the understanding of illness causality and that the subjective experience of depression may affect attitude towards mental illness and mentally ill people. The effect of the social desirability is discussed.

The authors have not supplied their declaration of competing interest.

The concept of psychogenic psychosis was introduced by Wimmer in 1916 and subsequently extended by Strömgren in the mid twentieth century. It typically describes a polymorphic psychotic episode of abrupt onset and which follows a trauma or stressful life situation. The duration of the episode is usually brief and remission occurs ad integrum. In recent decades, the notion has fallen into disuse in clinical psychiatry and international classifications. This could be due to a general improvement in living conditions, with less exposure to traumatic situations.

We intend to study the characteristics of psychogenic psychosis in immigrants. We believe that the condition could be observed better in this population, given their greater vulnerability to trauma. For this purpose, we chose a sample of Romanian patients, who nevertheless have considerable cultural affinity with the Spanish population.

We collected the clinical and biographical data of four cases of psychogenic psychosis admitted to our clinic between 2012 and 2015.

Four Romanian women aged 25 to 42 were diagnosed with psychogenic psychosis in this period. Mean length of hospitalization was 5, 0 days. All patients reported familiar or occupational stress prior to the onset of symptoms. Psychotic symptoms remitted quickly with low doses of medication, despite being initially intense.

Reported cases fit remarkably well with the original description of Wimmer. The concept of psychogenic psychosis, along with similar brief psychotic entities, could be useful in describing the psychopathology derived from new social models and crises.

The authors have not supplied their declaration of competing interest.

Psychotic symptoms occur in a variety of psychiatric disorders and medical conditions. In addition, a significant proportion of the general population reports history of psychotic symptoms in the apparent absence of a psychiatric disorder. Reviewed literature suggests that Latino patients report certain forms of visual and auditory hallucinations without other indications of psychotic illness. In addition, it is common that some individuals with diverse religious or cultural backgrounds may present with psychotic transient experiences, which can be culturally normative.

To determine the prevalence of hallucinations and describe the nature of hallucinatory experiences in relation to cultural belief in Latino and non-Latino psychiatric outpatients.

We conducted a retrospective case control study of 146 patients who were admitted to the outpatient psychiatric clinic for a period of ten months. We assessed clinical characteristics of these patients and reviewed the extended mental status examination, which contained questions about various form of hallucinations and spiritual experiences. This poster will explore the prevalence of hallucinations in the Latino population and determine the percentage of patients with a diagnosis of psychotic illness. A discussion of the phenomenological hallucinatory experiences and its relationship to cultural beliefs in the Latino psychiatric patients will also be presented.

Psychotic symptoms present differently across cultures. The Latino population is most likely to have psychotic like symptoms related to their cultural beliefs. Clinicians must understand the diverse cultural experiences and beliefs of the patients they work with to prevent misdiagnosis of culturally normative experiences.

The authors have not supplied their declaration of competing interest.

Unemployment is common in persons with severe mental illness (SMI) and more in Latino population. Department of Mental Health and Addiction Services (DMHAS) of Connecticut offers a supported employment (SE) Program to help clients get competitive work in integrated settings with nondisabled workers in the community.

Capture perspectives of key informant groups to describe barriers for linking Latinos with SMI to employment and adapt SE Services for subpopulations.

Four focus groups were conducted (employment specialists, case managers and peer support counselors/employers/two with clients-one in Spanish and other in English). They were conducted during January-February 2015, 70–90 minutes each one. A question guide was developed for each group. Participants per focus group ranged from 3–10, voluntarily. Two new questionnaires to the baseline pack were developed: challenges to Employment Assessment–provider and client version.

Thirty individuals participated. Several barriers to employment were reported. Clients and staff reported criminal record, lack of employment history and lack of motivation. Staff described client hygiene, mental status, physical health, substance abuse and discrimination. Clients, staff and employers reported language barrier for Latinos who don’t speak English. Non-adherence to medication was reported by clients and employers. About Spanish-Speaking Latinos with mental illness, medication, discrimination, previous abuse by employers, inappropriate employment, difficulties of the job interview and computer skills appeared as challenges. English-Speaking Latinos with mental illness identified transport, stability, support, keeping apartment and financial needs.

Focus groups can help in knowledge about the diversity of Latino communities to improve SE Services and outcomes for Latinos.

The authors have not supplied their declaration of competing interest.

In the past 50 years, the continent of Africa has witnessed major conflicts ranging from civil wars and liberation wars to chaos from failed States. Increasingly in these political upheavals, kidnapping and abductions of women and young persons have become more prominent.

In this paper the consequences of political upheavals will be discussed. For the community there are economic, political and social disruptions. For the individuals there are family disruptions and improvements. For the abducted and kidnapped individuals there are physical, psychological and cognitive impairments, as well as consequences of sexual injuries.

There is controversy as to prevention, reduction, and management of young victims of war and conflicts. Some workers have suggested that:

–the imposition of peace agreements by foreign powers may not be strictly relevant to the parties engaged in the conflicts;

–culturally appropriate rituals have efficiency in the readjustment of boy soldiers and abducted girls. Nevertheless the guidelines suggested in international disagreements provide a basis for there adjustment of young war conflict victims.

–Traditional healing rituals have a place in the healing and reintegration in person's abduction in post conflict situations.

– Community approaches are superior to individual approaches.

The author has not supplied their declaration of competing interest.

Due to constant flow of people in and out of Europe several drugs are now days appearing in European markets that were previously unknown. There is a need to gain awareness and knowledge about these new substances and to recognize their use and learn about their effects and management.

Ayahuascais commonly called yagé is a traditional spiritual medicine in ceremonies among the Indigenous peoples of Amazonian Peru. It is undetected in urine or blood and therefore it is important to understand and ask about its usage during clinical assessment.

Thirty-six years old woman immigrant from South America came to us with auditory hallucinations. About three years ago she was introduced who introduced her to a community of Euto poeple that performed daily rituals of spiritual awareness involving the use of Ayahuasca. She became a part of it and started consuming Ayahuasca daily. She started becoming socially isolated accompanied by delusional and mystical religious ideations. She later began having persecutory delusions and auditory hallucinations that Archangels speak to her about how to create music. Patient was involuntary admitted in a mental health unit and started on risperidone. Gradually her condition improved and she stopped having auditory hallucinations. After being discharged from the hospital, patient was followed on an outpatient basis with injectable risperidone.

Due to the blend of different cultures in Europe, it is necessary to have a better understanding about the cultures, rituals and the substances that are relatively new and are currently been used.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The author has not supplied his declaration of competing interest.

The author has not supplied his declaration of competing interest.

Utilization of E.C.T. has diminished since the middle of 20th century but, inspite of widespread use of pharmacological agents for treatment of major psychiatric disorders, E.C.T. is still treatment of choice for patients with severe suicidal symptoms, catatonia and diseases resistant to various pharmacological agents. But inspite of its excellent effect in various psychiatric disorders, acceptance of E.C.T. is very poor in society.

Objective of this study was to know the attitude of attendants for E.C.T. and acceptance after detailed description of procedure and discussing merits and demerits of E.C.T.

As still it is the best treatment for certain psychiatric disorders, so to increase the awareness about its benefits and try to remove the negativity regarding E.C.T. in society.

In this study, 61 patients were randomly selected who had indication for E.C.T. without any discrimination of male and female. Their attendants were categorized by their socioeconomic status. All the attendants were asked open questions regarding their opinion for E.C.T. before taking consent.

Sixty patients were selected who had indication for E.C.T. and their attendants were asked to give their opinion for E.C.T. Amongst them 9.84% were from upper socioeconomic status, 68.86% were from middle socioeconomic status and 21.31% were from lower socioeconomic status. Only 11.48% had a positive attitude, 75.40% had a negative attitude and 16.39% had no comments.

After developing good rapport and confidence with attendants and detailed explanation of E.C.T. procedure, its merits and demerits 75.40% had given a positive attitude, 22.95% had given negative attitude and still 1.64% had no comments.

The author has not supplied his declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Auditory hallucinations are perceptional experiments that occur in schizophrenia, schizoaffective disorder and bipolar disorder with psychotic features. Characteristic of these hallucinations may have relation with cultural factors.

We have done this study to understand more about content and characteristic of auditory hallucinations in Schizophrenia, schizoaffective and bipolar disorder with psychotic features in Qazvin, a state in north-center of Iran.

We used the questionnaire that prof. Romme and Escher developed in 1987 for research purposes. Sixty patients diagnosed with schizophrenia, schizoaffective and bipolar disorder with psychotic features that admitted or attended at clinic of Qazvin medical science university hospital, psychiatry ward, were interviewed.

The 45 men and 15 women in three groups were interviewed. The most were men, single, and in fourth decade of their life. Most patients mentioned that they heard one voice. Mean age of appearing voices in patients were 19 to 29 years old. Most patients in the schizoaffective and bipolar group heard male voices and in schizophrenia were both sexes. Eighty-five percent of bipolar patients, 65% of patients with schizoaffective disorder heard friendly voices. It was 30% in patients with schizophrenia. Fifteen percent of bipolar patients, 75% of schizophrenia and 45% of schizoaffective stated that voice was hostile.

Our study has revealed that culture affected content and characteristic of auditory hallucinations. We suggested that some complementary studies will be done in future from different Iranian cultures not just people of Qazvin.

The authors have not supplied their declaration of competing interest.

It has been widely recognized that DM can result in psychological, social and physical problems. Parents of children with DM are likely to be highly distressed.

The study of the relationship between mood status of children with type I DM and some factors that might be implicated in its determination.

To evaluate the presence and degree of depression in a sample of children with type I diabetes and how much it might be affected by their metabolic control and the level of their parents’ stress.

Ninety-three children were diagnosed with DM type I. They were clinically interviewed and examined. They went through Childhood Depression Rating Scale (CDI), Family Attitudes Questionnaire and HbA1c% assessment. An age and sex matched control group was taken.

The age range of diabetic children was 7–18 and two thirds of them were females. Thirty-five patients (37.6%) were depressed according to CDI results. Diabetic children had significantly higher CDI total score and total parenting stress index (PSI) compared to the control group. CDI total score was positively and significantly correlated with indicators of poor diabetes control (frequency of DKA and HbA1C%) and with duration of diabetic illness. CDI total score was also positively and significantly correlated with PSI score.

Depression was highly present in this sample of diabetic children. The degree of their mood impairment was positively correlated with duration of diabetic illness, indicators of poor metabolic control of DM and to the level of their parents’ stress.

The authors have not supplied their declaration of competing interest.