The aim of this study was to monitor the use of electroconvulsive therapy (ECT) in the Czech Republic for the purpose of harmonizing national practice.

A 13-item questionnaire was sent to all Czech inpatient psychiatric facilities. This questionnaire assessed technical background of ECT, indications for the treatment, procedure in detail, way of documentation and monitoring of side effects.

ECT is used 23 centers (10 psychiatric hospitals, 5 university psychiatric departments and 8 psychiatric wards) across the Czech Republic. There is no special legal act regulating the use of ECT in the CR, but there are guidelines issued by the Czech Psychiatric Society available. All centers use instruments delivering brief pulse stimuli. All patients have to be indicated for this treatment and have to sign inform consent form/excluding situation when patient's life is endangered/. Somatic state is assessed/EKG, blood tests, eye check-up regularly and other examinations in individual cases/. Thiopenthal and succinylcholine are used most often for anesthesia and myorelaxation. Bitemporal electrode placement is the preferred option in all centers. The ECT is provided 2–4 times a week in special ECT rooms in the presence of staff team/psychiatrist, anesthetist, psychiatric and anesthesiological nurses/. Continuation ECT and outpatient ECT is not used. The procedure including side effects is documented in individual patient's documentation, but summarizing documentation is conducted only in some centers.

ECT is widely used in the Czech Republic. Procedures in all centers follow national guidelines. There is need to improve documentation system to harmonize national practice.

The authors have not supplied their declaration of competing interest.

To find out how the use of ECT in psychiatry is perceived by the public in the Czech Republic.

The questionnaire (8 questions monitoring awareness, knowledge of ECT and its use in modern psychiatry) created for the purpose of this study was shared through internet and also distributed in paper version to public.

The sample consists of 365 respondents – age average 28.9 years, 62% of females, 53% of university graduates, 44% with secondary education, 3% other education, 27% of healthcare professionals outside the field of psychiatry, 20% of medical students before the start of the traineeship at psychiatry, 53% of the public. Among the respondents, 98% have heard about ECT, 7% of them think that ECT is no longer used. Among the respondents, 62% learned about ECT from the media (film, print). Among the respondents, 22% do not believe in the effectiveness of ECT, 30% think that ECT is abused by psychiatrists, 86% believe that ECT has side effects (personality changes, permanent memory disorders, brain damage, epilepsy). Among the respondents, 77% would agree with ECT, if it should be applied to their relative.

ECT is an effective method in treating of severe mental disorders. But until now the public view is influenced by media. Due to the negative stereotype of the method many people are afraid of this treatment. The interesting fact is that also health professionals and medical students are influenced by public stigma of ECT.

The authors have not supplied their declaration of competing interest.

The finding of prefrontal dysfunction in schizophrenia patients with negative symptoms (NS) has raised interest in using transcranial magnetic stimulation (TMS), which can modulate prefrontal function and dopamine release, as potential treatment for NS.

To briefly review current literature concerning the use of TMS as treatment for NS.

To assess whether current evidence supports the use of TMS for NS.

Narrative review of articles found through a PubMed database search using the keywords “transcranial magnetic stimulation”, “schizophrenia”, and “negative symptoms” between 1998 and 2015.

Up to date, reviews of randomized sham-controlled studies found positive effects of TMS in NS. However, they exposed several methodological difficulties. More recent studies, reviewed in this poster, tried to overcome these, using results from multiple centers, larger samples and blinding. Various TMS techniques were studied, differing in frequency, motor threshold (MT), stimulus location, and treatment duration. Overall, TMS continues to show promising results in reducing NS; particularly rTMS 10 Hz, for at least 15 sessions on the left dorsolateral prefrontal cortex (DLPFC) at a 110% MT.

TMS may be a useful treatment for NS for patients not responding to pharmacological treatment alone. Studies remain difficult to compare due to different measures of outcome (PANSS and SANS being the most commonly used) and techniques. Furthermore, possible modulators of response include duration of illness, cognitive symptoms amelioration, medication and their dose, and different NS may respond differently to TMS. More studies are needed to better understand the utility of TMS in NS.

The authors have not supplied their declaration of competing interest.

ECT can be a safe treatment choice in cases of PVD.

The authors have not supplied their declaration of competing interest.

It is not clear whether electroconvulsive therapy (ECT) is a safe procedure in depressed older adults with unrepaired abdominal aortic aneurysm (AAA). ECT is potentially incriminating to the cardiovascular system due to a transiently elevation of blood pressure and heart rate during the seizure.

To report a case of an older adult presenting a psychotic depression complicated by an unrepaired AAA.

To report a case study, describing the safety of ECT in patients with unrepaired AAA.

A case report and retrospective review was conducted.

A 75-year-old male was admitted to hospital for the treatment of a psychotic depression. Treatment was complicated since for one year he was diagnosed with an AAA (diameter 4.7 cm). In collaboration with vascular surgeons and anesthesiologists we decided to start ECT. After fourteen ECTs an improvement of mood was achieved. Post-ECT we noticed an AAA expansion of 0.1 cm.

Our findings indicate that ECT may be a safe procedure for patients diagnosed with unrepaired AAA. Published data suggest that the risk for aortic aneurysm rupture during ECT is low. However, multidisciplinary collaboration among psychiatrists, anesthesiologists and vascular surgeons is essential for a positive outcome.

The authors have not supplied their declaration of competing interest.

Repetitive Transcranial Magnetic Stimulation (rTMS), through modulation of cortical activity, has become an invaluable tool in experimental and clinical neurosciences. Although this form of noninvasive treatment is considered safer than other means of brain stimulation it has been associated with adverse effects (AE).

To make a brief review, concerning the AE of rTMS, their prevention and management.

To understand and be able to deal with the most common AE associated with rTMS.

A PubMed database search, using as keywords “Transcranial magnetic stimulation”, “Repetitive Transcranial magnetic stimulation”; “adverse effects”; “management” and “guidelines” between the year 1998 and 2015.

AE caused by rTMS are rare. They can be classified into severe (seizures) and mild (syncope, and transient hearing impairment, acute psychiatric changes, headache, local pain, neck pain, toothache, paresthesia and cognitive/neuropsychological changes) and into early and late AE. In order to obviate and avoid them, guidelines have been created; some state that to apply rTMS the technician needs to obtain the patient's informed consent and assess the risks/benefit ratio. To meet these criteria, screening tools have been created, and since then the number of AE has reduced.

Even though rTMS is considered safer than other forms of brain stimulation it is still associated with AE. In order to avoid them, screening tools have been created allowing the clinician to assess the risks and benefits of applying this technique.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

In the past few years, social media has gained a high popularity as a dynamic and interactive computer-mediated communication tools. Although it has become a part of everyday life for most of our clients, yet we did not have the opportunity to study its impact on compliance to therapy.

Assessment of impact of parallel social media group to dialectical behavior therapy (DBT) skills training group in a sample of Egyptian patients suffering from borderline personality disorder (BPD).

The aim of the current study was to estimate impact of parallel social media group on compliance to DBT skills training group and its adverse events.

Patients with BPD enrolled to an outpatient comprehensive DBT program in Alexandria were assigned either to group (A) skills training, where a parallel Facebook group was crated aiming at increasing to compliance to the original group, or group (B) skills training alone and dropout rates were calculated based on completion of 6 months full skills training. We considered patients out of the group if they missed 4 sessions in a raw.

Two patients of 15 patients who joined group (A) missed four consecutive sessions with a dropout rate of 13%, whereas group (B) showed 43% drop out rate as 10 out of 23 patients did not complete the group. The difference was statistically significant. We reported only one privacy issue dealt with it immediately.

Utilization of social media group could lead to increase patient compliance to DBT skills training group.

The authors have not supplied their declaration of competing interest.

Bipolar disorder is a chronic disease with a major impact on patient's functioning and quality of life, not only during episodes of mania/hypomania or depression, but also during euthymic periods. In recent years, it has been noticed that pharmacotherapy, albeit its great value, is not enough to prevent recurrences of the disease. Therefore, it has been a greater investment in psychosocial interventions as adjuvant treatment. The utmost studied of these interventions is Cognitive-Behavioral Therapy (CBT).

Gather information about the efficacy of CBT in bipolar disorder.

Literature review.

Several studies have compared groups of bipolar patients submitted to CBT to controls submitted to treatment as usual. The methods and size of samples differ, but the results are in general concordant. Individual or group CBT has had positive results in reducing symptoms, increasing the euthymic periods, decreasing duration of episodes and improving global functioning and quality of life.

There are limitations on the application of CBT in bipolar patients, mainly the decrease of its effects over time; less efficiency in patients with more severe disease; major impact on depressive symptoms than manic; and lack of human resources trained to apply these techniques. Notwithstanding these limitations, the demonstrated gain in the use of CBT on bipolar disorder is evident; hence, investment in this area is undoubtedly important.

The authors have not supplied their declaration of competing interest.

Over the last years, literature has dedicated increased interest to post-traumatic stress disorder (PTSD), a mental disorder that was initially included in Diagnostic and Statistical Manual of mental disorders in 1980. Trauma is any event that overwhelms the individual coping strategies. Patients with PTSD experience symptoms of hyper-vigilance, intrusive thoughts, flashbacks, re-experiencing the trauma event, avoidance of stimuli related with trauma or exaggerated startle response. Mindfulness is the process of being aware, paying attention in the present moment, in a non-judgmental way. Research has been showing that mindfulness has positive effects on mental health.

Assessment of eventual benefits of mindfulness in patients with PTSD.

Literature research.

Many studies have reported on correlations between self-reported mindfulness and mental health. Literature suggests that mindfulness training can enhance life skills and its effectiveness is being studied in several mental disorders. Its positive effects on enhancing emotion regulation and decreasing anxiety, hyperarousal and depressive symptoms, led to investigation in the context of PTSD's treatment. Some studies show decreased perceived stress and post-traumatic avoidance symptoms and increased positive states of mind. Most studies reviewed were related with war veterans with PTSD and showed that mindfulness-based treatments could enhance their quality of life. Other results imply that mindful awareness alone may not be sufficient to help reduce symptoms.

Mindfulness based therapies could be useful on improving PTSD symptoms but, to assess its efficacy, further research is needed, in different samples of patients.

The authors have not supplied their declaration of competing interest.

The suppression of negative feelings and traumatic events has detrimental effect on mental and physical health. One of the promising techniques to reduce stress related to trauma is expressive writing. Expressive writing has been found successful with different types of maladaptive behaviors e.g., pain, depression, anxiety and cognitive dysfunctioning.

This study investigates the impact of different categories of expressive writing on improving every day memory performance and cognitive functioning.

Examining the impact of cognitive functioning and everyday memory.

A sample of 90 participants took part in this study. The participants aged (21 and 65 yrs.) 47 of them are females aged between average of (21.64 yrs.), and 43 males aged between average of (21, 49 yrs.). The participants were classified randomly into three groups (a control group, and two experimental groups [pen and oral writing]). The three groups were administered the Every Memory Questionnaire and Taranto Alexithymia Scale.

The results showed that there were no significant differences among the three groups in each of the Alexithymia and Everyday memory, which indicates random distribution of the three groups. The results showed that both of the experimental groups were improved on everyday memory functioning. More importantly, the results indicated that there were no significant differences between using pen or figures in expressive writing to improve Everyday memory.

Study results showed the significant impact of expressive writing on every day memory functioning, furthermore, the study results are used to empathize on the cognitive rehabilitation of the individuals as well as to improve self-esteem on general psychological individual cases.

The authors have not supplied their declaration of competing interest.

Patient's outgroup socialization may be a problem in the psychotherapeutic group functioning. Disadvantages – and even benefits – of this common issue in psychotherapy have been described (Vinogradov S., Yalom I.). However, the impact of new social networks – that facilitate other ways of immediate and easy communication – on this phenomenon is still unknown.

To explore the risks of spontaneous “self-help groups” supported by new technologies for the psychotherapeutic group functioning.

Course description of a psychotherapeutic group, composed by patients with eating disorders (bulimia nervosa and binge eating disorder) in the context of a specialized hospital day.

A patient – who has recently had a breakup – asked help to the group through a non-reported whatsapp chat. Gradually, patients used this new channel to express distress and daily interpersonal difficulties, showing less implication in the supervised group sessions. The patient presented a symptomatic relapse with self-harm injuries and severe eating symptoms. Finally, she left the therapy and, in the next weeks, other patients also left the group, due to different reasons, in a “drag phenomenon”. The analysis showed that the formation of this outgroup socialization changed the relationships between members and new roles were taken.

It is necessary to early address the formation of outgroup socialization in the pre-group interview, emphasizing its high risk for the future group functioning. Therapists should consider that out-group communication is common and easy due to new technologies, so the use of specific questionnaires about this issue may prevent or detect pathological events.

The authors have not supplied their declaration of competing interest.

Most experienced psychotherapists use an eclectic approach in their practice, combining techniques of different schools of psychotherapy to treat their patients. However, there are no good teaching models to train the new generation of psychotherapists in the technique of psychotherapy integration. FEP is a form of psychotherapy that combines techniques from four different psychotherapies: psychodynamics, CBT, IPT and supportive therapy. It also incorporates mindfulness, motivational interviewing, exercise and nutrition. A strong therapeutic alliance is crucial to the success of FEP. Techniques are tailored to the patient's current clinical state. Several techniques from different psychotherapies may be used in the same session. The therapist is empathic, flexible adaptive to the patient's needs and assumes an active role in the therapeutic process.

To present a model of psychotherapy integration that can be used by psychotherapists in their clinical practice.

We aim to present a model of psychotherapy integration that can be taught and implemented by psychotherapists in their clinical practice.

We present ten case examples were FEP was effective clinically and we compare it to the standard of care received by these patients and show the savings to the healthcare system.

The results of our study suggest that FEP could be a cost effective treatment that could be added to the psychotherapists toolbox. Teaching and training methods, like manuals and workshops can be developed to train the new generation of psychotherapists.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

According to studies done in recent years regarding the treatment of patients with recurrent depressive disorder, a shift of interest from studies evaluating the effectiveness of therapy to the study of remission is seen. According to the literature, complete remission occurs in only 40–50% of patients, in other cases there is residual symptoms.

Evaluating the effectiveness of art therapy in treatment in patients with recurrent depressive disorder on the quality of remission.

The study involved 135 patients: 60 male and 75 female patients aged from 18 to 30 years old. The main group of patients apart the combined treatment also participated in group art therapy with the use of drawing techniques, while the control group – statutory standard therapy. We used clinical, psychopathological, psychodiagnostic and statistical methods.

The results of the effectiveness of art therapy in complex treatment in patients with recurrent depressive disorder is detected primarily in reducing of the level of anxiety at the early stages of treatment, as well as in reducing of the severity of anhedonia and improving the quality of life in remission period.

These results support the use of art therapy in treatment in patients with recurrent depressive disorder during period of active treatment, and after achieving clinical remission contributes to achieving and maintaining high-quality and stable remission with full restoration of quality of life and social functioning.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

ICD-10 classifies trichotillomania (TTM) as one of the habit and impulse disorders. It is characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. Persons suffering from TTM often hide it. TTM is often unrecognised by doctors, treated by dermatologists or untreated, causing a lot of suffering.

To present treatment of trichotillomania.

To present one case report of trichotillomania treated online.

This is case report of female patient with TTM untreated 13 years. She had earlier been treated for depression and had multiple traumatic experiences. Patient both self-diagnosed TTM and asked for treatment online. During two months, there were 7 sessions and 2 follow-ups. Sessions were online and based on Habit Reversal Training (HRT) and Rational Emotional Behavioural Therapy (REBT). The following issues were addressed: hair pulling, shame, guilt, low self-confidence, assertiveness, low frustration tolerance, panic attacks, sadness. No medications were used.

Hair pulling has almost completely stopped. Social functioning and self-acceptance were improved. Guilt and shame have reduced, self-confidence and frustration tolerance have increased.

HRT and REBT online treatments have reduced hair pulling and the associated emotional problems.

The authors have not supplied their declaration of competing interest.

In the past six decades, extensive research has been done on family therapy from different areas of knowledge such as psychology, psychiatry and social work. Leading to development of different intervention techniques and optimal clinical evaluation with families.

The systemic perspective focus on the study of the dimensions that contribute to the stability and consistency of the members of the family system. The family is an interrelated system, dependent on each other, where there is an influence of the group over the individual, which is why each of its members plays a pivotal role in family therapy. Throughout all these years of evolution of systemic family therapy, many different concepts and techniques have been used, including the ones currently used today.

Knowing the evolution of the different techniques allows us to understand the functioning of families, for example, their links and the elements that constitute it: their roles, the functions performed by each member in the family, communication, standards and power relations.

The descriptive diagnosis of family ties, help us implement intervention strategies that could improve clinical care and diagnostic approach.

The authors have not supplied their declaration of competing interest.