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ObjectivesDissociation has been related to emotional dysregulation and eating psychopathology. Dissociation may interfere with the learning process, affecting at the therapy negatively. The aim of the study is to analyse if at the eating disorders (ED), dissociation is linked to temperamental traits or also to character traits, which are susceptible to be modulated during the therapeutic process.MethodsWe studied 119 females that started an outpatient program for their ED. We used the Dissociative Experience Scale (DES), Temperament and Character Inventory (TCI), Eating Attitudes Test (EAT-40), and the State Trait Anxiety Inventory (STAI). We used multiple regression analysis.ResultsDissociation was associated with high scores on the EAT-40, even controlling the effect of anxiety traits, which also was related to dissociation. The temperament dimension “searching for novelty”, has been related in an opposite way to the DES. Also, the “dimension of transcendence “character and “self determination” influenced on the DES.ConclusionsThis study confirms the importance of improving Self Determination levels at ED therapy, which influence on a lot of prognostic aspects, such as protecting from dissociation, which is related to anxiety and alimentary psychopathology and can interfere with the therapeutic progress.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe first time when people attempt suicide first contact is critical. Psychiatrists must decide to hospitalize them or follow-up in mental health units and the bases of a doctor-patient relationship are formed.ObjectivesAn analysis of referrals to psychiatry from the emergency room (ER) was developed. Our objective was to discover if there was a statistical correlation between gender and other variables, especially repeated visits and admissions.MethodsOur sample was composed of patients who visited the ER for suicidal tendencies for 20 months. We carried out an observational retrospective study. The variables collected were: age, gender, cause, repeated visit (visit to the ER in the following two months), previous attempts, previous follow-up, method used, use of toxic substances during the attempt, intentionality, referral from the ER, later follow-up and diagnostic impression at the ER.ResultsA total of 620 patients were sampled. The relationship between gender and repeated visit, previous attempts, dysfunctional personality traits, use of substances and later follow-up was found (Chi2). Although the relationship between admissions and gender were not statistically significant, influence by gender (over all in males) can be observed in logistic regression models. As well as, in patients who visited the ER several times, dysfunctional personality traits seem to be the most common but gender marks significant differences between groups.ConclusionsThe data obtained is consistent with those reported in previous studies. To know who the riskier groups are can allow professionals to plan protocols and unify admission criteria.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionReferrals to psychiatry from primary care has increased in recent years. This can be the result of the global economic situation and represents a problem for specialized care, because patients can’t usually be correctly attended to. On the other hand, patients who don’t come to visits make up other important issues that we must analyze.ObjectivesTo analyze the differences between patients who did not come for their first visit and those who did in order to try to describe variables that could be affecting them.MethodsThis is an epidemiological, analytic, prospective study of patients referred to our department. The following variables were collected: (1) referral protocol, (2) reason, (3) demographic data, (4) attendance to appointment, (5) diagnosis impression and (6) destination of referral. The SPSS 19.0 was used to analyze the data.ResultsWe studied a total of 1.048 patients for 15 months, of which 20.6% did not come to their first visit. A statistically significant relationship between attendance and gender, year of the appointment, adequate demand or not, previous follow-up and diagnosis was found (Chi2). However, if a logistic regression was carried out, only the adequacy of the demand was included in the model.ConclusionsCoordination with general practitioners is essential to improve referrals and, most importantly, the attention to patients. If we can agree on the referral criteria, a better-personalized assistance can be offered to patients who have more difficulties in coming (because of characteristics of illness, place of residence, and other variables).Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionPerfectionism is considered a multidimensional key risk factor for Eating Disorders (EDs). There are discrepancies regarding if it is mainly associated to Anorexia nervosa (AN) but not to other EDs.ObjectivesTo study if Perfectionism is not only related with AN, but it is present in all EDs and associated with more transdiagnostic attitudes and behaviors.AimsTo see if there were significant differences among EDs subgroups concerning Perfectionism and to study which abnormal eating attitudes were more associated with this trait.MethodsParticipants were 151 outpatients with EDs. DSM-IVTR diagnoses were: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders not Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2) subscale; general psychopathology with the Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self-Esteem Questionnaire (RSE). Eating psychopathology was measured with the Bulimic Investigatory Test (BITE), Eating Attitude Test (EAT-40), EDI-2 and the Body Shape Questionnaire (BSQ).ResultsNo significant differences were found regarding Perfectionism among the three groups. Body dissatisfaction was the variable most associated with Perfectionism (β = 0.330, F = 14.2, P < 0.001, 10.9% of the variance) adjusting for general and eating psychopathology. Ascetism and Interoceptive awareness were the EDI-2 subscales most associated with Perfectionism.ConclusionsThe findings confirm that Perfectionism is present in all EDs and there is a relationship between body dissatisfaction and Perfectionism. Interplay has been suggested between these two factors for the development of EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

US Latinos have higher rates of substance use disorders (SUDs) than Latinas, but Latinas face substantial barriers to treatment and tend to enter care with higher SUD severity. Immigrant Latinas may face greater barriers to care than native-born despite lower overall SUD prevalence. This study aimed to identify how SUD treatment needs of Latinos are addressed depending on patient gender and immigrant status within an urban healthcare system serving a diverse population.MethodsData from electronic health records of adult Latino/a primary care patients (n = 29,887 person-years) were used to identify rates of SUD treatment in primary and specialty care. Treatment characteristics and receipt of adequate care were compared by gender and immigrant status.ResultsTobacco was the most frequently treated substance followed by alcohol and other drugs. Forty-six percent of SUD patients had a comorbid psychiatric condition. Treatment rates ranged from 2.52% (female non-immigrants) to 8.38% (male immigrants). Women had lower treatment rates than men, but male and female immigrants had significantly higher treatment rates than their non-immigrant counterparts. Receipt of minimally adequate outpatient care varied significantly by gender and immigrant status (female non-immigrants 12.5%, immigrants 28.57%; male non-immigrants 13.46%, immigrants 17.09%) in unadjusted and adjusted analyses.DiscussionResults indicate overall low prevalence of SUD treatment in the healthcare system. Low rates of minimally adequate care evidence the challenge of delivering integrated behavioral healthcare for Latinos with SUD. Results also demonstrate gender and immigrant status disparities in an unexpected direction, with immigrant women receiving the highest rates of adequate care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe first visit is crucial, since it is where a treatment plan is selected and the decision to refer or not the patient to a specialized unit is made. Mental care could be improved through the centralization of demand and the identification of patients’ and psychiatrists’ expectations.ObjectivesAnalyzing patients’ and psychiatrists’ demands and expectations in the first visit to use them as a starting point for the planning and coordination of treatment actions.AimsTo design a record system of the Minimum Basic Data Set of the Centralized Department of our Unit.MethodsThis is an epidemiological, observational, prospective study of patients referred to our department. Following variables were collected:– referral origin;– reason;– demographic data;– diagnosis impression;– destination of referral.The Statistical Package for Social Science version 19.0 was used to analyze the data.ResultsTable 1.ConclusionsThe data obtained are consistent with those reported in the literature for this population. The high rate of wrong referrals reveals the necessity of improving coordination and establishing specific referral criteria. Some initiatives have been designed and will be prospectively evaluated in the future.Table 1Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionBody dissatisfaction is one of the core psychopathological components in Eating Disorders (EDs) and it tends to persist over time regardless treatment interventions. Perfectionism is considered as a mediator and moderator between body dissatisfaction and disordered eating.ObjectivesTo study the influence of Perfectionism in EDs outcome.AimsTo analyze changes in body dissatisfaction at one year follow-up in patients with eating disorders and the effect of perfectionism over these changes.MethodsParticipants were 151 patients with eating disorders. DSM-IVTR diagnoses were as follows: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders no Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2). The Body Shape Questionnaire (BSQ) was also distributed. One year after the beginning of their treatment, patients were reassessed.ResultsPatients with BN showed significantly higher scores on BSQ than those with AN. There was a significant improvement in BSQ after one year of treatment regardless the diagnostic (repeated measures ANOVA: F 8.4, PConclusionsThe results confirm the interaction between perfectionism and body dissatisfaction in the treatment outcome of EDs. It has been described an interplay between Perfectionism, body dissatisfaction and disordered eating attitudes and behaviours, being Perfectionism a moderator factor. The results highlight the need of dealing not only with the core symptoms of EDs, but also with the moderator factors such as Perfectionism to enhance the outcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionPerfectionism is considered a risk factor and is very close related to Eating Disorders (EDs). It estimates heritability of 29-42%. However, it has also been related to psychosocial factors such as the insecure attachment style.ObjectivesTo study the relationship of perfectionism with personality dimensions, its likelihood of improvement and its treatment.AimsTo analyze if Perfectionism is associated with dimensions of Temperament or dimensions of Character and therefore more psychosocial.MethodsParticipants were 151 female outpatients who consecutively started treatment at the Eating Disorders Unit (Ciudad Real University General Hospital). Personality was assessed by using the Temperament and Character Inventory (TCI). Perfectionism was assessed by using the Edinburg Investigatory Test (EDI-2) subscale (t0). One year later, patients were re-assessed with the EDI-2 (t1).ResultsThe scores on Perfectionism significantly improved from t0 to t1, (repeated measures ANOVA, F = 6.6, P < 0.01). At baseline, Perfectionism was related to any of the Temperament dimensions, but the Character variable Purposefulness (SD2) (β = .25 95% CI .17, 98), 2.7% of variance). Responsibility (SD1) and Self-Aceptance (SD4) were inversely associated with Perfectionism. At t1, Responsibility still was a protective factor for Perfectionism, regardless the effect of Perfectionism at t0.ConclusionsPerfectionism is also related to psychosocial and developmental factors. People with an internal locus of control tend to take responsibility for their own actions and are resourceful in solving problems. Thus, Self-directedness, mainly Responsibility for their own actions, is a protective factor for Perfectionism in EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction Although investigation have demonstrated that stimulants are effective medication for the treatment of the symptoms on the ADHD, a commonly described but quite slightly studied side effect of this type of medication, is the effect on the emotional expression of patients. Objectives evaluate the effect of the treatment with Methylphenidate on the affective/emotional expression in children diagnosed with ADHD. Methods It's a descriptive study of several cases series, from a center and about a unique group, where 'n” will be 15 children diagnosed with ADHD at the University Hospital, who were required beginning treatment with methylphenidate, with a daily dose of at least 0,3mg/Kg. In this study it will be evaluated the emotional expression of the group, according to the scale Expression and Emotion Scale for Children (EESC) making a comparison between the previous moment to the treatment and a subsequent month from its beginning. Results The evaluation of the total result of the EESC conducted by the parent didn't show statistically significant differences between scores previously of the treatment and results after a month with it. The dominions (positive emotions, emotional flatness and emotional lability) didn't show differences between both periods of time, nevertheless, the positive emotions showed a tendency of reduction more showy than the rest, without getting to be statistically significant (p=0.0638). Conclusion Statistically there haven't been significant changes in the emotional expression of the children caused by the treatment with methylphenidate. Nevertheless, the data show that there is a tendency to an improvement in it.

Introduction:Interest in the premorbid personality of schizophrenic patients is well established in the psychiatric literature. The relationship between personality disorders and acute phase proteins (APP) in schizophrenia is not well known.Aim:Investigating the relationship among acute phase proteins and personality disorders in schizophrenic patients in a sample of adult schizophrenic patients under psychiatric treatment in a general hospital health setting.Material and Methods:37 adult paranoid schizophrenics undergoing treatment in the University Hospital of the Canary Islands with DSM-IV diagnosis of paranoid schizophrenia are included. Years from onset 9.20 s.d. 6.29, age at onset 19.75 s.d. 4.73. The record of personality disorders as a secondary diagnosis in the medical chart was taking into account. A blood sample as routine standard analysis was carried out in each patient.Results:In 21 patients (56.7%) a personality disorder, mainly with paranoid and schizotypal traits, was registered. The percentage of each personality disorder is as follows, Schizotypal (16.2%), Paranoid (13.5%), Schizoid (2.7%), Paranoid and Schizotypal (24.3%). The results point to no significant correlation according to APP (C3, C4, alpha2-macroglobulin, alpha1-glicoprotein, ceruloplasmin) in the different diagnostic groups.Discussion and conclusions:In our study there is no evidence to support a significant correlation among APP and the different personality disorders in our sample of schizophrenics in spite of a positive correlation of APP and some psychopathology dimensions that has been communicated earlier elsewhere. In order to set some possible specificity of acute phase proteins and other clinical features in schizophrenia further research is required.