Therapeutic Writing ist not yet commonly used in Psychiatry and Psychotherapy although it seems to be a promising supportive and well accepted therapeutic tool. Over the last years we have implemented group therapy for Therapeutic Writing at four psychiatric clinics.

Exclusion criteria were insufficiant knowledge of language, illiteracy or insufficiant ability to participate in therapeutic groups. We treated in-patients in a secure environment, on general psychiatric wards and in a day-clinic setting from adolescence to seniority mainly with Schizophrenia, Depression, Bipolar Disorders, Personality Disorders, Anxiety Disorders,and Eating Disorders.

This poster outlines our theoretical framework as well as practical aspects of implementing Therapeutic Writing as a group therapy in a psychiatric/psychotherapeutic setting.

Over the recent years, meta-analysis has become a very influential tool to synthesize information from multiple primary studies of similar design. Widespread use of increasingly complex statistical methods makes it ever more challenging to adequately assess the results reported and conclusions drawn in meta-analyses of psychopharmacological studies.

This study aimed to identify potential fallacies of meta-analytic reporting and interpretation by in-depth examination of recent publications on anti-depressant medication.

Published meta-analytic datasets were re-analysed and the results and possible interpretations obtained in this way were compared with the published results and interpretations.

Several widespread methodological problems were identified in the example studies. As most important among these appear the choice of effect size measures and modeling approaches, as well as the related risk of data dredging. Concerning the level of granularity, two pitfalls encountered were inappropriate aggregation of original data and lack of adequate subgroup analyses. Finally, a low level of transparency regarding data and methodology often hampers re-analysis and cross-checking of reported findings by peers.

The difficulty of replicating meta-analytic results on independent data leads to the often conclusive nature of meta-analytic findings, and therefore a realistic assessment of the limitations of the respective analysis is pertinent. To this end, practically relevant quality criteria for readers to bear in mind when dealing with meta-analytic publications are summarized in a ten point checklist for a rough assessment of the quality of meta-analyses by the reader.

Most studies investigating the problems and needs of schizophrenia patients’ carers include only one care-giving relative - mostly the patients’ mothers.

The compare needs of mothers and fathers of patients with schizophrenia.

101 sets of parents of patients suffering from schizophrenia were included in this study. They were assessed by means of the “Carers’ Needs Assessment for Schizophrenia”.

Compared to fathers, mothers reported significantly more often problems concerning stress due to earlier life events and burn-out. Mothers required some interventions such as individual psychoeducation or family counselling more than twice as often than fathers. Overall, mothers reported more problems and needs than fathers. The number of mothers’ problems was predicted by not living with a partner and a shorter duration of the patients’ illness (DUPI). The number of mothers’ needs was predicted by patients’ psychiatric symptoms, not living with a partner and a shorter DUPI. Among fathers we could not identify any predictors, neither for problems nor for needs.

Parents of schizophrenic patients have various problems handling their child's illness and therefore need professional support. Overall, mothers reported more problems and needs for interventions than fathers. The differences between mothers’ and fathers’ problems and needs indicate the importance of considering the carer's gender in clinical work.

Determination of the best evidence involves a systematic, comprehensive review and synthesis of the research literature as performed in high-quality meta-analysis. In a recently published multiple-treatment meta-analysis by Cipriani and collegues (Lancet, 2009) the authors finally concluded to favour sertralin over escitalopram due to lower costs.

Based on the example published by Cipriani et al. we tried to highlight possible pitfalls, the clinican with limited time might not be able to spot easily whilst skimming the results of meta-analysis.

Escitalopram had the best efficacy and tolerability profile in the study. Sertraline was recommanded as first choice because of the most favourable balance between benefits, acceptability and acquisition costs. Analyzing study-design, statistical procedures and knowledge such as the early launching of generics of escitalopram lead to a different view of the interpretation by Cipriani and collegues.

We concluded that the findings of Cipriani et al. have limited generalizability due to problematic study design issues including statistical concerns. Despite the fact that meta-analysis might provide best evidence-based information, the findings of the latter should always be interpreted with caution as the quality of them can only be as good as the studies included and the study design implemented.

Non-adherence of medication still is a major problem among patients suffering from bipolar disorders.

Previous studies focused mainly on possible side-effects, attitudes and subjective well-being. Most scales concerning this issue have been developed by psychiatric experts and based on their knowledge not on the patients points of view.

The purpose of this study was to find out what kind of drug effects the patients themselves want.

2 focus-groups with 13 patients and In-depth interviews with 15 mania patients were conducted to collect information about subjective burden and symptoms of the illness. Content analyses of the transcriptions were performed and the results were used to develop a first draft of the questionnaire.

The final German test version consists of 32 items and is called “The Subjective Mania Scale”. The study of content-validity showed that all SMS items were considered to be important by more than 50% of the sample. Test-retest reliability and sensitivity to change were evaluated. All SMS-items showed a significant change between time-point 1 and 3.

The SMS-rating scale is a feasible, reliable and valid instrument for clinical trials among mania patients.

The purpose of this study was to investigate disability among patients suffering from schizophrenia and to identify predictors of disability.

101 patients from different types of psychiatric services in Vienna and diagnosed with schizophrenia according to ICD-10 were included. They were investigates by means of 36-Item self-administered version of the WHO Disability Assessment Schedule II (WHO-DAS-II) and the PANSS-scale. Patients’ mothers and fathers were asked to fill in the Family Problem Questionnaire.

The mean total score of the WHO-DAS-II was 74.1 (SD 21.9). When using weighted sub-scores the highest disability scores were found for social contacts, participation in society and household (means 2.58, 2.57 and 2.51 respectively). Using logistic regression, overall disability was positively associated with patient's age, overall severity of symptoms (PANSS) and number of previous hospital admissions. Overall disability was not associated with duration of illness and or patient's gender. The subjective burden experienced by patients’ fathers and mothers were increased by reduced social contacts and impaired participation in society, while we could not find an association with other domains of patient's disability (understanding, mobility, self-care, household).

This study shows that schizophrenia results in disability in several domains. Family caregivers’ burden was predominantly increased by social consequences of schizophrenia.

To investigate caregiving and its consequences among fathers and mothers of the same patients suffering from schizophrenia.

101 patients as well as both parents were investigated using the “Carers' Needs Assessment for Schizophrenia”, the “Beck Depression Inventory”, the “Involvement Evaluation Questionnaire” and the “Family Problem Questionnaire”.

The mean number of days fathers lived together with the patients was not significant from that of the mothers, but the average duration (hours per week) of contact with the patient was significantly higher for mothers than for fathers. Among 40% of the sample, fathers and mothers spend an equal amount of time caring for the patient. Mothers reported significantly more often problems than fathers concerning stress due to earlier life events and burn-out. Mothers needed some interventions such as individual psychoeducation or family counselling more than twice as often as fathers. Mothers reported overall higher numbers of problems and needs for intervention than fathers. The overall score of caregivers' involvement did not differ significantly between fathers and mothers. The mothers' objective burden was significantly higher than the fathers' objective burden, but parents did not show differences concerning subjective burden. Using the “Beck Depression Inventory”, mothers were more often depressed than fathers.

This study shows that often fathers and mothers spend an equal amount of time caring for the patient. The differences found between mothers and fathers should be considered when planning services for family caregivers.

To present a multimodal analysis of psychopathology among African unaccompanied refugee minors (URMs) in Austria. These youths experience well documented war and flight related non-normative stressors on their way from Africa to Europe. We have previously reported 17% of PTSD, a number below expectations. We now report on trauma related personality variables which indicate that these youths are resilient but at high risk for decompensation. We tested the hypothesis that PTSD specific defenses would be high (most notably dissociation, conversion, projection, withdrawal and somatization).

Forty-one URMs participated in the study. The following standardized instruments were used: UCLA PTSD Index for DSM IV, Mini International Neuropsychiatric Diagnostic Interview for Children and Adolescents, Weinberger Adjustment Inventory, Response Evaluation Measure for the measurement of defenses.

Levels of psychopathology were below previously reported levels in URMs. By contrast, all defenses previously reported as elevated in PTSD (conversion, projection, dissociation, withdrawal and somatization) showed significant increases (p < 0.05), putting these defenses in the 80–95TH percentile for the norm population.

While syndromal illness was less than expected, indicators of trauma related habitual function were all elevated. The present findings reveal that URMs manage the extreme stress of their lives by defensive self-regulation. These findings have implications for diagnosis and management.

We assessed the prevalence of lifetime suicidal ideation and associated psychosocial factors among Viennese secondary school pupils.

An anonymous self-report survey which assessed the major psychiatric risk factors of teen suicide, as well as demographic characteristics, was completed by pupils of three Viennese secondary schools (n=214).

Eighty-one (37.9%) secondary school pupil reported ever having suicidal thoughts, girls significantly more often than boys (48.5% vs. 29.1%, p=.004). Furthermore, lifetime suicidal ideation among Viennese secondary school pupils was associated with living in “broken-home” families, cigarette smoking, substance problem (alcohol/drugs), self-reported depression, and school type. After adjusting for confounders, we found that female gender, substance problem, school type and cigarette smoking were significantly associated with lifetime suicidal ideation among secondary school pupils in Vienna.

In context of suicide prevention, attention should be paid to the psychosocial factors associated with pupils' suicidal ideation.

The aim of the study was to explore how many physicians intended to be psychiatrists and how many of those physicians practising as psychiatrists originally desired this area of expertise

For this cross-sectional survey, a self-administered questionnaire with 12 items was sent to all licensed physicians (n = 8127), based on the register of the Vienna Medical Chamber in June 2000

2736 respondents (34%) completed the questionnaire validly. 50.3% (m: 43.2%; f: 58.6%) of all physicians in Vienna did not achieve their desired subject, whilst 86% of psychiatrists did so. These study results represent the highest percentage compared to other medical specialisations. Further, 6% of all physicians (m: 5%; f: 7%) initially defined psychiatry as their desired medical career regardless whether they attained this specialty later on or not. An average of 9% of all physicians changed their minds about their preferred specialty during their training.

Compared with other specialties the average number of physicians who practice a specialty different from the one desired is low in psychiatry. We think that this fact constitutes a favourable aspect with regard to recruitment of graduates for specialty training in psychiatry. Data found in this survey are similar to other studies conducted in German speaking countries, when focussing on psychiatry as desired career.

Originally, the General Health Questionnaire (= GHQ) was designed to detect mental disorders among general medical outpatients and in community. The aim of the present survey is to compare the criterion validity indices of three different GHQ versions among general hospital inpatients when using different scoring methods.

The GHQ-30 was filled in by inpatients prior to the research interview. For psychiatric case-identifiation the Clinical Interview Schedule was performed by three research psychiatrists.

The final sample consisted of 993 inpatients. When comparing the three different GHQ-versions, no significant differences were found in OMR and ROC-AUC as well as in sensitivity (0,612–0,701) and specificity (0,601–0759). When comparing the four scoring methods no significant differences were found in sensitivity. By contrast, OMR and specificity showed better indices for the 20 item and 12 item GHQ versions when using the bimodal and modified Lickert scoring method. Further, the Lickert scoring method showed no significant differences to the other scoring methods for the GHQ-30, where as the modified Lickert and the bimodal method showed lower OMR and higher specificity compared to the chronic method.

Due to the results of this survey, the future use of the chronic scoring method for the GHQ has to be questioned when used for general hospital inpatients.

Cerebral insulin has an immediate lowering effect on hypothalamic-pituitary-adrenal (HPA) axis response to strong psychosocial stress.

So far, little is known about the modulation of ACTH and cortisol values by intranasal insulin administration under conditions of absolute rest as well as moderate activity changes.

To determine whether single low-dose intranasal insulin application reduces the overall HPA-axis excitability and increases mood in healthy young men.

In a randomized, double-blind, placebo-controlled, cross-over study, 15 healthy young men (22 to 28 years old) received a single intranasal dose of 40 IU human insulin or placebo after an overnight fast. Mood as well as blood concentrations of cortisol and ACTH were measured before and after insulin administration.

In comparison to placebo, intranasal insulin reduces the HPA-axis excitability (all P > 0.004) as well as levels of arousal (P = 0.050), and increases feelings of well-being (P = 0.038) as well as of self-confidence (P = 0.005) as compared to placebo.

Present study shows that single low-dose intranasal insulin application effectively improves mood and lowers the HPA-axis response to moderate activity changes in healthy young men. These findings have meaningful implications for humans who suffer from diseases characterized by enhanced stress axes activity such as depression and metabolic syndrome. Based on its diminishing effect on cortisol concentrations, intranasal insulin administration might represent a promising therapeutic strategy to prevent and to treat such diseases.

Despite recent worldwide migratory movements, there are only a few studies available that report robust epidemiological data on the mental health in recent refugee populations. In the present study, post-traumatic stress disorder (PTSD), depression and somatisation were assessed using an epidemiological approach in refugees who have recently arrived in Germany from different countries.

The study was conducted in a reception facility for asylum-seekers in Leipzig, Germany. A total of 1316 adult individuals arrived at the facility during the survey period (May 2017–June 2018), 569 of whom took part in the study (N = 67 pilot study and N = 502 study sample; response rate 43.2%). The questionnaire (11 different languages) included sociodemographic and flight-related questions as well as standardised instruments for assessing PTSD (PCL-5), depression (PHQ-9) and somatisation (SSS-8). Unweighted and weighted prevalence rates of PTSD, depression and somatisation were presented stratified by sex and age groups.

According to established cut-off scores, 49.7% of the respondents screened positive for at least one of the mental disorders investigated, with 31% suffering from somatisation, 21.7% from depression and 34.9% from PTSD; prevalence rates of major depression, other depressive syndromes and PTSD were calculated according to the DSM-5, which indicated rates of 10.3, 17.6 and 28.2%, respectively.

The findings underline the dramatic mental health burden present among refugees and provide important information for health care planning. They also provide important information for health care systems and political authorities in receiving countries and strongly indicate the necessity of establishing early psychosocial support for refugees suffering from psychological distress.