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length of stay.All statistical analyses were performed with the
Statistical Package for Social Sciences(SPSS 27.0).
Results: Males and females differed according to the method used
for suicide attempt(x23=10.96,p<0.05),the scores for risk and
rescue(t175=2.55,p<0.05;t146.6=-1.99,p<0.05,respectively),and
the length of stay(U=3084.5,p<0.05).Females were more likely to
use drug/poisoning ingestion as method for suicide attempt than
were males(72.8% vs.51.4%),whereas males were more likely to use
hanging than were females(20.3% vs. 6.8%).The risk score was
higher for males(3.760.68)than for females(3.490.72),and the
rescue score was higher for females than for males(2.791.09
vs. 2.431.22).Finally,the length of stay was longer for males than
for females(10.668.09 vs. 8.256.48).These results confirm the
role of difference in suicide methods used by males and females for
explaining the “gender paradox.”
Conclusions: The present study illustrates the usefulness of the
Risk-Rescue Rating Scale which is a descriptive and quantitative
method of assessing the lethality of suicide attempts.Identifying sex
related characteristics of suicide risk in patients is important for
implementing specific suicide prevention strategies to reduce sui-
cidal intent, psychological pain and rehospitalization in patients
with psychiatric disorders.Men and women may need different
strategies for the prevention of future suicidal behavior.
Disclosure of Interest: None Declared
EPP0386
The Last Straw: Conflicts and Suicide Attempts in
Armenian Adolescents
M. Arsenyan
Republican Child Psychiatry Department, “St. Grigor Lusavorich”MC,
Yerevan, Armenia
doi: 10.1192/j.eurpsy.2023.701
Introduction: Adolescence is, arguably, the most vulnerable period
of a person’s development when the susceptibility to emotional-
affective and behavioural disorders is at its height and conflict
situations can result in self-injuries and suicide attempts, some
with lethal outcomes (Woycex W., Сlinical Suicidology, 2007.-
280p). Research indicates that conflict with family is associated
with suicide attempts in adolescents (Elise P. JAD, 2018; 241:499-
504). There is a small body of research on the risk factors for suicide
attempts in Armenian adolescents. However, there is a lack of
research on understanding what role conflict can play in developing
suicidal thoughts and behaviour.
Objectives: The present research aims to understand the role of
conflict in suicide attempts among Armenian adolescents.
Methods: The researcher conducted a qualitative analysis of
39 patient histories of adolescents hospitalised after a suicide
attempt using the documentary method. The patient histories
included, among others, the results of psychiatric tests using Hamil-
ton’s Rating Scale for Depression (HAM-D), Hamilton’s Rating
Scale for Anxiety (HAM-A), Columbia Suicide Severity Rating
Scale (C-SSRS), and the records of psychiatric consultation.
Results: The psychiatric tests showed that all adolescents suffered
either mild, moderate or severe levels of depression and anxiety.
They also exhibited mild, moderate or severe suicide risk, based on
C-SSRS. The results revealed that before the suicide attempt, ado-
lescents were exposed to continuous distress and traumatic events
at home that lasted for months, sometimes years. They often
witnessed domestic abuse and attempted to protect one of the
parents (usually their mother) from being physically and psycho-
logically abused. In some cases, the distress was the result of parents
trying to end the adolescent’s relationship with their boyfriend.
During psychiatric consultation, adolescents disclosed reoccurring
suicidal thoughts and suicidal ideation when exposed to continuous
trauma and distress at home. In most cases, conflict with parents
was the trigger that made adolescents act. The conflict was the last
straw that pushed them to attempt suicide.
Conclusions: Suicide attempt in Armenian adolescents remains
one of the least investigated areas. Domestic abuse is often silenced
and almost never reported to authorities. This usually leaves ado-
lescents one-on-one with their struggles. The needs of adolescent
witnesses of domestic abuse and those suffering controlling behav-
iour and developing suicidal thoughts, some of them eventually
attempting suicide - remain largely unaddressed. More research is
needed to understand factors associated with suicidal behaviour in
Armenian adolescents. Research studies can hopefully become a
basis for a future centralised mental health strategy aimed at helping
adolescents find a way out and not resort to suicidal attempts.
Disclosure of Interest: None Declared
EPP0387
Factors linked to suicide risk in a diverse sample of
psychiatric patients
M. Pontiggia
1
*, S. Bonaldi
1
, C. Gramaglia
2,3
, P. Zeppegno
2,3
,
F. Madeddu
1
, R. Calati
1,4
and S. Magliocca
1
1
Department of Psychology, University of Milan-Bicocca, Milan;
2
Institute of Psychiatry, Università del Piemonte Orientale;
3
S.C.
Psichiatria, Azienda Ospedaliero Universitaria Maggiore della Carità,
Novara, Italy and
4
Department of Adult Psychiatry, Nîmes University
Hospital, Nîmes, France
*Corresponding author.
doi: 10.1192/j.eurpsy.2023.702
Introduction: Suicidal behavior is a global public health problem.
Among the most investigated theories for the explanation of suicide
there is the interpersonal-psychological theory of suicide (IPTS) by
Thomas E. Joiner. IPTS focuses on 3 variables related to lethal
suicide attempt: thwarted belongingness, perceived burdensome-
ness and acquired capability for suicide.
Objectives: We aimed to understand which variables were mostly
related to suicidal ideation (SI) and suicide attempts (SA) in a
sample of psychiatric patients.
Methods: A sample of 80 psychiatric patients including inpatients
(n=18), outpatients (n=21) and patients from various Italian
rehabilitative psychiatric communities (n=41) was recruited
between June 7
th
, 2021 and September 12
th
, 2022. We administered
a battery of various scales, including State-Trait Anxiety Inventory,
STAI, Beck Depression Inventory, BDI, Reasons For Living Inven-
tory, RFLI, Acquired Capability for Suicide Scale-Fearlessness
About Death, ACSS-FAD, Rosenberg self-esteem scale, RSES, Men-
tal pain questionnaire, MPQ, Interpersonal Needs Questionnaire,
INQ. For each scale we compared a) patients with and without
lifetime SI; b) patients with and without history of SA. Then, we
performed two logistic regression models (stepwise backward
method), one for SI and one for SA.
S316 e-Poster Presentation
https://doi.org/10.1192/j.eurpsy.2023.702 Published online by Cambridge University Press
Results: Both patients with SI and SA have higher anxiety (STAI),
depression (BDI), mental pain (MPQ), perceived burdensomeness
(INQ), thwarted belongingness (INQ), fearlessness about death
(ACSS_FAD) and lower self-esteem (RSES), beliefs about coping
strategies (RFLI) and moral objections (RFLI). Depression (BDI)
and beliefs about coping strategies (RFLI) were the variables most
strongly associated with SI; higher fearlessness about death (ACSS-
FAD) and low self-esteem levels (RSES) were the variables most
strongly associated with history of SA. The SI model was able to
predict 84% of ideation cases; the SA model was able to predict 74%
of the attempts.
Conclusions: The results supported that improving the ability to
cope with suicidal thoughts is a key component of therapeutic work
with suicidal patients. In addition, according to the IPTS, the
history of SA has been particularly explained by fearlessness about
death. Hence it may be important to focus on these aspects in
suicide prevention.
Disclosure of Interest: None Declared
EPP0388
Saving and Empowering young lives in PAKistan
(SEPAK): An Exploratory Cluster Randomized
Controlled Trial (cRCT)
M. Panagioti
1
, T. Kiran
2
, S. Irshad
2
, R. Sattar
2
, A. Hodkinson
1
,
S. Tofique
2
, N. Tyler
1
, I. Angelakis
3
, Z. Zadeh
2
, A. Maqsood
4
,
S. Sultana
5
, S. Dawood
6
, M. Bhattia
7
, A. Tamiduddin Nizami
8
,
H. A. Khan
9
, I. B. Chaudhry
2
, N. Husain
10
and N. Chaudhry
2
*
1
Division of Population Health, Health Services Research & Primary
Care, Institute for Health Policy and Organisation /Alliance
Manchester Business School, Manchester, United Kingdom;
2
Research, Pakistan Institute of Living and Learning, karachi,
Pakistan;
3
School of Psychology, University of South Wales, Wales,
United Kingdom;
4
Department of Behavioral Sciences, Fatima Jinnah
Women University, Rawalpindi;
5
Department of Applied Psychology,
Bahauddin Zakariya University, Multan;
6
Center for Clinical
Psychology, University of Punjab, Lahore;
7
Department of
Psychiatry, Peoples University of Medical and Health Sciences for
Women, Nawabshah;
8
Department of Medicine, Institute of
Psychiatry, Benazir Bhutto Hospital, Rawalpindi;
9
Baloshistan
Institute of Psychiatry & Behavioral Sciences, Bolan Medical College,
Quetta and
10
Division of Psychology and Mental Health, University of
Manchester, Manchester, Pakistan
*Corresponding author.
doi: 10.1192/j.eurpsy.2023.703
Introduction: Suicide is a leading cause of death among young
people and most deaths by suicide occur in low and middle-income
countries. School is the best place where we can identify and
respond to youth suicide risk. School-based interventions for sui-
cide prevention in young people have been successful across US,
Europe and Australia, but require adaptations to be acceptable and
feasible in Pakistan.
Objectives: To develop and test culturally adapted preventative
interventions for suicidal behaviours among pupils in secondary
schools in Pakistan. The qualitative component aimed at exploring
the views of students, parents, teachers and general practitioners on
cultural adaptation, experience of participation, areas of improve-
ment and suggestions for scale-up of the school-based suicide
prevention program (SEPAK).
Methods: A clustered randomised controlled trial. The four cul-
turally modified interventions 1) Linking Education and Awareness
of Depression and Suicide Awareness (LEADS) Training for pupils
(students=260) 2) the Question, Persuade, and Refer (QPR) for
teachers (students=203) 3) QPR for parents (students=445); 4)
Screening by Professionals (Profscreen) (students=260) were com-
pared against control intervention (educational posters) (stu-
dents=227). Structured questionnaires were administered at
baseline and 1-month post-intervention to assess suicidal behav-
iours, psychological well-being and quality of life. A total of 8 focus
groups (FGs) were conducted at pre and post intervention stage
with each stakeholders.
Results: Patient and public involvement and Engagement (PPIE)
was strongly embedded in the project to ensure meaningful benefits
for participants. A total of 40 schools were recruited from 8 cities
across Pakistan. A total of 243 students attended LEADS interven-
tion, 92 teachers and 304 parents completed QPR training, and
9 general practitioners were trained in ProfScreen. The retention
rate at follow-up was 99% that shows feasibility of delivering
intervention package in Pakistan. All participants marked SEPAK
as effectivein identifying risk of and preventing self-harm and suicide
in young people and in improving pathways to treatment. Interven-
tions were perceived as helpful in improving knowledge about
mental health, impact of mental health difficulties on functioning,
reducing stigma, equipping stakeholders to identify and signpost
at-risk people. Improvement in clinical and teaching practice as well
as understanding others behaviors were also reported.
Conclusions: This study suggest feasibility of integrating a suicide
prevention program in existing educational system and highlights
positive role of creating awareness about suicide in youth, intro-
duction of school-based mental health programs, parental counsel-
ing and strengthening of the health system by training general
practitioners in early identification of suicide risk and promoting
suicide prevention strategies
Disclosure of Interest: None Declared
EPP0389
Suicidality in Treatment-Resistant Depression Patients
E. B. Lyubov
1
and N. D. Semenova
2
*
1
Suicidology and
2
Psychological Counselling, Moscow Research
Institute of Psychiatry, Moscow, Russian Federation
*Corresponding author.
doi: 10.1192/j.eurpsy.2023.704
Introduction: Depression and treatment-resistant depression
(RD) are associated with suicidal behavior (SB) at a higher rate.
Objectives: 1) determination prevalence of RD in district out-
patient psychiatric сlinics (i.e., dispensaries) and the socio-
demographic characteristics of RD patients with SB.
Methods: In this multicenter (3 sites), retrospective, observational
epidemiological study, patients (n=148) with diagnoses F 30-39
(ICD-10) were recruited in 2020. Patients (n=22) were assessed for
RD, defined as failure to respond to ≥two antidepressant medica-
tions of adequate dose and duration for at least three months.
Results: The prevalence of depression is ≤2% of the outpatient
population. RD prevalence ˜15%. SB (i.e., suicidal attempts) was
noted in every fifth (n=5) for the index year. SB patients differed in
the following typical features: a woman (82%) mean age, 46.8 years
with long-term (≥10 years) depression and annual hospitalizations
european Psychiatry S317
https://doi.org/10.1192/j.eurpsy.2023.702 Published online by Cambridge University Press