Recent evidence confirms the risks of discontinuity of care when young people make a transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS), although robust data are still sparse. We aimed to identify when and how patients get lost to care during transition by tracking care pathways and identifying factors which influence dropping out of care during transition. This is a retrospective observational study of 760 patients who reached the transition age boundary within 12 months before transition time and being treated at CAMHS for at least during preceding 18 months. Data were collected at two time points: last visit to CAHMS and first visit to AHMS. Socio-demographic, clinical and service utilization variables on CAMHS treatment were collected. In the 12 months leading up to the transition boundary, 46.8% of subjects (n = 356) withdrew from CAHMS without further contact with AHMS, 9.3% withdrew from CAHMS but were referred to AHMS by other services, 29% were transferred from CAHMS to AHMS, 10% remained at CAHMS and 5% patients were transferred to alternative services. Fifty-six percent of subjects experience cessation of care before the transition age. The risk of dropout increases with shorter contact time in CAMHS, is greater in subjects without pharmacological treatment, and decreases in subjects with psychosis, bipolar disorder, eating disorders, mental retardation, and neurodevelopmental disorders. This study confirms that a large number of people drop out of care as they approach the CAMHS transition and experience discontinuity of care during this critical period.

Background Coronavirus disease-2019 (COVID-19) has been challenging for patients and medical staff. Radical changes have been needed to prevent disruptions in patient care and medical education. Methods A web-based survey was sent to European Society for Pediatric Nephrology (ESPN) members via the ESPN mailing list to evaluate the effects of the COVID-19 pandemic on delivery of pediatric nephrology (PN) care and educational activities. There were ten questions with subheadings. Results Seventy-six centers from 24 countries completed the survey. The time period was between the beginning of the pandemic and May 30, 2020. The number of patients admitted in PN wards and outpatient clinics were significantly decreased (2.2 and 4.5 times, respectively). Telemedicine tools, electronic prescriptions, online applications for off-label drugs, and remote access to laboratory/imaging results were used in almost half of the centers. Despite staff training and protective measures, 33% of centers reported COVID-19 infected staff, and 29% infected patients. Difficulties in receiving pharmaceuticals were reported in 25% of centers. Sixty percent of centers suspended living-related kidney transplantation, and one-third deceased-donor kidney transplantation. Hands-on education was suspended in 91% of medical schools, and faceto-face teaching was replaced by online systems in 85%. Multidisciplinary training in PN was affected in 54% of the centers. Conclusions This survey showed a sharp decline in patient admissions and a significant decrease in kidney transplantation. Telemedicine and online teaching became essential tools, requiring integration into the current system. The prolonged and fluctuating course of the pandemic may pose additional challenges necessitating urgent and rational solutions.

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Depression is one of the most prevalent mental disorders and a notably heterogeneous condition with regard to etiology, symptom expression, course, and treatment response. This is why it is extremely unlikely that a “one size fits all” approach to the treatment of depression will be particularly effective. Quite the contrary, it is clear that the future of the treatment of depression may lie in a combined disorder- and person-centred, tailored-made approach, which takes into account the broader interpersonal context and life history of the individual. Depressed patients with a characteristic cognitive-affective schema of self-critical perfectionism are prone to typical dysfunctional transactional cycles or dominant interpersonal narratives in which rage, distrust and ambivalence are apparent. In addition to this, in these subtype of depressed patients is common to find the overuse of attachment deactivating strategies, in response to threats to attachment relationships specially, and the inhibition of mentalizing as a defensive response to the feelings of rage, emptiness and sadness that are developmentally linked to attachment experiences. The implications of these findings for treatment, particularly with regard to the nature of the therapeutic relationship, are readily important. In this poster we take several cases in order to detail the main psychodynamics and the dominant interpersonal narratives of this subtype of depressed patients and to specify a therapeutic proposal tailored for them.Disclosure of interestThe authors have not supplied their declaration of competing interest.

S79 multinominal logistic and Cox regression analysis (p< 0.05). Statistical tests were performed using the SPSS version 19.0. RESULTS: 263 women met the criteria with 27.80% mortality rate at 180 day respectively.Logistic and Cox regression identified higher age (HR: 1.037, OR:1.067) as risk factor for 180 day mortality. Location of contralateral hip fracture (pertrochanteric fracture vs. femoral neck fracture HR: 2.310) showed significant association with 180-day mortality in women with Cox regression analysis. CONCLUSIONS: Higher age and pertrochanteric fracture type proved to be risk factors for 180-day mortality after contralateral hip fracture in women over 60 years. There is a need to identify further risk factors in order to develop an efficacious prevention strategy for the reduction of the mortality after the contralaetral hip fractures.