S742 P.7.f.

Child and adolescent disorders and treatment − Other (clinical)

perceptual priming of trauma-related contents [4]. Moreover, some Results: PIU was identified in 292 (18.2%) of the 1,608
individuals were shown to activate the extra-synaptic GABA students who were ultimately included in the present study.
system (instead of glutamate) to form consciously inaccessible Clinically significant PTSD symptoms were identified in 494
traumatic memories [5]. This protects from the emotional pain (30.7%) subjects measured using the UCLA-PTSD RI and in 239
of recalling, but eventually causes serious long-term psychologi- (15.6%) subjects using the CROPS. Female, high school level, low
cal consequences. These mechanisms warrant further elucidation socioeconomic status, poor academic achievement, and PIU were
since they could serve as treatment targets for managing traumatic associated with PTSD symptoms. The CES-D and SAIC scores
experiences. were significantly higher in subjects with PTSD symptoms than in
those without. The logistic regression analysis revealed that PIU
References was a significant predictor of PTSD symptoms after adjusting for
[1] Gilbert R, Kemp A, Thoburn J, Sidebotham P, Radford L, Glaser D, other variables.
Macmillan HL, 2009. Recognizing and responding to child maltreat- Conclusions: PIU may be a predictor of PTSD symptoms
ment. Lancet 373(9658), 167–180. in vulnerable children and adolescents who have experienced a
[2] MacMillan HL, Fleming JE, Streiner DL, Lin E, Boyle MH, disaster. Our findings suggest that children and adolescents with
Jamieson E, Duku EK, Walsh CA, Wong MY, Beardslee WR, 2001.
Childhood abuse and lifetime psychopathology in a community sample. PIU require intensive follow-up and special care to prevent the
Am J Psychiatry 158(11), 1878–1883. development of PTSD symptoms following a disaster.
[3] Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T, 2012.
The long-term health consequences of child physical abuse, emotional Table. Logistic regression analysis of PTSD predictors
abuse, and neglect: a systematic review and meta-analysis. PLoS Med UCLA-PTSD RI CROPS
9(11), e1001349. Odds ratio (95% CI) p-value Odds ratio (95% CI) p-value
[4] Holz E, Lass-Hennemann J, Streb M, Pfaltz M, Michael T, 2014. Effects
Sex Boys
of acute cortisol administration on perceptual priming of trauma-related
Girls 1.41 (1.03–1.93) 0.033 1.03(0.68–1.55) 0.894
material. PLoS One 9(9), e104864.
School level Primary
[5] Jovasevic V, Corcoran CA, Leaderbrand K, Yamawaki N, Guedea AL, Secondary 1.01(0.67–1.50) 0.960 0.59(0.34–1.02) 0.060
Chen HJ, Shepherd GM, Radulovic J, 2015. GABAergic mechanisms High 1.54(0.99–2.40) 0.057 0.60(0.33–1.09) 0.096
regulated by miR-33 encode state-dependant fear. Nat Neurosci 18(9), Socioeconomic status High
1265–1271. Middle 1.27(0.86–1.87) 0.237 0.86(0.51–1.47) 0.585
Low 1.58(0.97–2.56) 0.077 1.04(0.55–1.97) 0.898
Academic achievement Good
Average 1.07(0.74–1.55) 0.722 1.14(0.69–1.89) 0.615
P.7.f.003 Relationship between problematic internet Poor 1.14(0.78–1.67) 0.499 1.59(0.97–2.61) 0.065
use and post-traumatic stress disorder Internet use Normal
PIU 2.50(1.74–3.61) <0.001 1.82(1.17–2.82) 0.008
symptoms among students in a rural town CES-D 4.32(3.20–5.83) <0.001 9.99(6.19–16.13) <0.001
near the Sewol ferry disaster in Korea SAIC 35.98(14.16–95.43) <0.001 61.78(16.38–233.01) <0.001

J.Y. Lee1 ° , S.W. Kim1 , H.J. Kang1 , J.M. Kim1 , I.S. Shin1 ,
J.S. Yoon1 1 Chonnam National University Hospital, psychiatry,
Gwangju, South-Korea
Introduction: On 16 April 2014, the Sewol ferry sank off the
coast of Jindo Island on the way from Incheon to the southern
resort island of Jeju, South Korea. Students who lived in the Jindo
area were acutely affected by the Sewol ferry disaster because of
their geographical proximity and because most of the victims were
students like themselves. Indirect exposure to traumatic events is
sufficient for the development of PTSD symptoms in children and
adolescents [1,2]. In addition, individuals may be more vulnera-
ble to PTSD symptoms if they suffer from addiction [3,4]. We
investigated the association between PIU and PTSD symptoms in
children and adolescents who experienced or observed a traumatic
disaster to identify predictors of PTSD.
Objective: We investigated the association between problematic
internet use (PIU) and post-traumatic stress disorder (PTSD)
symptoms among Korean students who witnessed the Sewol ferry
accident in which approximately 300 people drowned.
Methods: A cross-sectional survey was administered to 1,744
students from the Jindo area 1 to 2.5 months after the Sewol
ferry disaster. PTSD symptoms were measured using the Uni-
versity of California Los Angeles Post-traumatic Stress Disorder
Reaction Index (UCLA PTSD-RI) and the Child Report of Post-
traumatic Symptoms (CROPS). The severity of impairment caused
by excessive internet use was evaluated using Young’s Internet
Addiction Test [5]. Additionally, the Center for Epidemiological
Studies Depression Scale (CES-D) and State Anxiety Inventory
for Children (SAIC) were administered.
References
[1] Nader, K., Pynoos, R., Fairbanks, L., Frederick, C., 1990. Children’s
PTSD reactions one year after a sniper attack at their school. Am
J Psychiatry 147, 1526–1530.
[2] Otto, M.W., Henin, A., Hirshfeld-Becker, D.R., Pollack, M.H., Bieder-
man, J., Rosenbaum J.F., 2007. Posttraumatic stress disorder symptoms
following media exposure to tragic events: impact of 9/11 on children
at risk for anxiety disorders. J Anxiety Disord 21, 888–902.
[3] Koenen, K.C., 2006. Developmental epidemiology of PTSD: self-
regulation as a central mechanism. Ann N Y Acad Sci 1071, 255–
266.
[4] Orr, S.P., Lasko, N.B., Macklin, M.L., Pineles, S.L., Chang, Y., Pit-
man, R.K., 2012. Predicting post-trauma stress symptoms from pre-
trauma psychophysiologic reactivity, personality traits and measures of
psychopathology. Biol Mood Anxiety Disord 18, 8.
[5] Young, K.S., 1998. Internet addiction: the emergence of a new clinical
disorder. Cyberpsychol Behav 1, 237–244.
P.7.f.004 Pittsburgh Sleep Quality Index in younger
medical students. Are they poor sleepers and
do they consume sleeping medication?
M. Henry1 ° , L. Huerga-Garcia2 , A.A. Perez-Morell2 , A.A. Henry-
Gonzalez3 1 School of Medicine, Department of Internal
Medicine- Dermatology and Psychiatry, Santa Cruz de Tenerife,
Spain; 2 University of La Laguna Medical School, Health
Sciences Department, Santa Cruz de Tenerife, Spain; 3 Gerencia
de Atención Primaria, Health Care Department of the Canary
Islands, Santa Cruz de Tenerife, Spain
Introduction: Sleep is something everyone needs, but many don’t
get enough. For a student it often means to have sleep deprivation

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 P.7.f. Child and adolescent disorders and treatment − Other (clinical)
due to all the late nights of working or being unable to sleep.
Whether it is studying homework you put off that needs to be
done or stress that is keeping you up. In medical school students
adjustment efforts, personality traits, highly demanding tasks and
curricula burdens could be associated with impairment in sleep
quality. Insomnia, for example, is associated with an increased
prevalence of somatic diseases and lower achievement. General
population studies have estimated that the prevalence of sleep
disorders ranges between 15 and 42% and may reach even a 62%
figure. There is some need in research concerning sleep quality
in a comprehensive way in medical students.
Objectives and Aim: Studying sleep variables according to
a common rating scale in sleep research in lower grade medical
students.
Methods: Pittsburgh Sleep Quality Index (PSQI) was adminis-
tered to a 135 (mean age 19.90 y.o. voluntary sample (76% female
/ 33% male) of first cycle, initial coursers, medical students in
Tenerife through February 2015. PSQI studies sleep by measuring
seven domains: subjective sleep quality, sleep latency, sleep du-
ration, habitual sleep efficiency, sleep disturbances, use of sleep
medication, and daytime dysfunction over the last month. Data
were considered applying standard Statistical Analysis.
Results and Discussion: Mean Duration of Sleep is 6.5 hours
per night. And 80% of the alumni slept less than 8 hours. A
considerable number of students reported, nearly 34 of the sample
(72% 97/135), poor sleeping. This figure is really higher than
that observed in general population in adult individuals and than
the recorded percentage in the elderly. No age or sex differences
were observed (p > 0.05) in our sample. Drug consumption with
sleeping improving purpoes (Need Meds to Sleep) was acknowl-
eged by 29% of the medical alumni though it may suppose little
improvement.
Conclusions: The vast majority of younger medical alumni can
be considered poor sleepers. Less than a third use medication
for sleeping purposes. The results of this study may underline
the importance of evaluating sleeping in academic competence
and performance in medical students, seemingly crucial items in
academic success [1−4]. Efforts in understandings the implication
of sleep quality in students and their academic performance
should be focused. Thus, both sleep deprivation and poor sleep
quality are prominent in society, especially in college student
populations. Sleep problems are often a primary disorder rather
than secondary to depression. Sleep deprivation and/or poor sleep
quality in university students was associated with lower academic
performance in a sample in the US. A significant correlation
between Global Sleep Quality score (GSQ) on the Pittsburgh Sleep
Quality Index and grade point average was found, suggesting that
poor sleep quality is associated with lower academic performance
for nondepressed psychology students [5].
References
[1] June, J., Pilcherdouglas, R., Ginterbrigitte, S., 1997. Sleep quality ver-
sus sleep quantity: relationships between sleep and measures of health,
well-being and sleepiness in college students. Journal of Psychosomatis
Research, 42: 583–596.
[2] Hannah, G., Lund, B.A., Brian, D., Reider, B.A.J., Prichard, R., 2010.
Sleep patterns and predictors of disturbed sleep in a large population
of college students. Journal of Adolescent Health. 46: 124–132.
[3] Bajo-Bajo, A., Santos-Perez, M.E., Sanz-Ortega, F., Zapico-
Alvarez, N., Okatsu, K.T., Garcia-Perez, A., Borras-Beato, R., 1999.
Estudio epidemiológico sobre intoxicaciones agudas y dotación de
botiquines de antı́dotos. An Med Interna, 16: 285–289.
[4] Veldi, M., Aluoja, A., Vasar, V., 2005. Sleep quality and more common
sleep-related problems in medical students. Sleep Med; 6: 269−75.
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S743
[5] Gilbert, S.P., Weaver, C., 2010. Sleep Quality and Academic Perfor-
mance in University Students: A Wake-Up Call for College Psycholo-
gists Journal of College Student Psychotherapy, 24: 295–306.
P.7.f.005 Child and adolescent abuse through the
internet: shared psychotic disorder through
virtual communication
A. Dzubur Kulenovic1 ° 1 University of Sarajevo Clinical Center,
Department of Psychiatry, Sarajevo, Bosnia and Herzegovina
Introduction: The poster is a case report of a shared delusional
disorder resulting from the internet relationship of an adolescent
boy, age 15 who developed psychotic symptoms under the influ-
ence of anonymous domineering person who he was in frequent
contact with via Internet.
Objective: To describe the development of symptoms of shared
delusional disorder in a 15 year old boy who was in a prolonged
and intensive Internet communication with an anonymous person
who was posing increasingly demanding commands and demands
to the subject that has resulted in the occurrence of psychotic and
affective symptoms and has led to significant impairment of social
and family functioning.
Methods: This case report is based on a case history that
was obtained from the boy and his parents and older sister,
his psychiatric examination and description of treatment and its
results.
Results: The boy who has had no previous psychiatric history
presented for treatment as an outpatient in the Department of
Psychiatry of the University Clinical Center Sarajevo accompa-
nied by his parents and sister. In the previous several months the
boy was spending most of his time at the computer, increasingly
withdrawing from contacts with family members, his peers, and
even missing school occasionally. He also became increasingly
irritable and repulsive to his parents and sister, even refused to
take food and water for a short period of time, and has also
developed some other behavioral changes that appeared strange
and bizarre to his parents, and caused their concern that has led to
a visit to the Department of Psychiatry. Before this visit, his older
sister managed to break into and search the boy’s computer where
she found evidence of his communication with the individual
who called herself ‘The Mistress’ and who kept insulting and
demanding from the boy to perform increasingly demanding tasks
in order to avoid being punished by the Mistress. The punishments
included tasks like sending an e-mail to her every half an hour
during 48 hours period, or not taking food or water, and eventually
asking him to blackmail certain individuals. He complied with
all tasks without a word. Psychiatric exam of the boy revealed
psychotic symptoms comprising of bizarre delusions and nihilistic
depressive delusions.
Results: Before coming for treatment, the boy’s parents ordered
him to stop this communication and turned off the internet
connection. The treatment consisted of supportive psychotherapy,
psychoeducation, family interventions and a low dose risperidone
and sertraline. Complete resolution of symptoms accompanied by
full restitution in functioning occurred within first two months of
treatment.
Conclusions: This case report illustrates the potential role of
new communication technologies in the development of mental
health disorders and the potential for abuse of children as well as
the need for parental supervisions and restrictions of the Internet
use.