Depression in the elderly is common and closely interrelated with the deterioration of the quality of life, especially in the institutionalized elderly.

In this work, we propose to determine the prevalence of depression in the elderly in institution, to assess their quality of life and to evaluate the correlations between depression and the quality of life.

Our study concerned 30 elderly subjects institutionalized at the retirement home(Sousse, Tunisia). Three validated Arabic version scales were used: The 30-item GDS (Geriatric Depression Scale), the MMSE (Mini Mental State Examination) and the SF36 (assessing the quality of life).

The mean age of our population was 75±7.3 years, the sex ratio was 1.73. The prevalence of depression was 37%. The elderly had a cognitive impairment in 16.7%. The mean global SF36 score were 11.2, attesting an altered quality of life in all our subjects: the mental component (9.43) were more altered than the physical one (13.03). No correlation between depression and quality of life was found. Depression was significantly correlated with the presence of a medical history (p=0.05). Depression had a negative and statistically significant correlation with the physical score of SF36 (r=-0.41, p=0.02) and tended towards significance for the “general health” dimension of SF36 (r=-0.32, p=0.08).

Our study shows a high frequency of depression in the institutionalized elderly as well as a deterioration in their quality of life. Depression is strongly linked to deterioration in physical condition.Our results underline the influence of somatic diseases as a major risk factor for depression in the elderly.

No significant relationships.

Othello syndrome (OS) is a psychiatric condition consisting of delusional jealousy, and irritability. It is often associated with psychiatric or neurological disorders. The most common are delusional disorder and dementia.

The purpose of this poster is to examine the phenomenon of OS and its etiopathogenesis throughout a case report.

We present the case of a 78-year-old male patient who was treated in our department due to delusional jealousy and depressive symptoms. The patient has a medical history of cardiac events in the past, being stable at the current moment. We performed a detailed psychiatric and physical history paying special attention to personality traits in the past. The patient was administered Mini Mental State Examination and CamCog (subscale of Camdex).

According to him and his family our patient had neither episodes of jealousy nor affective disorders. His results were: 18 in MMSE and 57 in CamCog. Both compatible with a dementia course.

Attending our results we inferred that the OS belongs to a dementia clinical picture instead of a psychotic disorder. Therefore we decided to treat the patient with neuroleptics, with partial improvement, and to start cognitive stimulation treatment in a day centre and a short term psychological family intervention to help the family to understand and cope with the course of dementia. Thus, clinicians should keep in mind the possible organic origin of OS, especially in elderly persons, to develop an appropriate individual and familiar case approach.

No significant relationships.

Dementia develops slowly and insidiously and causes cognitive impairment. The diagnosis is pivotal for relevant treatment and care. However, 50,000 people are estimated to have undiagnosed dementia in Denmark, while 36,000 are diagnosed.

The municipalities offers a home visit to the population at the ages of 75 and 80 years to assess the need of care and prevent sickness. These home visits are well established and might offer an unused opportunity to detect cognitive impairment and dementia.

To assess impaired cognition at home visits in order to initiate clinical examination for dementia.

A feasibility study with the use of Brief Assessment of Impaired Cognition Questionnaire (BASIC-Q) (sensitivity 0.92, specificity 0.97) at home visits. It is expected to include 1000 participants without a dementia diagnosis at the ages of 75 and 80 years. Participants will be included in a period of 12 moths (in the year of 2022), in a number of municipalities.

If the screening for cognitive impairment is positive, the participant is motivated for clinical examination at the general practitioner. Follow-up through registers and general practitioners.

Preliminary results will be presented at the conference.

Assessment of cognition might give an opportunity to start medication and social support early in the elderly with impaired cognition and undiagnosed dementia.

No significant relationships.

Preservation of health, increase in life expectancy determine the need to improve the effectiveness of medical recommendations, which, despite the success of pharmacology, are insufficient for reasons related to the low level of compliance with these recommendations by patients.

Participants of the study-148 employees of medical institutions: 12 men, 136 women, their age ranged from 27 to 74 years.

Despite the absence of signs of decompensation of concomitant pathology, representatives of the subgroups took a different amount of concomitant therapy. Using the scale of assessment of drug compliance, it was found that compliance is most reduced in the subgroup of 41-50 years. In this subgroup, a comprehensive decrease in compliance across the “behavioral”, “emotional”, and “cognitive” domains was detected in 87.8% of cases, while in the younger subgroup partial non-compliance was 32.4%, in the older subgroup - 74.5%

An analysis of the states of cognitive functions in 52 representatives of the middle age subgroup with low compliance rates showed that, unlike other representatives of the same subgroup, their indices for a number of neuropsychological tests are close to the results of more adult participants in the study.Individuals demonstrating low compliance with quite favorable CNS resources are at risk for the formation of pathological aging.

Compliance is considered as Compliance is considered as a control mechanism for preventing normal aging into pathological by regulating risk factors that are dangerous for the brain and associated with the formation of dementia

No significant relationships.

The COVID-19 pandemic caused significant disruptions in services and necessitated innovation to continue care provision to the vulnerable population of older adults with psychiatric needs.

The objective of this study was to examine the experiences of staff and patients using a hands-free electronic smart-hub (eSMART hub) intervention to keep patients connected with psychiatry of old age following COVID-19 restrictions.

A risk stratification register was created of all patients known to the Psychiatry of Old Age service in the North-West of Ireland to identify those at highest risk of relapse. These patients were offered a smart-hub with remote communication and personal assistant technology to be installed into their homes. Smart-hubs were also installed in the team base to facilitate direct device to device communication. Semi-structured qualitative interviews were conducted with 10 staff members and 15 patients at 6-12 months following the installation of the smart-hubs.

The smart-hubs were utilized by the POA team to offer remote interventions over video including clinician reviews, regular contact with key workers and day-hospital based therapeutic interventions such as anxiety management groups and OT led physical exercises. Patients also used the personal assistant aspect of the hub to attend to personal hobbies such as accessing music and radio. Positive feedback related to companionship during isolation and connectivity to services. Negative feedback was mainly related to technology, particularly internet access and narrow scope of communication abilities.

Electronic smart-hub devices may offer an acceptable avenue for remote intervention and communication for isolated high-risk older persons.

The smart hub devices used in this study were donated by Amazon. However, the company was not involved in any other aspect of the study and the researchers have no significant financial interest, consultancy or other relationship with products, manufactur

The older adults have been considered one of the groups at highest risk of SARS-CoV-2 infection and death due to COVID-19. Fear of SARS-CoV-2 infections has become widespread. It’s constantly being enhanced by the media reports and social distancing principle.

The aim of the study was to assessment the occurrence of symptoms of fear of COVID-19 among participants of the Polish University of the Third Age (UTA).

The study included 296 participants of the UTA in Poland, including 258 women and 38 men. The study conducted with the use of the following validated psychometric scales: General Anxiety Disorder-7 (GAD-7), Short Health Anxiety Inventory (SHAI) and State-Trait Anxiety Inventory (STAI).

The mean scores in STAI and SHAI demonstrated mild symptoms indicative of anxiety disorders in the older adults. Women and men did differ significantly in terms of the scores obtained in STAI(X-1) (p=0.002) and STAI(X-2) (p=0.020). There were no statistically significant differences between respondents with higher education and those with a different level of education. The single respondents differed significantly from divorced ones in terms of STAI(X-1) (p=0.046). Moreover, widows/widowers differed significantly from divorced ones in terms of STAI(X-2) (p=0.045) and GAD-7 (p=0.032).

The subjective experience of anxiety symptoms associated with fear of contracting COVID-19 was increased due to the ongoing pandemic, but was not significantly high in the analysed population of older people. COVID-19-related anxiety was significantly more common in lonely individuals. Women and men differed significantly in terms of perceived state anxiety and trait anxiety measured by STAI.

No significant relationships.

During the last decades, the incidence of syphilis is on the rising, particularly in the United States of America and Europe. Neurosyphilis is a disease that has a vast differential diagnostic. With that in mind, clinicians have some difficulties to identify it rapidly. A case of a 57-year-old man is presented, with a brutal change in his behavior, associated with a dementia-like syndrome. He is diagnosed with neurosyphilis.

The main goal is to present his clinical psychiatric symptoms and diagnosis procedure, the treatment that he received and his clinical outcome in the psychogeriatric department.

The treatment was based in an integrated framework of pharmacology and psychotherapy.

The patient was able to slowly recover and to get back home, we a solid structure to make the follow up.

This clinical vignette represents a growing number of adult patients that present themselves for the first time with dementia-like symptoms. It is important to remember, that many diseases are capable of mimicking dementia and their exclusion before admitting a diagnosis of dementia is mandatory.

No significant relationships.

Charles Bonnet syndrome (CBS) is defined like visual hallucinations found in individuals who are not necessarily mentally ill, who have visual impairment and no cognitive deficits. Although CBS make reference to visual hallucinations, in this case we are going to deal about Auditory Charles Bonnet Syndrome (aCBS), a very infrequent condition that consists in the presentation of musical hallucinations in patients with sensorineural hearing loss and which etiology is not clearly due to a psychiatric condition.

Review the scientific literature available on aCBS to see how much we know about this syndrome.

Review of available literature sources were obtained through electronic search in PubMed database.

Musical hallucination is a complex form of auditory hallucinations. The most common of these are idiopathic and they present in elderly patients with deafness or impaired audition, which suggests a deterioration of cerebral function. The pathophysiologic mechanism is not understood. These patients tend to have intact reality tests. The time course is variable. In those cases in which it is possible, treating the hearing loss can lead to a significant improvement of the symptom. However, when every this strategies are insufficient, pharmacological treatments can be considered.

- aCBS is an uncommon condition characterized by the presence of complex auditory hallucinations that mainly affect elderly patients with hearing loss. - In most cases there is no previous psychiatric history. - The etiology and pathophysioplogic are not well defined. - There is no etiological treatment. We can use pharmacological and no pharmacological methods of treatment.

No significant relationships.

Agitated behaviors is a common neuropsychiatric symptom (NPS) in dementia, defined as inappropriate verbal, vocal, or motor activity that is not thought to be caused by an unmet need. It is frequently reported as a major problem, that impairs the quality of life for the elderly themselves and for caregivers. There has been increasing interest in the use of sedative antidepressants to treat NPS due to concerns over the safety and efficacy of antipsychotics in this setting.

We aim to review clinical evidence of alternatives to antipsychoticst to manage agitation in dementia.

We conduct a non-systematic review of recent evidence on dementia and agitation, using PubMed/Medline database.

Although non-pharmacological interventions are the first-line treatment for agitation, it is a legitimate target for therapeutic intervention and according to previous guidelines, antipsychotic are among the most used drugs, albeit restricted because of side-effects. A substitution strategy to avoid antipsychotic prescription was highly considered, however there is limited evidence to support the use of antidepressants as a safe and effective alternative for agitation in dementia. Studies compare Mirtazapine, Selective serotonin reuptake inhibitors (SSRIs) and Trazodone and a reduced benefit in mortality is observed. However, citalopram was more effective were more likely outpatients for moderately agitation and Mirtazapine reveals being potentially harmful, in different studies.

Moving forward, a greater understanding of NPS neurobiology, will help to clarify the efficacy of Antedepressants for the treatment of agitation in dementia. Benefits an also the patient and caregiver preference should be kept in mind.

No significant relationships.

Syphilis is a sexually transmitted infection which in its late phase can cause all kinds of neuropsychiatric symptoms. A case report of a 79-year-old male with a manic episode probably due to lues is presented.

A case of a patient with neurosyphilis is presented followed by a theoretical review on the topic.

A case is presented with a bibliographic review.

A 79-year-old male was hospitalized with symptoms of disorientation, inattention, and difficulty for abstract thought. His speech was verbose, incoherent with megalomaniac ideas. He presented affective symptoms such as hyperthymia, emotional lability and intermittent crying. He also had nomination problems and recent memory mistakes. He also suffered from insomnia. He presented as his medical history HIV infection under control and syphilis treated in December 2020 with a negative RPR test in June 2021. During his hospitalization he was treated with increasing doses of olanzapine and valproic acid. Irritability improved with this treatment.

Neurosyphilis may be presented as any kind of neuropsychiatric disorder. Laboratory tests are required as there is no conclusive imaging test. Penicillin and symptomatic management are the proper treatment. Neuropsychiatric disorders in elderly population must consider infectious diseases and previous pathologies as differential diagnosis.

No significant relationships.

Patients with mild cognitive impairment may present deficits in naming, speech production, oral comprehension and written comprehension. In the differential diagnosis, cerebrovascular disease that can lead to cognitive impairment must also be differentiated from endogenous depressive disorder or language impairment.

The aim is to highlight the importance of differential diagnosis in cognitive disorders in relation to a case.

A 68-year-old female patient attended a psychiatric consultation derived from neurology when presenting a language disorder. The husband who accompanies her and the patient indicate that she has problems finding words and substitutes other expressions for them or sometimes does not answer or does so with something different from the topic that is being asked. She refers that she presents repetitive language with memory problems, alteration in the evocation of memories. The patient reports mood swings and irritability and crying with a low tolerance for frustration since she cannot express herself. Cranial MRI: cortical and central involutional changes. Periventricular leukoaraiosis and ischemic gliosis-like lesions in the white matter of both hemispheres. Psychopathological exploration: Conscious, oriented. She smiles at the questions but doesn’t answer them. Repetitive language. Alteration in the articulation of language. Depressed mood reactive to current situation. Some irritability Alteration in recent memory and evocation.

She was diagnosed with organic mental disorder compatible with mild cognitive impairment. Treatment with rehabilitation of the language disorder of vascular etiology is established.

Imaging and neuropsychological tests should always be performed in a patient with language, memory, and mood disorders to study its etiology.

No significant relationships.

Elderly people have always presented physiological changes and suffered from many diseases. There are few studies focused on this growing particular population, especially with mental pathologies. Thus, psychiatric hospitalization of the elderly population is more frequent nowadays.

The aim of this study is to establish the socio-demographic characteristics of elderly patients hospitalized in psychiatry.

Retrospective and descriptive study over a period of 20 years and 6 months on patients aged over 65 years old hospitalized in the psychiatry “B” department of the Hedi Chaker University hospital in Sfax, Tunisia, for a psychiatric disorder, selected according to the DSM 5 diagnosis criteria.

The number of records identified was 62, out of 4019 patients (15.4%). The mean age of patients was 71.1 years old and the sex ratio (Male / Female) = 0.67. Patients were originally from Sfax in 58.1% and from rural areas in 58.1% of cases. Most of patients (78.4%) were living at least with one member of their family. They were married in 53.2% of cases. The average number of children was 5.21. The majority of patients were illiterate (61.3%) and never had a professional activity in 45.2% of cases. Social coverage concerned 96.8% of our sample.

Elderly patients hospitalized in our department were mainly illiterate, females and living with their family. Despite everything, family involvement in care is still necessary for this category of patients.

No significant relationships.

Early diagnostics of neurodegenerative disease and their comorbidities is linked to better treatment outcome and improved quality of life. The first patient assessment should lay strong foundations for the direction of the upcoming diagnostic procedure. Clock Drawing Test (CDT) is often used as an early screening instrument in geriatric patients presenting with cognitive disorders.

The goal of the present study was to evaluate diagnostic accuracy of the CDT in a geriatric cohort with mild cognitive difficulties.

Out of a pool of in- and outpatient data presenting with subjective cognitive difficulties three diagnostic groups were formed – mild cognitive impairment, depressive disorder and healthy controls. CDT was scored using a quantitative scoring system with each aspect of the clock evaluated separately. CDT data was analysed for its discriminative value in early diagnostics of AD and DD.

Logistic regression produced a significant model with a low percentage of explained variance in both DD and AD groups. Same CDT items were significant predictors for DD and AD pathology. ROC curve inspection allowed only a poor discrimination capability for the significant predictors.

Despite being a popular screening test, CDT is a poor choice for individuals presenting with a mild cognitive impairment. Using CDT alone might result in initial stages of neurodegeneration going undetected, thus depriving patients of early treatment options. Same error types were significant predictors in DD and AD. This indicates that CDT can detect a general impairment; however, an in-depth neuropsychological assessment is needed for differential diagnostics.

No significant relationships.

Glycemic control for elderly diabetics is a challenge. Treatment satisfaction reflects this control.

To determine the factors associated with insulin treatment satisfaction among type 2 diabetic elderly.

A cross-sectional study on 86 type 2 diabetic insulin dependent elderly recruited from the outpatient endocrinology consultation during June and July 2021. We applied the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and geriatric assessment scores.

Three quarters of the patients were satisfied with the insulin therapy. Satisfied patients had significantly less history of hospitalization and more regular follow-up. Diabetic neuropathy medications were significantly less taken by satisfied patients. The number of daily insulin injections was significantly higher in the unsatisfied patients. Diabetic foot was significantly more frequent in unsatisfied patients. Satisfied patients were significantly less depressed, more independent in both basic and instrumental activities of daily living, without memory impairment, in better nutritional status and not falling. Higher DTSQ scores were associated with regular follow up (β 7.92, 95% CI 1.83 to 34.3). Lower DTSQ scores were associated with the history of hospitalization (β 0.12, 95% CI 0.02 to 0.58), the taking of medications for diabetic neuropathy (β 0.07, 95% CI 0.09 to 0.51), the high number of insulin injections (β 0.43, 95% CI 0.19 to 0.97) and the presence of diabetic foot (β 0.17, 95% CI 0.01 to 0.38).

Risk factors for patients’ insulin dissatisfaction should be detected early and managed appropriately to improve patients’satisfaction and consequently their well-being.

No significant relationships.

Although depression is one of the most common diseases among older people, it is still underdiagnosed due to frequent misleading symptoms.

The aims of our study were to assess depression in type 2 diabetic insulin-dependent older adults and to identify factors associated with depression among this population.

A cross-sectional study on 100 type 2 diabetic insulin-dependent elderly recruited from the outpatient endocrinology consultation during June and July 2021. We applied the geriatric assessment scores: the Geriatric Depression Scale 15-item, the KATS score, the Lawton scale. the five-word test, the Mini Nutritional Assessment and the Timed Up and Go test.

The mean age of the population was 70.8±5.8 years with sex ratio of 0.85. Depression was noted among 57% of the patients who were distributed as follow: around one fifth (21%) had mild depression while 36% had moderate to severe depression. Around one quarter of the patients (24%) were dependent in the basic activities of daily living. Depression was significantly associated with dependency (β = 5.27; 95% CI, 1.01 to 27.35), ophthalmologic diseases (β = 8.81; 95% CI, 2.18 to 35.63), high frequency of nocturia (β = 3.71; 95% CI, 1.24 to 11.05) and high frequency of bleeding at insulin injection site (β = 4.21; 95% CI, 1.49 to 11.84).

Our findings suggest that the prevalence of depression is high among type 2 diabetic insulin-dependent older adults. Early assessment of depression’s risk factors is a major pillar of the comprehensive care of our seniors.

No significant relationships.

Anti-Hu related Paraneoplastic Neurological Syndrome (PNS) is one of the most common paraneoplastic-associated neurological syndromes (Kayser 2010). While the primary clinical manifestations are neurologic in nature (Smitt 2002), only rare reports exist regarding psychiatric manifestations. Our poster presents two cases of Anti-Hu Encephalitis manifesting as psychosis as well as a systematic literature review on the co-occurrence of psychosis and PNS.

The aim of this case series is to show psychosis as the primary symptom of a paraneoplastic syndrome that does not typically present in this way. It also serves as a reminder to have a detailed work-up and maintain a wide differential diagnosis when evaluating patients with first-episode psychosis.

Two cases of anti-Hu encephalitis primarily presenting with psychiatric symptoms are discussed. A systematic literature review was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model on three electronic databases: PubMed, Embase, and PsycINFO. Search terms included were (Anti-Hu) AND (Psychosis OR Hallucinations OR Schizophrenia OR Schizoaffective).

Our case series reports on two patients with diagnosed anti-Hu encephalitis who were treated by our psychiatry team, where the primary manifestations of the illness were psychiatric in nature. Psychotic symptoms in these cases were managed with Risperidone, Olanzapine, and Paliperidone.

Psychotic symptoms are seldom reported in the literature and cases like the ones presented emphasize the importance of a full medical work-up for first episode psychosis as well as a wide differential. Given the increased association between PNS and psychiatric illness, more emphasis and further research is warranted.

No significant relationships.

Expectations and fears about chemotherapy and radiotherapy in patients with oncological illness may not only affect their subjective well-being (Shaverdian et al., 2018) but also treatment satisfaction and complaints of side effects (Guidolin et al., 2018, Dong et al., 2014, Colagiuri et al., 2013).

The aim was to compare beliefs about treatment in patients referred to radiation therapy and chemotherapy, and to reveal their relationship to health anxiety and subjective well-being.

53 patients referred to radiation therapy and 63 patients referred to chemotherapy completed the Treatment Perception in Oncological Illnesses Scale (Kovyazina et al., 2021), Illness and Treatment Self-Regulation Questionnaire (Kovyazina et al., 2019), Satisfaction with Life Scale (Diener et al., 1985) and Scale of Positive and Negative Experiences (Diener et al., 2009).

Compared to radiation therapy, with chemotherapy, patients tend to be more doubtful about the effectiveness of treatment and more anxious about the need for it (p<.05). Moderated mediation analysis demonstrated that lack of understanding, doubts about the effectiveness and anxiety about radiation and chemotherapy are associated with subjective ill-being indirectly - through a higher level of health anxiety (β=-.79--.35, SE=.17-.26, 95% CI [-1.42 - -.75 – -.37 - -0,08]). Feelings of helplessness regarding treatment mediated the relationship between doubts and confidence about treatment effectiveness and well-being in both groups.

Results demonstrated that some fears and expectations about chemo- and radiotherapy could provoke health anxiety and helplessness regarding treatment that is related to poorer well-being.

No significant relationships.

The diagnosis of pediatric cancer is a traumatic event that is considered to be one of the most adverse situations the child and his family can experience. The psychological impact of this diagnosis on the parents has triggered a great scientific attention in these recent years.

Estimate the prevalence of depression and post-traumatic stress among parents of children with cancer.

Our study was cross-sectional over a period of 1 month in the medical carcinology department at the Salah Azaeiz Institute. We used the Beck Depression Scale II and the Post Traumatic Stress Disorder Cheklist-Civilian assessements.

Thirty parents participated in our study. Most of whom were mothers (73%). The educational level was primary in 63% of cases and socio-economic level was average in 60% of parents. 40% of parents were assessed within six months after diagnosis. Prevalence of depressive disorder and post-traumatic stress disorder were 73% and 57% respectively. The low educational level was correlated to the presence of these two disorders. Similarly, the low educational level was correlated to the presence of depressive disorders (p=0.008). The number of children in the family was also associated to the presence of post-traumatic stress disorder (p=0.029).

The prevalence of depressive and post-traumatic stress disorders was high among parents of children diagnosed with cancer. The low socio-economic and educational level and the large number of children in the family are risk factors for psychological distress. Psychosocial support should be offered to parents of children with cancer to optimize the management of this disease.

No significant relationships.

The diagnosis of leukemia in a child is traumatic life experience that negatively affects parents and especialy the mother which is the “caregiver” who assists and coordinates all stages of treatment.

To determine the prevalence of psychological distress among mothers of tunisian children with leukemia and to investigate their coping strategies.

A cross-sectional study was conducted at Aziza Othmana hospital department of pedo-oncology in Tunisia between June and July 2021. HADS scale was used to estimate the prevalence of anxiety and depression and coping strategies were measured via arabic version of the brief cope scale.

We included 31 mothers, their middle age was 41 years old. In this study we didn’t include mothers with psychiatric history. Acute lymphoblastic leukemia was the most frequent type of cancer in our sample (94%). The middle age of the children was 10 years old and all of them were under chemotherapy. Clinically significant levels of anxiety and depression were reported by 58% and 49% of mothers, respectively. In our study, 81% of the participants practiced prayer and all mothers turned to religion as a coping strategy. Approach coping styles (especially acceptance and planning) were more frequently used than avoidant coping styles (especially substance use and denial).

Mothers are profoundly affected by a child’s cancer diagnosis, they should have early assessment of their mental health needs to have access to appropriate interventions.

No significant relationships.

What does the physician think in his/her intimacy about clinical care for when his/her death would be near? Living Will is a type of advance directive with the aim to guarantee the testator’s autonomy when faced with death. Particularly oncologists are often faced with human finitude. Their delicate work does not protect them from the possible anguish of thinking and preparing for their own death. It is pertinent to know the psychic mechanisms normally present in the management of this expectation.

To explore symbolic representations of oncologists such as referred to the possible elaboration of their own Living Will.

Qualitative design. Eight participants, clinicians, sample closed by theoretical saturation of information. Semidirected interviews in-depth were conducted online during the pandemic, fully transcribed. Technique of Clinical-Qualitative Content Analysis used for data treatment to generate categories of discussion. The authors search for core meanings in the corpus of interviews, after free-floating readings.

Three categories emerged from the material: Living Will: postponing the decision in order to not anticipate death; From Rationalization Mechanism to Intellectualization: a more sophisticated defensive strategy; Loss of Autonomy: the doctor’s belief while to feel him/herself patient.

(1) Even with all scientific knowledge, respondents have archaic thoughts on defining advance directives as healthy individuals would mean rushing time of their death. (2) Resistance of these professionals to an imagined scenario of end reveals underlying anguish in writing of living will. (3) There is fear of losing autonomy when they do not know how their Living Will can be seen.

No significant relationships.