d University of South-Eastern Norway, Health and Social Sciences, Drammen, Norway e Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Aim: Communication between patients and providers has been shown to be crucial for mutual understanding and improvement of medically unexplained symptoms (MUS). The aim of this systematic review is to gain a detailed understanding of recurrent communication practices and their functions in medical interactions about MUS, by synthesizing evidence from interactional and discourse analyses. Methods: Systematic review of qualitative linguistic and interac- tional studies. We searched 8 electronic databases, screened reference lists and consulted experts. We developed a data extraction template and appraised the quality of the studies. Findings were synthesized through an iterative process. Results: We found 5021 publications of which 17 met the inclusion criteria. We sorted findings into three different interactional areas: 1) patients and providers orient to the importance of recognition of symptoms and suffering, e.g. by using extreme case formulations (“terrible”) to portray the severity of complaints; 2) patients and providers orient to their separate conflicting epistemic territories (i.e. conflicts in knowledge domains), e.g. with physicians using restricted question-answer sequences; and 3) the diagnosis is constructed in interaction, e.g. by searching for common ground with frames that are acceptable for patients. Conclusion: Linguistic and interactional aspects in medical consul- tations show that talking about MUS is a very delicate activity. Treating MUS as delicate could elicit patient resistance. Providers can overcome resistance by constructing explanations in a collaborative manner and by searching for common ground. doi:10.1016/j.jpsychores.2019.03.031 SID90 Cloudy attitude? Healthcare professionals' one-word descriptions of working with patients with medically unexplained symptoms Denise Hanssen a,1 , Judith Rosmalen b a University Medical Center Groningen, Psychiatry, Groningen, The Netherlands b University Medical Center Groningen, Psychiatry & Internal Medicine, Groningen, The Netherlands Aim: Patients with Medically Unexplained Symptoms (MUS) often feel stigmatized, which may possibly be related to healthcare professionals' (negative) attitudes and/or prejudices towards this patient group. In this study we aim to explore healthcare profes- sionals' attitudes towards working with MUS-patients. Methods: Currently, 33 psychiatrists (in training), 40 occupational medicine specialists and 39 children's physicians participated. All participants were asked to answer the question: ‘What is the first word that comes into your mind when you think about patients with MUS?’. Data were collected during lectures about MUS, using an online, anonymous, tool. Since this study is ongoing, more data will be collected in various professional groups. Results: The most frequently mentioned word (including syno- nyms) was ‘difficult’ (7.9%; n = 9), followed by ‘complex’ (7.1%; n = 8). Overall, 39.8% (n = 45) of all words had a negative connotation, such as ‘complicated’, ‘whining’, and ‘exhausting’. Only 6.1% (n = 7) oneword descriptions had a positive connotation, such as ‘important’ and ‘interesting’. Other words (52.2%; n = 59) were neutral, such as ‘fibromyalgia’, and ‘unclear’. More results will be presented in due time, as well as results per profession. Conclusion: Negative attitudes and/or prejudices may hamper the healthcare professional's ability to provide the best possible care for MUS-patients. Therefore, prejudices deserve attention in medical education and training. doi:10.1016/j.jpsychores.2019.03.032 SID183 Posttraumatic stress and motivators of refugee aid volunteers and fulltime employees Ekaterini Georgiadou a , Theresa Grimm b , Yesim Erim b,1 a Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Klinik für Psychiatrie und Psychotherapie - Klinikum Nürnberg, Nürnberg, Germany b University Hospital of Erlangen, Friedrich-Alexander University Er- langen-Nürnberg, (FAU), Department of Psychosomatic Medicine and Psychotherapy, Erlangen, Germany Aim: Since 2015 about 1.3 million asylum seekers were documented in Germany. A huge group of volunteers (VAD) engaged in support activities for them, like accompanying them to official departments, teaching them the language etc. On the other side, municipalities and different state departments hired new employees as full-time aid workers (FAD). We surveyed the motivation for helping activities and the specific stressors in refugee aid. Methods: This is a cross-sectional questionnaire survey. Depress- ion was measured with Patient Health Questionnaire (PHQ), traumatic events and posttraumatic stress with the Essen Trauma Inventory (ETI). Results: A total number of 111 aid workers participated, 39 (35.1%) were Volunteering Aid Workers and 72 (64.9%) Fulltime Aid Workers (FAD). 30.6% of aid workers have own immigration background; 12.8% of VAD vs. 40.3% of FAD. VAD reported religious motivation in first place, FAD vocational motivation, but also charity motives in about 70%. Depression (PHQ-9 ≥ 10) was measured in 9.0%; in 11.8% of the VAD vs. in 8.5% of the FAD. Traumatic events were reported in 91% in the sample vs. 24% in the German general population. None of the VAD but 5.1% of the FAD fulfilled the psychometric requirements of a PTSD. Conclusion: FAD and VAD both present risk factors for mental disorders. They should be supported by regular preventive screen- ings and trainings for resilient mental health. doi:10.1016/j.jpsychores.2019.03.033 SID28 The development of a patient-reported outcome measure for real-time symptom assessment in a population with functional urologic complaints—A focus group study Alexandra Herrewegh a,1 , Lisa Vork b , Eline Eurelings c , Carsten Leue c , Joanna Kruimel b , Gommert van Koeveringe a , Desiree Vrijens a a Maastricht University Medical Center+, Urology, Maastricht, The Netherlands b Maastricht University Medical Center+, Gastroenterology and Hepatology, Maastricht, The Netherlands c Maastricht University Medical Center+, Psychiatry and Medical Psychology, Maastricht, The Netherlands Abstracts 109