Untitled - European Psychiatry - Volume 41 - April 2017

916 Pages·2017·43.71 MB·English

Vol . 41 , Supplement April 2017
CONTENTS
Abstracted in: BIOSIS/Biological Abstracts, Current Contents/Clinical Medicine and Social & Behavioural Sciences, EMBASE/
Excerpta Medica, MEDLINE/Index Medicus, PASCAL/INIST-CNRS, Psychological Abstracts, PsycINFO, PsyLIT, Research
Alert, SciSearch
Abstracts of the 25th European Congress of Psychiatry
Plenary Sessions: Psychiatry 2017 ............................................................................................................................................ S1
Debates ....................................................................................................................................................................................... S2
Joint Symposia ........................................................................................................................................................................... S3
State of the Art Symposia .......................................................................................................................................................... S6
Symposia .................................................................................................................................................................................... S8
Workshops .................................................................................................................................................................................. S53
Oral Communications ................................................................................................................................................................ S69
e-Poster Walk Part 1 .................................................................................................................................................................. S106
e-Poster Walk Part 2 .................................................................................................................................................................. S170
e-Poster Walk Part 3 .................................................................................................................................................................. S238
e-Poster Walk Part 4 ................................................................................................................................................................. S303
e-Poster Walk Part 5 .................................................................................................................................................................. S365
e-Poster Viewing Part 1 ............................................................................................................................................................. S405
e-Poster Viewing Part 2 ............................................................................................................................................................. S465
e-Poster Viewing Part 3 ............................................................................................................................................................. S521
e-Poster Viewing Part 4 ............................................................................................................................................................. S583
e-Poster Viewing Part 5 ............................................................................................................................................................. S645
e-Poster Viewing Part 6 ............................................................................................................................................................. S710
e-Poster Viewing Part 7 ............................................................................................................................................................. S772
e-Poster Viewing Part 8 ............................................................................................................................................................. S847
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EuropeanPsychiatry41S(2017)S1
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25thEuropeanCongressofPsychiatry
Plenary
Plenarysession:Psychiatry2017:Acknowledging Plenarysession:Publicmentalhealthandclinical
complexitywhileavoidingdefeatism psychiatry:Aretheytwoseparateworlds?
PL01 PL02
Psychiatry2017:Acknowledging Publicmentalhealthandclinical
complexitywhileavoidingdefeatism psychiatry:Aretheyreallytwo
M.Maj separateworlds?
DepartmentofPsychiatry,UniversityofLargoMadonnadelleGrazie, S.Priebe
80138Naples,Italy QueenMary,UniversityofLondon,UnitedKingdom
Inthepastfewyears,ithasbecomeasortofclichétostatethat Publicmentalhealthandclinicalpsychiatry:Aretheytwoseparate
psychiatryisinacrisis.Inparticular,ithasbeenrepeatedlyargued worlds?
that:(a)psychiatricdiagnosesareinvalid;(b)psychiatricresearch Stefan Priebe, unit for social and community psychiatry, Queen
hasnotprogressedsignificantly(inparticular,ithasnotbeenable MaryUniversityofLondon.
toidentify“thecause”ofschizophrenia,depressionorbipolardis- Public mental health focuses on health indicators and inter-
order); (c) psychiatric treatments are of limited value, and their ventions on population level with an emphasis – although not
widespreadusehasnotbeenabletoreducetheincidenceofmen- exclusively–onprevention.Incontrast,clinicalpsychiatryinvolves
tal disorders. This perception of crisis has been at least in part treatmentofindividualsinthesettingofahealthserviceanddeals
generatedbyanidentificationofmainstreampsychiatrywiththe withpeoplewhousuallyalreadyhaveamentaldisorder.Thethe-
neo-kraepelinianparadigm,sothatthecrisisofconfidenceinthat oreticalbackground,theunderpinningevidenceandthepractical
paradigmhasexpandedintoacrisisofconfidenceinthepsychiatric approachofpublicmentalhealthandclinicalpsychiatrydifferfrom
discipline.AccordingtoKuhn,thecrisisofconfidenceinaparadigm eachotherandconceptsofoneofthetwocannoteasilybetrans-
isaccompaniedbyaperiodof“extraordinaryscience”,markedby ferredtotheother.
aproliferationofcompetingmethodologies,thepropositionofa Nevertheless,thepresentationwillarguethattherearealsolinks
varietyofdivergentsolutionsfortheproblemdefiningthecrisis, betweenthetwo.Theselinksmaybebasedonoverallapplicable
andtherecoursetophilosophyandtodebateoverfundamentals values,acommonunderstandingofmentaldisorders,andsocial
ofthediscipline.Thecrisisofconfidenceintheneo-kraepelinian modelsofovercomingmentaldistress.Theselinkscanhaveimpli-
paradigm has generated such a period, in which we are all now cationsforhowclinicalpsychiatristsareengagedinpoliticaland
immersed.Inthispresentation,Iwillsummarizethemaincompo- societalactivities,getinvolvedwithlocalcommunities,andwork
nentsoftheneo-kraepelinianparadigm;Iwillillustratewhythat indailypracticewiththeirpatients.
paradigmhasfailed,oratleasthaslostpeople’sconfidence;andwill Thepublicmentalhealthperspective,usedinawidesenseofthe
summarizethemainelementswhichareemerginginthecurrent term,hasplayedasubstantialroleinthehistoricaldevelopment
periodof“extraordinaryscience”. ofpsychiatry,includingitsmajorreforms,andmightalsoopenup
Disclosureofinterest Theauthorhasnotsuppliedhisdeclaration howclinicalpsychiatrymightbeattractiveasacareeroptionand
ofcompetinginterest. relevantasaprofessioninthefuture.
http://dx.doi.org/10.1016/j.eurpsy.2017.01.014 Disclosureofinterest Theauthorhasnotsuppliedhisdeclaration
ofcompetinginterest.
http://dx.doi.org/10.1016/j.eurpsy.2017.01.015
http://dx.doi.org/
0924-9338/
EuropeanPsychiatry41S(2017)S2
Availableonlineat
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25thEuropeanCongressofPsychiatry
Debate
Debate:Istheconceptofschizophreniauseful? Disclosure of interest The author declares that he has no
competinginterest.
http://dx.doi.org/10.1016/j.eurpsy.2017.01.011
D001
Pro D002
W.Gaebel Con
Heinrich-Heine-Universität,Düsseldorf,Germany
M.Musalek
AntonProkschInstitute,GräfinZichyStraße4-6,1230,Vienna,
Theconceptofschizophreniahasundergonemanychangessince
itsfirstinceptionintheearly20th century.Basically,theconcept Austria
hasstoodthetestsoftime,asitprovidesusefulinformationabout The analysis of the historical development of the currently used
the clinical picture, the clinical course and the available treat- diagnosis schizophrenia in DSM or ICD classification indicates
mentmodalities.Anyalternativeconceptwillneedtoshowthat that sticking to established terms and methodologies more and
itprovidessimilarinformation.Theconcepthasalsobeenusefulto moredevelopstoanobstacleinschizophreniaresearch.Theaim
establishevidence–basedguidelinesfordiagnosisandtreatment, of the currently used operational diagnostic approach was to
andtoprovidevaluableinformationasregardspsychosocialout- reachreliabilityofdiagnosesbetweendifferentpsychiatristsand
comes.Inaddition,recentgeneticandneurophysiologicalstudies researchers as high as possible. This should improve the com-
have shown that common grounds of aetiopathogenesis can be munication between different research groups and better the
identified, in that schizophrenia is a mental disorder with some comparisonofstudyresults.Theaimofahighreliabilityhassurely
geneticinfluencesandacommonpathwayincomplexdisturbances beenreached,however,theexpectedstrikingprogressinresearch
ofbraincircuitsduetoalteredneurotranmission.Currentresearch and clinical praxis failed to materialize till today. Reliability,
focusesonidentifyingbiomarkersforearlydetection,anotherarea which means agreement, does not simultaneously means valid-
of mental healthcare in which a staging model of schizophrenia ity.Modernbrainandgeneticresearchrequiresmorehomogenous
proveduseful.Thispresentationwillhighlightthemostpertinent clinical syndromes or ‘diseases’ to examine them with scientifi-
arguments for keeping schizophrenia as a useful diagnostic and callybasedmethodologiesandtechnologies.Theprerequisitefor
therapeuticconceptofamentaldisorder. doingthis,however,isgoingbacktoclinicalandempiricalreal-
UnterstützungbeiSymposien/SymposiaSupport ities and to integrate these realities into the development of a
−Janssen-CilagGmbH,Neuss; newgenerationofclassificationsystemsthatarefreeofdogmatic
−AristoPharmaGmbH,Berlin; thinking.
−LillyDeutschlandGmbH,BadHomburg; Disclosure of interest The author declares that he has no
−ServierDeutschlandGmbH,München; competinginterest.
Fakultätsmitglied/FacultyMember;
http://dx.doi.org/10.1016/j.eurpsy.2017.01.012
−LundbeckInternationalNeuroscienceFoundation(LINF),Däne-
mark.
http://dx.doi.org/
0924-9338/
EuropeanPsychiatry41S(2017)S3–S5
Availableonlineat
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25thEuropeanCongressofPsychiatry
Joint Symposia
Jointsymposium:Howlongdowehavetowaitfor of grants from Lundbeck. He is also co-author of the patent
theantidepressanteffect? WO/2011/131693 for the siRNA and ASO (antisense oligonu-
cleotides)molecules.
http://dx.doi.org/10.1016/j.eurpsy.2017.01.017
JS001
Jointsymposium:Howlongdowe JS002
havetowaitfortheantidepressant Whatdoclinicaltrialstellusabout
effect?Mechanismsofactionfordelay antidepressantdelayedonsetof
ofonsetresponsetoantidepressants action?
F.Artigas J.Rabinowitz
Institutd’investigacionsbiomèdiquesdeBarcelona,Spain BarIlanUniversity,Israel
Majordepressivedisorder(MDD)isaseverepsychiatricsyndrome Responsetoantidepressantsinmajordepressivedisorderishighly
withveryhighprevalenceandsocioeconomicimpact.Monoamine- variableanddeterminantsarenotwellunderstood.Presentation
basedantidepressantdrugs(AD)displayslowonsetofactionand will provide clinical trial data on time to response and deter-
limitedefficacy.PreclinicalstudiesshowthatADstriggeraseries minants of response to antidepressant treatment. Data is from
of slow adaptive mechanisms that limit the clinical response. the Innovative Medicines Initiative funded NEWMEDS collabo-
These mechanisms result from the pharmacological blockade of ration, a large public-private collaboration which assembled the
monoamine transporters (SERT, NET) and involve presynaptic, largest dataset of individual patient level information from ran-
suchasautoreceptordesensitization(e.g.,5-HT and5-HT for domizedplacebo-controlledtrialsofantidepressantdrugs.Studies
1A 1B
serotonin neurons) as well as postsynaptic mechanisms, such as wereconductedbyfourlargepharmaceuticalcompanies.Dataset
increasedneurogenesisandexpressionoftrophicfactors,increased includes placebo-controlled trials of citalopram, duloxetine, esc-
dendriticcomplexity,etc. italopram, quetiapine and sertraline in adults with MDD. We
Given the strong homeostasis of serotonin and noradrenaline examined patient and trial-design-related determinants of out-
neurons, a way to improve antidepressant action is to prevent come as measured by change on Hamilton Depression Scale
self-inhibitory presynaptic mechanisms mediated by auto- and or Montgomery–Asberg Depression Rating Scale in 34 placebo-
heteroreceptors after reuptake blockade. This strategy was used controlled trials (drug, n=8260; placebo, n=3957). While it is
inthepastwiththenon-selective5-HT antagonistpindololand conventionalfortrialstobe6–8weekslong,datapresentedwill
1A
hasbeenincorporatedbytworecentlydevelopedAD(vilazodone show that drug-placebo differences were observable at week 4
and vortioxetine). Likewise, new molecular strategies using RNA withnearlythesamesensitivityandlowerdropoutrates.Having
interference(RNAi)showthatthemodulationofgeneexpression any of these attributes was significantly associated with greater
inserotoninneuronsoffersagreatpotential.Hence,localorintr- drug vs. placebo differences on symptom improvement: female,
nasal administration of small interfering RNA (siRNA) molecules patientsbeingmiddleaged,increasingproportionofpatientson
targeting SERT or 5-HT autoreceptors evokes rapid and robust placebo, excluding all patients from centers with high placebo
1A
antidepressant-likeeffectsinrodents. responseregardlessofactivetreatmentresponse,usingactiverun
Moreover, glutamatergic drugs such as the non-competitive inperiodsandincludingself-reportmeasures.Proofofconcepttri-
NMDA receptor antagonist ketmaine, offer a potential for the alscanbeshorterandefficiencyimprovedbyselectingenriched
development of fast-acting AD due to its rapid and persistent populations based on clinical and demographic variables, ensur-
antidepressant effects in treatment-resistant unipolar and bipo- ingadequatebalanceofplacebopatients,andcarefullyselecting
larpatientsaftersinglei.v.infusion,aneffectthatlikelyinvolves andmonitoringcenters.Inadditiontoimprovingdrugdiscovery,
the activation of AMPA receptors in ventral areas of the cin- patientexposuretoplaceboandexperimentaltreatmentscanbe
gulate gyrus and the subsequent fast activation of serotonergic reduced.
function. Disclosure of interest I have received research grant(s) support
Disclosure of interest F.A. has received consulting honoraria and/ortravelsupportand/orspeakerfeesand/orconsultantfees
on antidepressant drugs from Lundbeck and he has been PI from Takeda, Minerva, Intra-cellular Therapies, Janssen (J&J), Eli
http://dx.doi.org/
0924-9338/
S4 25thEuropeanCongressofPsychiatry/EuropeanPsychiatry41S(2017)S3–S5
Lilly, Pfizer, BiolineRx, Roche, Abraham Pharmaceuticals, Pierre JointsymposiumwiththeItalianpsychiatric
Fabre,MinervaandAmgen. association:Earlyinterventioninpsychotic
http://dx.doi.org/10.1016/j.eurpsy.2017.01.018 disorders:Comparingmodelsandexperiences
JS005
Jointsymposium:Thevalueoftreatmentforbrain Assertiveinterventionsforfirst
andmentaldisorders episodepsychoses:TheDanish
experience
M.Nordentoft∗,N.Albert,C.Hjorthoj,H.Jensen,M.Melau
JS003 MentalhealthservicesinthecapitalregionofDenmark,universityof
Closingthetreatmentgap:TheEPA Copenhagen,Denmark
∗ Correspondingauthor.
casestudyofschizophrenia
W.Gaebel EarlyInterventionserviceswithteam-basedintensivecaseman-
Heinrich-Heine-universitätDüsseldorf,Germany agement and family involvement are superior to standard
treatment in reducing psychotic and negative symptoms and
Introduction Schizophreniastillranksamongthefirst10leading
comorbidsubstanceabuseandimprovingsocialfunctioningand
causes of disability worldwide. Recent analyses show that there
user satisfaction. The results of the OPUS-trial will be presented
is a considerable treatment gap in schizophrenia in Europe and
togetherwithmeta-analysesbasedonsimilartrials.Theimplemen-
worldwide.
tationofOPUSalloverDenmarkwillbepresentedtogetherwith
Objectives To provide evidence-based information and give a
theDanishOPUS-fidelitystudy.Specializedelementsarebeingare
conciseoverviewofwhatisneededtoovercomethetreatmentgap
beingdevelopedsuchasinclusionofnewmethodsinCBTforpsy-
inschizophrenia.
choticandnegativesymptoms,neurocognitiveandsocialcognitive
Methods Usingacombinedapproachofsystematicreviewand
training programs, interventions for supported employment and
healtheconomicswasusedtoassessthesocioeconomicimpactof
focus on physical health. Results of long term follow-up studies
medicalinterventions(orthelackofthereof)forschizophrenia.
indicatethattheprognosisoffirstepisodepsychosisisverydiverse
Conclusions The case study analysis demonstrates socioeco-
withtheextremesrepresentedbyonegroupbeingwellfunction-
nomic impact and health gains of best practices in specific
ingandabletoquitmedicationwithoutrelapse;andanothergroup
healthcareinterventionsforschizophreniaincomparisonwiththe
havingalongtermchroniccourseofillnesswithaneedforsup-
costburdenofcurrentcareornon-treatment.
porttomaintaindailyactivities.TheDanishTAILOR-trial–testing
Disclosure of interest Unterstützung bei Symposien/Symposia
dosereductionversusmaintenancetherapywillbepresented.It
Support
will be of immense value to be able to intervene in risk groups
–Janssen-CilagGmbH,Neuss
identifiedinthepremorbidphase,andtherearefewexamplesof
–AristoPharmaGmbH,Berlin
ongoingtrialforchildrenofparentwithschizophreniaandbipolar
–LillyDeutschlandGmbH,BadHomburg
disorder.
–ServierDeutschlandGmbH,München
Disclosureofinterest Theauthorshavenotsuppliedtheirdecla-
–Fakultätsmitglied/FacultyMember
rationofcompetinginterest.
–LundbeckInternationalNeuroscienceFoundation(LINF),Däne-
mark http://dx.doi.org/10.1016/j.eurpsy.2017.01.021
http://dx.doi.org/10.1016/j.eurpsy.2017.01.019
JS006
Assertiveinterventionsforfirst
JS004
episodepsychoses:TheItalian
Thecostofnon-treatment
experience
M.Knapp
LondonSchoolofEconomicsandPoliticalScience,London,United A.Meneghelli
Kingdom Solari19,20144,Milan,Italy
Therearelargetreatmentgapsinrelationtoschizophreniaacross In Italy, despite the favourable conditions created by the 1978
allEuropeancountries,eitherbecausetheillnessisnotrecognised reformlawandthecommunitypsychiatry,attheendofthepast
orbecausetheresponsefromtreatmentandcareservicesisinad- centurytherewerenocultureorinitiativesorientedtoinnovative
equate-notevidence-based.Thiscouldbebecauseofresourceor andevidence-basedfoundedinterventionsinearlypsychosis.The
otherconstraints.Theconsequencecanbeverydamagingindeed watershedwasthesettingupintheMHDofNiguarda(Milan)of
forindividualswithschizophrenia,theirfamiliesandforthewider Programma 2000, addressed to FEP and HR mostly inspired by
society.InthistalkIwillsetouttheeconomicconsequencesofnot the knowledge of existing studies and experiences and with the
identifyingorrespondingappropriatelytoschizophrenia.Evidence recommendedcharacteristicsofspecificity,multicomponentiality,
willbedrawnfromanumberofstudies,butwillbechannelledto assertiveness and doctrinal orientation. From the very start, one
shownewfindingsinrelationtobothEnglandandCzechRepublic. fundamentalaimwastodisseminateinformation,training,super-
Thesefiguresaddtotheargumentforearlierandbettertreatment, vision,andtoraiseconsensusandinitiativesthroughoutItaly,as
tobenefiteverybodyincludingpublicandprivatebudgets. well as to improve international links. In many ways, the con-
Disclosureofinterest Theauthorhasnotsuppliedhisdeclaration sequences have been extremely positive. In 2005, Angelo Cocchi
ofcompetinginterest. and Programma 2000 team founded the AIPP (Italian Association
forEarlyInterventioninPsychosis),nownamedItalianAssociation
http://dx.doi.org/10.1016/j.eurpsy.2017.01.020
for Prevention and Early Intervention in Mental Health. Over the
25thEuropeanCongressofPsychiatry/EuropeanPsychiatry41S(2017)S3–S5 S5
years, the Association has organized conferences, scientific days, strategies and further efforts are then necessary to stimulate
working network, two national surveys on EIS and produced a resources allocation as well as to assess and address adherence
documenttofavourtheirdevelopment.Theresultsofthesecond andfidelitytoguidelinesrecommendations.
surveyarethemoreupdatedandarticulatedaboutthenumberof Disclosureofinterest Theauthorhasnotsuppliedhisdeclaration
earlyinterventionsservices,theircharacteristicsanddistribution ofcompetinginterest.
in the different Italian regions. The survey conclusion is that
http://dx.doi.org/10.1016/j.eurpsy.2017.01.022
EI Services implementation in Italy has been proceeding, albeit
slowly.Nevertheless,thereisstillagreatvariabilityoftherapeutic
EuropeanPsychiatry41S(2017)S6–S7
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25thEuropeanCongressofPsychiatry
State of the art
Stateoftheart:Workingtogetherforearly Stateoftheart:psychotherapiesvs.
detectionofpsychosis pharmacotherapiesvs.combinationtherapiesin
depressiveandanxietydisorders
SOA001
Workingtogetherforearlydetection SOA002
ofpsychosis Psychotherapiesvs.
A.Riecher-Rössler pharmacotherapiesvs.combination
UniversityofBaselpsychiatrichospital,CH-4051,Basel,Switzerland therapiesindepressiveandanxiety
Introduction Inthelastdecadespsychiatryhastakenanimpor- disorders
tantandoverduestepwhichothermedicaldisciplineshadtaken P.Cuijpers
much earlier, i.e. recognizing the chances of early detection and FacultyofBehaviouralandMovementSciences,VrijeUniversiteit,
intervention–firstinthefieldofemergingpsychosis,inthemean- Amsterdam,TheNetherlands
timealsoinotherfields.
Bothpsychologicalandpharmacologicaltherapieshavebeenfound
Objectives To review new developments in the field of early
to be effective in the treatment of adult depression and anxi-
detectionofpsychosisandtocriticallydiscusstheobstaclesstill
etydisorders.Psychologicaltreatmentsincludecognitivebehavior
deprivingmanyofourpatientsofanimmediatebenefit.
therapy, interpersonal therapy, behavioral activation, exposure
Methods Reviewanddiscussion.
therapies, and several other types of therapy. Pharmacological
Results Newdevelopmentsareverypromising.Identificationof
treatments include SSRIs, SNRIs TCAs, MAIOs and several other
individualsatriskandpredictionoftransitiontopsychosisispos-
types. In this presentation the results of meta-analyses of trials
siblewithanexcellentaccuracy,comparabletootherpreventive
directlycomparingtheeffectsofpsychologicalandpharmalogical
approachesinmedicine.Andthereisgrowingevidencehowthis
treatmentswillbepresented,aswellasmeta-analysesofcombined
accuracy can even be more improved by using not only clinical
treatmentsversuseitherpsychotherapyaloneorpharmacotherapy
assessmentsbutalsoadditionaldomainssuchasneurocognition,
alone.Resultsshowthatpsychologicalandpharmacologicaltreat-
neurophysiology,orMRI,aswellasnewmethodsforanalysessuch
mentsareprobablyaboutequallyeffectiveattheshortterm,and
aspatternrecognition.Stagedinterventionaccordingtothedegree
combinedtreatmentismoreeffectivethaneitherpsychotherapy
ofriskseemsfeasible.However,therearestillmanyobstaclestoa
orpharmacotherapyalone.Inthepresentationseveralotherissues
broadimplementationofthisnewknow-howintoclinicalpractice
relatedtothisgroupoftrialswillbediscussed,liketheinfluence
suchaslackofcommunication,politicalwillandfinances,orfears,
ofconflictsofinterestandthe(lackof)blindinginpsychotherapy
stigmaandprejudices.
trials.
Conclusions For the benefit of those concerned - patients and
Disclosureofinterest Theauthorhasnotsuppliedhisdeclaration
their relatives - a great effort to work together is required from
ofcompetinginterest.
allofus:clinicians,researchersfrompsychiatryandmanyother
fields,industry,politicians,andlast,butnotleast,patientsandtheir http://dx.doi.org/10.1016/j.eurpsy.2017.01.007
relatives.
Disclosureofinterest Theauthorhasnotsuppliedhisdeclaration
ofcompetinginterest.
http://dx.doi.org/10.1016/j.eurpsy.2017.01.006
http://dx.doi.org/
0924-9338/