European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S5–S7 S7
Symposium: mental health in young women: are
they more at risk in the 21st century?
CS07
Why mental health in young women
is more at risk in the 21st century
H. Herrman
Orygen – The National Centre of Excellence in Youth Mental Health
and The University of Melbourne, Centre for Youth Mental Health,
Melbourne, Australia
The mental health of women and girls is endangered when they
experience violence and gender-based discrimination, including
poor access to education and lack of autonomy in the family and
broader community. The conditions of conflict and poverty that fos-
ter violence against women, including systematic sexual violence,
are growing across some world regions including parts of Africa
and Asia, even while women are becoming more empowered in
others. The prevalence of abuse of women at home appears to be
high across the regions, and the widespread nature of other forms
of violence such as genital mutilation and trafficking is increasingly
recognised.
The psychological consequences of violence increase the risk of
mental illnesses such as depression and anxiety, including the risk
of these conditions in the perinatal period. The services provided
for women with mental ill health in primary health care, mater-
nal and child health services, community mental health services or
hospital settings do not in many places respond adequately to their
needs. The inadequacies in response can reproduce or amplify the
difficulties and injustices that women face in their lives, especially
maltreatment as girls and intimate partner violence as adults.
The World Psychiatric Association aims to increase awareness of
the need for improved mental health of women and girls world-
wide, especially in settings of disadvantage, conflict and adversity.
It is also aiming to work in partnership with other health and non-
health organisations to develop a platform for action to respond
to the need – for health promotion, risk reduction and access to
prevention and treatment services.
Disclosure of interest The author has not supplied his declaration
of competing interest.
CS08
Early psychosis in young women
A. Riecher-Rössler
University of Basel Psychiatric Clinics, Center for Gender Research
and Early Detection, Basel, Switzerland
Introduction It is well known that young women are at lower
risk for schizophrenic psychoses than young men. However, little
is known about the peculiarities of emerging psychosis in young
women.
Objectives To describe characteristics of emerging psychosis in
women.
Methods Within the FePsy (Früherkennung von Psycho-
sen = early detection of psychosis) study at the University of
Basel Psychiatric Clinics we have examined consecutively all
patients with a first episode of psychosis (FEP) or an at-risk mental
state (ARMS) referred to us between 2000 and 2015.
Results Women did not significantly differ from men regarding
psychopathology, neither in the ARMS nor in the FEP group. This
was true for positive as well as negative symptoms and basic symp-
toms. Interestingly, women had a higher correlation of self-rating
with observer-rating regarding psychotic symptoms. Duration of
untreated psychosis was significantly lower inwomen than inmen.
Women seek help more quickly than men and their first contact is
more often their partner.
Regarding neurocognition women showed a slightly better perfor-
mance in verbal tasks. They also had higher prolactin levels and
larger pituitary volumes, even when drug-naive.
Transition to psychosis occurred as often and as quickly in women
as in men.
Conclusions There are only few gender differences in patients
with emerging psychosis, which resemble mainly those found in
the general population, withwomen showing a better help-seeking
behavior, being more partner-oriented, having a better verbal per-
formance and potentially also a higher stress reactivity
Disclosure of interest The author has not supplied his declaration
of competing interest.
Reference
[1] Riecher-Rössler A, et al. Biol Psychiatry 2009;66(11):1023–30.
Symposium: brain plasticity in psychiatry
CS09
Relevance of brain plasticity to
neuroprogression and staging of
bipolar disorders – opposing effects
of illness burden and lithium
treatment
T. Hajek ∗, M. Kopecek , M. Alda
1 Department of Psychiatry, Dalhousie University, Halifax, Canada
2 National Institute of Mental Health of Czech Republic, Psychiatry,
Klecany, Czech Republic
∗ Corresponding author.
Introduction Brain changes in bipolar disorders (BD) may rep-
resent inherited risk factors or consequences of the illness (brain
plasticity). Neuroanatomical changes, which predispose for BD
could aid in early diagnosis, whereas the neuronal sequellae of
BD could yield biological outcome measures for prevention and
treatment.
Methods To separate neuroanatomical changes into those that
increase the risk of BD versus those that result from it, we acquired
MRI/clinical data fromparticipants at different stages of BD, includ-
ing: (1) affected and unaffected offspring of bipolar parents (n = 86);
(2) participantswith substantial illness burdenwho had had at least
2 years of current Li treatment (n = 37) or were Li naive (n = 19). We
also recruited 99 healthy controlsmatched to the above-mentioned
cohorts by age and sex.
Results Relative to controls, both the affected and unaffected off-
pring of bipolar probands showed increased right inferior frontal
gyrus (rIFG) volume, but comparable hippocampal volumes and
prefrontal N-acetyl aspartate (NAA) levels. Larger rIFG volume was
associatedwith an increased risk of conversion to psychiatric disor-
ders within 4 years following the MRI scanning (hazard ratio = 4.5).
In contrast, Li naive patients with substantial illness burden had
smaller rIFG, hippocampal volumes and prefrontal NAA levels than
controls, whowere comparable in these indices to the the Li treated
subjects with substantial illness burden.
Conclusions Brain structural changes in BD may not be static, but
may instead result from an interplay between illness burden and
compensatory processes. This illness related brain plasticity may
be modulated by lithium treatment.
Disclosure of interest The authors have not supplied his declara-
tion of competing interest.