European Psychiatry - Volume 33 - March 2016

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S166 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
EW146
The prevalence of depression and its
correlates in ankylosing spondylitis:
A systematic review and meta-analysis
C. Hopkins ∗, C. Moulton
1 Prospect Park Hospital, Berkshire Healthcare NHS Foundation Trust,
Reading, United Kingdom
2 Institute of Psychiatry Psychology & Neuroscience, King’s College
London, London, United Kingdom
∗ Corresponding author.
Introduction Ankylosing spondylitis (AS) is a chronic inflam-
matory disease, associated with significant pain, functional
impairment, and diminished quality of life. However, there is sig-
nificant uncertainty regarding the prevalence of depression in AS
and its associations.
Objectives We performed a meta-analysis to examine the preva-
lence of depression in AS and its associated correlates.
Methods The study protocol was prospectively registered with
PROSPERO (CRD42015019676). EMBASE, Medline, PsycINFO and
Web of Science were systematically searched for cross-sectional
studies with ≥ 50 adult AS patients, which reported depression
prevalence using diagnostic criteria or a validated screening tool.
Depression prevalence, tool and threshold used, age, gender, dis-
ease duration, as well as measures of disease activity, functional
impairment, pain and innate inflammation, were abstracted. Open-
Meta was used to calculate pooled prevalence estimates and to
conduct meta-regression.
Results Eight hundred and seventy-seven texts were identified
and 17 studies satisfied inclusion criteria, totalling 3187 partici-
pants (75.2% male). Six diagnostic tools and 10 different thresholds
were reported, with depression prevalence estimates ranging from
4.9–55.5%. In studies using the depression subscale of the Hospi-
tal Anxiety and Depression Scale (HADS-D), 37.1% of participants
satisfied criteria for mild (≥ 8) and 8.2% met criteria for moderate
depression (≥ 11). Multivariate meta-regression demonstrated sig-
nificant positive correlations between depression and, respectively,
disease activity (P < 0.001) and C-reactive protein (P < 0.001).
Conclusions The prevalence of depression in AS is comparable
with that of other rheumatic and degenerative diseases. Moreover,
depression demonstrates significant associations with age, inflam-
mation and disease activity, which require further investigation in
prospective studies.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW147
Medically unexplained
syndromes–Looking for common
reasons
A. Kulik ∗, A. Smotrycka
The John Paul II Catholic Uniwersity of Lublin, Department of
Psychotherapy and Health Psychology, Lublin, Poland
∗ Corresponding author.
Approximately 15% of general practice doctor’s patients and 50% of
patients with chronic disease experience persistent physical symp-
toms, which do not have medical reasons. Those symptoms are
often associated with high levels of distress, limited efficiency and
consumption of health resources. Each set of symptoms has partic-
ular diagnostic features and own operational definition. However,
there is a phenomenon of combination of different syndromes.
Approximately 96% of patients have several concurrent diagnoses
of different syndromes at the same time. One of the explicative
hypotheses is the premise that there is a latent factor common for
all medically unexplained syndromes (Deary, 1999). The verifica-
tion of the assumption about latent factor was based on studies of
premenstrual syndrome (PMS) and chronic fatigue (CF). The aim of
this study is to determine the relationship between selected sets of
symptoms and their conditions in the biopsychosocial paradigm.
Hundred and fourty-nine young women (aged 18–27 years) were
examined following questionnaires: PSST, CFSQ, NEO-FFI, PTS, TPI,
KAS. The relationship between symptoms of PMS and CF is 0.517
(P = 0.000). The adopted model explaining variables: (1) the PMS
33.3% of the variability of results, the most important are: neuroti-
cism ( = 0.436), the strength of excitation ( = 0.229) and negative
emotions–anger ( = 0.206); 2) in CF 57.1% of the variability of
results, the most important are: neuroticism ( = 0.298) and neg-
ative emotions-anxiety ( = 0.275). The relationship between the
severity of different medically unexplained syndromes in women
ismoderate. Among biopsychosocial determinants themost impor-
tant is the severity of neuroticism and negative emotionality.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW148
Psychological factors influence the
symptoms of Gastroesophageal Reflux
Disease (GERD) and their effect on
quality of life in Korean fire fighter
S.Y. Lee ∗, D.I. Jon , M. Kyung-Joon
1 Wonkwang University and Hospital, Psychiatry, Iksan, Republic of
Korea
2 Hallym University Colloege of Medicine, psychiatry, Chuncheon,
Republic of Korea
3 Chungang University College of Medicine, psychiatry, Seoul,
Republic of Korea
∗ Corresponding author.
Objective The aim of the study was to investigate the psycho-
logical factors influence the symptoms of gastroesophageal reflux
disease (GERD) and their effect on quality of life in Korean Fire
Fighters.
Methods This study examined data collected from1217 fire fight-
ers. Depression andAnxietywere identified using the Patient health
questionnaire-9(PHQ-9) and the 7-item Generalized Anxiety Dis-
order Scale. Occupational stress and Stress coping were identified
using the KOSS-26 and the Ways of Coping Checklist-Revised. Self-
esteem and quality of life were identified using the Rosenberg’s
Self-Esteem Scale and World Health Organization quality of life
scale abbreviated version (WHOQOL-BREF). The scores for anxiety,
depression and QoL of the two groups were analyzed. The correla-
tion between psychological factors and QoL was also analyzed.
Results Current psychological variables were associated with
increased odds of concurrent GERD-related symptoms. Current
depression, anxiety and stress were associated with increased
odds of GERD-related symptoms. According to the WHOQOL-BREF,
depression, anxiety, stress, stress coping and self-esteemwere sig-
nificantly correlated with quality of life in patients with GERD.
Quality of life was obviously affected by psychological variables
in patients with GERD.
Conclusions These results indicate that psychological symptoma-
tology, depression, anxiety, occupational stress and self-esteemare
associatedwithGERD-related symptoms. Acknowledging this com-
mon comorbidity may facilitate recognition and treatment, and
opens new questions as to the pathways and mechanisms of the
association.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.