European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S179
EW187
Revisiting melancholic depression:
Review of the concept and clinical
implications
L.A. Oliveira ∗, A. Machado , F. Polido
Centro Hospitalar e Universitário de Coimbra, Psychiatry, Coimbra,
Portugal
∗ Corresponding author.
Introduction Major Depression Disorder (MDD) represents a
major concern inmental and public health, being themost common
psychiatric disorder and one of themost prevalent diseases inwest-
ern societies. However, many studies demonstrate a significant
heterogeneity in MDD evidenced by different clinical presenta-
tions (up to 227 different symptom combinations can be fulfilled
to diagnose MDD), different sociodemographic variables, distinct
outcomes and significant differences in treatment response. This
data may suggest the existence of different ethiopathogenic mech-
anisms in the development of MDD, implying the review and
readjustment of MDD criteria into more distinct and homogeneous
subtypes of Depression.
Objectives andmethods In this non-systematic reviewthe authors
sought to identify different subtypes of MDD concerning their 1)
clinical features and outcomes, 2) neurocognitive and neurobio-
logical correlates and 3) treatment outcomes.
Results An increasing number of studies is being published con-
cerning MDD heterogeneity and its possible subtypes. However,
most of the authors try to recognizeMDDwithMelancholic features
(M-MDD) as an independent entity in opposition to the current
diagnostic criteria. The suggestion of a distinct MDD subtype is
based on several studies showing clinical, cognitive and neurobio-
logical differences shared between M-MDD patients which will be
further discussed in this review.
Conclusions M-MDD may represent an independent depressive
disorder with distinct clinical and outcome implications. However,
further research is needed to identify more homogeneous MDD
subtypes.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW188
Apathy and depression: Which clinical
specificities?
J. Palaric
Saint Ave, France
Introduction Apathy is a transnosographical symptom that is
often described in psychiatric and neurological illness. The most
known definition, proposed by Marin (1991), is a lack of goal-
directed voluntary behavior. Apathy and depression may be
present together but they are clinically independent. The confu-
sion between signs of apathy and those of depression might reveal
diagnostic and treatment issue. Our aim is to define a clinical
profile of apathetic patients (Ap) with depression, hypothesiz-
ing there is a different clinic profile than non-apathetic patients
(NAp).
Method Seventy adults diagnosedwithdepressionwere included
in a comparative, non-randomized and open cohort, since Novem-
ber 2014. Clinical assessments targeted clinical scale evaluations
(MINI, AES, MADRS, STAI, SHAPS). Patients were separated in two
groups, Ap VS NAp, using a 42 points cut-off at AES score.
Results Ap represent 30%; n(Ap)= 21, n(NAp)= 49. Depressive
severity scores (MADRS) are lower in the Ap group; W-test= 672, P=
0,044. State anxiety scores (STAI-A) are lower in Ap group; W-test=
739, P = 0,004. Anhedonia scores (SHAPS) are lower in Ap group; W-
test= 412, P= 0,004. Pearson test shownegative correlation between
AES/STAI-A (r = -0,27; P= 0,02); AES/SHAPS (r= -0,45; P= 0,001).
Conclusion Apathetic patients suffering from depression seem to
present different clinical pattern in term of anxiety and anhedonia.
These results are high of interest for therapeutic and further studies
focus on pathophysiological issues.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EW189
Systematic review of the association
between interferon treatment and
depression in patients with multiple
sclerosis
L. Alba Palé∗, B. Samsó Buxareu , J. León Caballero ,
V. Chavarria Romero , E.J. Pérez Sánchez , A.J. Palma Conesa ,
J.M. Ginés Miranda , P. Salgado Serrano , V. Perez Sola
Parc de Salut Mar, INAD, Barcelona, Spain
∗ Corresponding author.
Introduction Multiple sclerosis (MS) is a common chronic
neurological disease. Interferon beta (INF-1b) was the first disease-
modifying drug to be approved for the treatment of multiple
sclerosis. During INF-1b pivotal trials, an association to depression
was found. Later, in a study about its efficacy, three suicide attempts
were accounted.
Objectives Depression lifetime prevalence in MS patients is 50%,
almost three times the rate in the general population. Suicide rate
is also significantly higher. Depression has the greatest impact
on quality of life. Besides MS treatment, depression itself may
be related to neuronal damage, immune dysfunction and lifestyle
changes.
Aims The aim of this review is to assess the relationship between
INF-1b and depression risk in MS patients.
Methods We performed a literature search on PubMed database
using the following keywords.
depression, multiple sclerosis, interferon treatment. We included
only human studies in English for the past five years. The abstracts
were reviewed and also the full text when necessary.
Results We selected 8 articles. Regarding their design, therewas 1
cross-sectional study, 1 retrospective analyses, 1 clinical trial, 1 case
control-study and 3 cohort studies. No meta-analyses or previous
reviews were found. Two of the studies showed a prejudicial effect,
three found no differences and three reflected a beneficial effect.
Conclusions In conclusion, the link between INF-1b and depres-
sion is uncertain. Although some studies have found direct
relationship, recent publications have seen no changes in mood,
and even a positive effect. Studies’ limitations are remarkable,
which is why further investigation needs to be done.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW190
The role of augmentation treatment
with second-generation
antipsychotics in major depression
disorder–current evidence in the
literature
E. Pereira∗, F. Coutinho , M. Marinho , C. Hipólito-Reis
Centro Hospitalar de São João, Clinic of Psychiatry and Mental
Health, Porto, Portugal
∗ Corresponding author.
Introduction Major depressive disorder (MDD) is a chronic men-
tal illness with a considerable lifetime prevalence in adult men
and women. Only a third of MDD patients remit following ade-
quate antidepressant treatment, while most suffer from significant