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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.305

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.306

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.307

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