European Psychiatry - Volume 33 - March 2016

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S180 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
core depressive or residual symptoms during their clinical course.
Augmentation treatment with second-generation antipsychotics
(SGAs) has been one of the suggested approaches to overcome this
shortage of efficacy of antidepressant therapy.
Objectives To reviewthe role of SGAs as an augmentation strategy
to antidepressant therapy in MDD.
Methods A search of the MEDLINE/Pubmed database was con-
ducted for articles from 2010 to 2015, using the MeSH terms
“antypsichotics”, “depression” and “treatment”.
Results There is a general consensus in the literature that antide-
pressant augmentation treatment with SGAs is more effective than
placebo in the management of patients with MDD who failed to
respond adequately to antidepressant therapy alone. The majority
of studies found no significant differences between the differ-
ent studied drugs (namely, aripiprazole, quetiapine, olanzapine
and risperidone). On the other hand, discontinuation rates due to
adverse effects are also higher with SGAs versus placebo. However,
it remains unclear if augmentationwith SGAs is more effective than
other therapeutic strategies, such as combination or switching to
other antidepressant or augmentation with other psychotropics.
Conclusions There is strong evidence that SGAs augmentation is
an effective and generally safe therapeutic approach to patients
with MDD who respond poorly to antidepressants. Nevertheless,
more studies are needed to understand the efficacy of this treat-
ment comparing other therapeutic approaches.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW191
Antidepressant-induced
hyponatremia
L. Rodríguez Andrés ∗, S. Gómez Sánchez , A. Rodríguez Campos ,
R. Hernández Antón , L. Gallardo Borge , A. Álvarez Astorga
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid,
Spain
∗ Corresponding author.
Introduction Hyponatremia is one of the electrolytic disorders
most comonly observed among general hospitalized populations
(2% of hospitalized patients). A form of hyponatremia is the syn-
drome of inappropriate antidiuretic hormone secrection (SIADH).
One of its diverse causes is medication. Selective serotonine reup-
take inhibitors (ISRSs) can cause hyponatremia due to SIADH,
particularly among elderly population.
Clinical case report A 81-year-old female treated with paroxetine
20mg/day because of depression. Twoweeks later she starts feeling
nausea, somnolence and motor inhibition. The sodium level previ-
ous to the onset of treatment was normal but after two weeks it
has decreased to 121 mEq/L, pointing to SIADH induced by ISRSs.
Discussion The incidence of hyponatremia among elderly
patients treated with antidepressants of ISRSs class has increased.
The prevalence varies between 0.5 and 25%. Although half of the
patients are asymptomatic, the mortality is rate may reach 25%.
It generally develops during the first month of treatment and is
reversible between 2 and 28 days after the suspension of the ISRSs.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW192
The effectiveness of exercise on
weight loss and postnatal depression:
A systematic review
M. Saligheh ∗, D. Hackett , P. Boyce , S. Cobley
1 University of Sydney, Exercise and Sport Science, Lidcombe,
Australia
2 University of Sydney, Sydney Medical School, Camperdown,
Australia
3 University of Sydney, Discipline of Exercise and Sport Science,
Lidcombe, Australia
∗ Corresponding author.
Introduction Exercise has well-established benefits on depres-
sion and weight-management in normative populations. However,
its effectiveness at postpartum phase remains uncertain.
Objectives Determine the effectiveness of exercise or physical
activity (PA) interventions on postnatal depression (PND) and
weight-loss.
Aims Identify exercise and PAmodalities most effective in reduc-
ing PND symptoms and weight.
Methods Systematic review of RCTs and experimental studies
comparing exercise or PA modalities (e.g., flexibility versus resis-
tance training) against control or alternative interventions (e.g.
social support, diet). Data search included Cochrane Library (CEN-
TRAL), MEDLINE, PsycINFO, EMBASE, CINAHL, Scopus and Science
Citation Index.
Results Of 8099 studies retrieved, six fulfilled inclusion crite-
ria. Two implemented supervised exercise interventions, one
using ‘Yoga & Pilates’ (1 × 60 mins/session× 12 weeks) and one
using resistance (v flexibility) training focusing on major mus-
cle groups (2/week × 18 weeks). Yoga & Pilates decreased PND
and body mass index (BMI); though resistance training did not.
Four studies implemented PA interventions (e.g., walking) with
varying duration (i.e., 3-18 months (e.g., 30 mins per session
×1/week). Two studies showed significant declines in BMI but
no changes in PND, while two showed no changes in PND and
BMI.
Conclusion Limitations in the data available; research design
quality; inconsistencies in application of exercisemodalities aswell
as their structure and content; and, the standardization of PND
diagnosis, constrain the ability to determine whether exercise or
PA benefits PND and weight in postpartum women.
Keywords Exercise; Depression; Postpartum; Weight-loss
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW193
The impact of neuroinflammation and
inflammatory cytokines in depression
and suicidal behavior
G. Serafini ∗, M. Pompili , P. Girardi , M. Amore
1 Section of Psychiatry- San Martino Hospital- University of Genoa,
Neuroscience DINOGMI, Genoa, Italy
2 Sant’Andrea Hospital- Sapienza University of Rome, Neuroscience,
Rome, Italy
∗ Corresponding author.
Introduction It has been suggested that neuroinflammation and
inflammatory mediators may play a crucial role in the patho-
physiology of both major depression and suicidal behavior.
Immunological differences have been reported between both sub-
jects with major affective disorders and suicidal behavior.
Objectives The main objective of this review was to deeply
investigate the nature of the association between inflammatory
cytokines in depression and suicidal behavior. Aims: The study
aimed to conduct a systematic review of the current literature
to investigate the association between inflammatory cytokines,
depression, and suicidal behavior.
Results Generally, an imbalance between pro-inflammatory and
anti-inflammatory cytokines has been documented in both major
depression and suicidal behavior. The presence of major depres-
sive disorder (MDD)with suicidal ideation/attemptswas associated
with differences in inflammatory cytokine profile when com-
pared to that without suicidal ideation/attempts. However, not all