European Psychiatry - Volume 33 - March 2016

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S182 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
pathologies (such as psychotic, organic,. . .) were excluded through
a structured clinical interview. We analyzed variables considered
through variance analysis.
Results Significant differences between groups were found in
some of the variables considered.
Conclusions This study have important implications regarding
evaluation, differential diagnosis and psychotherapeutic approach
to patients with AD and MD.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW197
Use of GP services over a five-year
period after an episode of depression
P. Verhaak
University Medical Center Groningen, General Practice, Groningen,
Netherlands
Background Depression occurs frequently and is mostly treated
in general practice. Little has been reported about its long-term
course and long-term use of medical services.
Aim To follow up patients with these depression in general
practice for five years, looking at the length and number of index
episodes, prescribing behaviour and use of services within gen-
eral practice and compare them with patients with psychological
symptoms and mentally healthy patients.
Design and setting A case-control study based on data from Elec-
tronic Medical Records (EMR).
Methods Three cohorts of patients with depression (n = 453),
anxiety symptoms ( n= 442) and emotional distress (n = 185) were
compared against a cohort of control patients (n= 4156) during a
5-year follow-up looking at the occurrence or recurrence of the
index disorders, other psychological disorders and medical disor-
ders, numbers of prescriptions and the number of contacts with the
general practice.
Results The depression group had 1.1 follow-up episodes of
depression, the anxiety group 0.9 follow-up episodes of anxiety and
the emotional distress group 0.5 follow-up episodes of emotional
distress during five years. All three groups had more consultations
(for both psychological and somatic reasons) during each of the
follow-up years than control patients. Furthermore, they are given
more prescriptions for psychopharmacological treatment.
Conclusion Five years after the index episode in 2007, patients
with an episode of depression, anxiety or emotional distress are
still not comparable with control patients, in terms of the preva-
lence of psychological disorders, the number of prescriptions and
healthcare use. Depression appears to be a chronic disease.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EW198
Anhedonic brain while attending
sexual and emotional pictures
F. Von Duering
Heiligenthal, Germany
Anhedonia is defined as the inability to gain pleasure from nor-
mally pleasurable experiences and reduced sexual desire. Rees et al.
(2007) showed that limbic and paralimbic areas are responsible for
sexual arousal and that anhedonia is associated with frontolim-
bic inhibition. In major depression, reduced ventral striatum and
increased ventral prefrontal cortex areas was associatedwith anhe-
donia(Gorwood, 2009). Walter et al. (2009) indicated that there is a
deviation in the neuronal activation pattern of the pregenual ante-
rior cingulate cortex in anhedonic depression which is related to
a glutamergic deficit. Glutamate was suggested to play a relevant
role in reward system (Birgner et al., 2005). ACC is a key involved
in affective state and glutamate mediates ACC activation to sex-
ual attraction(Wu et al., 2009). Thus, a glutamatergic deficit might
be related to reduced hedonic effect specific to major depression.
Using an attention modulation of emotional and sexual pictures,
we investigate the role of anhedonia on the ventral and dorsal sys-
tems in healthy volunteers and patients with major depression.
They undergo an expectancy task in a 7 T scanner and passively
view sexual and emotional photographs and are asked to expect
either high salient pictures or high erotic pictures. Half of these
pictures are announced by an expectancy cue, whereas the other
half are preceded by a fixation cross. Snaith-Hamilton-Pleasure-
Scale and Hamilton Depression Rating Scale are employed to assess
anhedonia and depressive symptom severity. Brain metabolites in
the dorsal and pgACC are measured using MRS. We will show how
anhedonia modulates the neural response to sexual arousal.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
Eating disorders
EW199
Oxytocin secretion in anorexia
nervosa and bulimia nervosa:
Investigation of its relationships to
temperament personality dimensions
M. Nigro ∗, A.M. Monteleone , L. Steardo , G. Patriciello ,
V. Di Maso , M. Cimino , U. Volpe , P. Monteleone
1 Department of Psychiatry, University of Naples SUN- Naples- Italy,
Naples, Italy
2 University of Salerno, Neuroscience Section- Department of
Medicine and Surgery, Salerno, Italy
∗ Corresponding author.
Introduction Some temperament characteristics of personality
seem to be modulated by oxytocin. Patients suffering from eating
disorders (EDs) display aberrant personality traits.
Objectives and aims We investigated the relationships between
plasma oxytocin levels and personality dimensions of patients with
anorexia nervosa (AN) and bulimia nervosa (BN) and compared
them to those of healthy controls.
Methods Plasma oxytocin levels were measured in 23 women
with AN, 27 women with BN and 19 healthy controls and assessed
their personality traits by means of the Cloninger’s Temperament
and Character Inventory-Revised (TCI-R).
Results AN patients showed plasma levels of the hormone sig-
nificantly lower than BN and healthy controls. In healthy women,
plasma oxytocin levels resulted significantly correlated negatively
with novelty seeking scores and positively with both harm avoid-
ance (HA) scores and the attachment subscale scores of the reward
dependence: these correlations explained 82% of the variability
in circulating oxytocin. In BN patients, plasma oxytocin resulted
negatively correlated with HA, whereas no significant correlations
emerged in AN patients.
Conclusions These findings confirm a dysregulation of oxytocin
secretion in AN but not in BN and show, for the first time, that the
association of circulating oxytocin to patients’ temperament traits
is totally lost in underweight patients with AN and partially lost or
even inverted in women with BN. These findings suggest a role of
oxytocin in certain deranged behaviours of ED patients, which are
influenced by the subjects’ personality traits.