European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S183
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW200
Attachment style and salivary cortisol
awakening response in eating
disorders
F. De Riso ∗ iugliano . Monteleone Nigro
F. Pellegrino , M. Calvanese , G. Patriciello , V. De Stefano ,
U. Volpe , P. Monteleone
1 University of Naples SUN, Department of Psychiatry, Naples, Italy
2 University of Salerno, Neuroscience section- Department of
Medicine and Surgery, Salerno, Italy
∗ Corresponding author.
Introduction Early life experiences can influence hypotalamus-
pituitary-adrenal (HPA) axis regulation and adult attachment
styles. Furthermore, several studies showed that in patients with
eating disorders (EDs) there is a prevalence of insecure attachment.
However, the relationship between adult attachment style, HPA
axis functioning and onset of EDs is largely unknown.
Objectives and aims In order to evaluate possible associations
between attachment styles and HPA axis functioning in EDs, we
investigated Cortisol Awakening Response (CAR) in ED patients
with different attachment styles.
Methods Twenty adult patients with EDs were classified in three
groups, according to the Experience in Close Relationship ques-
tionnaire (6 with secure attachment, 6 with anxious attachment
and 8 with avoidant attachment). Saliva samples were collected at
awakening and 15, 30 and 60minutes after.
Results There was a significant difference among the groups in
both awakening and post-awakening cortisol concentrations. In
particular, compared to secure and avoidant groups, the anxious
group exhibited lower cortisol concentrations at awakening and
post-awakening with a preservation of the timing of the CAR.
Discussion Present findings demonstrate that anxious attach-
ment style is linked to flattened CAR in EDs. This pattern has
been associatedwith other psychiatric disorders. Therefore, attach-
ment style could influence the HPA functioning and it could play,
although not specifically, a role in pathophysiology of EDs.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW201
Obesity: The influence of expressed
emotion, anxiety and life events
E. Di Tullio ∗, E. Gattoni , C. Gramaglia , V. Ruggiero ,
G. Biroli , F. D’andrea , S. Gili , M.R. Gualano , R. Siliquini ,
P. Zeppegno
1 Università del piemonte orientale, medicina traslazionale, Novara,
Italy
2 Azienda ospedaliero universitaria maggiore della carità,
dipartimento dei servizi, Novara, Italy
3 Università degli studi di torino, Dipartimento di Scienze della Sanità
Pubblica e Pediatrica, Torino, Italy
4 Università del piemonte orientale, translational medicine, Novara,
Italy
∗ Corresponding author.
Background Expressed Emotion (EE) can be described as a mea-
sure of the emotional temperature of the family climate and plays a
role in disease course and outcome, especially in chronic illnesses.
Overweight and obesity are severe problems with serious implica-
tions as far as health risks are concerned. The literature suggests
having a high EE caregiver correlates with a worse treatment com-
pliance in obese patients.
Objectives To measure level of EE, stressful events and anxiety
in obese patients and their caregivers; to investigate the possible
correlations between treatment compliance and EE.
Methods We recruited 190 obese patients and 125 caregivers.
Socio-demographic features were recorded. Assessment included:
Level of Expressed Emotion Scale (LEE), one version for patients
and one for relatives in order to evaluate 4 dimensions: Intrusive-
ness, Emotional Response, Attitude toward Disease, Tolerance and
Expectation; the Paykel’s Interview for Recent Life Events; STAI Y1
concerning state anxiety and STAI Y2 concerning trait anxiety; BMI
(Body Mass Index) was measured at T0 and after 3,6 and 9 months.
Results We have found a correlation between gender and trait
anxiety, and an inverse correlation between age and trait anxi-
ety both in patients and caregivers. The decrease of BMI during
follow-up is statistically significant and this reduction seems to be
affected by tolerance and expectation perceived by patients and the
emotional response on behalf of caregivers.
Conclusions Levels of EE should be considered when planning
treatment interventions to enhance compliance in obese patients
and to support change in their life-style.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW202
How do obese people eat?
M.P. Felix-Alcantara ∗, J. Perez-Templado ,
C. Banzo-Arguis , R. Martínez de Velasco , E. Ruiz-Velasco ,
J. Quintero
1 Hospital Universitario Infanta Leonor, Psychiatry, Madrid, Spain
2 Fundación Psiformación, Psychiatry, Madrid, Spain
3 Hospital Universitario Infanta Leonor & Fundación Psiformacion,
Psychiatry, Madrid, Spain
∗ Corresponding author.
Introduction The recently published DSM-5 defines Eating Dis-
orders (ED) as “a persistent alteration in the food supply or
food-related behavior leading to an alteration in the consumption
or absorption of food and cause a significant deterioration in health
or psychosocial functioning” and, nevertheless, it does not include
obesity as an ED due to the lack of enough evidence to include it.
However, everyday more evidence supports that disordered eating
could be a significant factor, at least, in development and mainte-
nance of obesity.
Objectives Describe the eating behavior of a 180 obese sample.
Methods One hundred and eighty patientswith obesity that went
to the endocrinology service in order to lose weight are referred
to the Psychiatry department to be assessed. To explore the eat-
ing behavior it was administered the Bulimic Investigatory Test of
Edinburgh, BITE.
Results A total of 68.7% of patients showed a disordered eating
pattern, 71.6% tend to eat a lot when feeling anxious, 63.8% eat
rapidly large amounts of food, 72.8% worry about not to have con-
trol over how much eat, 40.5% consider that their pattern of eating
severely disrupt their life, 40.7% eat sensibly in front of others and
make up in private, 59.1% cannot stop eating when they want to
and 58.3% admit binges of large amounts of food.
Conclusions Most of our patients showed a pattern of disordered
eating, and then our findings support the idea of disordered eating
as a significant factor in the development and maintenance of obe-
sity. Therefore, obesity requires a multidisciplinary approach that
goes beyond the traditional nutritional guidance.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.