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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.317

EW200

Attachment style and salivary cortisol

awakening response in eating

disorders

F. De Riso

1 ,

, R . G

iugliano

1 , A.M

. Monteleone

1 , M.

Nigro

1 ,

F. Pellegrino

1

, M. Calvanese

1

, G. Patriciello

1

, V. De Stefano

1

,

U. Volpe

1

, P. Monteleone

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.318

EW201

Obesity: The influence of expressed

emotion, anxiety and life events

E. Di Tullio

1 ,

, E. Gattoni

1

, C. Gramaglia

1

, V. Ruggiero

1

,

G. Biroli

2

, F. D’andrea

2

, S. Gili

1

, M.R. Gualano

3

, R. Siliquini

3

,

P. Zeppegno

4

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.319

EW202

How do obese people eat?

M.P. Felix-Alcantara

1 ,

, J. Perez-Templado

2

,

C. Banzo-Arguis

1

, R. Martínez de Velasco

1

, E. Ruiz-Velasco

1

,

J. Quintero

3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.320