Table of Contents Table of Contents
Previous Page  190 / 812 Next Page
Information
Show Menu
Previous Page 190 / 812 Next Page
Page Background

S186

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.326

EW209

Trends of hospitalization for bulimia

nervosa in USA: A nationwide analysis

Z. Mansuri

1 ,

, M .

Rathod

1 , P. B

ansal

2 , A. S

utaria

1 , S. S

hambhu

1

1

Drexel University, School of Public Health, Philadelphia, USA

2

Mayo Clinic, Department of Cardiology, Arizona, USA

Corresponding author.

Objectives

Bulimia Nervosa (BN) is an important cause of mor-

bidity and mortality in hospitalized patients. While BN has been

extensively studied in the past, the contemporary data for impact

of BN on cost of hospitalization are largely lacking.

Methods

We queried theHealthcare Cost andUtilization Project’s

Nationwide Inpatient Sample (HCUP-NIS) dataset between 1998-

2011 using the ICD-9 codes. Severity of co-morbid conditions was

defined by Deyo modification of Charlson co-morbidity index. Pri-

mary outcome was in-hospital mortality and secondary outcome

was total charges for hospitalization. Using SAS 9.2, chi-square test,

t-test and Cochran-Armitage test were used to test significance.

Results

19,441 patients were analyzed. 94.13% were female and

5.87% male (

P

< 0.0001). 85.72% were white, 4.55% black and

9.73% of other race (

P

< 0.0001). Rate of hospitalization decreased

from 1136.99/million to 802.47/million from 1998-2011. Over-

all mortality was 0.20% and mean cost of hospitalization was

15,496.82$. The in-hospital mortality reduced from 0.23% to 0.15%

(

P

< 0.0001) and mean cost of hospitalization increased from

8,194.53$ to 22,547.86$. Total spending on BN related admissions

have increased from $73.96 million/year to $139.93 million/year

over the last decade.

Conclusions

While mortality has slightly decreased from 1998 to

2011, the cost has significantly increased from $73.96 million/year

to $139.93 million/year, which leads to an estimated $65.97 mil-

lion/year additional burden to US health care system. In the era of

cost conscious care, preventing BN related Hospitalization could

save billions of dollars every year. Focused efforts are needed to

establish preventive measures for BN related hospitalization.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.327

EW210

Current and emerging drugs

treatment for night eating syndrome

M. Martellini

1 ,

, M. Barchiesi

1

, M.G. Oriani

2

, B. Nardi

1

1

Polytechnic University of Marche, Clinica di Psichiatria, Ancona,

Italy

2

Dipartimento di Salute Mentale Ancona ASUR Marche,

Dipartimento di Salute Mentale Ancona ASUR Marche, Ancona, Italy

Corresponding author.

Introduction

The night eating syndrome (NES) is a categorized in

the diagnostic and statistic manual (DSM-5) as an “Other Specified

Feeding or Eating Disorder” and it is characterized by a reduced

feeding during the day, evening hyperphagia accompagned by fre-

quent nocturnal awakenings associated with conscious episodes of

compulsive ingestion of food and abnormal circadian rhythms of

food and other neuroendocrine factors. Frequently it is associated

with obesity and depressed mood.

Objectives

The purpose of this review is to investigate the state

of art concerning the psychopharmacological treatment of NES.

Methods

A Medline enquiry of published articles from 2005 to

October 2015 was performed using the following keywords: “NES,

pharmacological treatment, SSRI, antidepressants, antipsychotic,

sertraline, citalopram, escitalopram, duloxetine, venlafaxine,

paroxetine, fluoxetine, fluvoxamine, topiramate”. Reviews, single

case studies and RCT were also analyzed.

Results

Only few studies met the selection criteria. A recent 8-

week double-blind placebo controlled study, in 34 patients with

NES, has confirmed the efficacy of sertraline. Sertraline was associ-

atedwith significantly greater improvement than placebo in overall

symptomatology.

Conclusions

SSRIs should be considered the drug of choice for

the treatment of NES not only because of evidence in the litera-

ture but also since they display the best pharmacological profiles

with fewer adverse events. More evidence of efficacy is shown for

some SSRIs such us paroxetine, fluvoxamine and especially sertra-

line. Topiramate should be reserved for cases resistant to treatment

with SSRIs.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.328

EW211

Childhood trauma and cortisol

awakening response in eating

disorders: A dose-dependent trauma

effect

F. Monaco

1 ,

, A.M. Monteleone

1

, F. Pellegrino

1

, F. De Riso

1

,

G. Patriciello

1

, M. Cimino

1

, M. Calvanese

1

, U. Volpe

1

,

P. Monteleone

2

1

University of Naples SUN, Department of Psychiatry, Naples, Italy

2

University of Salerno, Department of Medicine and Surgery-

Neuroscience Section, Salerno, Italy

Corresponding author.

Introduction

A role for the hypothalamus-pituitary-adrenal

(HPA) axis has been suggested in the pathophysiology of anorexia

nervosa (AN) and bulimia nervosa (BN), and childhood trauma

experiences have been detected frequently in patients with AN and

BN. Since trauma exposure in the childhood may persistently affect

HPA axis functioning, we explored HPA axis activity in AN and BN

patients with and without childhood trauma history.

Objectives and aims

We aimed to examine possible associations

between childhood traumatic experiences and HPA axis function-

ing, as assessed by the cortisol awakening response (CAR), in adult

patients with AN or BN as compared to adult healthy controls.

Methods

Saliva samples were collected by 41 patients with

symptomatic AN, 32 with symptomatic BN and 45 healthy con-

trols at wakening and after 15, 30 and 60min. They filled in the

Childhood Trauma Questionnaire (CTQ), which assesses five spe-

cific types of childhood trauma.

Results

As compared to the control group, the no-maltreated

AN patient group exhibited an enhanced CAR whereas the no-

maltreated BNpatient group showed a similar CAR. On the contrary,

both AN and BN patients with a positive history of childhood

maltreatment exhibited statistically significant blunted CAR as

compared to no-maltreated patients. Moreover, in maltreated ED

patients the CAR tended to decrease when the number of trauma

types increased.

Discussion

Present findings confirm a dysregulation of the HPA

axis activity in symptomatic patients with AN and BN and suggest

a dose-dependent effect of childhood adverse experiences on the

CAR of adult ED patients.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.329