European Psychiatry - Volume 33 - March 2016

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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.
EW209
Trends of hospitalization for bulimia
nervosa in USA: A nationwide analysis
Z. Mansuri ∗ Rathod ansal utaria hambhu
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.
EW210
Current and emerging drugs
treatment for night eating syndrome
M. Martellini ∗, M. Barchiesi , M.G. Oriani , B. Nardi
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.
EW211
Childhood trauma and cortisol
awakening response in eating
disorders: A dose-dependent trauma
effect
F. Monaco ∗, A.M. Monteleone , F. Pellegrino , F. De Riso ,
G. Patriciello , M. Cimino , M. Calvanese , U. Volpe ,
P. Monteleone
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.