European Psychiatry - Volume 33 - March 2016

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S20 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55
use of this substance in alcohol-dependent individuals and higher
biomarkers of alcohol use.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
S06
Potential relationship between
inflammatory markers, neuroimaging
findings and treatment response in
depression
A. Szulc
Medical University of Warsaw, Department of Psychiatry, Pruszkow,
Poland
Pharmacological therapy in mental disorders is usually effective
in 60–70%, the treatment reaction is worsening with the disease
progression, and proper medication and early treatment regimen
choice is crucial. Research showed that specific brain changes
(structural and functional) are present in depressed patients. These
abnormalities are probably linked to neurodegeneration. There is
also an evidence that inflammation contributes to the depression
pathophysiology, and both these processes – neurodegeneration
and inflammation are related.
Novel biological markers allow us to better understand the indi-
vidual mechanisms of treatment response in depression. Recently,
several biological measures have been proposed, amongst them –
neuropsychological dysfunction, decreased GABA level in proton
magnetic resonance spectroscopy (1H MRS), body weight, genetic
factors andperipheral inflammatorymarkers. Latest research found
that brain changes assessedwith neuroimagingmethods (including
1 H MRS, e.g. glutamatergic system abnormalities), correlate with
peripheral inflammatory markers. Furthermore, both these factors
taken together may serve as one integrated treatment prediction
marker in depressed patients.
Disclosure of interest The author has not supplied his declaration
of competing interest.
Bipolar disorders: From detection to intervention
S07
Developmental trajectories to bipolar
disorder
S. Frangou
Icahn School of Medicine at Mount Sinai, Psychiatry, New York, USA
Background Childhood subclinical phenotypes have been infor-
mative for etiological research and as a target for preventative
interventions. Using a prospective longitudinal general population
cohort we investigated whether childhood manic symptoms pre-
dicted a diagnosis of bipolar disorder (BD) or other psychiatric
disorders by early adulthood.
Methods Subthreshold manic symptoms at age 11 years
(n = 1907) and clinical outcomes by age 19 years ( n = 1584) were
ascertained in the TRacking Adolescents’ Individual Lives Survey
(TRAILS), a prospective Dutch community cohort. We used latent
class analysis to stratify TRAILS participants at age 11 years into
distinct classes based on the pattern and severity of childhood
manic symptoms. We then determined the association between
class membership and clinical diagnoses by age 19 years.
Results At age 11 years, we identified a normative class with
negligible symptoms (n = 862), a mildly symptomatic (n = 846)
and a highly symptomatic class (n = 199). The risk of BD was
moderately increased in individuals in the mildly symptomatic
class (OR = 2.65, 95% CI 1.41–5.01), and substantially increased
in the highly symptomatic class (OR = 7.08, 95% CI = 3.32–15.11).
Children in the highly symptomatic class were additionally char-
acterized by lower IQ and socioeconomic status, greater family
dysfunction and increased rates of parental psychiatric morbidity.
Class membership did not show significant associations with
depressive, anxiety and substance abuse disorders by age 19 years.
Conclusions The results provide support to developmental mod-
els of BD, and suggest that manic symptoms in childhood may be a
marker for adult disorders and therefore potentially useful for early
identification of at risk individuals.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S08
Protecting the cardiometabolic health
of young people experiencing
psychosis
D. Shiers (Honorary Reader in Early Psychosis)
School of Psychological Sciences, University of Manchester, United
Kingdom
This presentation will highlight how the early phase of major men-
tal illness may provide a critical window of opportunity in which to
prevent future life-restricting and life-shortening physical comor-
bidities.
Despitemany recent advances in our understanding of severemen-
tal illnesses, those affected still lose 15–20 years of life on average
compared to the general population. Most premature deaths arise
from the same common disorders that affect the general popula-
tion such as cardiovascular disease, infections and cancers. Of these
cardiovascular diseases is now the single biggest cause, far greater
than suicide. Shockingly the mortality gap is still widening as the
reduction in CVD morbidity and mortality seen in the general pop-
ulation over the last three decades continues to elude people with
severe mental illnesses, for whom the prevalence of CVD, obesity
and diabetes are now of epidemic proportion.
And yet, much of this epidemic can be predicted. High rates of
tobacco use, physical inactivity and poor nutrition point to under-
lying health inequalities. Furthermore, initiation of antipsychotic
treatment is associated with aggressive weight gain and metabolic
disturbance from the early phase of psychosis, and yet often these
adverse effects remain unmonitored and untreated.
This presentation will argue that these potentially modifiable risk
factors provide natural targets for prevention from the onset of psy-
chosis and its treatment. Extending the early interventionparadigm
to embrace a far more holistic body & mind approach is overdue.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S09
Implementing the clinical standards
of the National Institute for Health
and Care Excellence (NICE) bipolar
clinical guideline
M. Tremblay ∗ alin
1 Cheshire and Wirral Partnership NHS Foundation Trust, Mental
Health, Winsford, United Kingdom
2 Fellow of NICE (2012–2015)
∗ Corresponding author.
In the UK, the National Institute for Health and Care Excellence
(NICE) sets standards for interventions to drive improvement in the
quality of services delivered. The actual update of clinical guidelines
remains patchy and difficult to ascertain.