European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55 S21
NICE most recent guideline on the management of bipolar disorder
in adults will be reviewed. A concept tool to facilitate adherence to
NICE clinical standards will be presented along with detailed out-
comes of its pilot application in a naturalistic treatment setting,
which drove the average concordance from 32% for a team provid-
ing treatment as usual, to 92% for a team supporting their practice
with the tool. This presentationwill also address additional impacts
of its use including allowing drawing key clinical characteristics of
an index population of individuals suffering from bipolar disorder,
supporting education and auditing the actual service delivery.
The usefulness of the tool to shape clinical practice according to
NICE evidence-based standards will be outlined. Its versatility and
limitations will be debated. The discussion of the findings will
include epidemiological considerations as well as implications for
mental and physical well-being.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Co-occurring psychiatric and substance use
disorders: Impact on illness course and recovery
S10
Alcohol and aggression
A. Heinz ∗, U. Kluge , M. Schouler-Ocak , A. Beck
Charité, Universitätsmedizin Berlin, Department of Psychiatry and
Psychotherapy, Campus Charité Mitte, Berlin, Germany
∗ Corresponding author.
About half of all murders are committed in Western industrial-
ized countries by subjects under the influence of alcohol. Chronic
alcohol use also increases the rate of violent attacks. These find-
ings appear to be due to an interaction between acute and chronic
environmental effects (acute alcohol consumption and chronic
social isolation stress) on the one hand and limbic processing of
aversive stimuli modulated by neurotransmitter systems such as
dopamine and serotonin on the other. Animal experiments showed
that early social isolation stress can induce serotonin dysfunction
and appears to predispose individuals towards increased threat
perception. Studies in humans revealed that depending on sero-
tonergic neurotransmission and serotonin transporter genotype,
some individuals are prone to show elevated functional activa-
tion elicited by aversive and threatening cues. Previous experience
with alcohol-related aggression seems to further predispose an
individual towards a “fight vs. flight” reaction when confronted
with perceived threat during alcohol intake. Together, these find-
ings point to complex gene-environment interactions and a specific
role of social isolation stress in the development of alcohol-related
aggression.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
S11
Multi-morbidity: Psychosis early
childhood adversity and substance
use within homeless people
M. Krausz
Institute of Mental Health at UBC, Vancouver, BC, Canada
Homelessness is the most visible indicator for social marginal-
ization and vulnerability. It is a risk factor for subsequent health
threats and especially individuals with a history of trauma,
substance use and severe persistent mental illness are at high risk
to loose their homes, jobs and social networks.
The Canadian At Home/Chez Soi study aimed to better understand
the entanglement of homelessness and mental illness and possible
strategies to provide care to themost vulnerable. In 5 Canadian cen-
ters, over 2000 patients were included and randomized to different
intervention arms based on a housing first approach.
Early trauma and foster care were as rampant as poly substance
use, which explains a significant increase in mortality too.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S12
Are attention-deficit/hyperactivity
disorder symptoms associated with a
more severe course of substance use?
A longitudinal study with young Swiss
men
F. Moggi
University Hospital of Psychiatry and Psychotherapy, University of
Bern, Bern, Switzerland
Introduction Adults with attention-deficit/hyperactivity disor-
der (ADHD) symptoms show higher prevalence rates for substance
use disorders (SUD).
Objectives Few longitudinal studies have been conducted to
observe the course of substance use among adults with ADHD.
Aims This study examined the predictive value of ADHD symp-
toms during the course of substance use in a population sample.
Methods In twowaves data froma representative sample of 5103
Swiss men in their early 20s were collected (baseline and 15-
month follow-up) in the longitudinal “Cohort Study on Substance
Use Risk Factors” (C-SURF). ADHD symptoms and substance use
were assessed using the adult ADHD Self-Report Scale (ASRS-v1.1)
and self-administered SUD questionnaires, respectively. Individ-
uals who screened positive for ADHD (ADHD+) were compared to
those who screened negative (ADHD−).
Results At baseline, the 215 individuals in the ADHD+ group
(4.2%) showed considerably higher prevalence and frequency of
substance use and prevalence of alcohol, tobacco, and cannabis
use disorders relative to the ADHD− group. While alcohol, tobacco,
cannabis, and heroin use remained stable from baseline to follow-
up, the ADHD+ group was more likely to begin using illicit drugs
(i.e. amphetamines, speed, ecstasy, hallucinogens, and cocaine)
and initiate nonmedical use of prescription drugs (i.e. stimu-
lants/amphetamines, hypnotics, and tranquilizers) relative to the
ADHD− group.
Conclusions Young men with ADHD symptoms displayed more
severe substance use patterns and were at a high risk of initiating
drug use within 15 months. The identification of ADHD symptoms
during early adulthood may be relevant in early interventions to
lower the risk of drug use.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S13
Autism and substance use
comorbidity: Screening, identification
and treatment
P.J.M. van Wijngaarden-Cremers
Dimence, Centre for Developmental Disorders, Zwolle, Netherlands
Objective Autism spectrum disorders (ASD) are well-known for
high prevalences of comorbid conditions especially anxiety, obses-
sions, depression, challenging behaviours.