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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.825

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.826

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.827

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.828

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.