European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S375
compulsorily (n = 65). The European Addiction Severity Index was
used at baseline and at follow-up to assess socio-demographics
and substance use variables. Regression analysis was conducted to
investigate factors associated with abstinence at six-month follow-
up.
Results The frequency of use of preferred substance showed
markedly improvement for both voluntary admitted (VA) and
compulsory admitted (CA) patients (61% and 37% respectively) at
follow-up. Seventy-five percent of VA patients using amphetamine
reported improvement compared to 53% of CA patients. At follow-
up, the CA group continued to have a higher rate of injection use.
The CA group had experienced higher rates of overdose the past six
months and lower abstinence rates (24% versus 50%) at follow-up.
Lower severity of drug use at intake (non-injectiondrug use), volun-
tary treatment modality and higher treatment involvement during
follow-up all were significant factors associated with abstinence at
follow-up.
Conclusion Voluntary treatment for SUD generally yielded better
outcomes; nevertheless we found improved outcomes also for CA
patients. It is important to keep in mind that the alternative to CA
treatment in reality is no treatment at all and instead a continuation
of life-threatening drug use behaviours.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV78
Cerebellar atrophy supporting
diagnosis of alcohol dependence: A
case report
F. Pavez Reyes ∗, M. Sánchez , E. Moral , M. Terradillos ,
N. López , M. Roca , A. García , J. Russo
1 Hospital General Universitario Reina Sofía, Psychiatry, Murcia,
Spain
2 Centro de Salud Mental Murcia Este, Psiquiatría, Murcia, Spain
∗ Corresponding author.
Chronic use of alcohol is a known cause of cerebellar atrophy.
This finding could be a valuable diagnosis support when there
are not other information sources. In this case report, we describe
a 65-year-old male patient who was referred from primary care
to specialized consultation because a depressive syndrome it was
unresponsive to treatment with desvenlafaxine and lorazepam.
In psychopathological exploration we found overvalued ideas of
suffering some kind of injury and damage by the family, which
oriented the diagnostic hypothesis of delusional disorder with sec-
ondary mood symptoms, although the clinical suspicion of abuse
of alcohol was proposed as a differential diagnosis. The contin-
uing minimization and denial of consumption by the patient as
well as their reluctance to incorporate an external informant made
that the workup was a key element to elucidate the diagnosis.
We found a discrete increase in transaminases, gamma glutamyl
transferase and alkaline phosphatase. Magnetic resonance imag-
ing showed cerebellar atrophy (vermian and, in a lesser extent, in
both hemispheres). Once the patient was confronted with these
results, he agreed to disclose his problem, which fulfilled alcohol
dependence criteria. After that, he accepted to initiate treatment
and detoxification in a specialized unity.
Conclusions Although psychiatric diagnosis is based on the clin-
ical features and the exclusion of associated medical conditions,
in this case the workup provided support to our clinical suspicion,
favouring recognition of the problem and willingness to treatment
by the patient.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV79
Addictive behaviour and bariatric
surgery: Case report and literature
review
F. Pavez ∗, N. López , E. Saura , M. Roca , A. García , J. Russo ,
M. Sánchez , E. Moral
1 Hospital General Universitario Reina Sofía, Psychiatry, Murcia,
Spain
2 Fundación Jesús Abandonado, Unidad de Asistencia Psicológica,
Murcia, Spain
∗ Corresponding author.
Even though the scientific evidence supports the benefits of
bariatric surgery, its indications and contraindications must be
continually revised in order to avoid psychiatric complications.
Substance use is more common in patients subjected to bariatric
surgery than in the general population. There are reports of
increased incidence of alcohol abuse in patients after bariatric
surgery.
Objective To review the available evidence, after treat the case
of a 50-year-old man with addiction history whose addictive
behaviour worsened after undergoing bariatric surgery, with
decreased tolerance to alcohol effect and increase of the intake,
as well as changes in the graduation of alcohol used (including
antiseptic). As a result, a dangerous revolving door that led him
to repeated admissions, including Intensive Care Unit.
Results The case is consistent with the literature that suggests
that there is an increased risk of later alcohol-related problems
after bariatric surgery. This risk is higher several years post surgery,
in patients with previous history of problems related to alcohol,
young, men, and Roux-en-Y Gastric Bypass procedure.
Conclusions The indications for bariatric surgery should thor-
oughly consider the history of addiction, an adequate assessment of
the patient’s mental status and psychoeducation about the possible
psychiatric side effects, in order to develop preventive strategies.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV80
Characteristics and outcome of
methadone maintenance treatment
(MMT) patients with depression
E. Peles∗, A. Sason , E. Malik , S. Schreiber , M. Adelson
Tel Aviv Medical Center, Adelson Clinic for Drug Abuse Treatment &
Research, Tel Aviv, Israel
∗ Corresponding author.
Introduction Comorbidity of depression and opioid addiction is
highly prevalent, but their outcome in MMT is not consistent.
Objectives To compare between depressed and non-depressed
MMT patients.
Methods Hamilton depression scale scores (taken during a
psychiatric assessment) were studied among MMT patients on
admission or during treatment (cutoff for depression > 18).
Results A total of 498 MMT patients were studied. Depression
proportion was 22.5%, and 23.2% among 263 who were studied
on admission; the depressed vs. non-depressed on admission did
not differ in female proportion (19.7% vs. 25.6%), age of admis-
sion (43.2 ± 10.4), opiate use onset (21.8 ±6.3) and education years
(9.5 ±2.8), but had higher proportion of cocaine (55.7% vs. 35.1%,
P = 0.005), and benzodiazepine abuse (73.8% vs. 58.4%, P = 0.04).
Retention was high and similar (80.3 vs. 82.9% P = 0.7) and of those
who stayed one year, cocaine and benzodiazepine were still higher
among the depressed patients (cocaine: 43.8% vs. 23.2%, P = 0.03;
BDZ: 61.2% vs. 40%, P = 0.01). Compared to the non-depressed,