European Psychiatry - Volume 33 - March 2016

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S400 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
to explore these symptoms and try different treatments to improve
them.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV157
The influence of treatment modality
on long-term neurocognitive
functioning in treatment resistant
bipolar depressed inpatients treated
with pharmacotherapy or
electroconvulsive therapy
J. Bjorke-Bertheussen ∗, B. Auestad , U. Kessler , H. Schoyen
1 Stavanger University Hospital, Psychiatry, Stavanger, Norway
2 Stavanger University Hospital, Research Department, Stavanger,
Norway
3 Haukeland University Hospital, Psychiatry, Bergen, Norway
∗ Corresponding author.
Introduction Bipolar depression is difficult tomanage, and causes
considerable disability and distress for patients and their surround-
ings. Electroconvulsive therapy (ECT) is an effective treatment, but
there are concerns regarding long-term neurocognitive impair-
ment, and in particular autobiographical memory.
Objectives To compare the long-term effects of algorithm-based
pharmacologic treatment (APT) and ECT in treatment-resistant
bipolar depression as measuredwith standard neurocognitive tests
and autobiographical memory interview.
Aims To examine the long-term neurocognitive effects of ECT.
Methods In this multicenter randomized controlled trial 73
in-patients with treatment resistant bipolar depression were ran-
domized to either APT or unilateral ECT. Patients were assessed at
baseline and at 6 months. Neurocognitive functions were assessed
with the MATRICS Consensus Cognitive Battery (MCCB), Wechsler
Abbreviated Scale of Intelligence (WASI) and the Autobiographical
Memory Inventory - Short form (AMI-SF). At 6 months, neurocog-
nitive data were available for 26 patients (APT n = 11, ECT n = 15).
Results There were no group-differences at baseline.
At 6 months, there was no group-difference in MCCB-score (APT
44.9 vs. ECT 46.0, P-value: 0.707), or WASI total IQ-score (APT 103.9
vs. ECT 107.2, P-value: 0.535). There were indications of (P-value:
0.109) poorer AMI-SF consistency score in the ECT group (APT 72.3%
vs. ECT 64.3%).
Conclusions This study does not find that ECT causes long-term
impairment in neurocognitive function as measured with standard
neuropsychological tests. We find a trend towards poorer autobio-
graphical memory in the ECT-group, and there needs to be further
research regarding this.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV158
Discontinuation of antipsychotic
therapy in severe mania: A six months
follow-up study
S. Brioschi , D. Delmonte , C. De Santis ∗ ranchini , C. Colombo
Scientific Institute and University Hospital San Raffaele, Clinical
Neurosciences, Milan, Italy
∗ Corresponding author.
Introduction Independently of the drug choice, antimaniac treat-
ment has to be continued at least until full remission. Most
guidelines recommend continuation therapy for 6–12 months but
controlled studies are lacking.
Objectives A six months follow-up study on a sample of 57 inpa-
tients affected by mania at Mood Disorder Unit.
Aims To evaluate a timeframe for the discontinuation of the
antipsychotic therapy.
Methods Fifty-seven bipolar inpatients affected by a manic
episode according to DSM-5 criteria. Patients treated according
to our pharmacological protocol with a mood stabilizer (lithium
or valproate) and an antipsychotic (haloperidol or risperidone).
Course of illness assessed with Young Mania Rating Scale (YMRS)
scored at week 0, 1, 2, 4, 8, 24. Remission defined as YMRS < 12.
Results Twenty men (35.09%) and 37 women (64.91%); mean
age 43.18 ±12.71 years. Mean YMRS basal score 38.55 ± 8.08. At
4th week, remission rate was 54.39% (31 patients); at 8th week
was 80.70% (46 patients). At 8th week, 39/57 patients (68.42%)
discontinued the antipsychotic. Relapse rate after 6 months was
26.32% (12 depressed, 3manic). Multiple regression, t-test and Chi2
analysis were performed: older patients (P = 0.01) and with higher
number of episodes ( P = 0.04) tend to relapse earlier. Neither sever-
ity of the episode (P = 0.3), nor delusional symptoms (P = 0.6) nor
discontinuation of the antipsychotic (P = 0.3) correlate with relapse
time.
Conclusions Our experience suggests that an early discontinua-
tion of antipsychotics, usually 4–8 weeks after remission, does not
worsen the short-term course of illness. This approach could mini-
mize the risk of side effects. Evidence is lacking about the duration
of this therapy, long-term studies are still necessary.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV159
Association between suicide attempts
and insight among patients with
bipolar disorders
A. Cardoso ∗ guiar Byrne Xavier
1 Faculty of Medical Sciences, Mental Health, Lisbon, Portugal
2 School of Public Health, New University, Public Health, Lisbon,
Portugal
3 University of Wollongong, Clinical and Forensic Psychology,
Wollongong, Australia
∗ Corresponding author.
Introduction Insight is an important factor associated with non-
compliance and poor outcome. Poor level of insight has been
described as a characteristic in patients with acute bipolar disor-
der with more unawareness in social consequences. In contrast,
awareness of having a mental disorder, of its symptoms, of its con-
sequences, and/or of the need for treatment is associated with a
number of positive prognostic indicators. Insight is also linked,
however, to depression and suicidal ideation in bipolar disorder.
Objectives (1) Assess the illness perception. (2) Assess the impact
of insight in suicidal tendencies.
Aims Contribute to development measures to improve the
insight in bipolar disorders.
Methods In this cross sectional study we use a convenience sam-
ple of patients with bipolar disorder attending in the mental health
departments of three general hospitals in Lisbon great area. We
have applied clinical and socio-demographic questionnaire and
additional measures to assess symptom severity, treatment adher-
ence and illness perception.
Results A samples was composed by 64 patients with bipolar dis-
order (mean age = 38.7; SD ±10.1). A total of 48.4% patients (n = 31)
hadmade a suicide attempted and 23.4% ( n = 15) of this patient done
5 or more attempted suicide. We found a significant correlation
with symptoms and insight ( rs = 0.56; P < 0.01).
Conclusion Mental health professionals often utilize insight as an
indicator of prognosis, because of its association with treatment
adherence. The findings of the current study suggest that having