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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1141

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

1 ,

, B. Auestad

2

, U. Kessler

3

, H. Schoyen

1

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1142

EV158

Discontinuation of antipsychotic

therapy in severe mania: A six months

follow-up study

S. Brioschi , D. Delmonte , C. De Santis

, L. F

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 Chi

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1143

EV159

Association between suicide attempts

and insight among patients with

bipolar disorders

A. Cardoso

1 ,

, P . A

guiar

2 , M.

Byrne

3 , M.

Xavier

1

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 (

r

s

= 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