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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55

S39

Old age depression: Do we need a special approach

S65

Clinical pharmacological

management of polypharmacy in old

age depression

P. Baumann

1 ,

, W. Greil

2 , 3

1

University Department of Psychiatry (DP-CHUV), Prilly-Lausanne,

Switzerland

2

Psychiatric Department, Universität München, München, Germany

3

Psychiatric Hospital, Sanatorium Kilchberg, Kilchberg-Zurich,

Switzerland

Corresponding author.

Polypharmacy is the rule in psychogeriatric patients, as they

present frequently comorbidities such as depression, demen-

tia [often including Behavioral and Psychological Symptoms of

Dementia (BPSD)] and somatic diseases. Recommended treat-

ments for geriatric depression are antidepressant medications,

psychotherapy and psychosocial interventions

[1] . B

esides antide-

pressants, other psychotropic drugs are often co-prescribed, but

somatic drugs are also needed for the treatment of other concomi-

tant diseases. This situation increases the risk for adverse effects

due to pharmacokinetic and pharmacodynamic interactions, espe-

cially since the organism of elderly patients displays a lowered

homeostatic reserve and a decrease of functions, which allows

resisting to xenobiotic influences.

On the other hand, there are also studies which suggest that in hos-

pitalized psychogeriatric patients, the incidence of severe adverse

reactions is lower in patients > 60 y than in those < 60 y

[2] .

This

is one of the results of the AMSP-study group, which in German

speaking countries has developed a pharmacovigilance program in

psychiatric hospitals.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

References

[1] Dines P, Hu W, Sajatovic M. Depression in later-life: an

overview of assessment and management. Psychiatr Danub

2014;26(Suppl. 1):78–84.

[2] Greil W, Haberle A, Schuhmann T, Grohmann R, Baumann P.

Age and adverse drug reactions from psychopharmacological

treatment: data from the AMSP drug surveillance programme

in Switzerland. Swiss Med Wkly 2013;143:w13772.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.881

S66

Physical comorbidity and

consequences for mortality and

treatment

R. Heun

1 ,

, D. Schoepf

2

1

Derbyshire Healthcare NHS Foundation Trust, Psychiatry, Derby,

United Kingdom

2

University of Bonn, Psychiatry, Bonn, Germany

Corresponding author.

Introduction

Ageing is related to an increase rate of physical

comorbidity. However, the interactionbetweenphysical comorbid-

ity and the development of depression in the elderly is not yet clear.

Depressionmay be the cause or consequence of physical morbidity.

Both may increase mortality.

Methods

A total of 9604 patients with depression and a control

sample of 96040 patients who attended a general hospital were

followed-up for up to 12 years. Physical comorbidity and mortality

was assessed.

Results

Twenty-nine physical disorders were more prevalent in

subjects with depression, but the effect of individual disorders on

mortality did not differ significantly in the depressed and control

sample.

Conclusions

Patients with depression suffer more physical health

problems than control patients that lead to death. The implications

for early treatment will be discussed, a preventative approach may

be most relevant.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.882

S67

Distinction of dementia and

depression in various stages of the

disease processes

W. Maier

University of Bonn, Department of Psychiatry, Bonn, Germany

Old age depression is often difficult to discriminate from dementia

(particularly of Alzheimer type) – particularly cross-sectionally.

Incident dementia is frequently associated with depressed mood

and agitation; depression in the elderly goes together with execu-

tive andmemory dysfunctions; associatedpsychotic symptoms and

activity-of-daily-life dysfunctions are shared by both conditions as

well as major risk factors as vascular and metabolic factors. Fre-

quently both syndromes are “masking” each other; depressionmay

furthermore present as the first clinical sign of Alzheimers disease.

Yet, both clinical syndromes/disorders emerging from quite

different are pathogenic neurobiological mechanisms with differ-

entiating neuropsychological, – imaging and – chemical features.

Clinical tools can be derived and enable accurate differential diag-

nosis. Thus, the distinction between both syndromes is a first

instance for biomarker supported differential diagnoses in psychi-

atry.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.883

Overcoming the stigma of mental illness: Current

proceedings and initiatives

S68

Seven years after ratification of the

UNCRPD: Are there any advances for

patients with mental health

conditions?

Y. Cohen

GAMIAN-Europe, Azor, Israel

The Convention on the Rights of Persons with Disabilities (CRPD) is

the first highest international legally-binding standard which aims

to promote, protect and ensure the full and equal enjoyment of

all human rights and fundamental freedoms by all persons with

disabilities, including those with mental health conditions, and to

promote respect for their inherent dignity. The CRPD embodies a

‘paradigm shift’, from the charitable and the medical approaches

to disability to one, which is firmly rooted in human rights. It pro-

vides a clear path towards non-discrimination, full and effective

participation and inclusion in society, respect for difference and

acceptance of persons with disabilities as part of human diver-

sity and humanity, equality of opportunity and accessibility just

to name a few.

States which have signed the CRPD have an obligation to respect,

protect and fulfil the internationally agreed upon set of standards