European Psychiatry - Volume 33 - March 2016

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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 ∗, W. Greil
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 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 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.
S66
Physical comorbidity and
consequences for mortality and
treatment
R. Heun ∗, D. Schoepf
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.
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.
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