European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S447
Methods Levels of different monoamines, their metabolites and
N-methylnicotinamide (end product of kynurenine pathway) were
measured in daily samples of urine from children (7–11 years old)
with mild and severe HKS using fluorimetric and chromatographic
methods as well as platelet monoamine oxidase (MAO) activity.
Thirty childrenwithmildHKS received psychostimulant Sydnocarb
5–15mg daily for 1–1.5 months (for ethical reasons children with
severe HKS were not included in study).
Results HKS was accompanied by activation of dopaminergic and
inhibition of noradrenergic systems. There were found metabolic
differences between two forms of HKS. Compared with mild HKS,
severe HKS was characterized by significant 2-fold increase of MAO
activity and L-dopa, dopamine and adrenaline excretion. After syd-
nocarb treatment children’s clinical status improved along with
decrease of excretion of homovanillic, vanillylmandelic and 5-
hydroxyindoleacetic acids and increase of N-methylnicotinamide.
Conclusions Results indicate that dopaminergic and nora-
drenergic systems play important role in pathogenesis of
HKS. Clinical improvement of HKS children was accompa-
nied by significant increase of N-methylnicotinamide excretion.
It is proposed that increased urine excretion of kynurenine
metabolite–N-methylnicotinamide and N-methylnicotinamide/5-
hydroxyindoleacetic acid ratio can serve as potential biomarkers for
evaluation of efficacy of psychostimulant medication. We hypoth-
esize that kynurenine system plays significant role in pathogenesis
of HKS/ADHD.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV309
Neuroanatomical basis of emotional
dysregulation in children and adults
with ADHD
R. Vela
Massachusetts General Hospital, Psychiatry, Chelsea MA, USA
Introduction Since the advent of DSM III, emotional dysregula-
tion has been relegated to “associated features” of ADHD. However,
research has shown that 25% to 40% of children and 30% to 70% of
adults with ADHD have emotional dysregulation. Deficient emo-
tional dysregulation is an important cause of disability, and poor
clinical course.
Objectives At the end of this presentation, the participants will
be able to:
– discuss the prevalence, disability and clinical/behavioral man-
ifestations of emotional dysregulation in ADHD as a dimensional
trait;
– discuss themajor brain functions of the hypothalamus, amygdala,
ventral striatum, cingulate gyrus, anterior insula and orbitofrontal
cortex, and how these may explain emotional dysregulation in
ADHD.
Aims The aim of this presentation is to elucidate the rela-
tionship between clinical manifestations of deficient emotional
self-regulation in ADHD and the neuroanatomical structures and
neurocircuitry involved in emotional regulation.
Methods This presentation will selectively review specific
research findings of functional imaging ADHD studies and ana-
lyze them in the context of emotional regulation exerted by the
interrelationships between the amygdala, ventral striatum, medial
prefrontal cortex, orbitofrontal cortex and anterior insula.
Results Bottom-up neuroanatomical mechanisms involve the
detection of hypothalamic and amygdalar firing, signaling higher
cortical structures that control is needed. Top-down regulatory
processes in ADHD subjects fail in the allocation of attention to
emotional stimuli and reward valuation necessary to maintain
focus on a goal.
Conclusions Further research is needed to continue elucidating
the anatomical structures and functional connectivity underlying
deficient emotional self-regulation in ADHD.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV310
Understanding of self-harm
behaviour in adolescents
L. Santri Razic Pavicic Vuk ∗ omac
1 Clinic for Psychological Medicine-University Hospital Center Zagreb,
Child and adolescent psychiatry, Zagreb, Croatia
2 Clinic for Psychological Medicine-University Hospital Center Zagreb,
Adult psychiatry, Zagreb, Croatia
3 Psychiatric Hospital ‘Sveti Ivan’, Adult psychiatry, Zagreb, Croatia
∗ Corresponding author.
Introduction The incidence and prevalence of self-harm
behaviour, with or without suicidal intent, is on the rise, both in
other countries as well as in Croatia. Understanding the nature
of patients who show self-harm behaviour can help us to better
understand the components that contribute to their morbidity and
mortality.
Objectives To expand the understanding of self-harm behaviour
in adolescents as a contribution to the planning and implementa-
tion of preventive and curative programs.
Aims To explore the psychopathological characteristics of
adolescents with and without self-harm behaviour who seek psy-
chiatric help for their mental health problems.
Methods In this study participated 150 adolescents, aged 14–18
years, of which 52% showed some form of self-harm behaviour.
During the initial examination of child and adolescent psychiatrist,
participants completed self-reported questionnaires: functional
assessment of self-mutilation (FASM, 1997) and the youth self
report (YSR, 2001).
Results Statistically significant difference between groups of
female adolescents with and without self-harm behaviour was
observed in all of eight problem scales, while in male adolescents
it was observed in five of them. This indicates considerably higher
level of psychopathological features in the group of patients with
self-harm behaviour.
Conclusions It is necessary to intensify monitoring of adoles-
cents who show self-harm behaviour because of the overall level
of psychopathological symptoms and the comorbidity which sig-
nificantly complicates the therapeutic process. It is particularly
important to continuously assess the suicide risk.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV311
Resilience in children of depressed
parents – a systematic review of
protective factors
O. Wlodarczyk∗ chramm , F. Metzner , S. Pawils
University Medical Center Hamburg-Eppendorf, Department of
Medical Psychology, Hamburg, Germany
∗ Corresponding author.
Introduction Children of depressed parents have an increased
risk of developing mental disorders. While there are various stud-
ies concerning a pathogenetic perspective, fewer studies examined
factors that protect mental health of these children. Knowl-
edge about protective factors is necessary to establish prevention
projects.