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S44

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

Relapse prevention in addiction – from bench to

bedside

S82

From genes to treatment: The effect of

polymorphisms in neurotransmitter

systems on addictive behaviour,

neural response and relapse

P. Bach

1 ,

, S. Vollstädt-Klein

1

, M. Kirsch

1

, S. Hoffmann

1

,

A. Jorde

1

, J. Frank

2

, K. Charlet

3

, A. Beck

3

, A. Heinz

3

, H. Walter

3

,

M. Rietschel

2

, F. Kiefer

1

1

Central Institute of Mental Health, University of Heidelberg, Medical

Faculty Mannheim, Department of Addictive Behavior and Addiction

Medicine, Mannheim, Germany

2

Central Institute of Mental Health, University of Heidelberg, Medical

Faculty Mannheim, Department of Genetic Epidemiology in

Psychiatry, Mannheim, Germany

3

Charité, Universitätsmedizin Berlin, Department of Psychiatry and

Psychotherapy, Berlin, Germany

Corresponding author.

Introduction

The development and maintenance of an alcohol

addiction is a complex interaction between genetic and environ-

mental factors. Genetic effects seem to contribute substantially

to the risk of developing an addiction, but also to its course and

patients’ responses to different treatments. Recent studies identi-

fied associations betweenpolymorphisms in the genes of glutamate

and -opioid receptors and addiction risk. Those receptors are of

special interest, because they are targets of therapeutic agents, such

as acamprosate and topiramate.

Objectives and aims

Several studies were conducted, in order to

further determine the effects of genetic polymorphisms in glu-

tamate and opioid receptor genes on addictive behavior, neural

response to alcohol cues and relapse risk.

Methods

Genetic effects were investigated in samples of alcohol-

dependent patients using functional imaging techniques, neu-

ropsychological tests and follow-up investigation after standard

clinical treatment. Data on clinical parameters, neuronal response

to alcohol cues, functional neuronal connectivity and relapse risk

were collected and analyzed.

Results

Results demonstrate effects of genetic polymorphisms in

glutamate and opioid receptors on neuronal response to alcohol

cues in frontal and mesolimbic brain areas, subjective craving and

time to first relapse. Current findingswill be discussed in the light of

existing evidence on the contribution of genetic effects to treatment

outcome and patient stratification.

Conclusions

The investigation of genetic risk factors and mech-

anisms by which they affect addiction related phenotypes seems

to be a promising tool to identify molecular treatment targets and

predictors for successful treatment strategies.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.898

S83

Role of inhibitory processes in relapse

prevention treatment

G. Rudio

Laboratorio de Psicofisiología Clínica, Hospital Universitario 12 de

Octubre, Madrid, Spain

Alcohol dependence is a chronic disorder with frequent relapses

during recovery. Most studies have pointed out that craving is the

main process involved in relapse, but recently other factors have

been implicated in it, such as attentional bias and impulsivity.

Some authors consider that different stages could be involved in

the relapse process, and each may be governed by different mech-

anisms: Attentional bias; motivational response to alcohol cues and

inhibitory control.

Motivationally salient cues attract and hold selective attention,

and this “attentional bias, (AB)” is related to individual differ-

ences in appetitive and aversive motivation. In a recent review,

attentional bias has been shown to be significantly present in

alcohol-dependent and is associated with craving and risk to a

relapse in alcohol consumption.

In alcohol-dependent subjects, alcohol-related cues reach a very

high motivational valence (Motivational response, MR), which,

in effect, increases craving for alcohol and activates behavioral

strategies towards alcohol intake. One method used to assess

motivational valence of alcohol is the craving self-assessment. In

addition, in recent years, the affective modulation of the startle

reflex has been used as an objective measure of craving. It has been

shown that subjects with a low baseline startle response when

viewing alcohol-associated pictures are at major risk of relapse

compared to those with increased reactions.

Once alcohol craving has appeared, the subject will either drink or

not, depending on his ability to resist his behavior towards alco-

hol consumption (impulsivity or inhibitory control, IC). Moreover,

subjects that exhibit greater impulsivity are those more likely to

relapse.

Our group has recently conducted a study on a sample of 172

alcohol-dependent patients seen in outpatient therapeutic pro-

gramduring 12weeks. All of themwere assessedwith the following

measures: Attentional bias was assessed using the dot task, motiva-

tional responsewas evaluated using the affectivemodulation of the

startle reflex paradigm, inhibitory control was assessed by the stop-

signal reaction time task. Alcohol relapse variables were: relapse,

days to the first relapse and days of accumulated abstinence.

One of the most relevant results was that processes related to

inhibitory control (Stop-signal reaction time and attentional bias)

were the most relevant measures to explain variables related to

relapse in alcohol consumption during the treatment period.

Our results support the use of assessment strategies, therapeutic

and pharmacological inhibtoria aimed at improving the ability of

serious alcohol-dependent patients.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

Acknowledgements

This project has been funded with the EA

1123 ERAB grant application.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.899

Self-related processes and underlying brain

networks: Relevance for major psychiatric

disorders

S84

Self-related networks and negative

symptoms in psychotic disorders

A. Aleman

Groningen, The Netherlands

Objective

Two factors of negative symptoms in schizophrenia

have been consistently described based on factor analysis, “expres-

sive deficits” and “social amotivation”. We aimed to investigate

the putatively differential involvement of self-related networks,

as measured with BOLD fMRI during a self-evaluation task, in

two dimensions of negative symptoms in schizophrenia (reduced

expression and social amotivation).

Method

Forty-five patients with a diagnosis of schizophre-

nia participated in an fMRI study in which they performed a