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S46

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

Sex matters – also in psychosis!

S88

Sex differences in emotional reactivity

to daily life stress in psychosis

I. Myin-Germeys

1 ,

, G. Merge

2

1

Leuven, Belgium

2

Maastricht University, Department of Psychiatry and

Neuropsychology, Maastricht, Netherlands

Corresponding author.

Background

A recent study did not find clear-cut sex differ-

ences in psychotic symptoms. Studies investigating altered stress

reactivity more consistently report differences between the sexes,

although the results are contradicting in suggesting either men

or women to be more stress-sensitive. We assessed self-reported

experiences in the context of real-life to more fully understand the

nature of sex differences in psychosis.

Methods

We employed the Experience Sampling Method, a

structured diary technique, to investigate in real-life:

– symptoms;

– behavior in context;

– underlying mechanisms in 283 healthy controls, 268 subjects at

risk for psychosis and 232 patients with psychotic disorder.

Results

Multilevel regression analyses revealed no differences

in symptom expression between the sexes. Similarly, men and

women did not differ in their level of social interaction and over-

all activity. However, men at increased risk of psychosis were

more often alone and were less involved in goal-directed activi-

ties compared to women. Finally, women reportedmore emotional

reactivity to daily life stress then men but women also reported

more positive affect when pleasant events had happened.

Discussion

The data thus suggest onlyminor differences between

men and women in psychotic symptoms and actual behavior.

However, whenever differences were apparent, they consistently

pointed towards more severe symptoms and more deficiencies in

men compared to women. In contrast, increased environmental

reactivity in women (to both negative and positive environments)

in addition to more social contacts may constitute a protective fac-

tor for the development of more severe psychopathology.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.904

S89

Sex and gender differences in

schizophrenic psychoses

A. Riecher-Rössler

University of Basel, Psychiatric Clinics, Basel, Switzerland

Introduction

Sex and gender differences in schizophrenic psy-

choses have often been described but treatment approaches so far

have hardly taken them into account.

Objectives

To describe the most important sex and gender differ-

ences in schizophrenic psychoses with clinical implications.

Methods

Review.

Results

Schizophrenic disorders show a later age of onset in

women and a slightly better course, especially in young women.

As to pathogenesis, there is some evidence that the age difference

might be at least partly due to the female sex hormone estradiol

being a protective factor. Differences in coursemight also have to do

with this biological factor, but at the same time with the psychoso-

cial advantages of a higher age of onset and other psychosocial

factors.

These gender differences have important implications for assess-

ment and therapy. Thus, we have to consider gender differences

in coping behaviour as well as psychosocial burdens and needs

deriving from differing roles in partnership, family, household

and profession, from dependent relationships, potential abuse and

violence. Furthermore, there are specific biological risks such as

gonadal dysfunction we have to deal with in both sexes differ-

ently. Thus, e.g. women with psychosis can also have very special

needs regarding fertility, pregnancy and motherhood. Also, around

menopause we have to consider special measures such as replace-

ment of physiological 17-b-estradiol.

Conclusions

Women, but alsomen, with schizophrenic psychoses

should get a gender-sensitive assessment and treatment.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.905

S90

Menopause and psychosis

J. Usall

1 ,

, E. Huerta-Ramos

2

1

Parc Sanitari Sant Joan de Déu, GTRDSM, CIBERSAM, Research Unit,

Sant Boi de Llobregat, Spain

2

Parc Sanitari Sant Joan de Déu, Research Unit, Sant Boi de Llobregat,

Spain

Corresponding author.

There has been little research into the effects of menopause

on symptoms, social and cognitive functioning in women with

schizophrenia, and the results are controversial. The most repli-

cated finding is that late-onset schizophrenia is more prevalent in

women than in men and that this fact appears to be related to the

diminution of estrogen levels during menopause.

Estrogens have a known protective effect on CNS. Animal research

has shown that estrogen has a modulating effect on the dopami-

nergic, glutamatergic and serotonergic systems.

There are concerns about long-termuse of sexual hormone therapy

in postmenopausal women with regard to breast cancer risk, and

the use of the selective estrogen receptormodulators (SERMS’s) can

be a better option.

Raloxifene is a SERM that is used in the preventive treatment of

postmenopausal osteoporosis and has no effect in the breast and

uterus. A number of studies seem to indicate that raloxifene acts

on brain dopamine and serotonin systems in a similar way to con-

jugated estrogens.

In this presentation, I will show the results of some clinical tri-

als that have studied the efficacy of raloxifene as a coadjuvant

treatment of patients with schizophrenia. Our team has done two

clinical trials that studied the efficacy of 60mg of raloxifene for the

treatment of negative symptoms in postmenopausal women with

schizophrenia. Our results showed that raloxifene improved the

negative symptoms better than placebo. We concluded that ralox-

ifene seems to be a promising option to treat some patients with

schizophrenia.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.906

Social anxiety disorder – from shyness and

blushing to brains and psychotropic drugs

S91

Recent guidelines for evidence-based

pharmacological treatment of social

anxiety disorder

D. Baldwin

University of Southampton Faculty of Medicine, Clinical and

Experimental Sciences, Southampton, United Kingdom