European Psychiatry - Volume 33 - March 2016

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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 ∗, G. Merge
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.
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.
S90
Menopause and psychosis
J. Usall ∗, E. Huerta-Ramos
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.
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