European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S505
a cluster of other vegetative and cognitive symptoms causing sig-
nificant distress of functioning. It has a relapsing and recurring
course and frequently becomes chronic. Thus, there is a need to fur-
ther develop therapeutic techniques to improve the course and the
prognosis of depressive disorders. Recent clinical trials suggest that
botulinum toxin (BTX) treatment may also have an antidepressant
effect.
Objective The authors aim to conduct a non-systematic review
in order to understand the relationship between MDD and BTX
treatment.
Aims To assess whether current evidence supports the BTX to
treat major depressive patients.
Methods A non-systematic review of English scientific literature
was conducted through research in the PubMed search engine,
using the keywords “botulinum toxin” and “depression”.
Results There is a small but growing body of evidence suggesting
that botulinum toxin may be useful for the treatment of depres-
sion. The main hypothesis for the proposed beneficial effects of
botulinum toxin is through the facial feedback. Low mood and
depression are often associated with a sad facial expression. Inject-
ing botulinum toxin and improving facial expression would lead to
the improvement of depression symptoms.
Conclusions Positive effects on mood have been observed in
subjects who underwent treatment of glabellar frown lines with
botulinumtoxin. It supports the concept that the facial musculature
not only expresses, but also regulates mood states.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV489
Impact and importance of anhedonia
as a mediating variable in
amelioration of social functioning in
depressed patients
D. Gourion ∗ inckier ouchabac
1 Private practice, Paris, France
2 Centre hospitalier Saint-Anne, Psychiatry, Paris, France
3 Centre hospitalier Saint-Antoine, Psychiatry, Paris, France
∗ Corresponding author.
Background Anhedonia is a core dimension of major depressive
disorder (MDD). Paradoxically, the association between anhedonia
and social impairment is poorly known.
Objective To determine the longitudinal relationships between
depressive symptoms, anhedonia, and social functioning in
depressed patients treated with agomelatine.
Material and method One thousand five hundred and seventy
patients withMDD starting treatment with agomelatine prescribed
by their GPs were included in a prospective study (follow-up: 10 to
14 weeks). Patients were assessed at baseline and at the end point
of the study, using the MADRS to assess antidepressant efficacy,
the SHAPS scale and an original visual analog scale exploring the
subjective pleasure felt by patients in their main leisure activity to
measure anhedonia, and the QFS to measure social functioning in
its qualitative and quantitative dimensions. In addition to the uni-
variate analyses, a mediation path analysis was performed using
the Sobel test.
Results The results showed a robust and significant improvement
in symptoms of depression, anhedonia, and social functioning. The
correlations between the SHAPS and QFS scores were high and
significant. Subsequent analyses showed that amelioration of anhe-
donia is a significant mediating variable between the progression
of depressive symptoms and social functioning ( QFS G = –14.3,
P < 0.0001) and explains around one third of the variance of the
model (35.37%).
Conclusion Anhedonia, a major dimension of depression, pro-
vides specific insights into the understanding of the complex links
between residual symptoms of MDD and social functioning. In con-
clusion, improving the evaluation of anhedonia is a fundamental
issue in primary care.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV490
Acceptance and commitment therapy
(ACT) predictive factors of return to
work after depression
S. Darbeda∗ Seznec
Institut national de la santé et de la recherche médicale Inserm,
UMR-1178 Mental Health and Public Health, Paris, France
∗ Corresponding author.
Introduction Prolonged sick leaves are a major risk to quit the
world of work and depression is the leading cause of disability in
France. New therapies from the third wave of CBT as the Commit-
ment and Acceptance Therapy (ACT) may be interesting to promote
the return to work (RTW).
Objectives To assess predictive factors of return to work after
depression.
Methods This is a descriptive, prospective andmulticentric study.
The recruitment of investigating doctors was conducted by the
publication of an advertisement in a French journal of occu-
pational medicine. Each investigator recruited patients during
reinstatement medical examination after a prolonged sick leave
for depressive syndrome. Sociodemographic, occupational, medi-
cal and psychological factors (particularly in connection with the
ACT) was assessed at baseline and 3 months later.
Results Thirty-one patients were initially included in the study,
but 2 were lost to follow up at 3 months and 29 were analyzed.
Twenty three patients RTW at 3 months. Those who RTW were
less anxious ( P= 0.023), less depressed (P = 0.021), had a better
impression of improvement (P = 0.0066) and had a lower score of
experiential avoidance (P = 0.0025).
Conclusions The ACT, through its action on the reduction of expe-
riential avoidance, and the definitions of new life values could allow
a faster RTW after a sick leave for depressive syndrome.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV491
Childhood abuse in adult women with
unipolar depression seeking
treatment at a tertiary care centre in
India, compared to healthy women
G. Devasthali ∗, K. Jangam , T. Ka , A. Raj , M. Kesavan
1 National Institute of Mental Health and Neurosciences, Dept of
Psychiatry, Bangalore, India
2 National Institute of Mental Health and Neurosciences, Deptt of
Psychiatry Social Work, Bangalore, India
∗ Corresponding author.
Introduction Childhood abuse has been reported as a precursor
and maintaining factors for adult psychiatric disorders. Childhood
physical abuse, neglect and sexual abuse have been independently
reported in women with depression. There is a serious dearth of
literature on the incidence of childhood abuse among women with
depression from India.
Objectives & aims We investigated and compared the incidence
of childhood abuse (overall) – physical, emotional and sexual (indi-
vidual components)- amongwomen seeking treatment for unipolar
depression (UD) compared to healthy women (HW).