European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S513
of non-availability of trained health professionals and in attain-
ment of millennium development goals of reducing mother and
child mortality.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV512
Pros and cons of prescribing
potentially addictive medications for
patients with refractory depression
and anxiety
D. Kolar
Queen’s University, Kingston, Canada
Treatment resistant depression and refractory anxiety disorders are
major mental health problems associated with a poor quality of
life and a risk of suicide. These conditions require intensive biolog-
ical treatments combined with psychosocial interventions. There
are new treatments that are effective, particularly in the short run,
but they are associated with negative effects such as risk of addic-
tion. Ketamine produces fast improvement in treatment resistant
depression (TRD), but effects are short-lasting and there is no sus-
tained benefit. Oral formulations of ketamine are associated with a
risk of addiction. No one has idea how long time oral or intranasal
ketamine should be used.
Stimulant augmentation may cause a significant reduction in some
type of residual symptoms of depression but these improvements
will disappear almost immediately after discontinuing stimulant
medication. There is no consensus if a long-term use of stimulant
medication, such as in ADHD, is acceptable in patients with treat-
ment resistant depression. Treatment refractory anxiety disorders
may not respond to SSRI/SNRIs as expected. Although a long-term
use of benzodiazepines is not recommended, benzodiazepine aug-
mentation is currently again supported. However, treatment effects
usually disappear upon discontinuing BZDs. There is a common
practice of using synthetic cannabinoid, nabilone for nightmares
in PTSD. Long-term use of nabilone is unfortunately not uncom-
mon. Some patients may even prefer a medical marijuana to get
short improvements in their anxiety symptoms and depression.
Physicians should be very cautious when prescribe medications
with addictive potential particularly if there is no strong scientific
evidence of their efficacy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV513
Does the supplementation of vitamin
D affect depressive symptoms?
P. Kolarov∗, M. Stoimenova
Medical University – Pleven – Bulgaria, Department of Psychiatry
and Medical Psychology, Pleven, Bulgaria
∗ Corresponding author.
Introduction Depression has been linked to decreased levels of
vitamin D in adults and the altered dietary intake of calcium and
vitamin D has been reported to have implications for the devel-
opment of depressive symptoms. Although, the relation between
vitamin D and depression has been established, it is not yet clear
whether the supplementation of vitamin D could affect the clinical
manifestation of depression. Therefore, the aim of this study was to
determine whether the supplementation of vitamin D could affect
the development/course of depression.
Material and methods A systematic literature search was per-
formed for randomized control trials (RCTs) in which vitamin D
was supplemented and depression was measured.
Results and discussion Six studies were identified as being eligible
to be included in this review. The results regarding the supplemen-
tation of vitamin D and its effect on the course and manifestation
of depression were conflicting. One study concluded that the sup-
plementation of vitamin D3 had beneficial effect in depression and
another study reported no improvement in the indices of mental
well-being in the vitamin D supplemented group and rejected the
hypothesis that an annual high dose of vitamin D3 could prevent
depressive symptoms. The remainder four studies reported incon-
clusive results regarding vitaminD supplementation and the course
of depression.
Conclusion As current literature displayed contradictory results
and no sound conclusion could be drawn regarding the supple-
mentation of vitamin D and its effect on depression, there is a need
of RCTs to determine whether the supplementation of vitamin D
levels could affect depression.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV514
The meaning of loss in the context of
elderly homes
C. Laranjeira
Piaget Institute, Research in Education and Community Intervention
RECI I&D, Viseu, Portugal
Introduction Family plays a pivotal function in life of all human
being and their significance even increases with the age. However,
living in a elderly home may result in a multitude of losses which
must be addressed by individual through the process of grief.
Aim The purpose of this study was to explore situations of loss
and grief among institutionalizes elders.
Methods It is a qualitative, descriptive and exploratory research.
Data was collected from two Portuguese elderly homes in the
municipality of Viseu, Portugal. A purposeful sample of 7 elders was
recruited, and audiotaped face-to-face semi-structured interviews
were conducted.
Results Three dimensions of emotional loss were created: loss
by death, loss by separation and other losses. Loss by separation
was further divided into three subcategories: marriage separation,
family separation and separation of peers living in the elderly home.
The death of a loved one reminds the elderly individual of his/her
own mortality, complicating the process of mourning. Separation,
however is much more difficult to overcome because there is a loss
among the living, with the possibility to lose the meaning of life
with the other one.
Conclusions Understanding loss and grief among elderly people
is fundamental for nursing care, in order to help them with the
process of coping and to prevent institutionalization to become an
unpleasant experience. This will also offer health care facilities sug-
gested ways to reduce or combat loneliness and depression among
the elderly people.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV515
Prevalence and risk factors of
peripartum depressive symptoms
among South Korean women –
Preliminary data of a large
prospective study
S.Y. Lee ∗, H.M. Ryu
1 Dankook University College of Medicine-Cheil General Hospital and
Women’s Healt, Psychiatry, Seoul, Republic of Korea