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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S523

sion feedbacks, change in nature of meta-cognitive beliefs, change

in executive control of attention to negative thoughts, changes in

beliefs related to threat monitoring, analysis of factors leading to

fluctuation in symptoms and the nature of coping skills.

Results

Improvements were observed between pre- and post-

analyses of all primary outcome variables. In addition, the

phenomenology of change in symptomatology has been explained

in the light of various qualitative descriptions.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1526

EV542

Metacognitive beliefs and rumination

in patients with major depressive

disorder in India

V. Sharma

1 ,

, M. Mehta

2

, R. Sagar

2

1

New Delhi, India

2

All India Institute of Medical Sciences, Department of Psychiatry,

New Delhi, India

Corresponding author.

Introduction

Emotional distress in patients of depression is a con-

sequence of a particular way of responding to negative thoughts

and emotions, which is influenced by attentional control, rumina-

tion, worry, and metacognitive beliefs of individuals.

Aims

The present study aims to address the nature of rumina-

tion and metacognitive beliefs in patients suffering from major

depressive disorder.

Methods

A cross sectional study design was used to explore the

symptomatology, nature of rumination and worry, and positive

and negative metacognitive beliefs in patients (

n

= 50) with major

depressive disorder.

Measures

Beck Depression Inventory (BDI-II), Anxious thoughts

inventory (AnTI: Wells 1994, 2000), Metacognitive questionnaire-

30 (Wells 1997), Positive beliefs about Rumination scale (Papageor-

giou andWells, 2001), and Negative beliefs about Rumination scale

(Papageorgiou, Wells and Meina, 2004) were used.

Results

The findings revealed that about 83% of the participants

reported that they spent upto 4–6 hours of their waking time

in rumination and worry. Rumination and worry had a severe

detrimental impact on the activities of daily living in 79% of the par-

ticipants. Maximum number of participants reported a high need

to control their rumination. Most participants believed that rumi-

nation and worry could help them gain information about their

illness and a possible way out of it. Participants obtained high

scores on scales of heath related worry and meta-worry as com-

pared to social worry. Cognitive self-consciousness and cognitive

confidence were found to be low in the overall sample. Signifi-

cant correlations between depressive symptoms, rumination, and

metacognitive beliefs suggest a pathological constellation operat-

ing in patients of depression.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1527

EV543

Oral ketamine for treatment resistant

major depression – A double blind

randomized controlled trial

Y. Domani

1

, M. Bleich-Cohen

2

, N. Stoppelman

2

, R. Tarrasch

3

,

T. Hendler

2

, R. Meidan

4

, S. Schreiber

1

, H. Sharon

5 ,

1

Tel Aviv Sourasky Medical Center, Psychiatry, Tel Aviv, Israel

2

Tel Aviv Sourasky Medical Center, Center for Brain Functions, Tel

Aviv, Israel

3

Tel Aviv University, School of Neuroscience, Tel Aviv, Israel

4

Tel Aviv Sourasky Medical Center, Emergency Medicine, Tel Aviv,

Israel

5

Tel Aviv Sourasky Medical Center, Institute of Pain Medicine and the

Center for Brain Functions, Tel Aviv, Israel

Corresponding author.

Background

Major depression is a devastating common disorder.

Current pharmacotherapy centers on noradrenergic and seroton-

ergic modulation, but effect may require up to 21. Moreover, over a

third of patients remain poorly unresponsive, termed Treatment

Resistant Depression (TRD). Recently, intravenous ketamine has

been shown to provide rapid amelioration of TRD, but patientswere

followed-up for extremely short times. We aimed to assess the clin-

ical efficacy and safety of a three-week course of oral ketamine in

outpatients with TRD.

Methods

In a double blind, randomized, placebo-controlled trial

and 22 TRD patients received either oral ketamine or placebo

as outpatients for 21 days. Patients were evaluated at pre-trial,

230minutes after drug administration, and at 21 days. The main

outcome measure was the change in Montgomry Asberg Depres-

sion Rating Scale (MADRS) score.

Result

Twelve subjects were randomized to the ketamine group,

and 10 to the placebo group. Four patients from the placebo

group opted out due to treatment ineffectiveness. A repeated mea-

sures ANOVA showed a significant effect of time (

F

(1,16) = 15.12,

P

= 0.001) together with a significant interaction between group

an time (

F

(1,16) = 7.58,

P

= 0.014). Tukey Honest significant dif-

ference (HSD) post hoc comparisons revealed a significant

reduction in depression after 21 days in the ketamine group only

(

P

= 0.0003).

Conclusion

In this study, oral ketamine in a sub-anesthetic dose

caused a rapid amelioration of depressive symptoms in ambulatory

TRD patients, and was well tolerated. The results of this study sug-

gest that oral ketamine may hold significant promise in the care of

outpatients with treatment resistant major depression.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1528

EV544

A novel, very short questionnaire as a

screening tool for depression

K. P˛ekala , T. Sobow

Medical University of Lodz, Medical Psychology, Lodz, Poland

Corresponding author.

Introduction

Self-assessment tools are frequently used as screen-

ing tools for depression. However, they are usually long and

time-consuming.

Aimof the study

To assess specificity, sensitivity and overall accu-

racy of a novel, very short, 5 questions tool.

Subjects and methods

The questionnaire consists of 3 phe-

nomenological (based on main symptoms of depression) and 2

questions to assess functional impact of the symptoms. One hun-

dred and ninety patients diagnosed clinically as having major

depression (according to ICD-10 criteria and with the help of

MINItool) filled the questionnaire in twice, during episode and

remission.

Results

At least two (out of three possible) “yes” answers to phe-

nomenological questions and both two “yes” functional answers

yielded 100% specificity (no person in remission). At least one “yes”

answer to phenomenological questions and both “yes” answers

to functional question yielded 82.8% specificity, 83.7% sensitivity

and 83,3% overall accuracy. These results varied insignificantly in

subgroups with different depression severity.

Conclusion

A short, 5-question questionnaire may be used as

a screening tool for depression. Specificity, sensitivity and over-

all accuracy are above 80% largely independently of depression

severity.