European Psychiatry - Volume 33 - March 2016

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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.
EV542
Metacognitive beliefs and rumination
in patients with major depressive
disorder in India
V. Sharma ∗, M. Mehta , R. Sagar
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.
EV543
Oral ketamine for treatment resistant
major depression – A double blind
randomized controlled trial
Y. Domani , M. Bleich-Cohen , N. Stoppelman , R. Tarrasch ,
T. Hendler , R. Meidan , S. Schreiber , H. Sharon ∗
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.
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.