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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55

S49

S97

Clinic risk associated with

comorbidity of (subclinical) psychosis,

anxiety and depressive symptoms: A

case for stratified medicine in

psychiatry

M. van Nierop

1 ,

, I. Myin-Germeys

1

, R. van Winkel

2

1

KU Leuven, Psychiatry, Leuven, Belgium

2

Maastricht University, MHeNS, Maastricht, Netherlands

Corresponding author.

Background

Meta-analyses link childhood trauma to depression,

mania, anxiety, and psychosis. It is unclear, however, whether these

outcomes truly represent distinct disorders following childhood

trauma, or that childhood trauma is associated with admixtures of

affective, psychotic, anxiety and manic psychopathology through-

out life.

Aim

To investigate the impact of trauma on psychopathological

phenotype, functional outcome, and daily life stress reactivity.

Methods

We used data from a representative general popula-

tion sample (NEMESIS-2;

n

= 6646), of whom respectively 1577

and 1120 had a lifetime diagnosis of mood or anxiety disorder, as

well as from a sample of patients with a diagnosis of schizophre-

nia (GROUP;

n

= 825). Multinomial logistic regression was used to

assess whether childhood trauma was more strongly associated

with isolated affective/psychotic/anxiety/manic symptoms than

with their admixture. Additionally, we examined these groups in

terms of social functioning, clinical severity, and quality of life. In a

separate sample (

n

= 621), daily life (emotional and cortisol) stress

reactivity was assessed, using ambulatory assessment.

Results

In all samples, childhood trauma was considerably more

strongly associated with an admixture of symptoms of depression,

anxiety, psychosis, and mania, rather than with these symptoms

in isolation. Individuals exposed to childhood trauma, who also

had an admixture of symptoms, had a lower quality of life, more

help-seeking behaviour, higher prevalence of substance use disor-

ders, and lower social functioning, compared with individuals not

exposed to trauma, without an admixture of symptoms, or neither.

Furthermore, trauma-exposed individuals with an admixed psy-

chopathological phenotype show a higher daily emotional stress

reactivity.

Conclusion

Childhood trauma increases the likelihood of a spe-

cific admixture of affective, anxiety and psychotic symptoms

cutting across traditional diagnostic boundaries. Stratifying accord-

ing to childhood trauma exposure thus identifies an admixed

phenotype, possibly induced by continuous daily life stress reac-

tivity, that has important clinical relevance. Identification of

functionally meaningful aetiological subgroups may aid clinical

practice.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.913

Suicidology in the 21st century

S98

Information and communication

technologies for the follow-up of

patients

E. Baca-Garcia

Fundación Jiménez-Díaz, Madrid, Spain

Clinical assessment in psychiatry is mostly based on brief, regu-

larly scheduled face-to-face appointments. Although crucial, this

approach reduces assessment to cross-sectional observations that

often miss critical information about course of disease and risk

assessment. Clinicians in-turn make all medical decisions based

on this inevitably limited information. We discuss recent tech-

nological developments in terms of assessment and information

triangulation, analysis of longitudinal data, approaches to enhance

medical decision-making and improve communication between

patients, caregivers and clinicians.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.914

S99

A neurosciences based – semiology of

suicidal behavior

P. Courtet

CHU de Montpellier, Emergency, Psychiatry and acute care,

Montpellier, France

The epidemiology, risk factors and biological basis of suicidal

behaviors have been the object of an ever-increasing research in

the last three decades. During this period, researchers all over the

world have identified potential biomarkers of risk and developed

several theories about the mechanisms leading to suicidal behav-

ior. However, the lack of common terminology, instruments and

cooperation has been a major deterrent. Today, the community has

established the bases for this collaboration and evidence coming

from neuroscientific studies can already be applied to the field of

suicidology. We present here a potential semiology based on cur-

rent evidence coming from biological, clinical and neuroimaging

studies. Besides suicidal ideation and warning signs, the clinical

features related to suicide risk and revealed by neuroscientific

studies include notably: impulsive-aggression and hopelessness as

well as high web consumption, sedentary behaviors and reduced

sleep time, an enhanced sensibility to social exclusion and loneli-

ness, a decreased sensitivity to detect social support, interpersonal

problems related to decision-making impairments, difficulties to

regulate negative emotional states, a propensity to perceive psychic

and also physical pain and to receive opiates treatments. Improving

the assessment will also open new targets for suicide prevention.

In the short-term, some of these targets await us: standard proto-

cols for evaluation of risk, healthcare continuity, implication of the

family/caregivers, mitigation of social or psychological pain.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.915

S100

Follow-up and chain of care in the

prevention of suicide recurrence

P.A. Sáiz Martinez

Universidad de Oviedo, Área de Psiquiatría, CIBERSAM, Oviedo, Spain

Suicide constitutes one of the most important problems in global

public health. However, assessment as well as corresponding ver-

ification of suicide risk, either in case histories or clinical reports,

is handled poorly in several clinical settings. Aspects as important

as the existence of a personal history of suicidal tendencies are fre-

quently omitted, despite this being one of the risk factors that most

clearly predict the possibility of a complete suicide in the future.

During this presentation, I would like to refer specific interven-

tions in at-risk populations, with special emphasis on individuals

who have made previous suicide attempts. Suicidal behaviour is

a very complex phenomenon, making a specific treatment for it

difficult to produce. Consequently, when the most appropriate

therapeutic approach for an at-risk population is raised, the follow-

ing fact is mentioned: in approximately 90% of suicide cases, there

is an underlying psychiatric disorder. This makes psychopharma-

cological treatment of the base pathology the most adequate. Still