European Psychiatry - Volume 33 - March 2016

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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 ∗, I. Myin-Germeys , R. van Winkel
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.
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.
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.
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