European Psychiatry - Volume 33 - March 2016

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S528 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
disorders. Psychometric instruments like the Eating Disorder
Examination 12th version (Cooper and Fairburn, 1987), Eating
Attitudes Test/EAT-25 (Garner e Garfinkel, 1979) and the Eating
Disorder Inventory (Garner et al., 1983; Machado et al., 2001) con-
tributed for the characterization of the Eating Disorders in the
Portuguese population.
Results The EatingDisorders have a higher incidence in the young
Caucasian woman, living in the urban area. The combination of
the restrictive diet with intense physical exercise in the anorexia
nervosa very often evolves with negative emotions. The emotional
instability, namely the dysphoria, the anxiety and the sleep pattern
changes are frequent. The bulimia nervosa initially manifests itself
by restrictive diet, which evolves to excessive food intake episodes
getting increasingly frequent and intense.
Conclusions The Eating Disorders come from the gene-
environment interaction and risk premorbid biological and
psychological changes may result. These are inseparable from
the interaction with the social context where the epigenetic
mechanisms may play an important role. The reason for thinness,
limitations at the level of interoception and obsessive-compulsive
character traits are predisposing factors.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV558
Contribution of Night Eating
Syndrome to the evolution of
anorexia nervosa – Case report
F. Coutinho ∗, I. Brandão
Centro Hospitalar de São João, Clínica de Psiquiatria e Saúde Mental,
Porto, Portugal
∗ Corresponding author.
Introduction Night Eating Syndrome (NES) was described in 1955
in a subset of patients resistant to weight loss. It is characterized by
morning anorexia, evening hyperfagia and sleep disturbances. It is
also more prevalent among patients with another eating disorder
(ED), particularly binge-eating disorder (BED) or bulimia nervosa
(BN).
Objective Reviewof the literature about the relationshipbetween
NES and another EDs and to present a case report of a patient with
a long-standing purgative anorexia nervosa (AN-BP) and comorbid
NES.
Methods review of the literature using the database Medline
through Pubmed, with the keywords: “night eating syndrome” and
“eating disorder”.
Results NES is highly prevalent among patients with EDs, with an
estimated prevalence of about 5–44%. However, most of the exis-
tent literature explores the relationship between NES and BED or
BN, and it is not consensual if NES is a subtype of another ED. There
is still scarce evidence about NES and AN comorbidity.
Conclusion In this case report, we present a patient with a history
of AN-BP, in which the recovery of lost weight and the increase of
body mass index (BMI) occurred simultaneously with a period of
worsening NES symptoms, which leads the authors to question if
the psychopathology of NES has contributed to the recovery of BMI
at the expense of maintaining a dysfunctional eating pattern.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV559
Effectiveness of Enhanced Cognitive
Behavioral Therapy (CBT-E) in the
treatment of anorexia nervosa – A
prospective multidisciplinary study
Y. Danielsen ∗, G. Rekkedal , S. Frostad , U. Kessler
1 Department of Clinical Psychology, Faculty of Psychology, Bergen,
Norway
2 Department of Psychosomatic Medicine, Haukeland University
Hospital, Bergen, Norway
∗ Corresponding author.
Introduction According to the most widely influential treatment
guidelines from the National Institute for Health and Clinical Excel-
lence and the American Psychiatric Association, existing evidence
for adult AN treatment is weak, and more treatment studies are
needed.
Objectives/aims The primary objective of this project is to gain
knowledge about the effectiveness of CBT-E in the treatment of
Anorexia Nervosa (AN). Secondary objectives are to prospectively
examine baseline predictors of treatment outcome/drop-out and
to examine variables related to treatment process and patient
engagement as predictors of outcome/drop-out. Thirdly, in a mul-
tidisciplinary approach, to focus on selected pathophysiological
mechanisms including disturbed neuropsychological functioning,
changes in the gut microbiota, immunological and genetic mea-
sures in patients with severe AN in different stages of the disease,
and further to investigate to what extent they are related to treat-
ment outcome.
Methods The sample consists of patients aged ≥ 16 years with AN
admitted to outpatient treatment (CBT-E) at Section for Eating Dis-
orders, Haukeland University Hospital, Bergen, Norway. Outcome
measures include BMI, self-reported eating disorder symptoms
(EDE-Q), depression (BDI), anxiety (BAI) general psychiatric symp-
tomatology (SCL-90-R, M.I.N.I 6.0), health related quality of life
(CIA, RAND-36), physical activity (accelerometers) and neuropsy-
chological functioning. The main measurement points are at the
start of treatment, 3months, end of treatment and one year follow-
up. Baseline predictors of treatment outcome and drop-out will
be examined as well as the association between early adherence,
behavioral change, therapeutic alliance and treatment outcome. In
addition biochemical, genetic and bacteriological assessments will
be conducted.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV560
Attachment style and cortisol
response to psychosocial stress in
eating disorder patients
R. Giugliano ∗, A.M. Monteleone , F. De Riso , M. Nigro ,
F. Monaco , U. Volpe , P. Monteleone
1 University of Naples SUN, Department of Psychiatry, Naples, Italy
2 University of Salerno, Neuroscience Section, Department of
Medicine and Surgery, Salerno, Italy
∗ Corresponding author.
Introduction Stress exposure is a risk factor for both the onset and
the maintenance of Eating Disorders (EDs). The attachment the-
ory may provide a framework to explain the relationship between