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S54

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

alterations in the serotonin transporter and the 5-HT

1A

receptor

that are similar to those seen in suicides and moreover the sever-

ity of the abnormality in 5-HT

1A

binding is correlated with the

lethality of suicidal behavior. Other studies examining CSF levels of

5-HIAA are consistent with imaging data and extend the findings

to the noradrenergic and dopaminergic systems. Finally, we will

present data on use of these biomarkers to predict treatment out-

come. Abnormal decision-making and mood regulation in suicidal

patients is linked to abnormal brain biology and has direct implica-

tions for clinical practice in terms of selecting specific types of med-

ication and how thesemay be best combinedwith psychotherapies.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.928

S113

Age and pharmacotherapy of suicidal

depressed bipolar patients

M.A. Oquendo

1 ,

, H. Galfalvy

2

1

Columbia University and New York State Psychiatric Institute, New

York, NY, USA

2

Columbia University, Biostatistics and Psychiatry, New York City,

NY, USA

Corresponding author.

The mortality and morbidity due to suicidal behavior associated

with bipolar disorder is the greatest among psychiatric diagnoses.

To address this problem, it is essential to find predictors of future

risk as well as protective factors. Studies from several international

teams have demonstrated that for bipolar disorder, the presence

of a depressive episode is the most robust predictor and risk

increases as does depression severity. Protective factors such as

older age and religious affiliation are also key moderators. The

role of pharmacotherapy in suicidal behavior has been studied

mostly utilizing data that are either observational and naturalis-

tic, rather than experimental. Only one randomized, double-blind

clinical trial has been conducted to date, although another one is

underway. The comparison of lithium and valproate in terms of

effect on suicidal behavior revealed no differences. Although the

trial was not powered to detect small effect sizes, results suggest

that the Relative Risk ratio generated from meta-analytic studies

(RR

5) is too optimistic. The trial also suggested that younger indi-

viduals may respond differently to pharmacotherapy, suggesting

opportunities to personalize treatment approaches. Robust phar-

macotherapy targeting both mood stabilization and depressive

symptoms is essential and may assist in the quest against suicidal

behavior.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.929

Treatment of people with dual diagnosis

S114

Treating adult ADHD and comorbid

substance-related disorders

J.A. Ramos-Quiroga

Hospital Universitari Vall d’Hebron, Universitat Autònoma de

Barcelona, Department of Psychiatry, CIBERSAM, Barcelona, Spain

Attention-deficit/hyperactivity disorder (ADHD) is a complex, and

multifactorial and chronic neurodevelopmental disorder. Comor-

bid psychiatric disorders are highly prevalent in individuals with

a diagnosis of ADHD. There is a solid overlap between ADHD and

substance use disorders (SUD). Prevalence of SUD is high among

patients with ADHD, so that SUD are approximately double as com-

mon among individuals with ADHD than in general population, and

individuals with SUD have much higher rates than expected of a

comorbid ADHD. Studies shown that treatment during childhood of

attention-deficit/hyperactivity disorder with stimulant medication

neither protects nor increases the risk of later substance use disor-

ders. Nevertheless, recent studies found that patients with ADHD

and SUD can reduce ADHD symptoms and SUD with stimulants

and cognitive-behavioral therapy. Treatment of ADHD in patients

with SUD requires a comprehensive diagnostic assessment. It is rec-

ommendable to stabilize the addiction prior to treating the ADHD.

In this talk, the recent literature for the treatment of adults with

co-occurring ADHD and SUD will be reviewed.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.930

Value-based health care

S115

Value in mental healthcare: The

patient aspect

Y. Cohen (Acting president)

GAMIAN-Europe, Azor, Israel

From the patients’ point of view, valued-based mental healthcare

is mental healthcare based on a holistic vision of care, according to

which patients are actively involved in their treatment to achieve

the best possible outcomes. They are invited to collaborate with

both mental health care providers such as psychiatrists and pri-

mary caregivers to determine what types of treatment are the most

effective.

GAMIAN-Europe believes that the best package of care includes the

following four elements:

– medication – antipsychotic medication is consensually regarded

as first-line treatment for people with mental health problems;

– psychotherapy/counselling – although antipsychotic medica-

tions are the mainstay of treatment for mental health problems,

pharmacotherapy alone produces only limited improvement in

negative symptoms, cognitive function, social functioning and

quality of life. Additionally, many patients continue to suffer from

persistent positive symptoms and relapses, particularly when they

fail to adhere to prescribed medications. These situations empha-

size the need for multimodal care, which includes psychosocial

therapies as adjuncts to antipsychotic medications in order to alle-

viate symptoms and to improve social functioning and quality of

life;

– psycho-education – the more a patient learns about his/her

condition the better placed he/she will be to take control of

it. Psycho-education embodies this principle by using a clearly-

defined therapeutic programme, in which a trained therapist

delivers targeted information designed to reduce both the fre-

quency and the severity of symptoms. Psycho-education increases

patients’ knowledge and understanding of their illness and treat-

ment options and helps them cope more effectively. Many people

find that they benefit not only from the information they receive

during psycho-education, but also from the learning process itself.

There are several different ways in which psycho-education can be

delivered, including one-to-one sessions with a therapist, sessions

aimed specifically at carers and family members, group sessions

attended by several people coping with mental illness and mixed

group sessions attended by people withmental illnesses and family

members;