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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S581

EV722

Late-life depression and dementia risk

N. Cherbuin

, S. Kim , K.J. Anstey

Australian National University, Centre for Research on Ageing-Health

and Wellbeing, Canberra, Australia

Corresponding author.

Introduction

A substantial body of evidence linking late-life

depression and dementia is now available. However, precise esti-

mates of the relative risk attributable to late-life depression

assessed with specific screening instruments at specified thresh-

olds have not been previously produced.

Objective

Summarise dementia risks associated with depression.

Aims

Conduct a systematic review of the literature to pro-

duce precise and specific risk estimates for all cause dementia,

Alzheimer’s disease (AD), and vascular dementia (VaD).

Methods

The PubMed, PsycInfo, and Cochrane databases were

systematically searched. Studies assessing incident dementia using

validatedmeasures of clinical depression or depressive symptoma-

tology fromprospective population studieswere selected. Themost

specific analyses were conducted using both continuous symp-

tomatology ratings and categorical measures of clinical depression

based on single instruments with defined cut-offs.

Results

The literature search yielded 121,301 articles, of which

36 were eligible. Included studies provided a combined sample size

of 66,532 individuals including 6593 dementia, 2797 AD, and 585

VaD cases. Random-effects summary estimates showed that the

risk associated with depression did not differ by type of dementia.

The most widely used instrument was the CES-D. A clinical thresh-

old of 20 produced similar estimates for all-cause dementia (HR

1.83, 95% CI 0.95–3.52) and for AD (HR 1.97, 95% CI 0.96–4.04).

Estimates based on other thresholds and continuous measures pro-

duced consistent results.

Conclusion

Reliable dementia risk estimates associatedwith late-

life depression can be produced and do not differ between dementia

types. Such estimates should be used in evidence-based medicine

practice to assess individual risk and to inform policy on interven-

tions to decrease risk in the population.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1707

EV723

The mosaic of life: Integrating

attachment and trauma theory in the

treatment of challenging behavior in

elderly with dementia

D. D’Hooghe

Traumacentre, Brugge, Belgium

Elderly with dementia are aware people who think and feel. Suffer-

ing from dementia made them feel unsafe. This lack of safety can

result in attachment behavior (e.g. proximity seeking) or challeng-

ing behavior resulting from posttraumatic symptoms, triggered by

the experience of insecurity. We can use the symbol of a mosaic to

illustrate that the elderly is the sum of all his different life experi-

ences which make him a unique person. I want to emphasize the

importance of a holistic assessment in which the attachment his-

tory and traumatic experiences of the person are integrated. In this

workshop, I want to present a treatment model, wherein different

important features such as mentalization, self-regulation, internal

working model

. . .

are highlighted. The model integrates neuro-

science to facilitate growth and change. By bringing together the

environmental aspects with the interpersonal aspects, a safe haven

is created.

The staff was trained in person-centered care, attachment and

trauma theory and tailor made treatment. The blend of attachment

and trauma theory with neuroscience brings us new therapeutic

possibilities in working with this specific part of the population.

Disclosure of interest

The author has not supplied his/her decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1708

EV724

Syndrome of inappropriate

antidiuretic hormone secretion

associated with desvenlafaxine

E. García Fernández

1 ,

, D .M

.I. Ramos García

2

1

University Hospital, Psychiatry, Leon, Spain

2

San Carlos University Hospital, Psychiatry, Madrid, Spain

Corresponding author.

Introduction

Desvenlafaxine is a prescription medication

approved for the treatment of major depressive disorder in adults.

Hyponatremia secondary to inappropriate secretion of antidiuretic

hormone (SIADH) is a possible side effect in patients receiving

serotonin-norepinephrine reuptake inhibitors (SNRIS)

Method

To report a case of SIADH associated with desvenlafax-

ine.

Results

We present a 80-year-old female patient who required

hospitalization due to an episode of psychotic depression. During

the hospitalization, the patient developed hyponatremia after com-

mencing treatment with desvenlafaxine. The serum sodium at this

time was 117mmol/L, serum osmolality was 249mosmol/kg, urine

osmolality 395mosmol/kg and urine sodium 160mmol/L, consis-

tent with a diagnosis of SIADH. Desvenlafaxinewas ceased and fluid

restriction implemented. The mental status improved, and elec-

trolyte studies 6 days later revealed serum sodium and osmolality

values of 135mEq/L during treatment with duoxetine.

Conclusions

SIADH has been reported with a range of antide-

pressants in elderly patients. This case report suggests that

desvenlafaxine might cause clinically significant hyponatremia.

Closemonitoring is recommended in patients starting therapywith

antidepressant treatment to study and prevent possible adverse

effects.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1709

EV725

Informal caregivers of Alzheimer’s

patients and socio-economic burden

F. Ghali

1 ,

, M. Karoui

2

, M. Zghal

2

, L. Robbana

2

, I. Ben Ghzaeil

3

,

R. Rafrafi

4

1

Ariana, Tunisia

2

Razi Hospital, Psychiatry, Mannouba, Tunisia

3

Razi Hospital, Neurology, Mannouba, Tunisia

4

Mongi Slim Hospital, Psychiatry, Tunis, Tunisia

Corresponding author.

Introduction

Tunisia is knowing a significant increase of the

elderly population, this phenomenon comes along with an increase

of the incidence of degenerative pathologies “dependent on the

age” as the Alzheimer’s disease. The physical and psychic conse-

quences of the disease and also the behavior of family members are

an important determinant of quality of life and economic activities

of both patients and informal caregivers.

Objectives and methods

Our aims are to establish characteristic-

sof60 informal cargivers of Alzheimer’s patients followed in the

department of neurology in Razi’s Hospital and to estimate their

socioeconomic burden through a descriptive study.

Results

Our sample of caregivers was predominantly female with

a moderate socio-economic conditions in 36,66%. The support was

provided in 2/3 of cases exclusively by the informal caregivers.