European Psychiatry - Volume 33 - March 2016

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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.
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.
EV724
Syndrome of inappropriate
antidiuretic hormone secretion
associated with desvenlafaxine
E. García Fernández ∗ .I. Ramos García
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.
EV725
Informal caregivers of Alzheimer’s
patients and socio-economic burden
F. Ghali ∗, M. Karoui , M. Zghal , L. Robbana , I. Ben Ghzaeil ,
R. Rafrafi
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.