Table of Contents Table of Contents
Previous Page  61 / 812 Next Page
Information
Show Menu
Previous Page 61 / 812 Next Page
Page Background

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S56–S71

S57

of anxiety disorder in the age groups with the greatest vulnerability

for developing those disorders.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.936

W03

Anticipation of age at onset in

anorexia nervosa

A. Favaro

, P. S

antonastaso

University of Padova, Neurosciences, Padova, Italy

Corresponding author.

It is a common clinical observation that early-onset cases of

anorexia nervosa (AN) are increasing. In a previous study in a large

cohort, we found that age of onset in both AN and bulimia ner-

vosa was significantly decreasing in younger generations. We now

present data about cohort effects in a sample of more than 3000

patients with eating disorders.

Methods

The sample is composed of 2200 AN subjects and 900

BN subjects without previous AN consecutively referred to our out-

patient Unit in the period between 1985 and 2014. Time trends

have been analysed according to the year of birth of subjects. All

diagnoses were reviewed according to DSM-5 criteria.

Results

Age of onset in AN showed a significant decrease accord-

ing to year of birth. A regression model showed a significant

independent effect of socio-economic status, age at menarche and

number of siblings in predicting age of onset. A second analysis

including a subsample representative of the general population

confirmed the effect in AN. In BN, although the age of onset showed

a decrease in new generations, the effect is not significant.

Conclusion

Age of onset of AN continues to decrease in younger

generations. The implications of our findings in terms of long-term

outcome remain to be understood. Biological and socio-cultural fac-

tors explaining this phenomenon need to be explored by future

studies. It is important to acknowledge the clinical implications of

this cohort effect.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.937

W04

Familiarity, gender and cannabis use

determine age of onset in

schizophrenia

R. Murray

Institute of Psychiatry, London, United Kingdom

There is evidence that certain risk factors for schizophrenia (e.g.

copy number variations, obstetric complications) are associated

with an earlier age of onset of psychosis. One possible explanation is

that in such cases, early neurodevelopmental damage is associated

with greater perturbance of critical neural systems and that this

leads to the early presentation of psychosis. Less is known about

the significance of age of onset for treatment response and out-

come though patients presenting in childhood are reported to have

a worse outcome than those who present later. We have conducted

two large first episode psychosis studies in which we have exam-

ined those baseline characteristics which predict later treatment

resistance, notably the AESOP and GAP studies. In each of these,

early age of onset and also male gender were associated with treat-

ment resistance. Interestingly in approximately three quarters of

cases, treatment resistance was present at onset of psychosis and

only in the remaining quarter did it develop over the course of the

illness. One possibility is that there exists a type of schizophre-

nia which is associated with neurodevelopmental damage, early

age of onset and lack of response to dopamine blockade; this is

compatible with our previous finding that patients with treatment

resistant schizophrenia do not show the increased synthesis of

striatal dopamine which is usually found in actively psychotic indi-

viduals.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.938

Child and adolescent mental health services in

Europe: The current scenario and the future

prospects

W05

The current state of child and

adolescent mental health services in

Europe: A survey in 28 countries

G. de Girolamo

1 ,

, G. Signorini

1

, S.P. Singh

2

, J. Warwick

3

1

Saint John of God Clinical Research Center, Psychiatric Epidemiology

and Evaluation Unit, Brescia, Italy

2

Warwick Medical School, University of Warwick, Coventry-UK,

Mental Health and Wellbeing Division, Warwick, United Kingdom

3

Warwick Medical School, University of Warwick, Coventry-UK,

Warwick Clinical Trials Unit, Division of Health Sciences, Warwick,

United Kingdom

Corresponding author.

Introduction

Transition to adulthood is the period of onset of

most serious mental disorders. The current discontinuity of care

between Child and Adolescent Mental Health (CAMHS) and Adult

Mental Health (AMHS) Services is a major socioeconomic and soci-

etal challenge for the EU.

Objectives/aims

In the framework of the MILESTONE project this

study aims to map current services and transitional policies across

Europe, highlighting current gaps and the need for innovation in

care provision.

Methods

An on-line mapping survey has been conducted across

all 28 European countries through the administration of two ad-

hoc instruments: the Standardized Assessment Tool for Mental

Health Transition (SATMEHT) and the European CAMHS Mapping

Questionnaire (ECM-Q). The survey systematically collected data

about CAMHS organization and characteristics, with a specific focus

on actual national transition policies and practice.

Results

Response rate was 100%. Despite up to 49% of CAMHS

service users need to continue with specialist AMHS care, written

policies for managing the interface between these two services are

available only in 4/28 countries and transition support services are

reported as missing by half of the respondents. Lack of connection

between CAMHS and AMHS is reported as themajor (82%) difficulty

experienced by young service users.

Conclusion

Preliminary results indicate a marked variability in

characteristics of services and in data activity among the 28 Euro-

pean countries, with important missing information at national

level about CAMHS and their functioning. All these conclusions

warrant an improvement in data collection and service planning

and delivery.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.939