European Psychiatry - Volume 33 - March 2016

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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.
W03
Anticipation of age at onset in
anorexia nervosa
A. Favaro ∗ 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.
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.
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 ∗, G. Signorini , S.P. Singh , J. Warwick
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.