European Psychiatry - Volume 33 - March 2016

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S624 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
conservative use of opioid analgesics. Importance of evaluation and
treatment of any underlying mood and/or anxiety syndromes was
stressed as well as liaison with other professionals (e.g. psycholo-
gists, neurologists, orthopaedics, and physiotherapists).
Conclusions Patients with EUPD often report chronic pain, which
can only be managed by close collaboration of professionals from
different disciplines.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV859
Duloxetine added to tramadol in
chronic pain syndrome
M. Domijan ∗, Z. Lonˇcar , S. Udoviˇci´c
1 “Sestre milosrdnice” University Hospital Center- Clinic for
Traumatology, Department of Anaesthesiology, Reanimatology and
Intensive Care, Zagreb, Croatia
2 “Rebro” University Hospital Center- Psychiatric Clinic, Center for
Crisis Intervention, Zagreb, Croatia
∗ Corresponding author.
Introduction About 15–20% of the population suffering from the
chronic pain. Over time, chronic pain can result in different emo-
tional problems, social isolation, sleep disturbances, which reduce
the quality of life. Chronic pain syndrome (CPS) indicates persistent
pain, subjective symptoms in excess of objective findings, associ-
ated dysfunctional pain behavious and self-limitation in activities
of daily living. Duloxetine is a potent antidepressant approved by
the Food and Drug Administration for the chronic musculoskele-
tal disorder, diabetic neuropathic pain, fibromyalgia, generallized
anxiety disorder and major depressive disorder.
Objective To determine the effect of duloxetine on the reduction
of pain and psychosocial suffering.
Aims The goal of the treatment should be to effectively reduce
painwhile improving function and reducing psychosocial suffering.
Methods Thirty-six adult, nondepressed patients, already on tra-
madol therapy were included. Patients with VAS (visual analogue
scale) ≥ 4were treated with duloxetine for 13weeks. We mea-
sured pain intensitywith theMcGill PainQuestionnaire-Short Form
(MPQ-SF) and compared VAS before starting the treatment with
duloxetine and weekly for 13weeks.
Results Pain response was defined as a 30%decrease in the MPQ-
SF. A total of 62.5% of the sample met these criteria for response.
Among them, 13.8% of patients were discontinued because of
adverse effects. Duloxetine significantly improved functioning and
the quality of life in patients with CPS.
Conclusions Because of it is analgesic properties, duloxetine in
the lower antidepressant doses (60mg taken ones daily) combined
with tramadol (another analgesic agent) can be useful in CPS for
patients who do not respond satisfactory to monotherapy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV860
Prevalence of different pain
categories based on pain spreading in
older adults in Sweden: A multilevel
association with socio-demographic
characteristics, comorbidities and
drug consumption (Pain S65+)
E. Dragioti ∗, B. Larsson , L. Bernfort , L.Å. Levin , B. Gerdle
Linköping University, Department of Medical and Health Sciences,
Linköping, Sweden
∗ Corresponding author.
Introduction Understanding of factors related to chronic pain in
elderly is limited.
Objectives and aims To estimate the prevalence of pain categories
based on spreading of pain on the body and to investigate how
such spreading is related to demographic variables, pain intensity,
comorbidities and medication in an elderly general population in
southeastern Sweden.
Methods A total of 6611 adults aged ≥ 65 years participated
(mean age = 76.2; SD = 7.4). Pain categories were assessed by a self-
reported postal questionnaire covering 45 anatomical predefined
pain regions along with demographics, pain intensity during previ-
ous seven days, comorbidities and medication. Poisson regression
models with robust error variance were used for data analyzing.
Results The prevalence of pain spreading categories was: chronic
local pain (CLP) 16%; chronic regional pain medium (CRP-Medium)
17%; chronic regional pain heavy (CRP-Heavy) 5% and chronic
widespread pain (CWSP) 2%. Overall, increased prevalence for
CRP-Heavy and CWSP in subjects 75–79 years old compared to
those 65–69, 70–74, 80–84 and ≥ 85 years were revealed. In men,
75–79 years old, CRP-Heavy was more common than in the other
pain categories. In women, 75–79 years old CWSP, was more
common than in the other pain categories. Pain intensity was
strongly associated with all pain categories ( P < 0.001). CLP was
associated with trauma, rheumatoid arthritis, cancer, prescribed
and non-prescribed analgesics. CRP-Medium was associated with
rheumatoid arthritis, CRP-Heavy with rheumatoid arthritis and
lung diseases and CWSP with rheumatoid arthritis and prescribed
analgesics (P < 0.001).
Conclusions Our findings elucidate heterogeneity of pain in
elderly which has to be further investigated.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV861
Distinct subgroups derived by cluster
analysis based on pain characteristics
and anxiety-depression symptoms in
Swedish older adults with chronic
pain (PainS65+)
E. Dragioti ∗, B. Gerdle , B. Larsson , L. Bernfort , L.Å. Levin
Linköping university, department of medical and health sciences,
Linköping university, Sweden
∗ Corresponding author.
Introduction There is a lack of research on subtypes of chronic
pain (CP) characteristics in the elderly.
Objective To scrutinize major subgroups based on pain aspects
and psychological factors on an elderly population.
Aims To determine possible differences between the derived
subgroups with respect to pain aspects and anxiety-depression
symptoms, health aspects and health care costs.
Methods A cross-sectional study was implemented. A large
sample of 2300 individuals (M= 75.9 years, SD = 7.4) partici-
pated. Self-reported postal measurements regarding pain intensity,
spreading of pain, anxiety and depression (General well-being
schedule [GWBS]), and pain catastrophizing [PCS]) were used as
classification variables. A two-step cluster analysis was employed.
We further investigated whether the derived subgroups expe-
rienced different quality of life and general health. Calculations
regarding health care costs were also performed.
Results Two major subgroups were identified: one low symp-
tom severity subgroup (Cluster 1; n = 1326; 58%) and one high
symptom severity subgroup (Cluster 2; n = 974; 42%). There were
statistical significant differences on pain intensity, spreading of
pain, anxiety, depression and pain catastrophizing between the two
subgroups (P < 0.001). Significant lower levels for quality of life and
general health (P < 0.001)were found for the high symptomseverity