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

S59

Results

First results are expected in 2016with furthermajor find-

ings following in 2019.

Conclusions

The MILESTONE project will provide unprecedented

information on the nature and magnitude of problems at the

CAMHS-AMHS interface, andpotential solutions to overcome these.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.942

Future experts on the floor: Young researchers in

addiction

W09

Neurostimulation in alcohol

dependence: The effect of repetitive

transcranial magnetic stimulation on

brain function and craving

J. Jansen

1 ,

, O. van den Heuvel

2

, Y. van der Werf

3

, S. De Wit

2

,

D. Veltman

2

, W. van den Brink

1

, A. Goudriaan

1

1

Academic Medical Centre, Psychiatry, Amsterdam, Netherlands

2

VU University Medical Center, Psychiatry, Amsterdam, Netherlands

3

Netherlands Institute for Neuroscience, Amsterdam, Netherlands

Corresponding author.

Background

Alcohol dependence has long been related to

impaired processing and handling of negative emotions. This is the

first study to compare emotion regulation (ER) at a behavioral and

neural level in alcohol dependent patients (ADPs) and healthy con-

trols (HCs). It also examines the effects of high-frequency repetitive

transcranialmagnetic stimulation (rTMS) onER abilities and related

craving levels in ADPs.

Method

Thirty-six ADPs and 32 HCs matched on age, sex, and

education, were included in a within-subject fixed-order study

with one functional magnetic resonance imaging (fMRI) session

and one rTMS plus fMRI session, with high-frequency (10Hz) rTMS

over the right dorsolateral prefrontal cortex (dlPFC). An fMRI emo-

tion regulation task (ERT) was administered during both sessions

and craving was measured before and after each ERT.

Results

ADPs were impaired in the regulation of negative emo-

tion and showed a higher activation of ER related brain areas

compared toHCs. Furthermore, active rTMS improvedER abilities in

both ADPs and HCs, but was accompanied by a decrease in anterior

cingulate and left dlPFC activity only in ADPs. In addition, the ERT-

induced increase in craving levels in ADPs was trend-significantly

reduced by active rTMS, with a large effect size.

Conclusions

ADPs are impaired in the regulation of negative emo-

tion and show enhanced neural activity in the ER brain circuit.

High-frequency rTMS improves ER in ADPs and HCs and normalizes

neural activity and tends to reduce craving in ADPs. Future studies

are needed to test the long-term effects of (multiple session) rTMS

on ER, craving, and drinking.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.943

W10

The impact of appetite regulating

peptides on substance use disorders

A. Koopmann

, F. Kiefer

Central Institute of Mental Health, Department of Addictive Behavior

and Addiction Medicine, Mannheim, Germany

Corresponding author.

Background

Preclinical and clinical data suggest modulating

effects of the appetite regulating peptide ghrelin on food intake.

Recent data suggest that in food intake the “endostatic” energy-

homeostatic systems of the lateral hypothalamus (LH) and the

motivational, mesolimbic reward systemoperate in dynamic inter-

play with each other. Ghrelin receptors have been detected in

the ventral tegmentum of the midbrain (VTA), where they mod-

ulate the activity of dopaminergic neurons projecting to the NAc.

Assuming that Ghrelin modulate mesolimbic reactivity, the ques-

tion remains: is this only the case in response to food cues? Or

is this the case in response to reward-associated cues in general

(including those related to nicotine and alcohol)?

Methods

Study 1: a consecutive sample of 61 alcohol-dependent

male inpatients was included. Blood was drawn at onset of with-

drawal 12-24 hours after admission, and following 14 days of

controlled abstinence in order to assess plasma concentrations of

both active and total ghrelin. In parallel, we assessed alcohol crav-

ing applying the Obsessive Compulsive Drinking Scale (OCDS) as

well as symptoms of depression (Beck Depression Inventory [BDI])

and anxiety (State Trait Anxiety Inventory [STAI]). The severity of

alcohol dependence was assessed with the Alcohol Dependence

Scale (ADS). Study 2: 54 non-treatment seeking smokers and 30

healthy controls with normal eating behavior, as measured by the

Three Factor Eating Questionnaire (TFEQ) participated in this study.

We measured plasma concentrations of both active and total ghre-

lin, using a blood sample taken two hours after a standardizedmeal

during early nicotine abstinence in the smoking group. Addition-

ally we quantified severity of addiction in the smoking group using

the number of cigarettes smoked per day, cotinine plasma concen-

tration and the Fagerström Test for Nicotine Dependence (FTND).

Results

Study1: we found a significant positive correlation

between the plasma concentration of active ghrelin and alcohol

craving in both blood samples. Plasma concentrations of active

ghrelin increased significantly during early abstinence. In a linear

regressionmodel, the plasma concentration of active ghrelin on day

one, the scores of the ADS, and the BDI explained 36% of the vari-

ance in OCDS sum score (

P

< 0001). By day 14, these same factors

accounted for 54% (

P

< 0.0001). We did not detect any association

between the plasma concentration of total ghrelin and patients’

alcohol cravings. Study 2: plasma concentration of acetylated ghre-

lin but not total ghrelin was significantly higher in smokers than

in non-smokers. Moreover, we found significant negative correla-

tions between acetylated ghrelin and all measures of the severity

of nicotine dependence.

Discussion

In conclusion, both studies supports the general idea

that ghrelin’s central effects go beyond the endostatic regulation

of energy homeostasis, also involving pathways underlying reward

expectation and craving. Physiologic factors modulating the reac-

tivity of mesolimbic pathways represent an important research

topic for developing pharmacologic treatments for disorders char-

acterized by altered reward-related behaviors, such as substance

use disorders and behavioral addictions.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.944

W11

Novel psychoactive substances

L. Orsolini

1 , 2 , 3 , 4 ,

, D. Papanti

4

, R. Vecchiotti

1 , 2 , 3

,

A. Valchera

1 , 3

, J. Corkery

4

, F. Schifano

4

1

Villa San Giuseppe Hospital, Hermanas Hospitalarias, Department

of Psychiatry, Ascoli Piceno, Italy

2

Maastricht University, Department of Psychiatry and

Neuropsychology, Maastricht, Netherlands

3

Polyedra, Polyedra Research, Teramo, Italy

4

University of Hertfordshire, School of Life and Medical Sciences,

Department of Pharmacy, Pharmacology and Medical Sciences,

Hatfield, United Kingdom

Corresponding author.