

S76
24th European Congress of Psychiatry / European Psychiatry 33S (2016) S72–S115
B-II related admissions have increased from $52.24 million/year to
$1.6 billion/year.
Conclusions
While mortality has slightly increased from 1998 to
2011, the cost has significantly increased from $52.24 million/year
to $1.6 billion/year, which leads to an estimated $1.55 billion/year
additional burden to US health care system. In the era of cost
conscious care, preventing B-II related hospitalization could save
billions of dollars every year. Focused efforts are needed to establish
preventive measures for B-II related hospitalization.
Disclosure of interest
The authors have not supplied their decla-
ration of competing interest.
http://dx.doi.org/10.1016/j.eurpsy.2016.01.014FC11
Analysis of genetic polymorphisms,
adverse drug reactions and targeted
treatment
E. Stella
1 ,∗
, M. La Montagna
1, D. Seripa
2, M. Giuseppe
2,
L. di Mauro
2, A. Greco
2, A. Rinaldi
1, M.S. Martone
1, A. Bellomo
1,
M. Lozupone
1 , 31
University of Foggia, Department of Mental Health, Psychiatric Unit,
Asl Fg, Foggia, Italy
2
IRCCS Casa Sollievo della Sofferenza, Geriatric Unit and
Gerontology, Geriatrics Research Laboratory, Department of Medical
Sciences, San Giovanni Rotondo, Italy
3
University of Bari “A. Moro”, Department of Basic Medical Sciences,
Neurosciences and Sense Organs, Bari, Italy
∗
Corresponding author.
Introduction
Bipolar disorders (BD) are chronic and recur-
rent psychopathological conditions characterized by therapeutic
failures (TFs), regardless of the initial choice of psychiatric med-
ication with a high prevalence of adverse drug reactions (ADRs).
Cytochrome P450(CYP)2D6 genetics has been recently suggested
to have a role in the response to treatment and extra-pyramidal
symptoms (EPS) across several psychiatric conditions.
Objectives
To evaluate interindividual differences in CYP2D6
enzyme activities, TFs and ADRs rates in BDs patients.
Aims
To tailor psychiatric medication choice and dose based on
pharmacogenetic test.
Methods
We analyzed 16 clinical relevant polymorphisms
CYP2D6 genotype in Psychiatric Unit of Foggia using the Infini-
tiTMAnalyzer; the Simpson Angus Scale (SAS) was used tomeasure
drug-induced EPS and Brief Psychiatric Rating Scale-24 (BPRS-24)
response to treatment.
Results
Ten drug-resistant patients were consecutively enrolled,
and six of these experience major ADR during therapy with wors-
ening of symptoms before screening for CYP polymorphism: BM
(*2A/*5 genotype, BPRS-24 T
0
: 63, T
14
: 51), SR (*2A/*4, BPRS-24
T
0
: 66, T
14
: 59), LT (*4/*17 BPRS-24 T
0
: 72, T
14
: 64), DC (*2A/*4A
BPRS-24 T
0
: 69, T
14
: 54), AL (*2A/*2A, BPRS-24 T
0
: 72, T
14
: 64), PA
(*2A/*2A BPRS-24 T
0
: 52, T
14
: 46).
Conclusions
According to the specific CYP2D6 polymorphism, we
personalized patients’ treatment considering that poor and exten-
sive metabolizers have different rates of ADR and responses to
treatment. CYP2D6 genotype’s knowledge is useful for the reduc-
tion of therapeutic attempt during patient clinical history, thus
reducing admission time and costs, and to guide clinicians toward
a better patient management.
Disclosure of interest
The authors have not supplied their decla-
ration of competing interest.
http://dx.doi.org/10.1016/j.eurpsy.2016.01.015FC12
Trends of hospitalization for major
bipolar unspecified in USA:
A nationwide analysis
A. Sutaria
1 ,∗
, Z. Mansuri
1, M. Rathod
1, S. Shambhu
1,
U. Mansuri
21
Drexel University, School of Public Health, Philadelphia, USA
2
Icahn School of Medicine at Mount Sinai, School of Public Health,
New York, USA
∗
Corresponding author.
Objectives
Bipolar unspecified (BP-U) is an important cause of
morbidity and mortality in hospitalized patients. While BP-U has
been extensively studied in the past, the contemporary data for
impact of BP-U on cost of hospitalization are largely lacking.
Methods
We queried the Healthcare Cost and Utilization
Project’s Nationwide Inpatient Sample (HCUP-NIS) dataset
between 1998–2011 using the ICD-9 codes. Severity of comorbid
conditions was defined by Deyo modification of Charlson comor-
bidity index. Primary outcome was in-hospital mortality and
secondary outcome was total charges for hospitalization. Using
SAS 9.2, Chi
2
test,
t
-test and Cochran-Armitage test were used to
test significance.
Results
A total of 711,147 patients were analyzed; 61.33% were
female and 38.67% were male (
P
< 0.0001); 77.63% were white,
13.17% black and 9.2% of other race (
P
< 0.0001). Rate of hos-
pitalization increased from 2,310.28/million to 74,908.88/million
from 1998–2011. Overall mortality was 0.81% and mean cost of
hospitalization was $25,152.02. The in-hospital mortality reduced
from 1.24% to 0.97% (
P
< 0.0001) and mean cost of hospitalization
increased from 11,308.05$ to 32,211.67$. Total yearly spending on
BP-U related admissions have increased from $207 million/year to
$19.15 billion/year.
Conclusions
While mortality has slightly decreased from 1998 to
2011, the cost has significantly increased from $0.21 billion/year
$19.15 billion/year, which leads to an estimated $18.94 billion/year
additional burden to US health care system. In the era of cost
conscious care, preventing BP-U related hospitalization could save
billions of dollars every year. Focused efforts are needed to establish
preventive measures for BP-U related hospitalization.
Disclosure of interest
The authors have not supplied their decla-
ration of competing interest.
http://dx.doi.org/10.1016/j.eurpsy.2016.01.016FC13
Trends of hospitalization for major
bipolar I (most recent episode-manic)
in USA: A nationwide analysis
A. Sutaria
1 ,∗
, Z. Mansuri
1, M. Rathod
1, S. Shambhu
1,
U. Mansuri
21
Drexel University, School of Public Health, Philadelphia, USA
2
Icahn School of Medicine at Mount Sinai, School of Public Health,
New York, USA
∗
Corresponding author.
Objectives
Bipolar I most recent episode-manic (BP-I-M) is
an important cause of morbidity and mortality in hospitalized
patients. While BP-I-Mhas been extensively studied in the past, the
contemporary data for impact of BP-I-M on cost of hospitalization
are largely lacking.
Methods
We queried the Healthcare Cost and Utilization
Project’s Nationwide Inpatient Sample (HCUP-NIS) dataset
between 1998–2011 using the ICD-9 codes. Severity of comorbid
conditions was defined by Deyo modification of Charlson comor-
bidity index. Primary outcome was in-hospital mortality and
secondary outcome was total charges for hospitalization. Using
SAS 9.2, Chi
2
test,
t
-test and Cochran-Armitage test were used to
test significance.