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Page Background

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S72–S115

S77

Results

A total of 10,875 patients were analyzed; 57.13% were

female and 42.87% were male (

P

< 0.0001); 74.78% were white,

14.51% black and 10.71% of other race (

P

< 0.0001). Rate of hos-

pitalization increased from 528.71/million to 588.76/million from

1998–2011. Overall mortality was 0.42% and mean cost of hos-

pitalization was 22,215.77$. The in-hospital mortality increased

from 0.37% to 0.82% (

P

< 0.0001) and mean cost of hospitalization

increased from 10,580.54$ to 40,737.65$. Total spending on BP-I-

M related admissions have increased from $44.24 million/year to

$187.00 million/year.

Conclusions

While mortality has slightly decreased from 1998 to

2011, the cost has significantly increased from $44.24 million/year

to $187.00 million/year, which leads to an estimated $ 142.76 mil-

lion/year additional burden to US health care system from. In the

era of cost conscious care, preventing BP-I-M related hospitaliza-

tion could save billions of dollars every year. Focused efforts are

needed to establish preventive measures for BP-I-M related hospi-

talization.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.017

Child and adolescent psychiatry

FC14

Separating efficacy and sedative

effects of guanfacine extended release

in children and adolescents with

ADHD from four randomized,

controlled, phase 3 clinical trials

M. Huss

1 ,

, K . M

cBurnett

2 , A.J

. Cutler

3 , A.

Hervás

4 , J. G

u

5 ,

B. Dirks

6 , J.H

. Newcorn

7

1

Johannes Gutenberg University Mainz, Child and Adolescent

Psychiatry, Mainz, Germany

2

University of California, Department of Psychiatry, San Francisco,

USA

3

Florida Clinical Research Center, Child and Adolescent Psychiatry,

Bradenton, USA

4

University Hospital Mútua de Terrassa, UEDT, Hospital Sant Joan de

Deu, Child and Adolescent Mental Health Unit, Barcelona, Spain

5

Shire, Biostatistics, Wayne, USA

6

Shire, Neuroscience, Wayne, USA

7

Icahn School of Medicine at Mount Sinai, Department of Psychiatry,

New York, USA

Corresponding author.

Introduction

Guanfacine extended release (GXR) is a non-

stimulant treatment for attention-deficit/hyperactivity disorder

(ADHD).

Objective

To separate efficacy and sedative treatment-emergent

adverse events (TEAEs) associated with GXR in four randomized,

controlled trials in children (6–12 years) and adolescents (13–17

years) with ADHD.

Methods

SPD503-301 (

n

= 345) and SPD503-304 (

n

= 324) were 8

and 9 week studies of fixed-dose GXR (

4mg/day). SPD503-312

(

n

= 314; adolescents only) and SPD503-316 (

n

= 338) were 10–13

week studies of dose-optimized GXR (1–7mg/day).

Results

In fixed-dose studies, pooled incidences of sedative

TEAEs with GXR were highest at week 1 (GXR, 13.9–18.7%; placebo,

8.7%) and decreased to placebo levels at week 8 (0–1.4%; placebo,

0%). In contrast, proportions of responders (

30% reduction from

baseline in ADHD Rating Scale IV [ADHD-RS-IV] total score)

increased from week 1 (GXR, 29.6–34.8%; placebo, 25.0%) through

endpoint (GXR, 66.7–72.2%; placebo, 42.6%). Incidences of sedative

TEAEs, but not proportions of responders, increased with GXR dos-

ing. GXR was associated with a statistically significant reduction

in ADHD-RS-IV total score from baseline to endpoint in patients

without sedative TEAEs in both fixed-dose and dose-optimized

studies (GXR versus placebo, effect size = 0.49 and 0.67, respec-

tively;

P

< 0.001). GXR was associated with statistically significant

improvements comparedwith placebo in both ADHD-RS-IVHyper-

activity/Impulsivity and Inattentiveness subscale scores (

P

< 0.001).

Conclusion

These data from pooled GXR clinical trials indicate

that incident sedative TEAEs do not contribute to increased treat-

ment response over time, and that sedation and symptomatic

improvement are distinct effects of GXR.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.018

FC15

Suicidality and psychiatric

comorbidities among adults with

childhood identified ADHD: Gender

differences – a population-based

longitudinal study

K. Yoshimasu

1 ,

, W.J. Barbaresi

2

, R.C. Colligan

3

, R.G. Voigt

4

,

J.M. Killian

5

, A.L. Weaver

5

, S.K. Katusic

5

1

Wakayama Medical University, Hygiene, Wakayama city, Japan

2

Boston Children’s Hospital, Medicine, Boston, USA

3

Mayo Clinic, Psychiatry and Psychology, Rochester, USA

4

Baylor College of Medicine, Pediatrics, Houston, USA

5

Mayo Clinic, Health Sciences Research, Rochester, USA

Corresponding author.

Objective

To evaluate the effect of comorbid psychiatric disorders

(PD) on the association between childhood ADHD and suicidal-

ity and the effect of gender on the association between PDs and

suicidality among adults with childhood ADHD.

Method

Subjects were recruited from a birth cohort of all chil-

dren born 1976–1982 remaining in Rochester, MN after five years

of age. Participating subjects with research-identified childhood

ADHD (

n

= 232; mean age 27.0 years; 72%men) and non-ADHD con-

trols (

n

= 335; mean age 28.6 years; 63% men) were administered a

structured psychiatric interview (MINI International Neuropsychi-

atric Interview) to assess suicidality and psychiatric comorbidities.

Results

Compared to controls, ADHD cases were significantly

more likely to meet criteria for suicidality [odds ratio (OR) = 2.7,

95% CI 1.7–4.5]. Although this association was not moderated by

the presence of PDs (

P

= 0.63 for interaction effect), the associa-

tion between ADHD and suicidality was partially mediated by the

presence of PDs [OR decreased from 2.7 to 2.1 (95% CI 1.2–3.5)].

Among adults with childhood ADHD, there was no significant mod-

erating effect of gender on the association between suicidality and

PD (

P

= 0.26 for interaction effect). However, the odds of suicidal-

ity was 6.1 (95% CI, 2.3–15.9) times higher among males with both

externalizing and internalizing PDs compared tomales with no dis-

orders; among females the corresponding odds ratio was 3.4 (95%

CI, 0.7–16.6).

Conclusion

Childhood ADHD is significantly associated with

adult suicidal risk. Among those with ADHD, associations between

suicidality and comorbid psychiatric disorders are more apparent

inmen among those with comorbid externalizing and internalizing

disorders.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.019