European Psychiatry - Volume 33 - March 2016

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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.
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 ∗ cBurnett . Cutler Hervás u
B. Dirks . Newcorn
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.
FC15
Suicidality and psychiatric
comorbidities among adults with
childhood identified ADHD: Gender
differences – a population-based
longitudinal study
K. Yoshimasu ∗, W.J. Barbaresi , R.C. Colligan , R.G. Voigt ,
J.M. Killian , A.L. Weaver , S.K. Katusic
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.