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

S87

3

Lausanne University Hospital, CHUV, Service of Biomedicine,

Lausanne, Switzerland

Corresponding author.

Introduction

Specific changes in personality profiles may repre-

sent early symptoms of Alzheimer’s disease (AD). Knowledge about

relationship between personality changes and biomarkers of cere-

bral pathology can contribute to early diagnosis of AD.

Objectives

To investigate to what extent the personality changes

predict the cerebral AD pathology.

Aims

To describe the relationship between the personality

changes and pathological cerebro-spinal fluid (CSF) biomarkers.

Method

One hundred and ten subjects, of whom57 patients with

mild cognitive impairment (MCI), 9 subjects with mild dementia,

and 44 healthy controls had an extensive medical and neuropsy-

chological examination as well as lumbar puncture to evaluate

concentrations of CSF biomarkers of AD pathology [amyloid-

1-42

(A

1-42

), phosphorylated tau (ptau-181), and total-tau (tau)]. The

proxies of the participants completed the Revised NEO Personal-

ity Inventory (NEO-PI-R) to assess subjects’ personality at the time

being and 5 years retrospectively.

Results

In a hierarchical multivariate regression analysis, includ-

ing age, gender, education, Mini Mental State Examination (MMSE),

and APOEe4 status, lower A

1-42

concentrations in CSFwere associ-

ated with increasing neuroticism, and decreasing extraversion and

conscientiousness. Decreasing extraversion, openness to experi-

ence and conscientiousnesswere associatedwith higher tau/A

1-42

ratio, and higher ptau-181/A

1-42

ratio was related to decreasing

extraversion. Personality changes in the domain of agreeableness

did not yield any significant effect as a predictor on any of CSF

biomarkers.

Conclusions

Our findings suggest that early and specific changes

in personality traits are associated with cerebral AD pathology, in

particular with amyloid pathology, and may serve as clinical signs

to consider when evaluating MCI and mild dementia.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.043

FC40

Diuretic medication use reduces

incident dementia risk: A

meta-analysis of prospective studies

P. Tully

1 ,

, O. Hanon

2

, S. Cosh

3

, C. Tzourio

4

1

University of Adelaide, Medicine, Adelaide, Australia

2

Inserm, Université Paris Descartes, Service de Gériatrie, Pairs, France

3

University of Adelaide, Psychology, Adelaide, Australia

4

University of Bordeaux, Neuroepidemiology, Bordeaux, France

Corresponding author.

Introduction

Numerous observational studies suggest that blood

pressure management with antihypertensive drugs may be effec-

tive in reducing dementia risk.

Objective

To quantify dementia risk in relation to diuretic medi-

cation use.

Methods

Electronic databases were searched until June 2015. Eli-

gibility criteria: population, adults without dementia at baseline

fromprimary care, community cohort, residential/institutionalized

or randomized controlled trial (RCT); exposure, diuretic medica-

tion; comparison, no diuretic medication, other or no antihyper-

tensive medication, placebo-control; outcome, incident dementia

in accordance with standardized criteria. Adjusted hazard ratios

(HR) with 95% confidence intervals (CI) were pooled in fixed-effects

models with RevMan 5.3. The overall quality and strength of evi-

dence was rated with GRADE criteria.

Results

Fifteen articles were eligible comprising a pooled sam-

ple of 52,599 persons and 3444 incident dementia cases (median

age 76.1 years, 40% male) with a median follow-up of 6.1 years.

Diuretic use was associated with 17% reduction in dementia risk

(HR 0.83; 95% CI 0.75 to 0.90) and a 21% reduction in Alzheimer’s

disease risk (HR 0.79; 95% CI 0.68 to 0.93). GRADE was rated as

moderate. Risk estimates were consistent comparingmonotherapy

versus combination therapy, study design and follow-up. Meta-

regression did not suggest that age, gender, systolic blood pressure,

attrition, mortality rate, education, cognitive function, stroke,

Apolipoprotein E allele, heart failure or diabetes altered the primary

results.

Conclusions

Diuretic medication was associated with a consis-

tent reduction in dementia and Alzheimer’s disease risk and the

absence of heterogeneity points to the generalizability of these

findings.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.044

Mental health policies

FC41

Changes in prescribing patterns of

benzodiazepines after training of

general practitioners

T. Alves-dos-Reis

1 , 2 ,

, A.L. Papoila

3

, R. Gusmão

4

1

Hospital do Espírito Santo de Évora, Psiquiatria e Saúde Mental,

Évora, Portugal

2

NOVA Medical School Faculdade Ciências Médicas, Mental Health

Department, Lisbon, Portugal

3

NOVA Medical School Faculdade Ciências Médicas, Biostatistics,

Lisbon, Portugal

4

Instituto de Saúde Pública da Universidade do Porto, Instituto Saúde

Pública, Porto, Portugal

Corresponding author.

Introduction

Benzodiazepines are the most utilized anxiolytic

and hypnotic drugs. The high consumption of benzodiazepines has

been a concern due to reported side effects of long-term use and

dependence. Portugal has the highest benzodiazepine utilization in

Europe.

Objectives

To analyze the change in general practitioners’ (GPs)

benzodiazepine prescription pattern after an intervention period.

Methods

An educational session was delivered to a group of

intervened GPs. The benzodiazepine prescription pattern of inter-

vened group was compared to the pattern of a non-intervened

matched group from the same region, and of another non-

intervened matched group from a different region. The research

time frame was 12 months before and after intervention. The anal-

ysis of the prescription trends used the defined daily dose (DDD)

and defined daily dose per 1000 patients per day (DHD) method-

ology. The statistical methods consisted of segmented regression

analysis.

Results

Therewas a decrease in benzodiazepine prescription pat-

tern of intervened GPs after intervention (

P

= 0.005). There was

also a decrease in benzodiazepine prescription pattern for the

non-intervened group from the same region (

P

= 0.037) and for

the non-intervened group from a different region (

P

= 0.010). Con-

cerning an analysis by gender, female gender prescribed a higher

amount of benzodiazepines. The intervened female gender pre-

scribers presented the highest decrease in prescription trend after

intervention (

P

= 0.008).

Conclusions

Intervention was effective in reducing benzodi-

azepine prescription after intervention. It demonstrates that a

single intervention has a positive impact on improving prescription

trends. The replication of this interventionmight be an opportunity

for changing the worrying benzodiazepine utilization in Portugal.