European Psychiatry - Volume 33 - March 2016

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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.
FC40
Diuretic medication use reduces
incident dementia risk: A
meta-analysis of prospective studies
P. Tully ∗, O. Hanon , S. Cosh , C. Tzourio
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.
Mental health policies
FC41
Changes in prescribing patterns of
benzodiazepines after training of
general practitioners
T. Alves-dos-Reis ∗, A.L. Papoila , R. Gusmão
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.