European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169 S113
Managing bipolar disorder in pregnancy and postpartum is a chal-
lenge. There is lack of literature to inform that and an urgent need
for more data.
Objectives To develop and validate a risk prediction model for
individual prognosis of the risk of recurrence of bipolar disorder
for women in the perinatal period.
Aims To provide evidence-based information to helpwomen and
the clinicians that look after themmake decisions about their care,
taking into account the most recent scientific knowledge and their
individual characteristics.
Methods The development of the model will be done in retro-
spective data from a large clinical cohort from the Bipolar Disorder
Research Network . The validation will be done in a
prospectively recruited sample.
Participants will be 2181 parous women with a lifetime diagno-
sis of bipolar disorder from BDRN and 300 prospectively recruited
pregnant women with a history of postpartum psychosis or bipolar
disorder.
Predictors will be chosen based on clinical experience and lit-
erature, from data collected via semi-structured interview (in
pregnancy and 3 months postpartum, medical and psychiatric
notes) e.g. medication, smoking, parity, obstetric complications and
sleep.
Results N/A.
Conclusions Wewill present the full predictionmodel (regression
coefficients and model intercept) and report performance meas-
ures (with CIs).
We will discuss its potential clinical use and implications for future
research.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0022
Review of risk prediction approaches
for bipolar episodes in the perinatal
period
M. Casanova Dias ∗ nes i Florio ones
N. Craddock
1 Cardiff University School of Medicine, MRC Centre for
Neuropsychiatric Genetics and Genomics, Cardiff, United Kingdom
2 Institute of Health & Society, Worcester University, Worcester,
United Kingdom
∗ Corresponding author.
Introduction The perinatal period is a high-risk period for the
development of illness episodes in women with bipolar disorder.
Relapse rates vary between 9 and 75% depending on the study. The
overall risk of a severe episode is approximately 20%. The impact
on women, the relationships with their babies and their families
can be devastating. In the UK costs to society are £8.1 billion per
year-cohort of births. The advice currently given to women is based
of general risk rates. Women’s needs of information for decision-
making in the perinatal period are not being met.
Objectives To review the risk prediction approaches used for
women with bipolar disorder in the perinatal period.
Aims To understand the existing risk prediction models and
approaches used for prognosis of the risk of recurrence of bipolar
disorder for women in the perinatal period.
Methods Systematic literature search of public medical elec-
tronic databases and grey literature on risk prediction for bipolar
episodes in the perinatal period.
Results Wewill present the existingmodels and approaches used
for risk prediction of illness episodes in the perinatal period.
Conclusions Awareness of existing risk prediction models for
recurrence of bipolar disorder in the perinatal periodwill allowbet-
ter informed risk-benefit analysis of treatment and management
options.
This person-centred approach will help women and clinicians in
their decision-making at this crucial high-risk period.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0023
Physical health in early and late stages
of bipolar disorder
M.P. García-Portilla ∗ e la Fuente-Tomás
L. García-Álvarez ierra rranz Sánchez
G. Safont
1 University of Oviedo, Psychiatrist, Oviedo, Spain
2 CIBERSAM, Psychiatrist, Oviedo, Spain
3 Hospital La Fe, Psychiatrist, Valencia, Spain
4 Fundación San Juan de Dios, Psychiatrist, Barcelona, Spain
5 Hospital Mutua de Terrassa, Psychiatrist, Barcelona, Spain
∗ Corresponding author.
Introduction Bipolar disorder (BD) is related to high prevalence of
somatic comorbidities, health care costs, and premature mortality
ome evidence supports the view of BD as chronic, progressive
and multisystem disorder in which not only mental system, but
also somatic systems are involved
Aim To investigate differences in physical health in patients with
bipolar disorder at different stages (early vs. late) of the disease.
Methods Cross-sectional, naturalistic, multicenter study. Sam-
ple: 110 outpatients with BD [68 early stage (diagnosed at least
5 years earlier) and 42 late stage (at least 20 years earlier)]. Assess-
ment: demographic and clinical variables; psychopathology: HDRS,
YMRS and CGI; biological information: anthropometric, vital signs
and lab results.
Results Early stage group: mean age 40.1 (11.9), 66.2% females
and CGI = 3.6 (1.4). Late stage group: mean age 55.8 (8.2), 69.0%
females and CGI = 4.0 (1.4). Patients in early stage have significantly
higher levels of glucose (t = −4.007, P < 0.001), urea (t = −2.724,
P = 0.008), creatinine (F = 0.560, P = 0.022), triglycerides (t = −3.501,
P = 0.001), Fe (t = 2.871, P = 0.005) and insulin (t = −3.223,P = 0.002).
Moreover, they have higher Body Max Index (BMI) (t = −3.728,
P < 0.000), abdominal circumference (t = −4.040, P < 0.000) and
greater number of somatic comorbidities (t = −2.101, P = 0.041).
Conclusions – patients with bipolar disorders in late stages have
worse physical health than those in early stage.
– these results could be an indication that bipolar disorder might
better viewed as a multisystem disorder.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
References
[1] Kleine-Budde K, et al. Cost of illness for bipolar disorder: a
systematic review of the economic burden. Bipolar Disord
2014;16(4):337–53.
[2] Leboyer M, Soreca I, Scott J, et al. Can bipolar disorder be
viewed as a multi-system inflammatory disease? J Affect Disord
2012;141(1):1–10.
EW0024
The late-onset bipolar disorder:
A comparative study
C. Derbel∗, R. Feki , S. Ben Nasr , S. Bouhlel , B. Ben Hadj Ali
CHU Farhat Hached, Psychiatry, Sousse, Tunisia
∗ Corresponding author.
Introduction Bipolar disorders (BP) with late onset are under-
estimated by their frequency, their misleading presentations and
therapeutic difficulties due to the high prevalence of somatic co-
morbidities.