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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169


Mood disorders in elderly patients

hospitalized for acute exacerbation of


I. Bonfitto

1 ,

, G. Moniello


, M. Pascucci


, A. Bellomo



University of Foggia, Department of Mental Health ASL-FG-SPCD,

Foggia, Italy


Azienda Ospedaliera-Universitaria “Ospedali Riuniti”, Operative

Unity of Geriatry, Foggia, Italy

Corresponding author.


Chronic obstructive pulmonary disease (COPD)

represents the most common cause of chronic respiratory fail-

ure and it’s associated with several comorbidities such as

depression. Depression is about four times more frequent in

elderly patients with COPD compared to peers who are not

affected and its prevalence increases with the degree of disease



To assess mood and perception of the quality of life in

elderly patients hospitalized for acute exacerbation of COPD.


Thirty-five elderly patients hospitalized for reactivation

of COPD were examined; they were subjected to spirometry test

for the calculation of FEV1 and to COPD Assessment Test (CAT)

and Hamilton Rating Scale for Depression (HAM-D) to evalu-

ate impact of COPD on patients’ quality of life and depressive

symptomatology, respectively. The number of COPD exacerba-

tions in the last year prior to hospitalization and the number of

recovery days required for the stabilization of patients were also



There were strongly significative correlations (


< 0.001),

positive between HAM-D scores, CAT scores, number of exacer-

bation in the last year and hospital length of stay and negative

between HAM-D scores and FEV1 values. Furthermore, females

were more depressed, with lower FEV 1 (


= 0.043) and with a

longer length of stay (


= 0.039) as compared to males.


A greater severity of depressive symptoms is related

to a greater severity of COPD exacerbations, disability associated

with it and perceived by the patient, as well as a higher number

of recovery days and annual acute exacerbations, particularly in

female gender.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Cortisol awakening response and

depression in acute coronary

syndrome patients

V.M. Buonomenna

1 ,

, F. Marciello


, V. Caivano


, G. Cascino



G. D’Agostino


, D. Nunziata


, P. Monteleone



Seconda Università di Napoli, Department of Psychiatry, Naples,



University of Salerno, Faculty of Medicine, Department of

Psychiatry, Salerno, Italy

Corresponding author.


Although the available evidence strongly supports

an association between depression and coronary heart disease

(CHD), the possible biological link between these two conditions

still remains to be clarified. The hypothalamus-pituitary-adrenal

(HPA) axis is the main endogenous system mediating the stress

response and changes in cortisol secretion have been associated

with depressed mood in patients with CHD. Therefore, the study

of the correlation between cortisol levels and depressed mood in

acute coronary syndrome (ACS) patients could help to clarify the

nature of the relationship between ACS and the risk to develop a

depressive syndrome.


We aimed to explore the relationships between HPA

axis activity and depressed mood in ACS patients.


The purpose of this study was to determine whether the

cortisol awakening response (CAR) is associated and/or predict

depressive symptoms in patients with an ACS.


Patients admitted to an ACSwardwere asked to fill in the

Beck Depression Inventory (BDI) and to collect saliva samples in the

morning to measure their CAR. All the procedures were carried out

within 1 week after an ACS. Patients were asked again to fill in the

BDI six months after their ACS.


A lower CAR was associated with higher BDI scores after

6months from an ACS.


Our preliminary results suggest that hypoactivity of

the HPA axis in the first week of an ACS may predict more severe

depressive symptoms after 6 months from the ACS.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Rewarding network mechanism of

left orbito-frontal cortex transcranial

magnetic stimulation in depression

Q. Dai

1 ,

, Y. Xuntao


, F. Zhengzhi



Third Military Medical University, Department of Nursing

psychology, Chongqing, China


Third Military Medical University, Radiological department, the

Southwest Hospital of the Third Military Medical University,

Chongqing, China


Third Military Medical University, Department of psychology,

Chongqing, China

Corresponding author.


The difficulties in the clinical antidepressant treatment

lead to the pursuing of more effective methods such as transcranial

magnetic stimulation (TMS). Mixed findings from DLPFC targeted

TMS result in the exploration of optimal stimulation location. Dis-

turbed function of obitofrontal cortex (OFC) has been indicated

in depression, which is involving in the remission of depression.

However, whether it could be a more specific treating target is not

tested. Simultaneously, disturbed reward network (RN) has been

confirmed in depression, however, whether this could be improved

by TMS treatment remains unclear.


Fourteen patients with major depressive disorder

(MDD) were allocated in a four-week course of OFC targeted TMS.

Motivated by the literature, before and after the treatment, the

function connectivity of RN with the seed of ventral striatum was

conducted. The results were also compared with the data from 33

healthy controls.


The OFC targeted TMS improved the clinical depression

significantly and enhanced the function connectivity within the RN

effectively. Specifically, lower baseline dorsolateral striatum con-

nectivity predicted strong therapeutic effect of TMS on depression,

while lower baseline insula connectivity predicted weak therapeu-

tic effect on depression.


The findings offer the first experimental evidence of

the therapeutic effect of OFC targeted TMS on clinical depression,

enhanced function connectivity within RN might be the potential

neural mechanism

( Fig. 1 ).

Lower dorsolateral striatum connection

might be a reliable neural biomarker of strong responding for TMS

treatment, which helps to identify the patients who will be cured

by TMS most effectively.