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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52

care providers were required to ponder over ethical dilemmas or

decisions. Several challenges were reported, such as: taking into

account and articulating personal freedom or needs with collec-

tive functioning or organizational constraints before, during and

after the assisted suicide; reconciliating self-determination with

protection towards vulnerable people (beneficere, nonmaleficere).


Assisted suicide challenges and changes professional

end-of-life practices. Education and support should be provided to

health and social care providers faced with it.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

Symposium: Is it possible to prevent Alzheimer’s



Setting the scene: The evidence for

pre-clinical change, projections of the

impact of intervention, and

implications for public health

T.C. Russ

1 ,

, K. Ritchie


, G.M. Terrera


, C.W. Ritchie



Centre for Dementia Prevention, University of Edinburgh,

Edinburgh, United Kingdom


Inserm, Montpellier, France


Department of Psychology, University of Victoria, Canada

Alzheimer’s disease has long been considered a neurodegenerative

disorder of late life for which there is currently no disease-

modifying treatment. This view is now being revised as increasing

evidence suggests a long pre-clinical phase extending back into

mid-life during which there is exposure to multiple potentially

reversible risk factors. Further thought is now being given to the

possibility of both early life intervention programs and devel-

opment of new drug treatments focusing on the pre-dementia

period. But how can the impact of such treatments be measured

at this early stage since overt dementia may not be diagnosed

for decades? In the four talks in this symposium, we will dis-

cuss evidence for pre-clinical change, theoretical models which

have been used to project the possible impact of risk factor mod-

ification in mid-life and their integration into a future public

health strategies. The development of new statistical risk mod-

els to determine the impact of such prevention measures will be

outlined. We will consider the possibilities for drug development

targeting the pre-clinical period before presenting the PREVENT

Project and EPAD


), a multi-million euro IMI-

Horizon 2020 funded project for the development of pre-clinical

proof of concept trials. Titles of the four presentations: 1. Setting

the scene: the evidence for pre-clinical change, projections of the

impact of intervention, and implications for public health (TCR) 2.

New statistical risk models for determining the impact of preven-

tion measures in the pre-dementia period (GMT) 3. The PREVENT

Study: a prospective cohort study to identify mid-life biomarkers

of late-onset Alzheimer’s disease (KR) 4. The European Prevention

of Alzheimer’s Dementia (EPAD) Project: developing interven-

tions for the secondary prevention of Alzheimer’s dementia


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

Symposium: Upscaling mental healthcare -

Implementing guidance and mental health care

recommendations in Europe


How can guidance recommendations

contribute to better mental health?

W. Gaebel

Heinrich-Heine-Universität, Düsseldorf, Germany


In European countries, the quality of mental health-

care services is often limited due to scarce and inequitable

distributed resources, and inefficient use of existing resources.

Against this background, the EPA Guidance provides recommen-

dations on how to optimize quality of mental healthcare for all

European countries.


Provision of guidance recommendations in order to

support optimization and harmonization of mental healthcare ser-

vices in European countries.


By means of evidence and consensus-based methods

EPA guidance papers are developed by experts in psychiatry and

related fields

[1] .


As of 2012, five EPA guidance series have been developed

and published

[2] . T

hey focus on various aspects of mental health-

care and clinical situations that have not been covered by medical

guidelines yet but are considered important to deliver high quality

mental healthcare. Papers deal amongst others with topics relating

to quality assurance of mental health services, as quality of men-

tal health service structures and processes, and building trust in

mental health services.


EPA guidance recommendations can improve men-

tal healthcare provision and thereby contribute to better mental

health of persons receivingmental healthcare. For this purpose, rec-

ommendations need to be widely disseminated and implemented

in European countries.

Disclosure of interest

Unterstützung bei Symposien/Symposia


Janssen-Cilag GmbH, Neuss

Aristo Pharma GmbH, Berlin

Lilly Deutschland GmbH, Bad Homburg

Servier Deutschland GmbH,



glied/Faculty Member

Lundbeck International Neuroscience Foundation (LINF), Däne-



[1] Gaebel W, Becker T, Janssen B, Munk-Jorgensen P, Musalek M,

Rössler W, Sommerlad K, Tansella M, Thornicroft G, Zielasek

J. EPA guidance on the quality of mental health services. Eur

Psychiatry 2012;27:87–113.

[2] Gaebel W, Möller H-J. European Guidance - a project of

the European Psychiatric Association. European Psychiatry



Implementation of EPA guidance -

One way for all countries?

M.M. Carrasco

Instituto de Investigaciones Psiquiátricas, Spain

The European Psychiatric Association (EPA) guidance project

launched in 2008 has the aim of providing European psychiatry

with guidance in topics, which are relevant for European mental

health care. Guidance from a European perspective can be favor-

able against the background of a growing sense of Europe and

the desirable associated harmonization on all levels of health care