European Psychiatry - Volume 41 - April 2017

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S172 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237
Table 1 Behavioral data (accuracy and response time) for healthy
controls and a MCI patients with different APOE 4 status.
Data are presented as mean ±standard deviation (SD). aMCI:
amnestic mild cognitive impairement; APOE: apoliprotein E;
HC: healthy controls.
aPost-hoc tests by Bonferroni’s analysis further revealed the
source of ANCOVA difference (P < 0.05, HC-APOE 4−vs. aMCI-
APOE 4 −).
bPost-hoc tests by Bonferroni’s analysis further revealed the
source of ANCOVA difference (P < 0.05, HC-APOE 4+vs. aMCI-
APOE 4+).
Table 2 ERP data (P300 amplitude) for healthy controls and aMCI
patients with different APOE 4 status.
Data are presented as mean ± standard deviation (SD); aMCI:
amnestic mild cognitive impairement; APOE: apoliprotein E;
HC: healthy controls.
aPost-hoc tests by Bonferroni’s analysis further revealed the
source of ANCOVA difference (P < 0.05, HC-APOE 4− vs. HC-
APOE 4+).
b Post-hoc tests by Bonferroni’s analysis further revealed the
source of ANCOVA difference (P < 0.05, aMCI-APOE 4− vs.
aMCI-APOE 4+).
c Post-hoc tests by Bonferroni’s analysis further revealed the
source of ANCOVA difference (P < 0.05, aMCI-APOE 4− vs. HC-
APOE 4 −).
dPost-hoc tests by Bonferroni’s analysis further revealed the
source of ANCOVA difference (P< 0.05, aMCI-APOE 4+ vs. HC-
APOE 4+).
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EW0195
Charles Bonnet Syndrome (CBS):
Successful treatment of visual
hallucinations due to vision loss with
agomelatine in three cases
H.C. Hsu ∗, Y.S. Huang , W.X. Fan , T.C. Chen
1 Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation,
Department of Psychiatry, Chia-yi county, Taiwan ROC
2 Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation,
Department of Neurology, Chia-yi county, Taiwan ROC
3 Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation,
Department of Ophthalmology, Chia-yi county, Taiwan ROC
4 Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation,
Department of Metabolism and Endocrinology, Chia-yi county,
Taiwan ROC
∗ Corresponding author.
Background CBS becomes more prevalent as the population ages.
CBS is characterized by the triad of impairment of vision, com-
plex visual hallucinations with insight, mentally normal people.
Although visual hallucinations in the elderly are often associated
with dementia with Lewy body, Alzheimer’s disease and delir-
ium, they are excluded from the diagnosis of typical CBS. Here,
we describe three typical CBS patients whose visual hallucina-
tions developed after bilateral severe visual impairment due to
diabetic retinopathy. The effectiveness of agomelatine adds to evi-
dence implicating serotonergic andmelatoninergic pathways in the
pathogenesis of visual hallucinations.
Case report The average age of these three patients (2 males and
1 female) is 71. Except for the visual hallucinations, all patients
showed no psychiatric symptoms or cognitive decline or neu-
rological focal signs. They were frequently upset by the fact of
hallucinating, fearing that they are losing their minds. They lived in
fear of impending insanity, guilty feeling, unhappymood, insomnia.
The frequency of visual hallucinations stopped with agomelatine
25mg/day for 3 weeks in these cases.
Discussion To our knowledge, this is the first report describing
the effectiveness of agomelatine in treating typical CBS patients
and indicates that agomelatine is an safer option for the treatment
of CBS, especially in the elderly, diabetic population. Therapeu-
tic options for CBS still remain poor and of uncertain benefit for
the individual patient. CBS has a high prevalence rate (0.4%–30%)
among the visually impaired. Clinicians must ask elderly people
with visual impairment whether they have hallucinations. Firm
reassurance that the syndrome is not related to mental illness is
a major relief to an elderly person burdened already with failing
vision.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0196
White matter hyperintensities as a
new predictor of driving cessation in
the elderly
K.Y. Lim ∗, S.J. Son , M. Jang , C.H. Hong
1 Ajou University School of Medicine, Department of Psychiatry,
Suwon, Republic of Korea
2 Ajou University School of Medicine, Psychiatry, Suwon, Republic of
Korea
∗ Corresponding author.
Background/aims Motor, perceptual, and cognitive functions
affect driving competence. White matter hyperintensities (WMH)
changes on brain MRI are associated structural brain changes along
with cognitive and motor performance. The aim of this study was
to investigate the association between WMH and driving ability in
the elderly.
Methods Participants (n = 540) were drawn from a nationwide,
multicenter, hospital-based, longitudinal cohort study. Each par-
ticipant underwent clinical evaluations, neuropsychological tests,
and interview for caregiver including driving capacity, which was
categorized as ‘now driving’, and ‘driving cessation (driving before,
not now)’. A total 540 participants were divided into three groups
(389 mild, 116 moderate, and 35 severe) depending on the degree
of WMH. The same evaluations of them were followed after each
year. The statistical analyses were performed using 2 test, an anal-
ysis of variance (ANOVA), structured equation model (SEM), and
generalized estimating equation (GEE).
Results In a SEM, greater baseline degree of WMH was directly
associated with driving cessation regardless of cognitive andmotor
dysfunction (ˇ = –0.110, P < 0.001). In GEE models controlling for
age, sex, education, cognitive, and motor dysfunction, the more
severe changes of the degree of WMH was associated with the