European Psychiatry - Volume 41 - April 2017

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S174 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237
EW0199
Psychotropic use in elderly with
cognitive impairment living in
nursing homes
A.R. Ferreira , S. Martins ∗, C. Dias , M.R. Simões ,
L. Fernandes
1 PhD Program in Clinical and Health Services Research/PDICSS,
Health Information and Decision Sciences Department, Faculty of
Medicine, University of Porto, Porto, Portugal
2 CINTESIS–Center for Health Technology and Services Research,
Faculty of Medicine, University of Porto, Porto, Portugal
3 Health Information and Decision Sciences Department, FMUP,
Center for Health Technology and Services Research/CINTESIS, Faculty
of Medicine, University of Porto, Porto, Portugal
4 Psychological Assessment Laboratory, CINEICC, Faculty of
Psychology and Educational Sciences, University of Coimbra,
Coimbra, Portugal
5 Department of Clinical Neuroscience and Mental Health, CINTESIS,
Faculty of Medicine, University of Porto, Porto, Portugal
∗ Corresponding author.
Introduction Elderly patients in nursing homes (NH) are often
prescribed medications for many physical and mental health prob-
lems, withpolypharmacy. There is a considerable number of studies
documenting this extensive prescription of psychotropic medica-
tion, despite the raised concerns about their overuse/misuse, due to
serious adverse effects, including increased rate of cognitive decline
associated with antipsychotics.
Aims To characterize the prescription of psychotropics in elderly
sample with cognitive impairment living in NH.
Methods Elderly living in three Portuguese NH were included
in this cross-sectional study. All residents were eligible, unless
they were unwilling or unresponsive. Participants’ medication was
obtained frommedical records. Guidelines of ATC were used to cat-
egorize the drugs. Participants were assessed with MMSE and GDS.
Results The sample included 172 elderly, mostly women (90%),
with average of 81(sd = 10) years and median lengths of stay of
3 years. Overall, 79.1% used ≥ 1 nervous system-acting drugs. Anxi-
olytics (54.7%), antidepressants (29.1%) and antipsychotics (23.3%)
were the most frequent. The majority (58%) presented cognitive
impairment (MMSE). Among those, 46.2% presented depression
(GDS) and 79.6% took at least one drug for the CNS and 41.9% ≥ 3.
Antipsychotics were received by 26.5%, while 57.1% used anxio-
lytics, 31.6% antidepressants and 16.3% anti-dementia drugs. No
significant relation between GDS and antidepressants was found.
Conclusion This study confirms the high usage of CNS drugs
in patients with cognitive impairment in NH. These rates were
comparable with previous studies. Antidepressants appear to be
under-used, which can be related to the under-recognition of
depression. Also, potential harmful psychotropic drugs such as
anxiolytics and antipsychotics are overused.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0200
A systematic review of association
between pain and suicidal behavior in
elderly people
J. Santos , S. Martins ∗, L.F. Azevedo , L. Fernandes
1 Faculty of Medicine, University of Porto, Porto, Portugal
2 CINTESIS, Center for Health Technology and Services Research,
University of Porto, Porto, Portugal
3 Department of Community Medicine, Information and Health
Decision Sciences, MEDCIDS, Porto, Portugal
4 Clinic of Psychiatry and Mental Health, CHSJ, Porto, Portugal
∗ Corresponding author.
Introduction Suicide rates worldwide are highest in elderly peo-
ple compared to younger ages. The recognition of risk factors for
late life suicide may be crucial, since one in four attempts is con-
summated. In this context, pain has been identified as a major
event raising the probability for suicide in elders although very little
research has examined this association.
Objective To conduct a systematic review to examine
whether pain is a risk factor for suicidal behaviour (suicide
ideation/attempt/suicide) in elderly people.
Methods The Cochrane Collaboration’s guidelines and PRISMA
statement were used. The electronic databases considered were
MEDLINE, ISI Web of Knowledge, Scopus and PsycARTICLES. Search
terms were “pain”, “suicide *” and “elderly”. Studies that assessed
the relation between pain and suicidal behavior among people
aged ≥ 60 years were included.
Results Of the 2655 references founded, only 41 articles met the
inclusion criteria. Most of the quantitative studies concluded that
there is a relationship between pain and late life suicidal ideation,
in particular severe and chronic pain. Physical or psychological pain
was also reported as the cause of attempting suicide in two studies
and was considered an important risk factor for committed suicide
in eight of them.
Conclusion The results suggest that pain is a risk factor for sui-
cidal behaviour in elderly people, especially suffering from severe
and chronic pain, which are in accordance with previous reviews
in this field. Future studies are needed to clarify this association
and highlight about the importance of pain in suicide prevention
initiatives for elders.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0201
Predictive factors of hospitalization
related to the caregiver burden in
older adults presenting to the
emergency department
G. Mattei ∗ oldoni ariani Casu occaletti
S. Ferrari , L. Ligabue , A. Colantoni
1 ARPSY, Association for Research in Psychiatry, Castelnuovo
Rangone, Italy
2 University of Modena and Reggio Emilia, Department of Clinical,
Diagnostic and Public Health Medicine, Modena, Italy
3 Progetto Anziani, AOU Policlinico di Modena, Modena, Italy
4 Anziani e Non solo, SocCoop, Carpi, Italy
∗ Corresponding author.
Background Long-term care for the elderly by their family
members represents a serious burden in Italy. The physical and
psychological health of informal caregivers is a growing public
health issue. Old patients often seek urgent medical attention in the
Emergency Department (ED) and hospitalisation is frequent event
among the elderly.
Aim Aim of the study was (1) to investigate the burden of care
among the caregivers of old patients; (2) to examine the influence
of the burden experienced by the caregivers on ED and hospital
admissions of the elderly.
Methods We conducted a descriptive study of patients aged
75 years or older and their caregiver admitted to the ED from
10/1/15 to 6/10/15 (77 patient-caregiver pairs). The caregivers
were evaluated using the Caregiver Burden Inventory (CBI). A case
manager collected the patient’s data.
Results CBI score is the highest among patients seeking ED eval-
uation due to caregiver’s concern. The majority of the elderly
admitted to the ED whose caregiver shows elevated emotional
burden at the CBI do not present with serious or urgent medical
condition and are not hospitalised. Emotional burden is the high-