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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237


Objectives and aims

To report and discuss the consequences of

bariatric surgery on changes in antidepressant drug absorption.


We present all published in vitro and in vivo studies on

antidepressant drug absorption after bariatric surgery.


In vitro studies showed that only bupropion had a

significantly increased dissolution in a post-RYGB environment;

venlafaxine and citalopram showed no alteration of dissolution;

fluoxetine, paroxetine, sertraline, and amitryptiline had an signif-

icantly decreased dissolution in a post RYGB environment. Some

in-vivo studies reported that only citalopram and escitalopramhad

an increased dissolution.


After bariatric surgery, special caution is required in

patients using antidepressant medication because of the expected

changes in drug absorption, nutritional status, and electrolyte bal-


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Differential effect of childhood

trauma subtypes on fatigue and

physical functioning in chronic

fatigue syndrome

M. De Venter

1 ,

, J. Illegems


, R. Van Royen


, B. Sabbe



G. Moorkens


, F. Van Den Eede



Campus Antwerp University Hospital UZA, University Psychiatric

Department, Edegem, Belgium


Antwerp University Hospital UZA, Behaviour Therapy Division for

Fatigue and Functional Symptoms, Edegem, Belgium


Antwerp University Hospital UZA, Department of Internal Medicine,

Edegem, Belgium


Campus Psychiatric Hospital St.-Norbertus, University Psychiatric

Department, Duffel, Belgium

Corresponding author.


There is a large consensus concerning the important

aetiological role of childhood trauma in chronic fatigue syndrome

(CFS). In the current study, we examine the differential effect of

childhood trauma subtypes on fatigue and physical functioning in

patients with CFS.


One hundred and fifty-five participants receiving treat-

ment at the outpatient clinic for CFS of the Antwerp University

Hospital in Belgium were included in this study. Stepwise regres-

sion analyses were conducted with the outcomes of the total score

of the Checklist Individual Strength (CIS) measuring fatigue and the

physical functioning subscale of the medical outcomes short form-

36 health status survey (SF-36) as the dependent variables, and the

scores on the five Traumatic Experiences Checklist (TEC) subscales

as the independent variables.


Fatigue and physical functioning scores in CFS patients

were significantly predicted by sexual harassment only. A signifi-

cant effect of emotional neglect, emotional abuse and bodily threat

during childhood on elevated fatigue or reduced physical function-

ing levels could not be found.


There is a differential effect of childhood trauma sub-

types on fatigue and physical functioning in CFS patients. Sexual

harassment emerged as the most important predictor variable.

Therefore, childhood (sexual) trauma has to be taken into account

in assessment and treatment of chronic fatigue syndrome.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Joint hypermobility syndrome and

anxiety disorder: Structural brain


J. Eccles

1 , 2 ,

, J. Tung


, N. Harrison

1 , 2

, C. Mathias

3 , 4


H. Critchley

1 , 2 , 5


Brighton and Sussex Medical School, Neuroscience, Brighton, United



Sussex Partnership NHS Foundation Trust, Psychiatry, Worthing,

United Kingdom


Hospital of St John and St Elizabeth, Autonomic & Neurovascular

Medicine Unit, London, United Kingdom


Insitute of Neurology, University College London, London, United



University of Sussex, Sackler Centre for Consciousness Science,

Falmer, United Kingdom

Corresponding author.


Joint hypermobility syndrome/Ehlers Danlos III

(JHS/EDS III) is a common, connective tissue condition. This group

is over-represented in panic/anxiety disorders and exhibits auto-

nomic abnormalities and heightened interoceptive sensibility.

Previous neuroimaging in healthy volunteers with hypermobility

has observed differences in key emotional brain regions, notably

amygdala and insula.

Aims and objective To explore, in a clinical population, the

structural brain correlates underpinning the association between

JHS/EDS III and anxiety.


Seventy participants were divided into four experimen-

tal groups: (2


2 factor design: presence/absence of hypermobility;

presence/absence of anxiety). Hypermobility was assessed using

Brighton Criteria. All participants underwent brief tests of auto-

nomic function and interoception. Structural images were obtained

using a 1.5 T MRI scanner. Results are reported at whole brain

uncorrected significance threshold of


< 0.001.


Comparison of grey matter volume revealed increased

insular volume in anxious patients with JHS/EDS-III compared to

anxious patients without

( Fig. 1 A

, B), correlating with initial peak

heart rate on standing. Additionally, amygdala volume correlated

with hypermobility score in anxious patients, but not in non-

anxious individuals

( Fig. 1 C

, D). Amygdala volume correlated with

interoceptive accuracy.


This data implicates amygdala and insula as likely

neural substrates mediating clinical relationships between hyper-

mobility syndrome and anxiety, demonstrating the relevance of

autonomic and interoceptive influences on this relationship. Fur-

ther work hopes to explore functional and structural connectivity

between these regions in JHS/EDS-III.