European Psychiatry - Volume 41 - April 2017

237 / 916

25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237 S233
Objectives and aims To report and discuss the consequences of
bariatric surgery on changes in antidepressant drug absorption.
Methods We present all published in vitro and in vivo studies on
antidepressant drug absorption after bariatric surgery.
Results 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.
Conclusion 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-
ance.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0375
Differential effect of childhood
trauma subtypes on fatigue and
physical functioning in chronic
fatigue syndrome
M. De Venter ∗, J. Illegems , R. Van Royen , B. Sabbe ,
G. Moorkens , F. Van Den Eede
1 Campus Antwerp University Hospital UZA, University Psychiatric
Department, Edegem, Belgium
2 Antwerp University Hospital UZA, Behaviour Therapy Division for
Fatigue and Functional Symptoms, Edegem, Belgium
3 Antwerp University Hospital UZA, Department of Internal Medicine,
Edegem, Belgium
4 Campus Psychiatric Hospital St.-Norbertus, University Psychiatric
Department, Duffel, Belgium
∗ Corresponding author.
Objective 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.
Methods 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.
Results 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.
Conclusion 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.
EW0376
Joint hypermobility syndrome and
anxiety disorder: Structural brain
correlates
J. Eccles ∗, J. Tung , N. Harrison , C. Mathias ,
H. Critchley
1 Brighton and Sussex Medical School, Neuroscience, Brighton, United
Kingdom
2 Sussex Partnership NHS Foundation Trust, Psychiatry, Worthing,
United Kingdom
3 Hospital of St John and St Elizabeth, Autonomic & Neurovascular
Medicine Unit, London, United Kingdom
4 Insitute of Neurology, University College London, London, United
Kingdom
5 University of Sussex, Sackler Centre for Consciousness Science,
Falmer, United Kingdom
∗ Corresponding author.
Introduction 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.
Method 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 P < 0.001.
Results Comparison of grey matter volume revealed increased
insular volume in anxious patients with JHS/EDS-III compared to
anxious patients without , 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 , D). Amygdala volume correlated with
interoceptive accuracy.
Conclusions 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.