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

Figure 1

Structural neuroimaging of the relationship between

joint hypermobility and anxiety. A. Insula structural differences in

anxiety disorder in those with hypermobility syndrome compared

to those without. B. Plot showing differences in insula volume. C.

Amygdala structural differences, demonstrating significant inter-

action between anxiety status and degree of hypermobility. D. Plot

showing interaction between anxiety on the relationship between

amygdala volume and hypermobility source.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Psychiatry and primary care: A global

medical care

B. Gelas-Ample

1 ,

, L. Fau


, A. Bailly


, F. Pillot-meunier



Centre hospitalier Le Vinatier, Pôle Ouest, Bron, France


Centre hospitalier Le Vinatier, Pôle Mopha, Bron, France

Corresponding author.

Patients suffering from psychiatric disorders have a decrease in life

expectancy of 15 years compared to the general population. This

excess mortality is not related predominantly to suicide but mostly

to a higher frequency of somatic diseases, such as cardiovascular,

neoplastic, metabolic diseases. Their high prevalence and their low

diagnoses are related to a poorer access to screening, prevention

and somatic care than in the general population. Indeed, we esti-

mated that more than 60% of patients treated in public psychiatry

do not have a general practitioner (GP) in France. The GP has a role

in the coordination, prevention and management of patient health

care circuit. To allow a better access to general practitioner, a con-

sultation and a somatic network have been created in Lyon. The

purpose is to bring the user back into the primary care system, to

ensure a durable monitoring, and a better prevention of avoidable

diseases. Patients without GP are oriented to the consultation by

their referent psychiatry team. During three consultations with a

doctor and a nurse, an assessment of the patient’s overall health is

realized as well as a synthesis and a redirection to the city network.

This reinstatement also allows a better communication between

somatic and psychiatric care, to insure a more global view of the

patient. A work around the re-empowerment and social rehabili-

tation is carried out to re-anchor the person in the city and in the

care, which every citizen is entitled.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Efficacy and safety of antidepressants

as analgesics in chronic pain: A review

J. Fennema

1 ,

, S. Petrykiv


, L. de Jonge


, M. Arts



GGZ Friesland, Geriatric Psychiatry, Leeuwarden, The Netherlands


University of Groningen, University Medical Center Groningen,

Department of Clinical Pharmacy and Pharmacology, Groningen, The



Leonardo Scientific Research Institute, Department of Geriatric

Psychiatry, Groningen, The Netherlands


University of Groningen, University Medical Center Groningen,

Department of Old Age Psychiatry, Groningen, The Netherlands

Corresponding author.


Due to the aging population worldwide, chronic

pain is becoming an important public health concern. Chronic

pain is bidirectional associatedwith psychiatric disorders including

depression and anxiety. Antidepressants are widely used as adju-

vant therapy for the treatment of chronic pain for many disorders.

Objectives and aims

To review available literature on the effi-

cacy and safety of antidepressants for the treatment of chronic

pain, including neuropathic pain, fibromyalgia, low back pain, and

chronic headache or migraine.


We performed a detailed literature review through

PubMed, EMBASE and Cochrane’s Library to assess the efficacy and

safety of antidepressants in chronic pain conditions.


In neuropathic pain, fibromyalgia, low back pain,

and chronic headaches/migraine, tricyclic antidepressants (TCAs)

showed a significant analgesic effect. Selective serotonin reup-

take inhibitors (SSRIs) are not effective for the treatment of

low back pain and headaches or migraine. Venlafaxine, a sero-

tonin norepinephrine reuptake inhibitor (SNRI) showed significant

improvement of fibromyalgia and neuropathic pain. Duloxetine

(SNRI) also reduced the pain in fibromyalgia.


TCAs are the ‘gold standard’ antidepressant anal-

gesics. However, an electrocardiogram and postural blood pressure

should be implemented prior to TCA treatment and TCAs should be

initiated at low dosages and subsequently increased to the maxi-

mum tolerated dose. One should pay attention to their cardiotoxic

potential, especially in the older population. For the treatment of

neuropathic pain, SNRIs are second-line agents. Although better

tolerated, inmost types of chronic pain conditions, the effectiveness

of SSRIs is limited. To conclude: start low, go slow, and prescribe

with caution.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Exploring the correlation between

perceived attachment security and

levels of GH hormone in a sample of

children with non-organic failure to

thrive: Preliminary findings

M. Fojanesi


, M. Gallo


, F. Russo


, M. Valentini


, M. Spaziani



A. Radicioni


, F.S. Bersani

1 ,

, M. Biondi



Sapienza University of Rome, Department of Psychiatry, Rome, Italy


Sapienza University of Rome, Department of Endocrinology, Rome,


Corresponding author.


Short stature caused by growth hormone (GH) defi-

ciency is one of the causes of the “Failure to Thrive” (FTT) condition.

In absence of clear organic causes, several different psychoso-

cial conditions may play a role in explaining the FTT phenotype.

Advances in developmental psychology have highlighted the role

of emotions and caregiving behaviors in the organization of child’s

personality and psychobiology, with the mother–son attachment