European Psychiatry - Volume 41 - April 2017

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S234 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.
EW0377
Psychiatry and primary care: A global
medical care
B. Gelas-Ample ∗, L. Fau , A. Bailly , F. Pillot-meunier
1 Centre hospitalier Le Vinatier, Pôle Ouest, Bron, France
2 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.
EW0378
Efficacy and safety of antidepressants
as analgesics in chronic pain: A review
J. Fennema ∗, S. Petrykiv , L. de Jonge , M. Arts
1 GGZ Friesland, Geriatric Psychiatry, Leeuwarden, The Netherlands
2 University of Groningen, University Medical Center Groningen,
Department of Clinical Pharmacy and Pharmacology, Groningen, The
Netherlands
3 Leonardo Scientific Research Institute, Department of Geriatric
Psychiatry, Groningen, The Netherlands
4 University of Groningen, University Medical Center Groningen,
Department of Old Age Psychiatry, Groningen, The Netherlands
∗ Corresponding author.
Introduction 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.
Methods 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.
Results 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.
Conclusion 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.
EW0379
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 ∗, M. Biondi
1 Sapienza University of Rome, Department of Psychiatry, Rome, Italy
2 Sapienza University of Rome, Department of Endocrinology, Rome,
Italy
∗ Corresponding author.
Introduction 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