European Psychiatry - Volume 41 - April 2017

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S236 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237
EW0382
The risk of depression and anxiety in
the post-diagnostic period of multiple
sclerosis measured by screening
instruments and structured
interviews
H. Hoang ∗, E. Stenager , E. Stenager
1 Institute of Regional Health Service, Research Unit of Mental Health,
University Hospital of Southern Denmark, Odense, Denmark
2 Institute of Regional Health Service, Department of
Neurology – Sønderborg, Odense, Denmark
∗ Corresponding author.
Objective To examine the risk of depression and anxiety in MS
patients in the post-diagnostic period by using clinical screening
instruments and a diagnostic structured clinical interview.
Method A population of 134 MS patients was examined for the
risk of depression and anxiety in the post-diagnostic period of MS
using the clinical screening instruments Beck Depression Inven-
tory (BDI) and Hospital Anxiety and Depression Scale (HADS).
Within six weeks of diagnosis, patients with cut-off > 12 for BDI
and > 7 for HADS were offered a clinical structured interview using
the Schedules for Clinical Assessment in Neuropsychiatry/SCAN
Version 2.1.
Results The prevalence of depressive symptoms and depression
in the post-diagnostic period of MS was 49.2% when using the
screening instruments, but only 15.2% when using the SCAN inter-
view. For anxiety, the prevalence was 3.4% for both the screening
instruments and the SCAN interview in the post-diagnostic period
of MS.
Conclusion MS patients have a risk of depression and anxiety
in the post-diagnostic period of MS, but it is crucial to consider
which tools to use in a clinical setting to investigate depression
and anxiety in MS patients.
Keywords Multiple sclerosis; Psychiatric co-morbidity;
Depression; Anxiety; HADS; BDI-II; Diagnostic interview
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0383
Psychosis induced by interferon- –A
limitation of treatment
M. Marinho ∗, M. Mota-Oliveira , J. Marques , M. Braganc¸ a
1 São João Hospital Centre, Clinic of Psychiatry and Mental Health,
Porto, Portugal
2 Local Healthcare Unit of Matosinhos, Clinic of Psychiatry,
Matosinhos, Portugal
∗ Corresponding author.
Introduction Psychosis is an uncommon but serious complication
of treatment with interferon- , a cytokine frequently used to treat
several infectious and malignant diseases.
Objectives To provide an overview of interferon- -induced psy-
chosis.
Methods Literature reviewbased onPubMed/MEDLINE, using the
keywords “interferon- ” and “psychosis”.
Results Psychotic symptoms usually emerge between 6 to 46
weeks and on average 3 months after the start of interferon-
treatment, occurring most frequently in the form of persecutory,
guilt or grandeur delusions and auditory hallucinations. Often they
are accompanied by mood symptoms, anxiety, attention distur-
bances and insomnia. Many factors are known to increase the
risk of psychiatric effects as a whole associated with interferon-
. Pathogenesis of interferon-induced psychosis remains unclear,
however several theories have been discussed, namely the over-
lap influence of biological vulnerability and the cytokine’s action
on the brain. Dopaminergic, opioid, serotoninergic and glutamin-
ergic pathways as well as hypothalamic-pituitary-adrenal axis
hypersensitivity are some of the hypotheses raised about the
underlying cause of that susceptibility. Psychosismanagement usu-
ally includes stopping interferon- and introducing antipsychotics
with minimal antidopaminergic effects and at the lowest possible
dose, due to the increased risk of extrapyramidal reactions in these
patients.
Conclusion The decision to use interferon-based treatments in
psychiatric patients should be highly individualized. Early recogni-
tion and adequate treatment of interferon-induced psychosismight
prevent subsequent emergence of serious debilitating symptoms.
Thus, it is very important that medical and psychiatric treatment
teams work closely together and are familiar with this important
subject.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0384
Depression among cancer patients–A
reality where therapeutic nihilism
cannot be accepted
M. Marinho ∗, J. Marques , M. Braganc¸ a
1 São João Hospital Centre, Clinic of Psychiatry and Mental Health,
Porto, Portugal
2 Local Healthcare Unit of Matosinhos, Clinic of Psychiatry,
Matosinhos, Portugal
∗ Corresponding author.
Introduction Cancer is a life-threatening disease, characterized
by a great deal of uncertainty and unpredictability. Thus, several
stressors and emotional upheavals pervade the everyday life of
cancer patients and can lead to the development of depression.
Objectives To review the recent research related to depression in
cancer patients.
Methods Literature reviewbased onPubMed/MEDLINE, using the
keywords “cancer” and “depression”.
Results It is estimated that 20–25% of cancer patients meet the
criteria for major depressive syndrome at some point in their ill-
ness. Depression is associated with a negative impact on treatment
adhesion, cancer progression and quality of life, besides increas-
ing suicide risk. However, it is often unrecognized and untreated.
Importantly, the mistaken belief that depressive symptoms are
expected in this group, the overlap between the neurovegetative
symptoms of depression, the somatic symptoms of cancer and its
treatment, as well as the effects of comorbid diseases make the
diagnosis of major depression so complex in these patients. Some
of the most helpful diagnostic indicators are feelings of hopeless-
ness, worthlessness, excessive guilt, loss of self-esteem, and wishes
to die. The several risk factors for the development of depres-
sion in cancer patients can be divided into four broad categories,
namely cancer-related factors, cancer treatment-related factors,
psychiatric history, and social factors. Effective management of
depression consists in a combination of psychotherapy and psy-
chopharmacology.
Conclusion Depression in cancer patients has serious conse-
quences, however appropriate psychiatric intervention can do it
over. Thus, its early recognition and appropriate management is
imperative.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.