European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry
e-Poster Walk part 3
e-Poster Walk: Depression – part 2
EW0388
Genetic variants in the ABCB1 gene
determine bioavailability of
antidepressants in the brain
E. Holsboer-Trachsler ∗, B. Breitenstein , T. Kirmeier ,
F. Holsboer
1 Psychiatric Clinics UPK of the University of Basel, Center for
Affective, Stress and Sleep Disorders, Basel, Switzerland
2 HMNC Brain Health, None, Munich, Germany
∗ Corresponding author.
Introduction Antidepressants are the first-line treatment of
major depressive disorder, but response rates following the first
antidepressant medication are moderate.
Objectives Clinical efficacy requires to overcome the blood-brain
barrier where p-gp molecules are located. If they recognize and
bind an antidepressant, they pump it back into the circulation. If
the antidepressant is not recognized, the passage is not impaired
by p-glycoproteins.
Aims We studied whether variants in the ABCB1 gene that
encodes the p-glycoprotein have an effect on blood-brain passage
of antidepressants and as consequence on their clinical benefit.
Methods ABCB1 gene variants were determined with sequencing
(Illumina Bead), substrate property analysis employed mice with
deletion of ABCB1-analog genes. Clinical protocols followed those
of the MARS-project.
Results – The SNPs rs2032583 and rs2235015 provide the best
clinical information about blood-brain-penetrance, with CC/CT and
TT/GT being the favourable gene variants whereas TT and GG are
less favourable. This distinction holds only true if antidepressants
are p-glycoprotein substrates;
– in the presence of the favourable gene-variant patients treated
with an antidepressant that is a p-glycoprotein substrate are more
likely to remit in shorter time;
– in the presence of the less favourable gene-variant treatment with
a substrate, higher dosages and augmentation strategies, or switch
to non-substrates are recommended.
Conclusion From these data, a treatment algorithm was devel-
oped that maximizes treatment benefit and minimizes adverse
effects.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0389
Self-stigma and quality of life in
outpatients with depressive
disorder – a cross-sectional study
M. Holubova ∗, J. Prasko , M. Ociskova , M. Marackova ,
A. Grambal , M. Slepecky
1 University of Palacky Olomouc, Department of Psychiatry, Olomouc,
Czech Republic
2 Regional Hospital Liberec, Department of Psychiatry, Liberec, Czech
Republic
3 Constantine the Philosopher University in Nitra, Department of
Psychology Sciences, Nitra, Slovak Republic
∗ Corresponding author.
Background Self-stigma is a maladaptive psychosocial phe-
nomenon that may disturbmany areas of patient’s life and have the
negative impact on their quality of life. The present study explored
the association between self-stigma, quality of life, demographic
data, and the severity of symptoms in patients with depressive
disorder.
Method Patients, who met ICD-10 research criteria for depres-
sive disorder, were enrolled in the cross-sectional study. All
probands completed these measurements: the Quality of Life
Satisfaction and Enjoyment Questionnaire (Q-LES-Q), the Inter-
nalised Stigma of Mental Illness Scale (ISMI), demographic
questionnaire, and the severity of the disorder measured by
objective and subjective Clinical Global Impression severity scales
(CGI).
Results Eighty-one depressive patients (with persistent affec-
tive disorder – dysthymia, major depressive disorder or recurrent
depressive disorder) and 43 healthy controls contributed to the
study. Comparing with the healthy control group, there was a
lower quality of life in patients with depression. The level of self-
stigma correlated positively with total symptom severity score and
negatively with the quality of life. Multiple regression analysis
discovered that the overall rating of objective symptoms severity
and self-stigma were significantly associated with the quality of
life.
Conclusions Present study suggests the lower quality of life in
outpatients with depressive disorder in comparison with healthy
controls, and the negative impact of self-stigma level on quality of
life in patients suffering from depressive disorders.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
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