European Psychiatry - Volume 41 - April 2017

26 / 916

S22 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52
obsessive (OCD), by assessing three core dimensions of addiction
in patients with OCD and healthy participants. Similar to the com-
mon findings in addiction, OCD patients demonstrated increased
impulsivity, risky decision-making, and biased probabilistic rea-
soning compared to healthy controls. During the presentation we
will discuss the behavioral addiction model of OCD by focusing on
common neuropsychological and neurobiological circuitries.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
S047
Pharmacological management of
impulsivity and compulsivity
G. Dom
Antwerp university ua and hospital uza, collaborative psychiatric
research institute, Boechout, Belgium
Increasingly patients present themselves to psychiatrists and other
care providers with a specific request for treatment of one or more
behavioral addictions. From a pathogenic point of view impulsi-
vity and compulsivity are important drivers of these behavioral
disorders, and as such may represent a target of pharmacologi-
cal and broader neurobiological, e.g. Neuro-stimulation, treatment.
Although currently treatment as usual has a focus on psychosocial
and cognitive behavioral interventions, interest is growing toward
the pharmacological interventions. In the presentation a state of
the art will be presented regarding the pharmacological treatment
of behavioral addictions, with a focus on Gambling Disorder and
Gaming Disorder.
Disclosure of interest Member Advisory Board Lundbeck - Bel-
gium.
Received funding from Belgian LOTTO for research into Cognitive
Behavioral Therapy for Gambling Disorder.
Symposium: New IT (information technology)
applications in mental health: how we can
improve outcomes?
S048
Results of the implementation of a
Spanish computerized guideline for
depression in primary care
D. Palao Vidal ∗, M. Cavero , J.A. Monreal , J.M. Bonet ,
M.D. Moreno , V. Peréz -Solà
1 Parc Tauli Sabadell hospital universitari, mental health, Sabadell,
Spain
2 Institute of neurociencies. hospital clinic., community mental health
center, Barcelona, Spain
3 Parc Tauli- university hospital, mental health, Sabadell, Spain
4 Institut Català de la Salut, SAP, Barcelona, Spain
5 Institut Català de la Salut, SAP Cerdanyola i Sabadell, Sabadell, Spain
6 Institut of neuropsychiatry and addictions- Parc de Salut Mar,
mental health, Barcelona, Spain
∗ Corresponding author.
A new computerized CPG for Major Depression (e-CPG-MD) was
integrated in electronic medical records of primary care in a 7 mil-
lion population in Catalonia (Spain). An integrated design allows
precise access in each patient visit, improving diagnosis, treat-
ment and follow-up. It facilitates an evaluation of suicide risk in
depressed patients.
Objective To evaluate the effects of a multifactor process of
implementation of the e-CPG MD, analyzing its use and the key
clinical outcomes.
Methods A cluster randomized clinical trial was performed in
10 primary care centers (PCC) in Barcelona. In five of ten cen-
ters a multifaceted implementation process of the e-CPG-MD was
developed during 6 month. The others five PCCs received only an
usual diffusion. Themultifaceted process includes an establishment
of local implementation teams, an interactive training program,
regular feedback audits, educational outreach visits and periodic
reminders.
Results At six month, a greater proportion of new MD patients
from active PCCs were included in the e- CPG-DEP (4.1% + 3.1% vs.
52.7% + 7.3%, p < 0.001); the incidence of MD diagnostics of Major
Depression increased significantly (rate quotient = 1.56, p < 0.001)
and the proportion of cases with moderate and severe MD too
(13.6% vs 41.1%, p = 0.002).
Conclusions Amultifaceted implementationmethod of an e-CPG-
MD increased significantly its uses, the registered incidence of MD
and improved the capacity of recognizing severity. Further analysis
is necessary in order to determine the impact on clinical outcomes.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
S049
Internet based interventions and
patient generated bio- and
self-monitoring data: How to use
them for self-management in
affective disorders
U. Hegerl ∗, C. Sander , N. Koburger
1 Universitätsklinikum Leipzig, department of psychiatry and
psychotherapy, Leipzig, Germany
2 German depression foundation, german depression foundation,
Leipzig, Germany
∗ Corresponding author.
Even in developed countries only a small minority of patients with
depression and bipolar disorders receives treatment according to
guidelines and the treatment gaps are especially pronounced con-
cerning psychotherapy.
A variety of digital and internet based interventions have been
developedmainly building on the principles of Cognitive Behavioral
Therapy (CBT). A quite consistent finding is superiority compared
to control groups with largest effect sizes when compared to wait-
ing list controls, however the evidence provided by such studies
is questionable. More support for efficacy is provided by stud-
ies showing a comparable efficacy compared to face-to-face CBT,
however sufficiently powered non-inferiority studies compared to
antidepressants or face-to-face therapy are needed. Such studies
are necessary for deciding whether digital intervention should be
integrated in the health care system mainly as a self-management
tool or as an alternative to regular treatment with psychotherapy
or pharmacotherapy.
A dynamic new area of research explores the value for
self-management and treatment decision of longitudinal data
generated by the patient via self-ratings, wearables and other
biosensors as well as the pattern of smartphone use. Within the
BMBF-funded study STEADY a platform will be developed which
allows the individual patient to securely store and integrate these
data and to analyze them using analytic tools involving time series
analyses. An overview will be given of similar approaches started
in the last years within mental health.
Disclosure of interest Within the last three years, Prof. Hegerl was
an advisory board member for Lundbeck, Takeda Pharmaceuticals,
Servier and Otsuka Pharma a consultant for Bayer Pharma and a
speaker for Medice Arzneimittel, Novartis and Roche Pharma.