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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.


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-


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?


Results of the implementation of a

Spanish computerized guideline for

depression in primary care

D. Palao Vidal

1 ,

, M. Cavero


, J.A. Monreal


, J.M. Bonet



M.D. Moreno


, V. Peréz -Solà



Parc Tauli Sabadell hospital universitari, mental health, Sabadell,



Institute of neurociencies. hospital clinic., community mental health

center, Barcelona, Spain


Parc Tauli- university hospital, mental health, Sabadell, Spain


Institut Català de la Salut, SAP, Barcelona, Spain


Institut Català de la Salut, SAP Cerdanyola i Sabadell, Sabadell, Spain


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.


To evaluate the effects of a multifactor process of

implementation of the e-CPG MD, analyzing its use and the key

clinical outcomes.


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



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).


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.


Internet based interventions and

patient generated bio- and

self-monitoring data: How to use

them for self-management in

affective disorders

U. Hegerl

1 ,

, C. Sander


, N. Koburger



Universitätsklinikum Leipzig, department of psychiatry and

psychotherapy, Leipzig, Germany


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.