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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302



Investigation of salivary cortisol

response to awakening in

underweight and weight-restored

patients with anorexia nervosa

F. Pellegrino

1 ,

, A.M. Monteleone


, M. Nigro


, V. Ruzzi



M. Cimino


, U. Volpe


, P. Monteleone



Second University of Naples, Department of Psychiatry, Naples, Italy


University of Salerno, Department of Medicine and Surgery, Salerno,


Corresponding author.


Anorexia nervosa (AN) is characterized by dysreg-

ulated eating that leads to chronic malnutrition, which may be

responsible for several physical complications, including endocrine

alterations, such as hyperactivity of the hypothalamus-pituitary-

adrenal (HPA) axis.


Several studies have shown a dysregulation of the

cortisol awakening response (CAR) in symptomatic AN patients.

However, it has not been established if the deranged CAR of under-

weight AN patients is a primary phenomenon or an alteration

secondary to malnutrition.


The aim of this study was to explore the salivary CAR in

both underweight and weight-restored patients with AN.


We recruited 59 women: 18 undernourished AN

patients, 15 weight-restored AN women and 26 normal-weight

healthy controls. Saliva samples were collected in the morning,

immediately after awakening and after 15, 30 and 60minutes, in

order to measure saliva levels of cortisol. Participants filled in the

state-trait anxiety inventory (STAI) to test their anxiety levels in

the morning of the test.


Compared to healthy controls, underweight AN patients

showed an enhanced CAR whereas the weight recovered patients

had a normal CAR. These results were not correlated with levels of



For the first time, our results demonstrate that the

deranged CAR found in acute AN patients is not present in weight-

restored ones, suggesting that altered activity of the HPA axis of

symptomatic AN patients is a state-dependent phenomenon.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Tracking insomnia seasonal variations

through consumption of hypnotics

I.P. Gradiˇski

1 ,

, P. Bili´c


, T. Sabo


, M. Vilibi´c



University Psychiatric Hospital Vrapˇce, Zavod za dualne

poreme´caje, Zagreb, Croatia


University Psychiatric Hospital Vrapˇce, Zavod za biologijsku

psihijatriju i psihogerijatriju, Zagreb, Croatia

Corresponding author.


Light-stimulated release of melanopsin suppresses

the nocturnal production of melatonin and is sending signals

to multiple brain areas, including hypothalamic suprachiasmatic

nuclei and thus controlling the release of the pineal hormone mela-

tonin and therefore control the circadian rhythm. Consumption

of sedatives and hypnotics was used as an indirect measure of

seasonal variations in sleep disturbances among inpatients at Uni-

versity Psychiatric Hospital Vrapˇce.


Retrograde record analysis was performed from1st Jan-

uary to 31st December 2012 on commonly used hypnotics and

sedatives: zolpidem, nitrazepam, flurazepam, and midazolam.


The lowest consumption of hypnotics was recorded in

the months of November, August and September while the highest

consumption was recorded in January, December andMarch which

can be seen in

Fig. 1 . A

lthough therewere differences in themonthly

prescription of hypnotics, when it comes to seasonal patterns, there

are no statistically significant differences.


There is no significant difference between the con-

sumption of hypnotics in the observed seasons although the

consumption of hypnotics is higher in the months with shorter

daylight. This study attempted to correlate exposure to light and

insomnia through the prescription of hypnotics and it is possible

there are other important variables not included in this study.

Fig. 1

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Antidepressants-induced sexual


H. Ben Ammar , G. Hamdi

, H. Z

alila , Z. El Hechmi

Razi Hospital, F, Mannouba, Tunisia

Corresponding author.


For a long time, antidepressants sexual side effects

have been neglected. Currently, no reliable scientific data is avail-

able regarding the nature and frequency of sexual dysfunction

induced by antidepressants. The aim of our study was to evaluate

the prevalence and type of sexual dysfunction induced by antide-

pressants, and to identify factors associated with the occurrence of

these disorders.


A descriptive and analytical cross-sectional study

extending over a period of two week. For the purpose of

this research, a socio-demographic card, the Arizona Sexual

Experiences Scale (ASEX) and the Psychotropic-Related Sexual Dys-

function Questionnaire (SALSEX) were used.


Fifty-five patients were recruited. The diagnosis of major

depressive episodes was dominant (49.1%). Moreover, fluoxe-

tine and tricyclic were in top of the list of antidepressants with

respective proportions of 41.8% and 38.2% and respective dose

20.86mg/24 h and 72.38mg/24 h. The score using the ASEX scale

was 14.63


5.23. Using the SALSEX scale, 47.3% of patients claimed

to have had sexual disorders secondary to antidepressants with a

moderate score of 9.19


2.56. Furthermore, sexual disorders were

more common in the elderly aged of 45 (66.66%) as well as in

patients started on paroxetine (66.66%) and on sertraline (66.66%)





The sexual side effects of antidepressants have a

major impact on the quality of life and adherence to treatment.

They also represent an important risk factor for relapse and recur-

rence in major depression, in this context, the prescription of an