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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S303–S364


In order to attain a sustainable long termeffects of the

proposed treatment, it is recommended that patients be reminded

on their next schedule of treatment.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Who did it? Exploring gaze agency in

obsessive-compulsive (OC) checkers

M. Giuliani

1 ,

, R . G

regori Grigc

2 , 3 , 4 , R .M

. Martoni

1 ,

M.C. Cavallini

1 , S.A

. Crespi

2 , 3 , 4 , 5 , C . d


2 , 3 , 4


IRCCS San Raffaele, department of clinical neurosciences, Milan,



Vita-Salute San Raffaele university, laboratory of action perception

cognition, Milan, Italy


Vita-Salute San Raffaele university, faculty of psychology, Milan,



IRCCS San Raffaele, division of neuroscience, Milan, Italy


IRRCS San Raffaele, CERMAC neuroradiology department, Milan,


Corresponding author.


Clinically, OC-checkers often report staring compul-

sions and “lack of action completion” sensations, which have

been linked to self-agency alterations. Belayachi and Van der

Linden (2009) theoretically proposed that “abnormal” checkers

self-agency could be due to an over-reliability on environmen-

tal cues and to a tendency to specify actions in a procedural and

inflexible way, conceiving them as “low-level” agents. Currently,

no studies have experimentally address this issue.


To investigate self-agency in OC-checkers subtype,

measuring gaze agency (the ability to understand that we can cause

events through our eye movements) and taking into account both

agency beliefs and agency feelings.


13 OC-checkers and 13 healthy controls underwent two

tasks. “Discovery” task, a completely novel task used to examine

causal learning abilities. Subjects watched bouncing balls on a com-

puter screen with the aim of discovering the cause of concurrently

presented acoustical beeps. “Detection” task, a two-alternative for-

ced choice task that required subjects to tell whether or not the

beeps were generated by their own eye movements.


Checkers exhibit:

– lower performance scores and confidence ratings when they have

to self-attribute the beep cause, but not eye behavioral differences,

during discovery task;

– lower confidence ratings, but a level of accuracy similar to that of

controls, during detection task.


Checkers do not show an altered self-agency per se,

but what we have called a “doubtful” self-agency: indeed, we argue

that agency beliefs alterations found during Discovery task can be

due to pathological doubt, rather than to altered agency feelings.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Paroxetine concentrations in

obsessive-compulsive disorder:

Support for a therapeutic interval

M.B. Humble

1 ,

, M. Reis



Örebro university, school of medical sciences, Örebro, Sweden


University health care in Region Skåne, department of clinical

chemistry, division of laboratory medicine, Lund, Sweden

Corresponding author.


Previous studies of concentrations of serotonin

reuptake inhibitors (SRIs) versus therapeutic efficacy have yiel-

ded inconsistent results. Even if the relationships between the

individual’s serotonergic system and the clinical symptoms of

obsessive-compulsive disorder (OCD) are poorly understood, the

SRIs are consistently effective in OCD. However, studies on SRI

concentrations in OCD treatment are rare.


To identify possible links between paroxetine

concentrations and anti-obsessive response.


In a randomised, double-blind trial, comparing clo-

mipramine, paroxetine and placebo in OCD treatment, serum

paroxetine levels were measured after 1 week and after 4 weeks

of treatment in 18 patients. Anti-obsessive response was asses-

sed with Yale-Brown obsessive compulsive scale (Y-BOCS) and

patients’ global evaluation (PGE), after 12 weeks of treatment.


Serum paroxetine concentrations after 4 weeks sug-

gested a therapeutic interval between 50 and 240 nmol/L

(13–63 ng/mL). The mean Y-BOCS decrease was 54% inside versus

7% outside this interval (


= 3.96;


= 0.0011).


Paroxetine levels seemingly predicted clinical out-

come. Studies with a greater number of patients are necessary in

order to confirm this finding and to discern whether it is useful in

clinical practice.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Augmentation in profound,

SRI-refractory OCD: Is aripiprazole

superior to other to other dopamine


I. Pampaloni

, H. Tyagi , L. Drummond

South West London and St Georges mental health NHS trust, national

services for OCD and BDD, London, United Kingdom

Corresponding author.


OCD is a common disorder, affecting 1% of the popu-

lation and usually responds to treatment with serotonin reuptake

inhibitors (SRIs) or exposure and response prevention (ERP) and

to augmentation with antipsychotics. However, some patients fail

to respond. The national inpatient unit for obsessive compulsive

disorder (OCD) and body dysmorphic disorder (BDD) (i) is the only

24-hour staffed inpatient facility for OCD in the UK and treats

patients with profound, treatment-refractory OCD. There is evi-

dence of efficacy of aripiprazole in augmenting SRI sin severe OCD



To compare the efficacy of aripiprazole versus other

antipsychotics as SRI augmentation.


One hundred and nine patients admitted to the unit

between March 2006 and September 2011 and discharged on an

antipsychotic and an SRI were included. The Yale-Brown obsessive

compulsive scale (YBOCS) was administered at admission and at

discharge. Data were analysed using SPSS version 23 using analysis

of variance (ANOVA). Two groups were compared: those receiving

SRI + aripiprazole versus those receiving SRI + another antipsycho-



sixty-two patients received SRI with aripiprazole and 47

SRIs with another antipsychotic. Overall, patients showed impro-

vement, with an average YBOCS reduction of 11.7 (33% reduction).

Patients taking aripiprazole improved by an average of 13 (36%



< 0.05).


Patients of the national unit with severe, treatment

refractory OCD treated with aripiprazole augmentation showed a

greater improvement than those on other antipsychotics. Further

research into aripiprazole in OCD is warranted.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.