European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S303–S364 S333
D. Piacentino ∗ Giupponi aniscalco olzer
M. Pompili irardi onca
1 Nesmos department (neurosciences, mental health, and sensory
organs), Sapienza university of Rome, school of medicine and
psychology, Sant’Andrea hospital, Rome, Italy
2 Psychiatric department, San Maurizio hospital, sanitary agency of
South Tyrol, Bolzano, Italy
3 Specialistic outpatient service for ADHD in adults, sanitary agency
of South Tyrol, Bolzano, Italy
4 Provincial service of developmental psychiatry and psychotherapy,
sanitary agency of South Tyrol, Bolzano, Italy
∗ Corresponding author at: Corresponding author.
Introduction Attention deficit/hyperactivity disorder (ADHD)
affects 5–6% of adults. Methylphenidate challenge is used to test
functions such as concentration. Therapeutic drug monitoring
(TDM) identifies optimal drug ranges in plasma.
Objectives/Aims We aimed to: assess the clinical impact of the
drug challenge in adults with ADHD; analyze the relationship with
the drug plasma levels after the challenge; identify predictors of
the challenge’s clinical impact.
Methods In 2015–2016, we recruited 45 consecutive adult
DSM-5 ADHD outpatients (mean age ±SD = 35.3 ±2.1 years;
females = 64.4%) at the Bolzano hospital department of psychia-
try. Before and after administration of methylphenidate 10mg, we
measured concentration, impulsivity, tension, and general well-
being with a VAS and an interview. After two hours, TDM was
performed. Deltas were calculated for pre-/post-challenge mea-
sures. Correlations were measured with Pearson’s r/point-biserial
coefficient. A generalized linear mixed model estimated the size of
association between tension/general well-being improvement and
patient characteristics.
Results After the challenge, the mean improvement ±SD was
24 ± 22 for concentration, 17± 23 for impulsivity, 21± 28 for ten-
sion, 16 ± 24 for general well-being. The mean TDM± SD was
4.6 ± 0.5 ng/mL. A negative correlation between TDM, tension
(P = 0.009), and general well-being (P = 0.028) after the challenge
emerged: higher drug plasma levels relate to less tension and
greater general well-being. At theGLMMthemainpredictor for ten-
sion/general well-being improvement was psychopharmacological
treatment (P = 0.011/P = 0.05, respectively). Older age and difficult
tasks prevented improvement.
Conclusions Methylphenidate challenge had a positive effect on
all patients’ performance. TDM values were lower than literature
ones, although the latter are usually obtained after the administra-
tion of methylphenidate 20 mg.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0665
Sensitivity and specificity of the
Italian version of the bipolar spectrum
diagnostic scale. Different scores in
distinct populations with unipolar
depression
D. Piacentino ∗, P. Girardi , K.G.D. Md , L. Sanna ,
I. Pacchiarotti , D.P. Rossi , N. Girardi , S. Rizzato ,
G. Callovini , G. Sani , G. Manfredi , R. Brugnoli , M. Pompili ,
R. Pies , S.N. Ghaemi , L. Mazzarini
1 NESMOS department (neurosciences, mental health, and sensory
organs), Sapienza university of Rome, school of medicine and
psychology, Sant’Andrea hospital, Rome, Italy
2 Psychiatric division, San Maurizio hospital, sanitary agency of South
Tyrol, Bolzano, Italy
3 Bipolar disorders programme, institute of clinical neuroscience,
hospital Clinic, university of Barcelona, Idibaps, Cibersam, Barcelona,
Espa˜na
4 Neurobehavioral clinical research section, social and behavioral
research branch, National human genome research institute (NHGRI),
National institutes of health (NIH), 20892 Bethesda, Maryland, USA
5 Department of neurology and psychiatry, Sapienza–university of
Roma, policlinico umberto I, Rome, Italy
6 Department of psychiatry, SUNY upstate medical university,
Syracuse, NY, USA
7 Mood disorder program and psychopharmacology consultation
clinic, Tufts medical center, Tufts university school of medicine,
Boston, MA, USA
∗ Corresponding author.
Introduction To date, the proposition of recurrence as a subclini-
cal bipolar disorder feature has not received adequate testing.
Objectives/Aims We used the Italian version of the bipolar spec-
trum diagnostic scale (BSDS), a self-rated questionnaire of bipolar
risk, in a sample of patients with mood disorders to test its specifi-
city and sensitivity in identifying cases and discriminating between
high risk for bipolar disorder major depressive patients (HRU) and
low risk (LRU) adopting as a high recurrence cut-off five or more
lifetime major depressive episodes.
Methods We included 115 patients with DSM-5 bipolar disorder
(69 type I, 41 type II, and 5 NOS) and 58 with major depressive
disorder (29 HRU and 29 LRU, based on the recurrence criterion).
Patients filled-out the Italian version of the BSDS, which is currently
undergoing a validation process.
Results The BSDS, adopting a threshold of 14, had 84% sensitivity
and 76% specificity. HRU, as predicted, scored on the BSDS inter-
mediate between LRU and bipolar disorder. Clinical characteristics
of HRU were more similar to bipolar disorder than to LRU; HRU,
like bipolar disorder patients, had more lifetime hospitalizations,
higher suicidal ideation and attempt numbers, and higher rates of
family history of suicide.
Conclusions The BSDS showed satisfactory sensitivity and sensi-
tivity. Splitting the unipolar sample into HRU and LRU, on the basis
of the at least 5 lifetimemajor depressive episodes criterion, yielded
distinct unipolar subpopulations that differ on outcome measures
and BSDS scores.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0666
Aggression and violence towards
healthcare workers in a psychiatric
service in Italy. A retrospective
questionnaire-based survey
D. Piacentino∗ oser osato onetto onca
J.V. Bizzarri
a Psychiatric department, San Maurizio hospital, sanitary agency of
South Tyrol, Bolzano, Italy
b NESMOS department (neurosciences, mental health, and sensory
organs), Sapienza university of Rome, school of medicine and
psychology, Sant’Andrea hospital, Rome, Italy
c Department of public health and community medicine, section of
psychiatry, university of Verona, Verona, Italy
d Provincial service of developmental psychiatry and psychotherapy,
sanitary agency of South Tyrol, Bolzano, Italy
∗ Corresponding author.
Introduction Violence at work is a major concern in health-
care services. Prevention programs have been implemented, albeit
being scarce in Italy.
Objectives or Aims The Bolzano psychiatric department adopted a
de-escalation model developed by the Institut-für-Professionelles-
Deeskalations-Management (ProDeMa®). It includes evaluation,
prevention, and practical training aimed at preventing/reducing
patients’ aggressive behavior toward healthcare workers.