European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S405–S464 S423
medical literature are references to cardiac alterations induced by
stress.
Objective Takotsubo is a rare cardiac syndrome that occurs most
frequently in postmenopausal women after an acute episode of
severe physical or emotional stress. In the text that concerns us,
we describe a case related to an exacerbation of psychiatric illness,
an episode maniform.
Method Woman 71 years old with a history of bipolar I disor-
der diagnosed at age 20. Throughout her life, she suffered several
depressive episodes as both manic episodes with psychotic symp-
toms. Carbamazepine treatment performed and venlafaxine. He
previously performed treatment with lithium, which had to be sus-
pended due to the impact on thyroid hormones and renal function,
and is currently in pre-dialysis situation.
She requires significant adjustment treatment, not only removal
of antidepressants, but introduction of high doses of antipsychotic
and mood stabilizer change of partial responders. In the transcurso
income, abrupt change in the physical condition of the patient
suffers loss of consciousness, respiratory distress, drop in blood
pressure, confusion, making involving several specialists. EEG was
performed with abnormal activity, cranial CT, where no changes
were observed, and after finally being Echocardiography and coro-
nary angiography performed when diagnosed Takotsubo.
Results/conclusions In this case and with the available literature,
we can conclude that the state of acute mania should be added to
the list of psychosocial/stressors that can trigger this condition.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0058
Determination of p11 multifunctional
protein in human body fluids by
enzyme-linked immunosorbent assay
H. Jiang ∗ uan uan
1 Southeast University, Department of Psychosomatics and
Psychiatry, Nanjing, China
2 ZhongDa Hospital Affiliated to Southeast University, Department of
Anesthesiology, Nanjing, China
3 Medical School of Southeast University, Department of
Psychosomatics and Psychiatry, Nanjing, China
∗ Corresponding author.
Objectives The diagnosis of major depressive disorder (MDD) is
symptombased due to the lack of biological biomarker. p11 protein
was recently found to be an important factormediating depression-
like states and antidepressant responses. The aim of the study was
to assess whether p11 protein in urine can serve as a potential
biomarker for major depression, and the relationship of its levels
among urine, serum and cerebrospinal fluid (CSF).
Methods We obtained urine samples from 13 drug-free MDD
patients and 13 age- and gender-matched healthy controls. We
also collected urine, serum and cerebrospinal fluid samples from
13 of fracture patients or cesarean section patients in the spinal
anesthesia. The concentrations of p11 proteinweremeasured using
ELISA.
Results In MDD patients, urine levels of p11 protein were all less
than the minimum detectable concentration of the ELISA kit. The
urine levels of p11 were detectable only in one healthy control. In
the spinal anesthesia patients, we can detect p11 concentrations in
both serum and urine in only two patients. Besides, levels of p11
were detectable in the serum of one patient and urine of another
patient. Wewere unable tomeasure CSF levels of p11 in all patients.
Conclusions Concentrations of p11 protein in the body fluids are
very low and unstable. The sensitivity of the current p11 ELISA kit
is currently unsatisfactory, requiring the development of an ELISA
kit of higher sensitivity to determine whether p11 in body fluids
can serve as biomarker for depression.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0059
Korean medication algorithm for
bipolar disorder (KMAP-BP): Changes
in treatment strategies for bipolar
depression over 12 years
D.I. Jon ∗, J.S. Seo , W. Kim , J.G. Lee , Y.C. Shin , K.J. Min ,
B.H. Yoon , W.M. Bahk
1 Hallym University Sacred Heart Hospital, Psychiatry, Anyang,
Republic of Korea
2 Konkuk University Chungju Hospital, Psychiatry, Chungju, Republic
of Korea
3 Inje University Seoul Baek Hospital, Psychiatry, Seoul, Republic of
Korea
4 Inje University Haeundae Baek Hospital, Psychiatry, Busan,
Republic of Korea
5 Kangbuk Samsung Hospital, Psychiatry, Seoul, Republic of Korea
6 Chung-Ang University Hospital, Psychatry, Seoul, Republic of Korea
7 Naju National Hospital, Psychiatry, Naju, Republic of Korea
8 The Catholic University St. Mary Hospital, Psychiatry, Seoul,
Republic of Korea
∗ Corresponding author.
Introduction Many guidelines for bipolar disorders have been
introduced based on evidences. In contrast, KMAP-BP was devel-
oped by an expert-consensus.
Objective To summarize the medication strategies for bipolar
depression over four published KMAP-BP (2002, 2006, 2010, and
2014).
Methods The questionnaire using a nine-point scale had covered
some clinical situations with many treatment options about the
appropriateness of treatment.
Results For mild-to-moderate depression, antidepressant
(AD) +mood stabilizer (MS) in early editions and MS or lamotrigine
monotherapy and AAP + (MS or lamotrigine) in later editions
were preferred strategies. For severe nonpsychotic depression,
MS + AD was the only first-line medication in early editions. In
2014, various medications [MS + AAP (atypical antipsychotic),
AAP + lamotrigine, MS + AD] were preferred. Valproate and lithium
has been rated as first-line MS in all editions. Lamotrigine were
positively preferred later. Adjunctive AD was accepted as first-line
strategy for severe depression in all editions. Preference of AAP also
has been increased remarkably. Adjunctive AAP was not first-line
treatment for mild-to-moderate depression in all editions, but was
for nonpsychotic depression in 2010 and 2014 and for psychotic
depression in all editions. Recommended AAPs have been changed
over 12 years: olanzapine and risperidone in 2002 and quetiapine,
aripiprazole, and olanzapine in 2014 were first-line AAP.
Conclusion There have been evident preference changes:
increased for AAP and lamotrigine and decreased for AD. The high
preferences for aripiprazole and lamotrigine in later editions were
likely derived from favorable tolerability.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0060
Obesity and quality of life in bipolar
disorder
R. Jouini∗, H. Ben Ammar , G. Hamdi , N. Smari , A. Aissa ,
E. Khelifa , Z. El Hechmi
Razi Hospital, Psychiatry F, Tunis, Tunisia
∗ Corresponding author.