European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S521–S582 S525
Objectives To review epidemiology, pathogenesis, risk factors,
consequences and current recommendations for therapeutic inter-
vention.
Methods Medline/Pubmed database search using the terms post-
stroke depression, depression and stroke, depression and cerebral
vascular accident, stroke patients, published in the last 16 years.
Conclusion The treatment of PSD has been shown effective in
improving the evolution and prognosis of these patients, therefore
it is very important early diagnosis.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0372
Management of treatment resistant
depression: A comparison between
French expert consensus guidelines
and international evidence based
guidelines
T. Charpeaud ∗, A. Yrondi , W. El-Hage , M. Leboyer ,
E. Haffen , P.M. Llorca , P. Courtet , B. Aouizerate
1 CHU de Clermont-Ferrand, service de psychiatrie de l’adulte B,
Clermont-Ferrand, France
2 CHU de Toulouse, service de psychiatrie de l’adulte, Toulouse, France
3 CHU de Tours, service de psychiatrie de l’adulte, Tours, France
4 Centre hospitalier Albert-Chenevier, service de psychiatrie de
l’adulte, Créteil, France
5 CHU de Besanc¸ on, service de psychiatrie de l’adulte, Besanc¸ on,
France
6 CHU de Montpellier, urgences et post-urgences, Montpellier, France
7 Centre hospitalier Charles-Perrens, pôle de psychiatrie, Bordeaux,
France
∗ Corresponding author.
Expert consensus guidelines rely on a relevant methodological pro-
cedure complementary to based-evidence recommendations. They
aim at offering support strategies derived from expert consen-
sus for clinical situations where the levels of evidence are either
absent or insufficient. Recommendations for resistant depressive
disorders proposed by french association for biological psychia-
try and fondamental foundation, were based on responses from
36 highly specialized experts in this field. They were invited to
complete a comprehensive questionnaire with 118 issues. The
questions raised covered a wide range of aspects from the eval-
uation of therapeutic resistance and clinical conditions increasing
the risk for treatment failure to the adopted therapeutic strate-
gies organized according the effects of previous treatment lines.
Specific populations/situations especially including elderly, comor-
bidities (anxiety disorders, personality disorders and addictions)
were also been studied through specific questions. Such recom-
mendations are intended to substantially help the decision and
therapeutic choice of clinician implied in the management of resis-
tant depressive disorders in everyday clinical practice. We propose
in this communication to compare the results of these recommen-
dationswith the various data fromthe evidence-based guidelines in
order to demonstrate their complementarity for the management
of resistant depressive disorders.
Disclosure of interest
The authors have not supplied their declaration of competing inter-
est.
EV0373
Electroconvulsive therapy as an
effective alternative in depressive
disorder
G.M. Chauca Chauca ∗, L. Carrión Expósito , P. Alonso Lobato
1 UGC-Salud Mental Hospital Infanta Margarita, Cabra, Córdoba,
Spain
2 UGC-Salud Mental Área Sanitaria Norte, Pe˜narroya, Córdoba, Spain
∗ Corresponding author.
Introduction The efficacy of electroconvulsive therapy (ECT) in
the treatment of depressive episodes is well established, and so is
reflected in the major guides.
Objectives Description of a clinical case of a patient diagnosed
with major depressive episode with psychotic symptoms and
obsessive compulsive disorder prevalence of compulsive acts that
do not respond to drug treatment but to electroconvulsive therapy.
Methods Presentation and review of a case.
Results A 55-year-old woman diagnosed with recurrent depres-
sive disorder with worsening in the last 4 years.
Clinical depressive Sadness, spontaneous crying in the form
of access, apathy, isolation and clinofilia desires, complaints
mnemonic deficits and complete anhedonia. Obsessional symp-
toms compulsive as more repetitive behaviors of obsessive ideas,
which repeats incessantly despite checking, that does not prepare
or calm. The patient has not responded to any pharmacological
strategy, despite using full doses and combinations of antidepres-
sant, but euthymics more antipsychotics (sertraline, fluoxetine,
reboxetine, venlafaxine, bupropion, lithium, valproic acid, lamot-
rigine, risperidone, quetiapine, trifluoperazine, clotiapine). For this
reason, it was decided to start treatment with ECT, progressively
responds in each session, after 8 sessions the patient is euthymic,
it has resumed normal activities, no obsessive or psychotic symp-
toms.
Conclusions It is important to know that it is a safe technique that
would save not only an economic cost, if not a personal emotional
cost. It is noteworthy that more than 50% of depressed patients who
respond to a course of ECT, fall between 6 and 12months despite
receiving adequate pharmacological treatment then sowewill have
to closely monitor the patient.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0374
Clinical predictors of antidepressant
response to ketamine in unipolar
treatment-resistant depression
L.C. Del Sant∗, E. Magalhães , A.C. Lucchese , H.N. Palhares Alves ,
L.M. Sarin , J.A. Del Porto , A.L. Tavares de Lacerda
Federal University of São Paulo, Psychiatry, Sao Paulo, Brazil
∗ Corresponding author.
Introduction The non-competitive N-methyl-d -aspartate gluta-
mate receptor antagonist ketamine has been shown to have rapid
antidepressant effects in treatment-resistant depression (TRD).
However, only a few studies have investigated which clinical char-
acteristics predict a response to ketamine.
Objectives To assess sociodemographic variables and clinical
markers that predict response to ketamine inunipolar TRDpatients.
Methods Searches of Pubmed, NCBI andGoogle Scholarwere con-
ducted for clinical trials and systematic reviews, through October
2016, using the keywords:
ketamine, N-methyl-d -aspartate receptor antagonist, rapid-acting
antidepressant, depression, treatment-resistant depression, clini-
cal predictors.
Results Findings support the following clinical predictors: