European Psychiatry - Volume 41 - April 2017

533 / 916

25th European Congress of Psychiatry / European Psychiatry 41S (2017) S521–S582 S529
2 Hacettepe University Faculty of Medicine Department of Psychiatry,
Hacettepe University Faculty of Medicine Department of Psychiatry,
Ankara, Turkey
∗ Corresponding author.
Objective Activation syndrome consists of 10 suicides associ-
ated symptoms, which is induced by antidepressant treatment.
These are anxiety, agitation, manic episodes, sleep disruption,
irritability, hostility, aggressiveness, impulsivity, akathisia and
mania/hypomania. This syndrome is reported to be associated with
a bipolar disorder diathesis. The aim of this study is to evalu-
ate lifetime hypomanic symptoms with major depressive disorder,
who are prescribed antidepressant medication, and to investigate
whether there is a relationship between these symptoms and the
development of AS.
Methods Sixty consecutive outpatients with the diagnosis of
major depressive disorder who were naturalistically given antide-
pressant treatment were examined prospectively. Patients were
assessed three times; at baseline, 2 and 4 weeks later. At baseline
visit, clinical characteristics of patients including Ghaemi crite-
ria were assessed, life-time history of hypomanic symptoms were
assessed with the Hypomania-Checklist-32. In all three interviews,
Barnes Akathisia Rating Scale, Hamilton Rating Scale for Depres-
sion, Hamilton Anxiety Rating Scale and Young Mania Rating Scale
were applied to detect the symptoms of AS. The patients who
present at least one of the 10 symptoms were considered to have
AS.
Results Of the 60 patients 25(41.7%) developed AS. The most
prevalent symptoms of AS are insomnia (31.7%), anxiety (25%) and
irritability (15%). Significant differencewas found between patients
with and without AS, with regard to HCL-32 test scores. A moder-
ate correlation between the number of AS symptoms and HCL-32
test scores were determined. AS was found to be significantly more
frequent in patients with mere hypersomnia and both increased
appetite and hypersomnia those without these symptoms.
Disclosure of interest The findings of this study suggest that cer-
tain features of BPS might be associated with the development
of AS. Antidepressant treatment of depressive illnesses in this
spectrum which are misdiagnosed as unipolar may reveal these
symptoms that will complicate the current episode and destabilize
the longitudinal course. For this reason, clinicians should evalu-
ate the patients who present antidepressant induced symptoms
meticulously and be careful not to overlook the characteristics of
BPS.
EV0385
Reduced latency to first
antidepressant treatment in Italian
patients with a more recent onset of
major depressive disorder
B. Grancini ∗, B. Dell’Osso , L. Cremaschi , F. De Cagna , B. Benatti ,
G. Camuri , C. Arici , C. Dobrea , L. Oldani , M.C. Palazzo ,
M. Vismara , A.C. Altamura
Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico-
University of Milan, Department of Psychiatry, Milano, Italy
∗ Corresponding author.
Introduction Major depressive disorder (MDD) is a prevalent
burdensome disease, which frequently remains untreated. The
duration of untreated illness (DUI) is modifiable parameter and a
valid predictor of outcome. Previous investigation in patients with
MDD revealed a DUI of different years, while recent reports have
documented a reduction of DUI across time, in patients with differ-
ent psychiatric disorders.
Objectives/aims The present study was aimed to investigate
potential differences in terms of DUI and related variables in
patients with MDD across time.
Methods An overall sample of 188 patients with MDD was
divided in two subgroups on the basis of their epoch of onset
(onset before and after year 2000). DUI and other onset-related
variables were assessed through a specific questionnaire and com-
pared between the two subgroups.
Results The whole sample showed a mean DUI of approxi-
mately 4.5 years, with a lower value in patients with more recent
onset compared to the other subgroup (27.1 ± 42.6 vs. 75.8 ±105.2
months, P< .05). Moreover, patients with onset after 2000 reported
higher rates of onset-related stressful events and lower ones for
benzodiazepines prescription (65% vs. 81%; P = 0.02; 47% vs. 30%;
P = 0.02).
Conclusions The comparison of groups with different epochs of
onset showed a significant reduction in terms of DUI and benzodi-
azepines prescription, and a higher rate of onset-related stressful
events inpatientswith amore recent onset. Reportedfindings are of
epidemiologic and clinical relevance in order to evaluate progress
and developments in the diagnostic and therapeutic pathways of
MDD in Italian and other countries.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0386
Efficacy of hypericum extract Ws®
5570 compared with paroxetine in
patients with a moderate major
depressive episode–a subgroup
analysis
E. Holsboer-Trachsler ∗, E. Seifritz , M. Hatzinger
1 C/o Psychiatric Clinics UPK, University of Basel, Basel, Switzerland
2 Psychiatric Hospital of the University of Zurich, Department of
Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
3 Psychiatric Services Solothurn, University of Basel, Solothurn,
Switzerland
∗ Corresponding author.
Introduction Various studies showed the efficacy and tolerability
of WS® 5570 (Hyperiplant® Rx, Dr. Willmar Schwabe GmbH & Co.
KG) for the treatment of acute mild-to moderate depression. Ben-
eficial effects of WS® 5570 have been also shown in patients with
moderate-to-severe depression.
Objectives/aims We present a subgroup analysis of a double blind,
randomised trial to compare the therapeutic efficacy of WS® 5570
with paroxetine in patients suffering from a major depressive
episode with moderate symptom intensity. This analysis on mod-
erately depressed patients treated with WS® 5570 tries to support
the hypothesis that WS® 5570 is an effective remedy in patients
with major depression and moderate symptom intensity.
Methods Moderate depression was defined by a baseline Hamil-
ton Depression Rating Scale (HAM-D) total score between 22 and
25. Sixty-four patients received, after a single blind placebo run-in
phase of 3–7 days, either 3× 300mg/day WS® 5570 or 20mg/day
paroxetine for six weeks. The change of the HAM-D total score was
used to describe the efficacy of WS ® 5570 compared with paroxet-
ine in the subgroup of patients with moderate depression.
Results The reduction of the HAM-D total score was signifi-
cantly more pronounced in patients treated with 3× 300mg/day
WS® 5570 compared to 20mg/day paroxetine. After six weeks,
responder (87.1%) and remission rates (60.6%) to WS® 5570 were
significantly higher than to paroxetine (71%/42.4%).
Conclusions After six weeks, patients treated with WS® 5570
showed a higher reduction in depression severity score and yielded
greater response and remission rates compared with patients
treated with paroxetine.