European Psychiatry - Volume 41 - April 2017

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S50 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52
Aims To examine miRNA expression in brain of suicide victims
and in plasma exosomes of suicidal individuals.
Methods microRNA expression was studied in prefrontal cortex
of depressed suicide subjects and healthy normal controls. Role of
microRNAs in synaptic plasticity was studied by examining total
and synaptonerosomes. microRNA expression was also studied in
plasma exosomes of depressed non-suicide and depressed suicide
subjects and healthy normal controls.
Results We found a global down–regulation of miRNAs in
depressed subjects (21 miRNAs significantly down-regulated).
Many of them were synaptically enriched and encoded at nearby
chromosomal loci, shared motifs within the 5’-seeds, and shared
putative mRNA targets. In addition, we found a dramatic reor-
ganization of microRNAs in a coordinated and cohesive fashion
in depressed subjects. We also detected changes in miRNAs in
plasma exosomes of depressed suicide subjects that corresponded
to microRNA changes in prefrontal cortex.
Conclusion Our study provides critical evidence that microRNAs
play amajor role in suicide pathophysiology and that thesemicroR-
NAs can be reliably used as peripheral biomarker.
Disclosure of interest The author declares that he has no compet-
ing interest.
Symposium: Driving ability and psychotropic
drugs
S138
Driving ability and psychotropic
drugs: Introduction, epidemiology
and general aspects
A. Brunnauer
kbo-Inn-Salzach-Klinikum gemeinnützige GmbH, Wasserburg am
Inn, Germany
Psychiatric illness, psychotropic drugs and driving ability. For most
people driving is an important activity in daily life affecting phys-
ical, social, and economic well-being. Driving mobility is also an
important part of one’s self-identity that may influence health
status. It could be demonstrated that 67% of psychiatric patients
reported to have a valid driver’s license and 77% of them referred to
regularly use their cars. Closer inspection of data reveals, that road
mobility is largely linked to psycho-functional status. In this con-
text a significant issue is the impact of medical conditions and/or
psychoactivemedicines on road safety. Psychiatric patients, consid-
ered as a group, seem to have a moderately elevated risk of being
involved in a road traffic accident with high-risk rates especially for
organicmental disorders.With respect to pharmacotherapy, within
psychotropic medicines an increased road traffic crash risk for ben-
zodiazepines, z-hypnotics and some antidepressants has been well
documented. The combination of psychoactive drugs additionally
increases risk that is highest when combined with alcohol. How-
ever, therapeutic drug use may also lower risk, as the illness itself
constitutes a higher risk of road traffic accidents. As many stud-
ies did not adequately control for confounding factors, results of
epidemiological studies must be interpreted cautiously.
Disclosure of interest The author declares that he has no compet-
ing interest.
S139
Antipsychotics and driving ability
C. De las Cuevas
University of La Laguna, Psychiatry, San Cristóbal de La Laguna, Spain
Driving a vehicle is an important everyday life skill associated to
a psychiatric patient’s autonomy and identity. Nevertheless, the
right to drive is not a right at all, it is a privilege granted and regu-
lated by rules and restrictions from the States that have also the
duty to pull this privilege and deny the ability to legally drive
in potentially unsafe drivers. The decision about for whom and
when to forbid driving is a difficult matter of judgment that must
remain a clinical and professional judgment within the medical
encounter. Both antipsychotics as the psychiatric disorders target of
these psychoactive drugs produce changes of psychomotor perfor-
mance that can interfere with the ability to drive safely. Moreover,
it is really hard to distinguish between the effects of the disease
itself as opposed to the effects of the medication when study-
ing the interaction between antipsychotics and driving ability.
Previous results of our research in the field indicate that psychi-
atric patients who improved clinically after drug treatment also
showed improvements in driving ability. So, adequate psychotropic
treatment causes a positive effect on driving performance that out-
weighs the possible deleterious effect of medication. However, it
remains essential to supply mental health professionals with new
information, which is quantitatively and qualitatively valid, on the
role of antipsychotics in driving ability. The purpose of the present
lecture is to review research undertaken to-date on the effects of
antipsychotic medications on driving ability. A search of various
databases, including Medline, Embase and PsycInfo, will be con-
ducted.
Disclosure of interest The author declares that he has no compet-
ing interest.
S140
Antidepressants and driving ability
J. Ramaekers
Department Neuropsychol, Psychopharmacol. Maastricht University,
The Netherlands
Depression is a mental disorder that is likely to affect daily func-
tions, including driving ability. However, driving performance of
depressed patients remains poorly investigated. We will present 2
studies designed to assess driving performance of patients receiv-
ing long-term antidepressant treatment. The first study compared
driving performance of untreated depressed patients, depressed
patients receiving SSRI or SNRI treatment for 6–52 weeks and
matched healthy controls. The second study compared driving per-
formance of long-term users of sedative antidepressants to that
of matched healthy controls. A standardized on-the-road driv-
ing test was used to assess standard deviation of lateral position
(SDLP), a measure of weaving. In the first study, mean SDLP of
untreated and treated patients were significantly higher as com-
pared to SDLP of matched controls. Driving impairment in the
treated group was significantly less as compared to the untreated
group. SDLP was positively correlated to severity of depression
across both groups of patients. In the second study, SDLP of patients
receiving sedative antidepressants (e.g. mirtazapine) during 0,5–3
yrs was significantly higher as compared tomatched controls. Driv-
ing performance of patients receiving sedative antidepressants for
more than 3 yrs did not differ from matched controls. Severity
of depression in these patients groups was low. It is concluded
that symptoms of depression are a major cause of driving impair-
ment. Reductions in severity of depression through antidepressant
treatment reduce severity of driving impairment. Sedative antide-
pressants such as mirtazapine however can still induce driving
impairment in patients with remission for up to 3 yrs of use.