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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52


To examine miRNA expression in brain of suicide victims

and in plasma exosomes of suicidal individuals.


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.


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.


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



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.


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-


Disclosure of interest

The author declares that he has no compet-

ing interest.


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.