European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S521–S582 S561
their bites. Then, they have started to restrict their food intake and
the types of food consumed, which led to emaciation with health
problems, interrupted daily routines, and social isolation; meeting
the diagnosis of avoidant/restrictive food intake disorder (ARFID)
in DSM-5. Due to traumatic experiences, EMDR therapy was
applied.
Discussion After five EMDR therapy sessions, patients turned
back to healthy eating habits, normal BMI, and effective daily life.
As expected, EMDR therapy made significant improvements in the
treatment of ARFID.
Conclusion EMDR can be useful to treat ED with traumatic back-
ground.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Reference
[1] Tagay S, Schlottbohm E, Reyes-Rodriguez M, Repic N, Senf W.
Eating disorders, trauma, PTSD, and psychosocial resources. Eat-
ing disorders 2013:33–49.
[2] Bloomgarden A, Calogero R. A randomized experimental test of
the efficacy of EMDR treatment onnegative body image in eating
disorder inpatients. Eating disorders 2008:418–27.
EV0482
Sleep disturbances in anorexia
nervosa
M.F. Vieira ∗, P. Afonso
1 Centro Hospitalar de Lisboa Central, Child and Adolescent
Psychiatry, Lisboa, Portugal
2 Centro Hospitalar de Lisboa Norte, Psychiatry, Lisboa, Portugal
∗ Corresponding author.
Introduction In clinical practice, insomnia is a common feature
in anorexia nervosa (AN). Sleep self-reports in AN suggest that
these patients report poor sleep quality and reduced total sleep
time. Weight loss, starvation and malnutrition can all affect sleep.
Patients with eating disorders who have sleep disturbances have
more severe symptomatology.
Objectives The authors intend to review sleep disturbances
observed in AN, describe possible pathophysiological mechanisms
and evaluate the clinical impact of sleep disturbances on the treat-
ment and prognosis of the disease.
Methods In this study, a non-systematic search of published liter-
ature from January 1970 and August 2015 was carried out, through
PubMed, using the following keywords: ‘sleep’, ‘anorexia nervosa’
and ‘insomnia’.
Results These patients subjectively report having poor sleep
quality, with difficulty falling asleep, interrupted sleep, earlymorn-
ing waking or reduced total sleep time. Sleep disturbances found
in AN using polysomnography are: reduction in total sleep time,
decrease in slow wave sleep, slow wave activity and reduced sleep
efficiency.
Conclusions Privation of adequate and restful sleep has a nega-
tive impact on the quality of life of patients, may contribute to the
appearance of co-morbidities, such as depression and anxiety, and
to a poor prognosis for AN.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0483
Eating disorders symptoms related to
gestational BMI in breastfeeding
mothers
F. Volpe∗, L. Giliberti , G. Soldera , G. Straface , V. Zanardo
Policlinico Abano Terme, Divisione Medicina Perinatale, Padova, Italy
∗ Corresponding author.
Background and aims Research has shown that maternal obe-
sity and underweight are major risk factors for reduced initiation,
duration, and exclusivity of breastfeeding. This prospective, cohort
study analysed the association between gestational body mass
index (BMI) and symptoms of eating disorders (ED) in breastfeeding
women.
Methods The study involved 1318 consecutive, at term, healthy
mothers, who delivered at the division of Perinatal Medicine
of Policlinico Abano Terme, located in a North-Eastern Italy
industrialized area, supporting advanced educational levels, good
socio-economic status and low and late fertility. The day of dis-
charge mothers completed the completed the eating disorder
examination-questionnaire (Fairburn and Beglin, 2008), including
four subscales, restraint (R), shape concerns (SC), weight concerns
(WC), eating concerns (EC) and a global score (GS). Mothers’ BMI
groups were categorized as underweight, normal weight, over-
weight and obese, according to 2009 IOM guidelines.
Results EDE-Q mean values ( ±SD) significantly increased with
BMI increasing categories. Compared to normal weight mothers
(n = 290, 22.0%), obese women (n = 273, 20.7%) had higher signifi-
cant GS (0.6± 0.7 vs. 0.2± 0.3; P= 0.006), R (0.6 ± 0.9 vs. 0.3± 0.6;
P < 0.0001), EC (0.4± 0.6 vs. 0.3 ± 0.5; P < 0.0001), SC (0.9± 1.0 vs.
0.3 ±0.5; P < 0.0001) and WC (0.7 ±0.8 vs. 0.1 ± 0.3; P < 0.0001).
In addition, formula-feeding adoption at discharge significantly
increased with BMI increasing categories (P per trend = 0.01).
Conclusions We present evidence that gestational obesity is asso-
ciated with reduced breastfeeding rates at discharge and higher ED
symptomatology. Women need information and support to gain
adequate weight during pregnancy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0484
Bulimia nervosa in Singapore: Clinical
profile, comorbidity and gender
comparisons
K.A. Zainal∗ . Ng , H.Y. Lee
Singapore General Hospital, Psychiatry, Singapore
∗ Corresponding author.
Introduction Though eating disorder cases have been on the rise
in Asia, little is known about them. Bulimia nervosa (BN) has been
associated with poor treatment outcome and high mortality risk,
and is the second most commonly diagnosed eating disorders in
Singapore, after anorexia nervosa (AN), yet no report thus far has
explored this condition.
Objectives The current study seeks to describe the clinical pop-
ulation diagnosed with BN in our hospital treatment program, as
well as to compare their clinical characteristics with a previously
published local study on patients with AN.
Method Retrospectivemedical records reviewwas carried out for
patients diagnosed with BN in our hospital’s eating disorders treat-
ment program. Patient records from 2003 to 2013 were retrieved
and analyzed. We also further compared presenting characteristics
across genders and with AN patients.
Results Between 2003 and 2013, 348 patients were diagnosed
with BN by psychiatrists based on the Diagnostic and Statistical
Manual of Mental Disorders (DSM IV-TR). BN patients presented
with high rate of self-harm behaviors (37.1%), previous suicide
attempts (19.0%) and psychiatric comorbidities (67.5%), many of
which require inpatient treatment. Significant differences were
found between genders and in comparison with the AN patients.
Conclusion Our results suggest that many patients with BN
present with severe psychiatric comorbidities, in some aspects
more severe than the AN population. The current study appeals
for the development of more effective detection and treatment
of vulnerable populations in Singapore. We further discuss about