European Psychiatry - Volume 41 - April 2017

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S62 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S53–S68
Introduction Among patients with major depression, increased
inflammatory markers at baseline may predict an anti-depressant
response. Reducing inflammation may augment response to
psychotropic medications. Few studies have investigated an asso-
ciation between Leukocyte Telomere Length (LTL) and therapeutic
response in depression, reporting mixed results. No studies
assessed LTL and treatment response with PPAR- agonists.
Objectives (1) LTL as a predictor of anti-depressant response to
PPAR- agonist in patients with unremitted depression.
(2) the correlation between LTL and insulin resistance (IR) status.
Aims We aimed to assess LTL as a predictor of antidepressant
response to Pioglitazone in groups of insulin resistant and insulin-
sensitive subjects using surrogate markers of IR.
Methods Medically stable men and women (n = 42) ages 23–71
with non-remitted depression participated in double-blind placebo
controlled add-on of Pioglitazone to treatment-as-usual. Oral glu-
cose tolerance tests were administered at baseline and at 12 weeks.
Results At baseline, no differences in LTL were detected by
depression severity, duration or chronicity. LTL was also not sig-
nificantly different between insulin-resistant and insulin-sensitive
subjects. Subjects with longer telomeres exhibited greater declines
in depression severity in the active arm, but not in a placebo arm.
LTL also predicted improvement in insulin sensitivity in the group
overall and did not differ between the active and placebo arm.
Conclusions LTL may emerge as a viable predictor of antidepres-
sant response. An association between insulin sensitization and LTL
regardless of the baseline IR status points to potential role of LTL
as a non-specific moderator of metabolic improvement in these
patients.
Disclosure of interest I, Dr. Natalie Rasgon, am a consultant for
Shire Pharmaceuticals and Sunovion Pharmaceuticals.
W030
Effect of BMI on resting-state
functional architecture of the brain in
healthy individuals and patients with
psychosis
S. Frangou ∗, N. Micali , R. Natalie , D. Gaelle , M. Bruce
1 New York, USA
2 Icahn School of Medicine at Mount Sinai, Psychiatry, New York, USA
3 Stanford University, Psychiatry, Palo, Alto, USA
4 Rockefeller University, Neuroscience, New York, USA
∗ Corresponding author.
Elevated bodymass index (BMI) is associated with increasedmulti-
morbidity and mortality. The investigation of the relationship
between BMI and brain organization has the potential to provide
new insights relevant to clinical and policy strategies for weight
control. Here, we quantified the effect of BMI on the functional
connectivity of the Default-Mode (DMN), Central Executive (CEN),
Sensorimotor (SMN) and Visual (VN) networks in 496 healthy
individuals that were studied as part of the Human Connectome
Project. We found that elevated BMI was associated with dis-
rupted functional integration of sensory-guided (SMN, VN) with
internally controlled (DMN, CEN) networks, implicating increased
attention to sensory stimuli as a possible mechanismunderpinning
overeating and weight gain. Our results suggest that weight con-
trol strategies should expand to include wider societal policies that
incorporate modifications to eating environments and to the visual
presentation and branding of food products.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
W031
Comorbidity of depression and
diabetes: Questions recently answered
and raised
N. Sartorius
Action for mental health, Geneve, Switzerland
This paper will present information about a multicentric inter-
national collaborative study, which explored the frequency of
depressive disorders in people with diabetes Type 2. The study
was carried out in 14 countries–5 in Asia (Bangladesh, China, India,
Pakistan and Thailand), two in Africa (Kenya and Uganda), two in
Latin America (Argentina andMexico) and five in Europe (Germany,
Poland, Russia, Serbia and Ukraine). The study found that depres-
sive disorders and sub threshold depression are frequent in people
with diabetes: one tenth of all the nearly 3000 patients examined
had major depression and another 15% sub threshold depressive
disorders. Depression was only rarely recognized by the physicians
dealing with diabetes and those few who were recognized were
not provided treatment of their depressive disorders. The presen-
tation will draw attention to the need to improve skills of diagnosis
and treatment of psychiatric disorders of physicians who are not
psychiatrists.
Disclosure of interest The author has not supplied his declaration
of competing interest.
W032
Depression and its somatic
consequences: Allostatic load as the
connecting link
B. Penninx
VU university medical center/GGZ inGeest, department of
psychiatry/PI NESDA study, Amsterdam, The Netherlands
Stress-related psychiatric disorders, such as depressive and anxi-
ety disorders, have been associated with increased risk of overall
mortality as well as with the onset of various aging-related somatic
diseases. In addition to unhealthy lifestyles and poorer (self) care,
various stress-related physiological processes likely contribute to
these detrimental health consequences of psychiatric disorders.
Considering the fact that the impact of stress-related disorders is
visible on many different somatic health outcomes, it is unlikely
that contributing biological systems are very specific. In fact, it
is likely that multiple dysregulations of stress systems, including
the immune, HPA-axis and autonomic nervous systems, but also
various general proteomic or metabolomic pathways are involved.
The concept of Allostatic Load (AL) emphasizes the presence of a
multi-system physiological dysregulation.
In this talk I will summarize what the evidence is for somatic
health consequences of psychiatric conditions, with depression as
an important example. Subsequently, I will provide an overview
of the various stress systems that are dysregulated in depressed
patients. In addition, I will provide empirical data from the Nether-
lands Study of Depression and Anxiety (n = 2981) that illustrate that
there is evidence that depressed patients are especially at risk for
a dysregulation in multiple physiological stress systems. I will also
illustrate how such a state of AL can impact on basis cellular aging
indicators like telomere length and epigenetic age.
In sum, this talk will highlight the current state-of-evidence for an
association between depressions with the onset of many adverse
somatic health outcomes, and will provide insight into the con-
tributing role of a multisystem physiological dysregulation.
Disclosure of interest The author has not supplied his declaration
of competing interest.