Oral Communication

Cite this article: (2020). Oral Communication. European Psychiatry 63(S1), S3–S44. https://doi.org/10.1192/j.eurpsy.2020.52 © The Author(s) 2020. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. p<0.01) and avoidance(r=-0.372 p<0.01).Impact of childhood trauma scores on resilience scores partly mediated by attachmentrelated anxiety(Sobel Z=-2.463 p=0.014) and avoidance(Sobel Z=-2.295,p=0.036), respectively. Conclusions: History of childhood trauma in patients with bipolar disorder is frequent.Childhood traumas are associated with lower resilience and higher attachment-related anxiety and avoidance.Impact of childhood trauma on resilience was partly mediated by attachment-related anxiety and avoidance.Since resilience is associated with increased quality of life and better clinical course even in stable patients with bipolar disorder, it might be helpful to develop attachment informed psychosocial interventions to ameliorate detrimental effects of childhood trauma on resilience. Conflict of interest: No

p<0.01) and avoidance(r=-0.372 p<0.01).Impact of childhood trauma scores on resilience scores partly mediated by attachmentrelated anxiety(Sobel Z=-2.463 p=0.014) and avoidance(Sobel Z=-2.295,p=0.036), respectively. Conclusions: History of childhood trauma in patients with bipolar disorder is frequent.Childhood traumas are associated with lower resilience and higher attachment-related anxiety and avoidance.Impact of childhood trauma on resilience was partly mediated by attachment-related anxiety and avoidance.Since resilience is associated with increased quality of life and better clinical course even in stable patients with bipolar disorder, it might be helpful to develop attachment informed psychosocial interventions to ameliorate detrimental effects of childhood trauma on resilience. Introduction: Electroconvulsive therapy is well established as an effective tool in psychiatry. In most cases ECT is gradually discontinued after clinical improvement, with a good remission rate if pharmacological treatment is continued. Nonetheless its estimated around 40% of patients relapse after 6 months and approximately 60% by one year. Objectives: To study the impact of Maintenance Electroconvulsive therapy in the course of Type I Bipolar disorder Methods: We conducted an observational mirror-image study in patients who started maintenance ECT between 2000-2016 at our center. We did a chart review of 43 clinical records that fulfilled inclusion criteria. Descriptive analyses were performed using SPSS Statistics 23 IBM, considering statistical significance as p<0,05 Results: The mean number of hospitalizations before maintenance ECT was 2 (AE2.53), mean number of hospitalization was 35 (AE56.68). While the mean number of hospitalizations during maintenance ECT was 0 (x=0.74; M=0AE1.48;Range=0-6), and number of hospitalization days during maintenance ECT was 0 (x=11.91; M=0AE28.5; Rang=0-168). Kolmogorov-Smirnov normality test showed a non Gaussian distribution of the "response" variables (p<0.0001). We performed the Wilcoxon test comparing "response" variables: number of hospitalizations "before" vs "after" (Z=-3.739; p<0.0001); and hospitalization days "before" and "after" (Z=-4.648; p<0.0001).

Conflict of interest: No
Conclusions: This study shows a significant reduction in the number of hospitalization and number of days in patients diagnosed with Bipolar Disorder undergoing maintenance ECT compared to pharmacological treatment alone. The use of this modality of treatment can help taper the socioeconomic, psychic and somatic repercussions of inpatient psychiatric care, for this reasons when indicated maintenance ECT should be taken into consideration Conflict of interest: No Keywords: Relapse prevention; Bipolar Disorders; Maintenance electroconvulsive therapy O0008 Sexual dysfunction in bipolar disorder: A systematic review Y. Cañada Pérez 1 *, P. Navalón Rodríguez 1 , R. Zazula 2 , M. Berk 3 , S. Dodd 3 , A. García-Blanco 1 and P. Sierra San Miguel 1 1 Spain,; 2 Brazil, and 3 Australia Introduction: Bipolar disorder (BD) implies sexual disturbances during affective phases but also during euthymia. Sexual dysfunctions (SD) in BD patients are specially pernicious, as they relate to an impact in quality of life, and a lower treatment compliance, making patients prone to new affective episodes. In spite of this, SD are typically misdiagnosed and their characteristics remain yet unclear. Objectives: To review the existent literature about SD in euthymic BD patients. Methods: We performed a systematic review following PRISMA guidelines (PROSPERO ID-CRD42019130095). We selected studies including BD patients over18 year-old. Sexual functioning was evaluated with a questionnaire/semistructured interview, that measured the following sexual domains: desire, arousal, orgasm, satisfaction; or was expressed with a validated diagnosis (i.e erectile dysfunction). Results: The search yielded to 132 eligible full text articles, 26 of which were included in this review. See Figure 1 (flow chart) A total of 7928 patients with BD with were evaluated in the review. Prevalence of SD was heterogenous among studies (14%-81.7%) and it was influenced by the type of clinical sample, the context of the study and the treatment. The main affected sexual domain was desire and the most frequent tool used was Arizona Sexual Experiences Scale (ASEX). When compared to healthy subjects BD patients had poorer sexual functioning and sexual satisfaction. Conclusions: Our review highlights the scarcity and heterogeneity of the existent literature about SD in BD. There is a need for new studies so as to reach a better comprehension of SD and implement prevention and treatment strategies. Disclosure: Yolanda Cañada has had support for conference from Janssen and Lundbeck. Pablo Navalon has received support from Lundbeck and Janssen. Seetal Dodd has received grant support from the Stanley Medical Research Institute, NHMRC, Beyond Blue, ARHRF, Simons Fo Keywords: euthymia; Bipolar disorder; sexual dysfunction O0009 Depressive polarity at illness onset is associated with lifetime suicide attempts in euthymic bipolar outpatients G. Serafini 1 *, A. Aguglia 1 , F. Santi 1 , G. Canepa 1 , X. Gonda 2 , Z. Rihmer 2 , M. Pompili 1 and M. Amore 1 1 Italy, and 2 Hungary Introduction: Differential characteristics related to first illness episode in bipolar disorder (BD) have been identified based on the current literature; however, evidence are currently inconsistent across studies. Objectives: Thus, this study aimed to identify whether first depressive episode (FDE) was associated with specific clinical correlates in a large sample of BD outpatients. Methods: The sample included 364 euthymic bipolar outpatients (mean age= 53.9AE16.05) of which 229 (62.9%) with FDE and 135 (37.1%) with first non-depressive episode (FNDE). A detailed data collection was performed and illness histories were retraced through clinical files and lifetime computerized medical records.
Introduction: Advances in machine learning could change the way health care delivery is organised. A common problem in machine learning applications is availability of data at the point of decision making. Objectives: The aim of the present study was to use routine data readily available at admission to predict aspects relevant to the organization of psychiatric hospital care. Methods: The study included consecutively discharged patients between 1 st of January 2017 and 31 st of December 2018 from nine psychiatric hospitals in Hesse, Germany. We compared the predictive performance achieved by stochastic gradient boosting (GBM) with multiple logistic regression and a naive baseline classifier. We tested the performance of our final models on unseen patients from another calendar year and from different hospitals. Results: The study included 45,388 inpatient episodes. The models' performance, as measured by the area under the Receiver Operating Characteristic curve, varied strongly between the predicted outcomes, with relatively high performance in the prediction of coercive treatment (area under the curve: 0.83) and 1:1 observations (0.80) and relatively poor performance in the prediction of short length of stay (0.69) and non-response to treatment (0.65). The GBM performed slightly better than logistic regression. Both approaches were substantially better than a naive prediction based solely on basic diagnostic grouping. Conclusions: The present study has shown that administrative routine data can be used to predict aspects relevant to the organisation of psychiatric hospital care. Future research should investigate the predictive performance that is necessary to provide effective assistance in clinical practice for the benefit of both staff and patients. Disclosure: Professor Franz (MF) received funding from Janssen Cilag in 2014 for a project with children of parents with mental and behavioral disorders. Introduction: Recent research has revealed that neurocognitive and social cognitive deficits are core features in patients with schizophrenia. However, the link between both branches of cognition remains still far from definitive in delusional disorder. Objectives: Thus, the main goal of this systematic review was to explore non-social and social cognitive deficits in patients with delusional disorder. Methods: In accordance with the PRISMA statement, a systematic computerized search was performed using Pubmed and Scopus databases from inception until 4 June 2019. Search terms: ("Social cogn*" OR "cognition" OR "cognitive" OR "neurocognition" OR "neurocognitive" OR "neuropsychological" OR "metacognitive") AND ("delusional disorder" OR "paranoia"). Inclusion criteria: a) delusional disorder (ICD or DSM) and b) studies assessing neurocognition or social cognition in delusional disorder. Results: A total of 2955 records were retrieved (Pubmed: 575; Scopus: 2380). After the screening and selection processes, 21 studies were eligible for inclusion: neurocognition (n=13), social cognition (n=6) and both (n=2). Studies reporting neurocognitive deficits: speed of processing (n=2), attention/vigilance (n=2), working memory (n=5), verbal learning (n=5), visual learning (n=2) and reasoning/problem solving (n=4). Studies reporting social cognitive deficits: emotion recognition (n=2), theory of mind (n=3), attributional style (n=5) and cognitive biases (n=3). Delusional disorder patients made more perseverative errors than healthy controls and showed lower deficits compared with schizophrenia. Conclusions: This systematic review supports the notion that patients with delusional disorder are not cognitively unimpaired.
Non-social and social cognitive deficits may be core features of delusional disorder. Dysfunctions in prefrontal and temporal brain regions may be implicated. Disclosure: Alexandre González-Rodríguez has received honoraria and/or travel costs from Janssen and Lundbeck-Otsuka. Introduction: Chronic loneliness has been associated with emotional disorders such as major depressive disorder and social anxiety disorder. More recently, loneliness is proposed to drive and maintain paranoia. Since emotional disturbances like depression and social anxiety often co-occur with paranoia, it is questionable whether loneliness is uniquely associated with paranoia after controlling for these emotional experiences. Besides, studying loneliness before onset of clinical psychosis will shed light on the possible role of loneliness as a contributor to paranoia rather than a consequence of the debilitating symptom. Objectives: Using a stepwise network analytic approach, we modeled the unique associations between loneliness, paranoia, depression and social anxiety in a representative non-clinical sample. The moderating role of schizotypy in these associations was also explored. Methods: Young adults (age 18-30) were recruited via multi-site visits, advertising in public places, and social media, etc. Mixed graphical models with loneliness, paranoia, depression and social anxiety as nodes were estimated without, and then with demographic covariates. Edges were estimated as unique associations between nodes. The effect of schizotypy on these associations was tested with a moderated network model. Results: The validated sample consisted of 1,935 participants. Loneliness was linked to paranoia directly and via depression and social anxiety indirectly. These edges remained robust after controlling for demographic covariates (Fig. 1). The association between loneliness and paranoia became weaker as level of schizotypy increased. Conclusions: Loneliness and paranoia are associated directly and indirectly via emotional disturbances. There is a potential moderating role of schizotypy in the association between loneliness and paranoia.

Conflict of interest: No
Keywords: perceived social isolation; Persecutory delusions; schizotypy; network analysis O0020 Self-and caregiver-reported disability after one year of LAI antipsychotic treatment in schizophrenia: Preliminary results G. D'Anna*, L. Tatini, V. Ricca and A. Ballerini Italy Introduction: Disability associated with schizophrenia constitutes a substantial obstacle to recovery. Over the years, SGA-LAI (Second Generation Antipsychotics, Long-Acting Injectable) have proved effective with regard to various clinical and patient-reported outcomes.
Objectives: To evaluate self-and caregiver-reported disability in 30 patients with schizophrenia before (T0) and one year after switching from an oral SGA to the corresponding LAI (T1). Methods: Sample characteristics at baseline are summarised in Table 1. At T0 and T1, patients were assessed with Clinical Global Impression -Severity (CGI-S) and Positive And Negative Symptoms Scale (PANSS), and both the patient and a caregiver answered the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Student's t test for longitudinal comparison was performed. Pearson's correlation was used to evaluate the overlap of proxy-and self-administered WHODAS 2.0 at each assessment. Results: CGI-S and each subscale of PANSS (excluding negative symptoms) improved, and a significant reduction in disability was seen in the overall score of proxy-and self-administered WHO-DAS 2.0 (Figure 1), as well as in the number of days with functional limitation during the previous month (data not shown). Pearson's correlation between proxy-and self-administered WHODAS 2.0 confirmed a substantial overlap between the reports at each time (data not shown). Conclusions: We observed a significant reduction in patients' disability, together with a psychopathological improvement. The overlap between caregiver and patient report underlines the consistency of this finding. Introduction: The molecular mechanisms of cognitive deficit in schizophrenia are poorly understood. They can be investigated by studying the functional consequences of genetic variants associated with both schizophrenia and cognition in whole-genome association studies (GWAS). Of particular interest is DNA methylation within such shared loci, as it can mediate the influence of genetic factors on schizophrenia risk and symptoms through the regulation of gene expression.

Conflict of interest: No
Objectives: To perform a detailed analysis of methylation of three DNA fragments of about 1000 bp in length within the MIR137HG, BAG5 and SLC39A8 loci, which are common for the largest schizophrenia and intelligence GWASs, using peripheral blood of 74 schizophrenia patients and 68 healthy controls.

Methods:
The methylation level of each cytosine in both the CpG and non-CpG contexts was assessed by single molecule real-time bisulfite sequencing and analyzed for the relationship with haplotypes, schizophrenia, and cognitive functioning.
Results: The majority of cytosines were hypo-or hypermethylated. The intermediately methylated sites were rare and mostly represented by CpG-SNPs. These sites showing allele-specific methylation were not associated with schizophrenia or cognition. At the same time, in the MIR137HG locus, we found an intermediately methylated CpG, which was not related to the local common polymorphism. Its methylation was higher in schizophrenia men compared to controls and correlated negatively with cognitive functioning. The adjacent CpH was also variably methylated. Introduction: The deterioration of social functioning is considered not only a concomitant symptom of schizophrenia, but is one of the central characteristics of the disease. The neurohormone oxytocin plays a key role in social cognition and social behaviors, which are important in disorders with impaired social functioning. It has also been shown to modulate reactivity to social stressors. There is some evidence that genetic polymorphisms in oxytocin pathway genes are associated with social dysfunction in schizophrenia.
Objectives: To search for the association between CD38 (rs3796863), OXTR (rs53576) , OXTR (rs4686302) and social functioning in patients with schizophrenia and to assess if the association is moderated by early-life stressors. Methods: Social functioning was assessed with the Personal and Social Performance (PSP) scale in 713 patients (women 47%), aged from 16 to 70 years, with ICD-10 diagnosis of schizophrenia or schizoaffective psychosis. Patients were stratified by the level of social functioning into two groups: "moderate and good" and "marked and poor". Allele and genotype frequencies were calculated in each group. Alcoholism in the family (n=120) and growing up in a single parent family (n=209) were studied as stressors of early-life.
Results: The early-life stressors exert no significant effects on social functioning. The frequency of the GG (rs53576) genotype was significantly higher (p=0.013; 95%CI 1.6 (1.1-2.3)) in the "marked and poor" group compared to the "moderate and good" group. Conclusions: The OXTR (rs53576) gene, reported earlier to be associated with social behavior, is associated with social functioning in schizophrenia. This work was supported by RFBR grant N 17-29-02088. Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in which symptoms respond to several pharmacological treatments. However, little is known about the brain mechanism of action of those treatments and the heterogeneity of response across different patients.
Objectives: To determine the resting-state fMRI correlates of treatment response to stimulants in ADHD children.
Methods: We recruited 68 boys and girls (ages 7-17) with ADHD in an outpatient setting. Sociodemographic, neuropsychological, and clinical data and blood samples were collected from participants, who also underwent neuroimaging (resting-state fMRI scan). Neuroimaging data were preprocessed (including motion correction) and (fractional) amplitude of low-frequency fluctuations ((f)ALFF) metrics were extracted with CPAC v1.4.3 software.
All data passed quality control assessments. Initial comparison between 38 patients treated with stimulants and 23 treatmentnaïve patients was done with AFNI 3dttest++. (f)ALFF were also compared in a subsample (n=8) of naïve subjects pre-vs. postacute treatment with methylphenidate, all of whom had good clinical responses. Results: Initial cross-sectional between-group comparisons of (f) ALFF yielded no statistically significant results. In the pre-post within-subject comparison, methylphenidate induced a significant increase of fALFF in a cluster in the right primary visual cortex (MNI coordinates 12,-78,12, corrected p<0.05).
Conclusions: Our findings suggest a modulatory effect of intrinsic BOLD signal fluctuations in the primary visual cortex by methylphenidate treatment in a small sample of clinically-responsive ADHD children and adolescents. Our preliminary results illustrate the improved statistical power of within-subject analyses, and highlight the primary visual cortex as a potentially relevant locus in the pharmacodynamics of ADHD treatment.

Conflict of interest: No
Keywords: ADHD; fMRI; stimulants; resting-state O0033 Dysfunctional brain activity and the inability to delay gratification in obesity with or without binge eating disorder R. Miranda-Olivos 1 *, T. Steward 2 , I. Martínez-Zalacaín 1 , G. Testa 1 , S. Jimenez-Murcia 1 , C. Soriano-Mas 1 and F. Fernandez-Aranda 1 1 Spain and 2 Australia Introduction: The inability to delay gratification, in some individuals with obesity (OB) and the eating disorder, could be associated with greater impulsivity to immediate rewards. Dysfunctional brain activity involves corticostriatal circuits related to motivation and impulse control. In obesity with or without binge eating disorder (BED) immediate rewards choices can impede to self-regulate food intake and a diminished success with weight loss in obesity treatment. Objectives: We examined differences of delay gratification between individuals with obesity and healthy-weight and we explore these differences associated with neural activity. Methods: Seventy adult women were recruited and classified by Body Mass Index (BMI) between healthy weight (HW-group) (N=33; BMI= 18-24.99) and OB-group (N=37; BMI= 30-40) with or without BED. All participants were underwent to functional magnetic resonance session, where a well-established monetary delay discounting task was implemented (5). Overall and three sizes of delay and reward (small, medium and large) scores were obtained and will be used in neuroimaging analyses at the singlesubject level and subsequently between-group comparisons. Results: Preliminary behavioral results OB-group (included BED) prefers a smaller-sooner reward comparison to HW women in scores: overall (T=-2.283; p-value=0.026), small (T=-2.067; p=0.043) medium (T=-2.158;p=0.033), but not in delayed and reward of large size (T=-1.999; p=0.050). Neural correlates results could support differences detected in delay discounting scores providing a better understanding of dysfunctional brain activity in obesity.

Conclusions:
The preference for smaller-sooner rewards may explain dysregulated eating in obese condition. Behavioral interventions based on the identified functional activity could optimize weight-loss strategies and improve eating behavior in this condition. Objectives: We sought to determine the response of social impairment to memantine treatment in adolescents with ASD and to explore spectroscopic dACC Glu activity as a biomarker of response to memantine therapy. Methods: 40 adolescents (ages 13-17 years) with ASD participated in a 12-week, double-blind, placebo-controlled trial of memantine. Treatment Responders were defined as those with ≥ 25% reduction in informant-rated SRS-2 score and clinician-rated improvement subscale of the CGI score of ≤ 2. Neuroimaging data was acquired from ASD participants before and after the trial and from age-, sex-, and IQ-matched healthy controls.

Conflict of interest: No
Results: Forty adolescents with ASD were exposed in the study (memantine=19/placebo=21). There were significantly higher rates of treatment responders with memantine treatment vs. placebo. High Glu activity was observed in 61% of the participating ASD population. Memantine response was significantly greater than placebo in ASD participants with High-Glu activity. Furthermore, the response to memantine in ASD was significantly higher in the presence of High versus Normal Glu activity.
Conclusions: The glutamate modulating agent memantine was well tolerated and significantly effective in treating social deficits in adolescents with HF-ASD. The atypically high dACC Glu activity observed in more than half of the ASD study population with ASD served as a predictor of response to memantine therapy. Introduction: Externalising symptoms in childhood, such as Hyperactive/inattentive symptoms (ADHD symptoms) or Irritability, are associated with adolescent suicidal behavior in clinical studies, but there is still a lack of population-based longitudinal investigations on the developmental aspects of this association.
Additionally, it is unclear whether the association is similar for boys and girls.
Objectives: The objectives of the study were to test the association between ADHD during childhood and suicidal ideation and attempt during adolescence, and to investigate sex differences. Methods: 1407 children from the Québec Longitudinal Study of Child Development were followed up from 5 months to 17 years of age. We used teacher-reports of ADHD symptoms from 6 to 12 years, and self-report of suicidal ideation and attempt at 13, 15, and 17 years. We identified three ADHD symptoms trajectories: low (  Introduction: The relationship between the inflammatory agents found in depressive disorder (DD) and physical health indicate that omega-3 FA intake may be a promising therapeutic modality.
Objectives: The aim of this pilot, single-centre, randomized, doubleblind controlled study was to investigate the levels of inflammatory markers, thromboxanes in plasma and urine in children with DD and in controls before fish oil emulsion administration and influence omega 3-FA intake on clinical status of depression. Methods: We randomised 41 children (11 to 17 years) to the Omega-3 FA or Omega-6 FA groups. Patients were clinically investigated with CDI score (Children's Depression Inventory). The level of thromboxane B2 in plasma was determined by ELISA kit and in urine as 11-dehydrothromboxane B2 by ELISA Kit-Monoclonal, 8-isoprostanes by kit Cayman. Results: CDI scores decreased after the omega-3 FA supplementation by 27% compared to omega-6 FA (13%). In patients with DD, we found increased basal plasma TXB2 level compared to the control group (p = 0.001). Omega-3 FA decreased level of thromboxanes in plasma after 6 and 12 weeks about 27% (p= 0.044, p=0.014, resp.) in the contrary to omega-6 FA, which had no effect on TXB2 levels (p = 0.693, p = 0.150, resp.).

Conflict of interest: No
Conclusions: Although severe Internet misuse is obviously related to wide range of psychopathology, normative perception of danger in the Internet could affect specific anxiety in youth but suppress anger and hostility in youth and adults. Study is supported by the Russian Science Foundation, project 18-18-00365. Disclosure: Research is supported by the Russian Foundation for Basic Research, project No. 18-013-01222.

O0043
Online multitasking in adolescents: Important skill or sign of internet addiction?

Russian Federation
Introduction: Internet opens opportunities and demands from children and adolescents involvement and switching between different activities. While multitasking is typically defined as favorable skill to simultaneously regulate different activities (Lee and Taat gen, 2002, Oberauer andKliegl, 2004), in adults it could lead to poorer performance (Furnham, Bradley, 1997, Foerde et al., 2006 Introduction: Anxiety and depression are very common causes of long-term sick leave. Different interventions are needed, but lack of coordination of these, seem to entail confusion among sick employees, afflicting their recovery. Objectives: The aim of this study is to examine the efficacy of the IBBIS intervention: integrated vocational rehabilitation (VR) and mental health care (MHC), compared to non-integrated interventions.
Methods: 3-armed RCT. 611 Participants on sick leave due to depression or anxiety were randomized to one of three groups: 1, treatment as usual, (standard MHC and standard VR; 2, IBBIS MHC, consisting of cognitive behavioral therapy, and standard VR; 3, the IBBIS intervention: integrated MHC and VR. Primary outcome is time to stable return to work (RTW), measured at 12-month follow-up. Secondary outcomes are RTW at 6-and 24-month followup, and at 6-month follow-up: levels of depression, anxiety, perceived stress, and functional measures. Results: Two of the groups seem to have a faster return to work than the third group (both HR~1.4, both p<0.036), as well as lower symptom levels. All secondary outcomes will be analyzed soon after abstract deadline.
Conclusions: From ongoing analyses, the currently emerging pattern shows two of the groups yielding consistent better results than the third, on both duration of sick leave and symptom levels. Seemingly, different organization and/or content of services matter: directions and magnitudes of all outcomes will be presented

Conflict of interest: No
Keywords: Dépression; Anxiety; Vocational rehabilitation; Integrated Care

O0049
Relationship between maternal mindfulness training during pregnancy and executive abilities in children S. Kiselev*

Russian Federation
Introduction: It is known that maternal anxiety during pregnancy can affect child outcomes. We have shown that maternal mindfulness training during pregnancy has positive effect on the development of executive, language and memory abilities in 5-7 years old children (Kiselev, Volik, 2017).
Objectives: The goal of this study is to evaluate the effect of the maternal mindfulness training during pregnancy on executive abilities in 7-8 years old children.
Methods: In current study we included 24 women who participated in the maternal mindfulness training during pregnancy. The control group included 24 women who did not participate in this training during pregnancy. When the offspring of the target pregnancies were between 7 and 8 years of age, their executive abilities was assessed by 4 subtests from NEPSY (Tower, Auditory Attention and Response Set, Visual Attention, Statue). Results: One-way ANOVA was used to reveal group differences in performing executive tasks. We have revealed the significant differences (p<.05) between groups in 3 subtests from NEPSY (Tower, Auditory Attention and Response Set, Visual Attention). The children from the experimental group had better executive abilities.
Conclusions: These results suggest that maternal mindfulness training during pregnancy may have positive effect on the development of executive abilities in 7-8 years old children. Introduction: Correlations between psychiatric diseases and consumption of substances of abuse are common. Nevertheless, there are few data regarding this correlation in patients admitted to an acute psychiatric unit.
Objectives: The purpose of this survey is to detect the prevalence of substance abuse in a sample of acute psychiatric unit inpatients and to evaluate statistically significant differences, among some domains (restraint, involuntary commitment, violent acts, LAI therapy prescription), between abusers and non-abusers patients. Methods: We included 542-inpatients (January 2017 -March 2019); 39,5% were abusers, 60,5% were non-abusers. The sample was divided into three age groups: 18-35 years, 36-50 years and over 50 years (img1).
Results: The percentage of restraint, involuntary commitment, violent acts and LAI therapy prescription were higher in the abusers. The percentage of abusers was higher in the 18-35 years range (53%). In 18-35 years, abusers, the percentage of restraint, violent acts and LAI therapy prescription (48% are treated with LAI, 71% of which second generation LAI) were higher than in non-abusers. In 36-60 years, abusers, the percentage of restraint, violent acts, involuntary commitment and LAI therapy prescription (43%) were higher than non-abusers. There were not statistically significant differences between abusers and non-abusers in the over 50 years group. Concerning the type of substance abused, almost the totality of 18-35 years group of abusers used cannabis alone or in polyabuse (img2).
Conclusions: The Increasing use of substances is related to a worsening of the psychiatric disturbances. Our results suggest that considerable complexity in treatment management of these patients is required. Introduction: Use of antipsychotic drugs is common in nonpsychotic disorders such as depression, anxiety, autism spectrum disorders, and insomnia. But exposure to antipsychotic drugs has been associated with a range of serious adverse events from arrythmias to diabetes. There is a need for detailed information on current practice and trends in the utilization of this drug class to guide future initiatives on the rational use of antipsychotic drugs. Introduction: The majority of randomized controlled trials (RCTs) on antipsychotics (APs) has efficacy as primary endpoint and provides a limited follow-up period. The lack of conclusive evidence on long term metabolic effects of antipsychotics has been reported as an issue demanding a more in-depth investigation.
Objectives: Aim of the present meta-analysis is to compare different APs for the long-term modification of risk of major adverse cardiovascular events and related mortality, in patients with schizophrenia and bipolar disorder.
Methods: All RCTs found on Medline/Embase of at least 52 weeks up to 19 December 2017, enrolling patients with bipolar disorder or schizophrenia and comparing an AP with another AP or placebo were included. The primary outcome of this analysis was the association of APs with the incidence of cardiovascular death (CVD), myocardial infarction (MI), and stroke. Mantel-Haenszel odds ratios with 95% confidence intervals (MH-OR) were calculated. Results: Of the 3013 studies screened, 92 met the selection criteria ( Fig. 1), with 11, 6 and 24 studies reporting data on MI, stroke and CVD, respectively. No significant difference was observed with respect to MI and stroke; a significantly higher cardiovascular mortality was observed for sertindole when compared to risperidone.
Conclusions: The paucity of available data does not allow to estimate the impact of APs on cardiovascular morbidity and mortality in the longer term. Long-term metabolic and cardiovascular effects of antipsychotics deserve to be studied more extensively: the request by regulatory authorities of cardiovascular safety data from specifically designed trials would be useful. Results: Group 1: HDRS-17 improved from 24.5 (SD 4.6) to 14.6 (SD 5.7). Group 2: HDRS-17 improved from 25.1 (SD 4.2) to 11.6 (SD 4.4). (p<0.05). Group 1: RRS improved from 60 (SD 6.3) to 47.6 (SD 9.2). Group 2: RRS improved from 63.7 (SD 7.2) to 43.5 (SD 9.3) (p<0.01) Conclusions: The combined protocol of iTBS of the L-DLPFC in addition to low frequency rTMS of the SMA decreased depressive symptoms and rumination in TRMDD patients more effectively than the iTBS of the L-DLPFC only protocol. This confirms highly ruminative TRMDD is a valid clinical subtype. Introduction: Depression is highly prevalent and clinically significant syndrome in schizophrenia which associates with poor outcome, decreased quality of life and increased mortality rates. It is known that depressive, negative and cognitive symptoms of schizophrenia are linked with prefrontal cortex dysfunction, thus rTMS of this target might be beneficial. Objectives: to estimate the possible association between early cognitive improvement and response of rTMS in depression.

Conflict of interest: No
Methods: 63 schizophrenia (ICD-10) patients with prominent and persistent negative symptoms (mean PANSS composite index was -11,03AE5,48) and depression (CDSS score ≥ 6) on stable medication were included in the study. Patients received 15-Hz rTMS on the left DLPFC (100% intensity, 15 sessions of 1800 pulses). Patients were assessed weekly with CDSS, PANSS, and with the battery of cognitive tests ("10 words", Benton's test, "Coding", "Switching count", "Verbal fluency test"). The criterion of response was 50% CDSS score reduction after 3 weeks of treatment.
Results: The response rate was 63,5% (40 patients). Mean CDSS score reduction was 53,1% (p<0,000001), mean PANSS negative subscale score reduction was 18,3% (p<0,000001). There was improvement in cognitive tests for executive functions and attention switching without significant changes in verbal and visual memory. Rapid cognitive response ("Coding" score increase ≥10% after 1 week) matches with rTMS response (Chi-square 4,03, p=0,0446 Conclusions: Prescriptions of Psychotropic medications, except for antipsychotics and psychostimulants, are more common among HC users. The nature of these findings will be further examined in a long-term prospective register-based setting. Conclusions: Llithium crosses the placenta completely and the concentrations in infant plasma decreased across time. We did not observe signs of lithium toxicity in nursing infants. Our suggestion is to monitor lithium concentration in mother-infant dyads at delivery, at 2, 10, 30 and 60 days postpartum.  Objectives: To study different factors that can influence the physician's empathy and the dimensions of the personality of the doctors to establish the link that can exist between these dimensions and the different dimensions of empathy.

Methods:
A cross-sectional analytical survey carried out among 120 public health doctors. We collect different personal and professional variables using a pre-established questionnaire. We used the Jefferson Hojat Empathy Scale for the assessment of empathy. The study of the personality was carried out using the "Big Five" scale.
Results: The average of the empathy scores among our participants was 96.24. We found that the "PP" dimension score increased with age, was significantly correlated with having psychotherapy training (p = 0.002), having training about communication (p = 0.004) and was higher among physicians with A dimension of personality (p = 0.03). The score of the "CE" dimension was higher among doctors who spend time with their entourage (p = 0.034), who practice a leisure activity and who do not have children (p = 0.002). The "Spis" dimension was lower in physicians with a high number of hours (p = 0.022) and a high number of consultants and it was higher in physicians with an E dimension of personality (p = 0.038). For the JSPE total score, it was significantly higher among physicians with training in psychotherapy (p = 0.014).

Conclusions:
We should now find a link between the best method to develop empathy based on personal representation. Introduction: Early detection of schizophrenia is one of most important questions in psychiatry. Apart from clinical signs, which are often represented by depressive symptoms, dysfunction of the immune system is also found at the early stages of psychosis.

Conflict of interest: No
Objectives: Detection of clinical and immune markers of schizophrenia prodrome in young adults with the first episode of depression.
Methods: 66 young in-patients (average age 19.7 years) with first depressive episode were divided into three groups: 1 -depression with attenuated psychotic symptoms (APS), 2 -depression with attenuated negative symptoms (ANS), 3 -pure youth depression without "schizophrenic signs". The scales HDRS, SOPS and SANS were applied to assess the severity of depression, APS and ANS respectively. The activity of inflammatory markers -leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI) -was determined in serum.
Results: Аn increase in the activity of inflammatory LE compared with the control group was found in all patients. An increase in the activity of α1-PI in groups 1 and 3 (p<0.0001; p=0.0044) was detected. Clinical and biological correlations were found: between activity LE, α1-PI and the total score on the HDRS (r=0.55; p=0.023 and r=-0,48; p=0,032) in the 1st group; between the activity LE and the positive SOPS subscale (r=0.52; p=0.027) and the negative SOPS subscale (r=-0,46; p=0,05) in the 2nd group; between LE activity and the score on the HDRS (r=0,47; p=0,038) and SANS (r = 0,63; p=0.049) in the 3rd group.

Conflict of interest: No
Keywords: hostility; interpersonal anxiety; cyberbullying Methylenetetrahydrofolate reductase (MTHFR) gene was previously associated with schizophrenia, metabolic risk and side-effects as well as with neurocognitive functions and treatment response in schizophrenia.
Objectives: The objective of this study was to investigate the association of MHTFR 1298 polymorphisms with treatment response measured by changes in facial emotional recognition (FER) and psychopathology in patients with first-episode psychosis (FEP). Methods: We conducted a prospective study including 159 patients with FEP recruited from two Croatian psychiatric hospitals. We performed assessment two weeks upon admittance to hospital and after 18 months of follow-up. We assessed psychopathology with the Positive and Negative Syndrome Scale (PANSS) and FER with Penn Emotional Recognition Test. Genotyping of blood samples was preformed according to usual practice. Statistical analysis included ANOVA. Results: Our results did not show statistically significant association of MHTFR genotypes and correct recognition of presented emotions. However, we found significant associations with initial general (F=3.36, p=0.04) and overall PANSS scores (F=3.14, p=0.05) as well as with changes of negative (F=-1.562, p=0.012), general (F=-2.686, p=0.005) and overall PANSS scores (F=-5.417, p=0.006). In all cases, the carriers of the CC alleles had better scores.
Conclusions: While we did not find association of specific MHTFR genotypes and FER, they showed strong association with both initial and changes of psychopathology scores after 18 months of follow-up which opens the possibility of their role as potential marker for treatment outcomes. Introduction: Although four atypical antipsychotics, including risperidone, showed better efficacy than typical antipsychotics in a large meta-analysis, specific studies failed to verify their effect on primary negative symptoms. Cariprazine, a D3/D2 partial agonist has proven to be effective in the treatment of acute and predominantly negative symptoms (PNS) of schizophrenia.

Conflict of interest: No
Objectives: The objective of this analysis is to evaluate the effects of cariprazine versus risperidone in the treatment of acute and PNS schizophrenia.
Methods: Analyses are based on one short-term, placebo and risperidone controlled study (NCT00694707) investigating the efficacy of cariprazine on acute symptoms (intention to treat population) and negative symptoms ( Introduction: Cognition is essential for self-reliant functioning and health-related quality of life. Psychiatric patients suffer from cognitive impairment as a core feature of their illness. Nonpharmacological interventions such as cognitive remediation have been proven effective in ameliorating cognitive performance. Objectives: We aim to investigate whether psychiatric patients with different diagnoses and admitted to a psychiatric department in a defined epidemiological catchment area differ from each other due to their premorbid intelligence and cognitive functioning. Furthermore, the effects of a combination therapy including psychotropic drugs and cognitive remediation were assessed to detect possible improvement. Methods: Patients received combination treatment with psychotropic drugs and cognitive remediation using COGPACK. Cognitive assessment was performed by means of the Screen for Cognitive Impairment in Psychiatry (SCIP). Premorbid intelligence was recorded using Mehrfachwahl-Wortschatz-Intelligenztest (MWT-B). Introduction: An estimated 300 million people worldwide are affected with major depressive disorder (MDD). Dysregulation of ɣ-aminobutyric acid (GABA) signaling is associated with MDD. SAGE-217 is an investigational, oral, neuroactive steroid and GABA A receptor positive allosteric modulator that has demonstrated reductions in depressive symptoms in a Phase 2 doubleblind, randomized, placebo-controlled study in MDD.
Objectives: The objective of this Phase 3, double-blind, randomized, placebo-controlled study was to evaluate the efficacy and safety of SAGE-217 in the treatment of adult subjects with MDD. Methods: Subjects with MDD were randomized 1:1:1 to SAGE-217 30 mg, 20 mg, or placebo capsules. Subjects were treated for 14 evenings, then followed frequently for 4-weeks and intervals through 182-days. The primary endpoint was change from baseline in Hamilton Depression Rating Scale (HAM-D) total score at Day 15 compared with placebo. Safety and tolerability were assessed by standard clinical assessments.
Results: The initial 4-week follow-up of this Phase 3 study will be completed at the end of 2019. Data will be reported on HAM-D time points Days 3-42 (including Day 15), HAM-D response (≥50% reduction) and remission (≤7), Montgomery-Åsberg Depression Rating Scale (MADRS) scores, and Hamilton Anxiety Rating Scale (HAM-A) scores. Safety and tolerability data will also be reported.
Conclusions: This Phase 3 study aims to confirm and extend the previous results in a larger study population utilizing two dose groups versus placebo. These results have the potential to be an important milestone in the development of SAGE-217 in the treatment of individuals with MDD. Disclosure: CMS is an employee of Sage Therapeutics, Inc. and have stock/stock options.

O0091
The safety, efficacy, and tolerability of a microbial therapeutic in people with major depression and/or generalized anxiety disorder: Preliminary findings A. Chinna Meyyappan* and R. Milev Canada Introduction: The bidirectional biochemical signalling between the gut microbiota and the brain, known as the gut-brain axis, is being heavily explored in current neuropsychiatric research. Analyses of the human gut microbiota have shown considerable individual variability in bacterial content which is hypothesized to influence mood and anxiety symptoms through gut-brain axis communication. Research examining these effects suggests that microbiota transplantation may help improve depression and anxiety symptoms and severity by recolonizing the gastrointestinal tract with healthy bacteria.
Objectives: The primary objective is to assess subjective changes in mood and anxiety symptoms throughout the study. The secondary objectives are to assess changes in metabolic functioning and level of repopulation of healthy gut bacteria, safety and tolerability of therapeutic, and effects of early stress on biomarkers of depression/ anxiety and response to treatment. Methods: Seven adults diagnosed with MDD/GAD were recruited from Kingston, ON, Canada. Participants consumed daily an encapsulated therapeutic, containing 40 strains of bacteria purified and lab-grown from a single donor, for 8 weeks. Participants completed assessments measuring mood/anxiety/GI symptoms for a 10-week period. Blood/fecal samples were assessed for biomarker changes and level of engraftment from feces. Results: Six of seven individuals responded to treatment (50% improvement in MADRS/GAD-7 scores since baseline). Over the 10-week course, MET-2 significantly decreased MADRS and -GAD-7 scores, F(1,6) = 14.19, p = 0.009 and F(1,6) = 18.07, p = 0.005, respectively. This improvement may be mediated by the recolonization of the gastrointestinal tract with healthy bacteria.
Conclusions: These preliminary findings may be the first to provide evidence for the role of microbial therapy in treating depression and anxiety. Introduction: We extensively reported on a higher expression of inflammatory gene clusters in monocytes of Major Depressive Disorder (MDD) patients, particularly those with a history of childhood adversity (CA). In our studies there were also signs that not only inflammatory, but also apoptosis/growth and cholesterol metabolism genes were abnormally expressed.
Objectives: To study the expression of growth/apoptosis and cholesterol metabolism genes in circulating monocytes of MDD patients collected at three EU-MOODINFLAME sites.
Methods: Adult patients with DSM-IV diagnosed MDD with (N=77) or without (N=58) CA (measured by Childhood Trauma Questionnaire) and healthy controls (HC) with (N=37) and without CA (N=81; reference group) were recruited. Monocyte gene expressions were determined using qPCR. Results: 1. MDD monocytes showed an abnormal expression of two inter-correlating clusters of apoptosis/growth and cholesterol metabolism genes (irrespective of CA  Fig.1).
Conclusions: Mental disorders were detected in 84% of patientsbehavioral, emotional and personality disorders, memory impairment. The increase in psychopathology after removal of craniopharyngiomas is detected in 43% of patients. Introduction: Women with a bi-and homosexual orientation have been associated with having elevated risks for developing substanse use problems compared to heterosexual women and to a greater extent than among sexual minority men (Burgard et al, 2005, Parsons et al, 2006. It raises the question wether there is a greater risk for developing behavioural addictions of gambling and gaming activities among sexual minority women. Two studies have indicated a higher prevalence of gambling problems among sexual minorities (Grantz & Potenza, 2006, Richard et al, 2018. A few publications have shown a higher prevalence of gaming problems among sexual minority populations, including a pilot project to this study in a Swedish setting (Broman & Håkansson, 2018).

Conflict of interest: No
Objectives: To investigate whether the prevalence of problematic gambling, gaming, internet behaviour differ depending on sexual orientation in a female European study sample. Methods: A web survey was performed in seven European countries; Sweden, Denmark, England, Spain, Italy, Poland, Switzerland. All data was self-reported. Chi-square tests and binary regression analysis were applied. Results: 10 969 complete answers were collected, among whom 771 defined as homosexual, bisexual or other. In descpritive analyses, problematic gambling, gaming and internet behaviour was significantly overrespresented in sexual minority women. Applying regression analysis, sexual minority status remained significant for having a problematic gambling (p=0.036) and gaming problem (p=003).
Conclusions: The result in this study is suggesting that behavioural addiction is overrepresented among sexual minority women. In accordance with ealier research, it highlights that sexual minority women need a special focus within clinical addiction settings. Disclosure: No financial support was received specifically for this study. AH holds at position as professor at Lund University, and AH and NB have overall research support from the collaboration between Lund University and the Swedish gambling operator monopoly, Sv Keywords: Behavioral addiction; sexual minority women; Gambling; Gaming

O0107
Betting on yourself is never a gamble: Cannabis users fail to take advantage of favourable opportunities in a novel gambling paradigm S. Perkins*, T.V. Lim and K. Ersche

United Kingdom
Introduction: Cannabis remains the most widely used illicit drug in Europe. There is a lack of consensus on the impact of cannabis use on cognitive function; disadvantageous decision-making has frequently been reported in cannabis use disorder, but the early signs are unclear. Objectives: We sought to investigate financial decision-making in cannabis users using a novel paradigm that is not dependent on learning or working memory. We hypothesised disadvantageous choices; either inappropriate risk-taking or selection of unfavourable options. Methods: We recruited 45 healthy young-adults from the general community: Twenty-eight reported harmful cannabis use (CUDIT score >13), 17 did not consume cannabis at all. They performed a roulette task in which bets were placed on anticipated outcomes. Reward and loss trials were administered separately. Statistical tests were conducted using SPSS v25 and were reported as significant if p<0.05. Results: The groups were well matched on age and socioeconomic status, but differed on gender and level of education which were controlled for in the analysis. During the task, cannabis users earned as much as controls (F 1,40 =0.5, p=0.479) and did not demonstrate any risk-taking behaviour (F 1,40 =0.1, p=0.780). However, they placed lower bets on favourable options when reward was at stake (F 4,160 =4.9, p=0.003).
Conclusions: These preliminary results elucidate a deficit amongst cannabis users in making use of favourable opportunities. This early feature of cognitive dysfunction may likely contribute to the disadvantageous pattern of decision-making apparent in cannabis use disorder. Our findings might represent an opportunity for early intervention, however further research is required to explain the underlying process. Disclosure: Acknowledgments: The authors thank all the participants who agreed to participate in our study, which was partly funded by the Introduction: People with severe mental illnesses (SMI) and common mental disorders (CMD) have higher premature mortality than the general population (GEP) largely due to common, preventable chronic physical illness (CPI). In fact, the mortality gap between people with and without SMI or CMD is growing. However, the effect on psychiatric treatment outcomes are not clear Objectives: To outline and discuss differences in the prevalence and patterns of CPI, multimorbidity (≥2 CPI) and their effects on psychiatric treatment outcomes. Methods: Presentation is based on retrospective cohort study conducted on psychiatric patients (PP) (n=1060), and the crosssectional European Health Interview Survey conducted on Croatian GEP (n=837). Results: PP had 27% (CI 95% 24%-30%; p<0.001) higher agestandardized relative risk for CPI and 31% (CI 95% 28%-34%; p<0.001) higher risk for multimorbidity than the GEP. The younger the patient, the larger was the difference to the GEP counterpart. The most vulnerable group were young women with schizophrenia. The specific multimorbidities' profiles and interconnectedness of different CPIs was very similar between PP and the GEP. Multimorbidity was significantly associated with higher rehospitalization rate in patients with schizophrenia and major depression disorder, and PP lower quality of life.

Conclusions:
The psychiatric population is disproportionately burdened with an increased risk of CPI and multimorbidity which affects the psychiatric treatment outcomes and patients´quality of life, and lead to premature mortality. The medical and lifestyle interventions should optimally be integrated into the psychiatric setting and brought to the forefront of psychiatric research. 3) ≤14 weeks of pregnancy, 4) exposed to an AD (users) or any exposure considered non-teratogenic (non-users) at the time of the call. Women were excluded if they were exposed to a known teratogen. Socio-demographic and lifestyles, and medical history were collected during each trimester of pregnancy and annually until 3 years after birth. Mothers annually reported children's development by filling out Age-and-Stage questionnaire, and validated measures of maternal depression (EPDS) were collected. Exposure to AD was reported by mothers, and defined by trimester, type, dosage. Results: Of 364 infants included, 10 (3%) were exposed to AD solely during the 1st trimester, 24 (7%) during the 1st/2nd trimesters, 181 (50%) throughout pregnancy, the remaining were unexposed. Adjusting for covariates, in-utero exposure to AD had no effect on cognitive function at 3 years old.

Conflict of interest: No
Conclusions: In-utero patterns/trajectories of AD use during pregnancy did not have an impact on children's cognitive function at 3 years old compared to non-use. Assessments at later life stages are needed.

Conflict of interest: No
Keywords: In-Utero Exposure; Children's cognitive development at 3 years; MotherToBaby Antidepressants Study; Antidepressants O0120 Sex-specific volumetric variations associated with alcohol use in adolescence: A longitudinal neuroimaging study X. Navarri*, I. Filippi and P. Conrod Canada Introduction: There is growing evidence that alcohol use (Thayer et al., 2017) during adolescence is associated with brain volumetric alterations. These variations can be interpreted as neurotoxic consequences of alcohol use or common vulnerabilities in crosssectional studies. Moreover, little is known about the sex-specific volumetric abnormalities that could predate alcohol use and thus present markers of vulnerability.
Objectives: The current longitudinal study aims to determine whether sex-specific variations in adolescence predate and predict alcohol use. Methods: Participants from the Neuroventure cohort were recruited at 12 years old (n = 155) to measure the correlates of adolescent drinking on the developing brain structure (Bourque et al., 2016). Data was collected at three time points when the participants were 12, 14 and 16 years old. Alcohol use was assessed using the DEP-ADO questionnaire. We used the Freesurfer longitudinal neuroimaging pipeline of the ENIGMA consortium to extract individual subcortical volumes and cortical thickness. We performed linear mixed-effect models for each regions of interest.
Results: Preliminary results indicates that alcohol use is associated with reduced volumes in a priori selected regions with the main sex effect considered in the model. Sex-by-time interaction are being explored.
Conclusions: Conclusion: The sex-specific volumetric variations observed in adolescents could predate and predict at-risk alcohol use. A better understanding of the sex-specific variations could lead to more targeted intervention programs. Introduction: Epigenetics is emerging as an important player underlying the interactions between genetic and environmental risk factors in the aetiology of psychiatric disorders. We could hypothesize that epigenetic changes related to childhood adversity (CA) contribute to the underlying mechanism linking CA and psychosis.

Conflict of interest: No
Objectives: We aim to explore, whether CA leads to DNAmethylation changes at the level of EWAS in First Episode of Psychosis (FEP) patients. We will also examine whether these changes in DNA-methylation mediate the link between CA and psychosis. Methods: We used EWAS profiling using the Illumina Infinium Methylation EPIC array in human peripheral blood tissue from 413 FEP and 521 healthy population controls part of the EUGEI study. Polyvictimisation scores were created with the Childhood Trauma Questionnaire (CTQ) ranging from 0-5. Linear regression models at an EWAS level and subsequent mediation analyses were perfomed, adjusting by a broad range of confounding factors. Results: Preliminary results showed that polyvictimisation scores were significantly associated to the case control status; in cases, EWAS analyses showed that polyvictimization was significantly associated (p<5x10-5) with DNA methylation in 82 probes, located in 48 genes, some of these involved in pathways such as extracellular matrix, neural development or the kynurenine pathway, among other important processes. In controls, DNA methylation changes in such probes did not appear to be associated with polyvictimisation.
Conclusions: Our results show that in FEP, polyvictimisation leads to epigenetic modifications in the form of DNA-methylation in genes previously described in psychosis aetiopathogenesis. Mediation analyses will allow to determine whether changes in these probes mediate the link between adversity and psychosis. Objectives: The hypothesis tested in the present contribution was that PIWG may have a signfiicant genetic compoent, especially when investigated through consistent molecular pathways. The analysis of complete molecular pathways granted a sufficient power to tackle the biologic variance and complexity of PIWG.

Conflict of interest: No
Methods: A genetic sample from the CATIE trial (n=765; M=556, mean age = 40.93AE11.03) -a multi-phase randomized controlled trial of antipsychotic medications involving 1,460 persons with schizophrenia followed for up to 18 months -was investigated. A molecular pathway analysis was conducted. A genome-wide analysis with standard quality procecudres was input for the analysis through Bioconductor and ReactomePA. Correction for multiple testing (Bonferroni, FDR) and 10E5 permutations (through creation of random molecular pathways) was implemented.
Results: The developmental biology molecular pathway was significantly (p.adj= 0.018) enriched in genetic variations significantly (p<0.01) associated with PIWG. The pathway is involved in the regulation of beta-cell development, and the transcriptional regulation of white adipocyte differentiation.
Conclusions: Results correlate with previous evidence and is consistent with our earlier result on the STAR*D sample. The involvement of the beta-cell development and the trasnscriptional regulation of white adipocyte differentiation pathways stresses the relevance of the peripheral tissue rearrangement, rather than increased food intake, in the biologic modifications that follow psychotropic treatment and may lead to PIWG. Methods: Biotinylated pUC1.77 probe was used for f-SatIII quantitation in leukocyte DNA by the non-radioactive quantitative hybridization for SZ patients (N = 840) and healthy control (HC,N=401).

Conflict of interest: No
Results: f-SatIII in human leukocyte varies between 5.7 to 44 pg/ng DNA. F-SatIII content in SZ group was significantly reduced compared HC-group (p < 10 -30 ). f-SatIII content in SZ patients negatively correlated with the index reflecting the seriousness of the disease (PANSS). The SZ (medicated) and SZ (drug-naïve) subgroups do not differ in the content of f-SatIII. current evidence reporting the involvement of the immune system in the pathogenesis and course of psychotic disorders. Moreover, our results suggest the need to define an "immunological print" of subjects affected by psychosis, with the final aim of translating it in clinical practice. Introduction: Standardized screening rating scales, such as the Adult ADHD Self-Report Scale (ASRS), are recommended for the diagnostic process. The most recent and longest version has not been translated into Spanish.

Conflict of interest: No
Objectives: To translate the 31-item ASRS into Spanish. Methods: Four independent translators conducted the initial forward translation, using previous WHO approved versions in Spanish as reference. The herein obtained version was pre-tested, debriefing participants to verify an equivalent understanding of the original meaning. An expert panel reviewed the observations afterwards.
Results: The independent translations were compared with a closer discussion of the last fourteen items. The resulting version was tested on 50 adults, aged 18-70. After being administered the scale, they were debriefed following a semi-structured interview. Difficulties understanding were mainly observed due to differing life situations of the sample, such as different employment status and age groups. The expert panel reviewed the results of the pretesting, and one item was changed to comply with the linguistic norms of Spain (Table 1). The total score range was 9-92 points; most individuals obtained total scores between 30 and 60 points ( Figure 1).

Conclusions:
A culturally equivalent Spanish translation of the updated ASRS is presented. Objectives: This study seeks to identify the most reliable neural abnormalities of PTSD identified in the functional neuroimaging literature and build a whole-brain, neural representation of taskbased hyperactivities and hypoactivities. Methods: We conducted the largest to-date meta-analysis of existing fMRI studies (N = 44) that compare PTSD patients (N = 723) to age-matched healthy controls (N = 813). We also used multilevel kernel density analysis and a voxelwise, whole-brain approach in order to search for abnormalities comprehensively throughout the brain and across multiple significance levels.

Conflict of interest: No
Results: Patients with PTSD showed reliable (α = 0.05 -0.001) patterns of neural abnormalities compared to healthy controls. These include brain regions responsible for stimulus detection, affective arousal, memory consolidation, and emotion regulation. Conclusions: These results may help better diagnose PTSD and further develop treatments such as transcranial magnetic stimulation that target specific brain regions. Introduction: Childhood abuse is a significant risk factor for the development of Eating Disorders (EDs), and can induce changes in the hypothalamic-pituitary-adrenal (HPA) axis. The impact of cognitive behavioral therapy (CBT) on cortisol levels remains to be explored. Objectives: To evaluate the effects of CBT on ED specific psychopathology, general psychopathology and blood cortisol levels in patients with EDs with and without a history of abuse.

Conflict of interest: No
Objectives: To characterise the development of disordered eating behaviours (DEBs) and related mental illnesses and identify early genetic, neural and psychopathological predictors of such trajectories.
Methods: Data were from the IMAGEN study, a large, prospective and longitudinal cohort of European adolescents assessed at ages 14, 16 and 19 years. For each self-reported DEB, we compared a developer group -consisting of participants who reported the DEB at 16 or 19 years, not at 14 years-to a control group in which participants did not report the DEB at any age. Grey matter volumes (GMVs), self-reports of emotional and behavioural problems, mental health symptoms, addiction-related behaviours and personality traits were investigated as predictors. Polygenic risk scores (PRS) for full neuroticism and its item clusters 'depressed affect' and 'worry', BMI and Attention Deficit Hyperactivity Disorder (ADHD) symptoms were calculated to investigate genetic contributions to DEBs. Results: Differences in GMVs in frontal and subcortical brain regions, body mass index (BMI), neuroticism, impulse control behaviours and addiction at age 14 differentially predicted future eating behaviours and subsequent symptoms of depression and generalised anxiety. Genetic analyses revealed etiological overlaps between BMI, neuroticism-related depressed affect and attentiondeficit hyperactivity disorder (ADHD) and dieting, binge-eating and purging, respectively. Conclusions: Genetic predispositions and biopsychopathological processes related to obesity, impulse control and neuroticism may be useful early and differential biomarkers of the vulnerability for eating disorders in adolescence.

Conflict of interest: No
Keywords: Eating disorders 'add' genetic 'add' brain 'add' biomarker

O0147
The validity of the 5th BMI percentile as weight cut-off for anorexia nervosa in children and adolescents: No evidence from a psychopathology investigation G. Cascino*, A. Mereu, V. Zanna, P. Monteleone, S. Vicari and A. M. Monteleone Italy Introduction: Although the 5 th Body Mass Index (BMI) percentile has been indicated by the DSM-5 in order to identify underweight in children and adolescents and to diagnose anorexia nervosa (AN), the validity of this cut-off has not been proved.
Objectives: Aim of this study was to compare general and specific psychopathology between adolescents affected by AN with a BMI above or below the 5 th percentile in order to test the validity of this weight cut-off. Methods: Four hundred-three adolescents with AN were recruited. They completed the Eating Disorder Inventory-3 (EDI-3) and the Youth Self Report (YSR). The sample was divided in two groups: below the 5 th (n = 172) and above the 5 th (n = 231). Quantitative differences between groups were investigated through t-test for independent samples. A network analysis was conducted in each group.
Results: The group with BMI above the 5 th percentile showed significantly higher scores in drive to thinness, body dissatisfaction, bulimia, personal and interpersonal alienation, social insecurity and asceticism. No significant differences emerged in general psychopathology measured through the YSR and in the occurrence of comorbidity between the groups. The group with BMI under the 5 th percentile had a longer illness duration. No difference emerged between the network structure of the two groups.
Conclusions: These findings suggest that the clinical utility of the 5 th BMI percentile as weight cut-off for diagnosis of AN in children and adolescents is questionable. Indeed, it may prevent early illness detection and intervention, which are essential to improve treatment outcome. Introduction: Digitalisation of global education is a reality which has profoundly shaped perceptions of mental health. Podcasts are set to change the way information is delivered, as studies have established they are a far-reaching and accessible vehicle for medical education.
Objectives: In collaboration with Maudsley Learning organisation, a series of podcasts were developed with a scope to: 1. Explore interdisciplinary working in mental health including psychiatry, psychology and philosophy. 2. Reach clinicians and non-clinicians. 3. Evaluate their effectiveness as an educational tool. Methods: Two psychiatrists and one psychologist were interviewed regarding their areas of expertise. Podcasts were distributed online and promoted using social media. Listener frequency was monitored using an online hosting service. A survey was distributed to podcast listeners, including: 15 questions spanning demographics and impact on knowledge of specific topics (e.g.: prescribing, psychotherapy). Quantitative data was collected using the Likert scale and analysed using Microsoft Excel. Qualitative data was collected using open ended questions and analysed using NVivo statistical software. Results: Total number of listens was n=320 with the most popular episode garnering 96 listens. Selected graphs represent current analyses of demographics (Image 1) and impact on knowledge (Image 2): Conclusions: Podcasts are a versatile and cost-effective means of promoting education in psychiatry. Alongside structured teaching, they provide an opportunity to produce more nuanced and in-depth content in the form of expert interviews.They represent an exciting tool to impart knowledge to both a clinical and non-clinical audience.
Results: 53.1% of the followed-up patients showed no changes on their stage, 37.5% improvedtheir stage and 9.4% showed a progression tothe worse stage.All patients with a worsened stage showed at least one psychiatric comorbidity and a significantly higherprevalence of somatic obsessions (p<.05).The age at onset of patients witha worsened stage was earlier compared to the other groups and theduration of untreated illness andduration of illness resulted almost two times higher compared to the other groups Conclusions: Preliminary results confirm the relevance of illness onset and early intervention in OCD. There is an emerging need of more stringent criteria for staging to better characterize OCD patients.

Conflict of interest: No
Keywords: obsessive compulsive disorder; staging; duration of untreated illness; severity

O0151
Assessment of over valuated thoughts, metacognition, magical beliefs and quality of life in patients with obsessive compulsive disorder and subtypes M.G. Teksin Bakir* and S. Aslan Turkey Introduction: Meta-cognitive thoughts are important predictors of severity, life quality and treatment response for obsessive compulsive disorder (OCD). Magical thoughts may affect the quality or quantity of obsessive beliefs in OCD patients. Occasionally obsessions are in form of Over Valuated Thought (OVT); and patients may be far from insight though they are not delusional, and aren't interpreting their obsessions always as egodistonic. Having obsessions characterized as OVT may lead to various clinical presentations and consequences. Objectives: Our aim in is to evaluate the association of OVT's with metacognition and magical beliefs in OCD patients and subtypes, to compare with control and to evaluate the impact of these clinical features on severity of disorder and quality of life. Methods: 54 OCD patients and 55 controls were included. According to the clinical interview, YBOCS and OVTS (Over Valuated Thought Scale), patients were divided into two groups as autogenous (n:23) and reactive (n:31). Magical Ideation Scale (MIS), Meta-cognition Scale (MCS), WHOOL-BREEF, Maudsley Obsessive Compulsive Questionnaire (MOCQL) and Beck Anxiety Inventory (BAI) scales were filled by all participants. Results: For OCD patients MCS total scores, WHOQOL-BREF-TR and BAI total scores were significantly higher. WHOOL-BREEF score in OCD patients were found to be inversely related to metacognition scores and the severity of magical thoughts. Our hypothesis is confirmed given the significant correlation between severity of OCD, YBOCS, MCS and BDI total scores. Conclusions: In OCD patients, higher level of metacognitive scores and OVT, related to severe magical beliefs, and poor quality of life. Introduction: Although the inflammatory hypothesis in depression is more than two decades old, only some aspects are well researched. Transforming growth factor beta (TGF-β), which has a role as an anti-inflammatory and regulatory cytokine, is very poorly investigated in patients with major depressive disorder (MDD) who experienced childhood trauma.

Conflict of interest: No
Objectives: Aim of our study was to analyze differences in serum concentrations of TGF-β between patients with MDD (with and without previous history of childhood abuse) and healthy controls, as well as to investigate possible predictors of TGF-β levels.
Methods: Blood samples were obtained from 55 patients who fulfilled DSM-IV-R criteria for a current MDD episode without psychotic symptoms and 45 healthy controls, matched for age and gender. Participants were administered the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS) and the Childhood Trauma Questionnaire (CTQ). Serum TGF-β concentration was determined by enzyme-linked immunosorbent assay.
Results: Concentration of TGF-β was significantly higher in patients compared to healthy controls and in those who reported experience of childhood abuse or neglect. Multiple logistic regressions showed a strong effect of CTQ total scores and duration of symptoms as predictors of TGF-β levels in patients. Conclusions: Conclusions: Childhood abuse as a predictor of TGF-β concentration in MDD patients could be an important missing puzzle in understanding immunological pathways and the role of cytokines in depression.

Conflict of interest: No
Keywords: Transforming growth factor beta; major depressive disorder; childhood abuse

O0155
Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: Phase II trial M. Hvenegaard* Denmark Introduction: Although cognitive-behavioural therapy (CBT) is an effective treatment for depression, less than half of patients achieve satisfactory symptom reduction during treatment. Targeting known psychopathological processes such as rumination may increase treatment efficacy.
Objectives: The aim of this study was to test whether adding group rumination-focused CBT (RFCBT) that explicitly targets rumination to routine medical management is superior to add-ing group CBT to routine medical management in treating major depression.
Methods: A total of 131 outpatients with major depression were randomly allocated to 12 ses-sions group RFCBT v. group CBT, each in addition to routine medical management. The pri-mary outcome was observer-rated symptoms of depression at the end of treatment