Explore the prevalence of lifetime suicide attempts in women with bulimia nervosa (BN), and compare eating disorder symptoms, general psychopathology, impulsivity, personality, and genetic variants in four candidate genes of the serotonin pathway: the serotonin transporter (SLC6A4), serotonin receptors 1A (HTR1A) and 2A (HTR2A) and tryptophan hydroxylase 1 (TPH1) between individuals who had and had not attempted suicide. Determine the best predictors of suicide attempts.

566 consecutively admitted BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN). Patients completed a comprehensive assessment battery.

Lifetime prevalence of suicide attempts was 26.9% CI 95%: 23.2 to 30.5). BN subtype was not associated with lifetime suicide attempts (p=0.36). Compared to non-attempters, attempters exhibited higher unemployment, eating disorder symptomatology, general psychopathology, previous eating disorder treatment, impulsive behaviors, and lower educational level (p<0.004). In relation to personality traits, suicide attempters exhibited significantly (p<0.002) higher Harm Avoidance and lower Self-directedness, Reward Dependence and Cooperativeness. No significant differences in any of the genetic variants between attempters and non-attempters. The best predictors of suicide attempts were (p<0.006): lower education, minimum BMI, previous eating disorder treatment, family history of alcoholism and self-directedness.

Suicidality in BN patients appears to be within the range previously found. Our results support that internalizing personality traits combined with impulsivity may increase the probability of engaging in suicidal behaviors in these patients. Our data do not support the hypothesis that variants of SLC6A4, HTR1A, HTR2A or TPH1 are associated with suicide attempts in BN individuals.

Although it is well know that the substance use during pregnancy has a negative impact on mother and child health, there are few data on pregnancy - related substance use as a risk factor for postpartum depression and child outcomes.

Aims: To determine maternal and child outcomes at 8 and 32 weeks postpartum of women who reported substance use during pregnancy.

This is a cohort study of 1804 Caucasian women in postpartum. Exclusion criteria: psychiatric disorders during pregnancy. Women were evaluated at 2-3 days, 8 and 32 weeks postpartum. Socio-demographic, obstetric, personal and family psychiatric history and substance use during pregnancy; the Edimburgh Postpartum Depression Scale (EPDS) were assessed. All women with EPDS>9 at 8 and 32 weeks were evaluated by a structured interview (DIGS) for DSM-III major depression.

The mean (SD) age was 31.7 (4.6). Forty-six percent of them were primiparous. Thirty-one percent has a family and 16% a psychiatry history. Fifty percent of women reported substance use during pregnancy: 42% caffeine, 21.6% nicotine, 8% alcohol and 0.6% cannabis. Incidence of major postpartum depression was: 12.7%. Incidence of: Apgar scores < 7 at 5 min after birth:0.4%, gestational age at delivery < 37 weeks:7.3%, birth weigt < 2.5 Kg:7.3%, and congenital malformations:1.4%.

In the presentation, the maternal and child perinatal outcomes of women exposed to licit and ilicit drugs will be summarize and will include a discussion of the future clinical and research implications. This work has been done in part with Grants: GO3/184;FIS:PI04178;PI041635,PI041783,PI041779,PI041758,PI041761,PI041791,PI041766,PI041782,RD06/0001/1009; CIBER-SAM.

Little evidence exists about suicidal acts in eating disorders and its relation with personality. We explored the prevalence of lifetime suicide attempts (SA) in women with bulimia nervosa (BN), and compared eating disorder symptoms, general psychopathology, impulsivity and personality between individuals who had and had not attempted suicide. We also determined the variables that better correlate with of SA.

Five hundred sixty-six BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN) participated in the study.

Lifetime prevalence of suicide attempts was 26.9%. BN subtype was not associated with lifetime SA (p = 0.36). Suicide attempters exhibited higher rates on eating symptomatology, general psychopathology, impulsive behaviors, more frequent history of childhood obesity and parental alcohol abuse (p < 0.004). Suicide attempters exhibited higher scores on harm avoidance and lower on self-directedness, reward dependence and cooperativeness (p < 0.002). The most strongly correlated variables with SA were: lower education, minimum BMI, previous eating disorder treatment, low self-directedness, and familial history of alcohol abuse (p < 0.006).

Our results support the notion that internalizing personality traits combined with impulsivity may increase the probability of suicidal behaviors in these patients. Future research may increase our understanding of the role of suicidality to work towards rational prevention of suicidal attempts.

Interferon-alpha (IFN-α) and Ribavirin is the recommended treatment for chronic hepatitis C (CHC). Common treatment side-effects include neuropsychiatric symptoms such as anxiety, which impairs patient's quality of life and treatment adherence. Inflammation and neurotransmission systems may play a role in the pathogenesis of IFN-α-induced anxiety. The GC/GG genotype at a polymorphism located in the interleukin-6 synthesizer gene (IL6 gene) has been related with a higher production of IL-6 and “higher inflammation response”. A polymorphism in the serotonin transporter gene (SERT) has been related with anxiety and antidepressant response. The aim of the study was to assess the role of IL6 and SERT polymorphisms as predictive variables of IFN- induced anxiety.

A cohort of 385 Caucasian outpatients with CHC initiating antiviral treatment. Patients were euthymic and without current anxiety disorder (SCID) at baseline. Anxiety evaluation: Hospital anxiety and depression scale. Assesment: Baseline, 4, 12, 24, and 48 weeks after antiviral treatment initiation. DNA was extracted and polymorphisms genotyped. Hardy- Weinberg equilibrium: IL-6 (p=0.72) and SERT (p=0.41). Statistical analysis: linear mixed-effects.

Patients carrying the G allele (GC/GG genotype) of IL6 polymorphism (G vs. CC) had more anxiety symptoms (p=0.004) during antiviral treatment. We did not find a significant effect of SERT (S vs. LL) on anxiety (p=0.15). No significant interaction between both genes was reported.

GC/GG genotype, that implies higher seric concentrations of IL6, predicts interferon-α-induced anxiety supporting a role of inflammatory pathway on pathophysiology of anxiety.

PSICOCIT-VHC-P110/01827, and PSIGEN-VHC-EC08/00201. ERDF, European Union “One way to make Europe”.

Contemporary cognitive models emphasize the importance of certain dysfunctional beliefs in the development and maintenance of Obsessive-Compulsive Disorder (OCD): overimportance of thoughts, need to control thoughts, perfectionism, intolerance of uncertainty, inflated responsibility, and overestimation of threat. Although a recent twin study suggests that these dysfunctional beliefs are significantly heritable, there have been no previous attempts to analyze candidate genes associated with them.

Our study aimed to investigate the possible association between OC-related dysfunctional beliefs and variants of two functional polymorphisms of the COMT (Val158Met) and BDNF (Val66Met) genes in 141 OCD patients.

The non-synonymous mutation Val158Met (rs4680) in the COMT gene and the Val66Met functional variant (rs6265) in the BDNF gene were genotyped with the KASPar assay system. The validated Spanish short version of the Obsessive Beliefs Questionnaire, (OBQ-44), was used to assess dysfunctional beliefs. Multivariate analysis of covariance (MANCOVA) and a post hoc one-way analysis of covariance (ANCOVA) were perfomed.

Variability in dysfunctional beliefs was not affected by the COMT or BDNF genotype when examining the two genes in isolation, but we detected a significant COMT x BDNF interaction effect on responsibility and overestimation of threat scores. These cognitive distortions were significantly higher among OCD subjects with the BDNF Met-present genotype who were also carriers of the COMT Val/Met and Met/Met genotypes.

Our data suggest that an interaction between dopaminergic and neurotrophic functional gene variants influences some of the dysfunctional belief domains hypothesized to contribute to the etiology of OCD.

There is increasing data supporting the role of endocannabinoid system (eCB) in the control of emotional homeostasis, mainly acting through CB1R activation (Menchoulam&Parker, 2012). eCB seems important to maintain baseline anxiety levels and to recovery/adapt to stressful and aversive situations (Moreira&Luz, 2008). A misbalance in eCB system might contribute to the etiology of anxiety related disorders (Crippa et al., 2009; Marco et al., 2012). The cannabinoid receptor 1 (CNR1) gene has been associated to “high neuroticism” and “low agreeableness” phenotype (Juhasz et al., 2009).

Study the association between personality traits and genetic polymorphisms located in genes related to eCB (CNR1, CNR2, FAAH and MGKLL) in patients with anxiety disorders.

In a case-control study, we analyzed 48 polymophisms tagSNPs in sample of 507 Caucasians subjects of both genders. All were assessed using the Semi-Structural Interview of DSM-IV criteria and the Temperament and Character Inventory of Cloninger. Multiple regression analysis was used to determine whether the different personality traits were associated with each variant in CNr1, CNr2, FAAH, and MGKLL, using age and gender as confounder variables.

A significant association was found between “high Harm-avoidance” trait and rs1049353 in the CNR1 gene (p< 0.005) and rs1157694 in the FAAH gene (p< 0.001). “Low novelty-seeking” trait was associated with rs324490 in the FAAH gene (p< 0.005).

These findings suggest that genetic variations in the CNR1 and FAAH genes may modulate the expression of some clinical aspects of anxiety traits and probably anxiety disorders. Grants: ICIII G03/184; SGR2009/1435.

Chronic hepatitis C infection (CHC) represents a public health problem that affects around 3% of population worldwide. Pegylated Interferon-alpha (PegIFN-α) and Ribavirin (RBV) is the recommended treatment reaching about 40–80% of sustained virological response. However, a common treatment side-effect is induced-depression that impairs patient's quality of life and treatment adherence (1,2). This paper showed polymorphisms in HTR1A, NCR1, TPH2 genes as predictive variables of IFN-induced depression.

396 consecutive, euthymic, CHC outpatients treated with PegIFN-α/RBV were included. Patients were assessed at baseline, 4, 12, 24 and 48 weeks of treatment using PHQ and MINI-DSM-IV-R interview to diagnose depression. Survival analysis was performed. in the univariated analysis functions were compared using logrank test. Significative variables (0.1 level) were extracted for the multivariated model, using a Weibull regression model.

The incidence of induced-depression along the treatment was 39.4%. Polimorphisms on HTR1A (P = 0.0104), TPH2 (P = 0.0231) and NRC1 (P = 0.0702) genes predicted IFN-induced depression.

Genes related with serotonine and inflamation system may play an important role in the pathogenesis of IFN-induced depression. Knowledge of predictive variables for IFN-induced depression may help to better manage patients at risk.

Recent research suggests that the brain-derived neurotrophic factor (BDNF) may play a role in extinction learning. The goal of this study was to test whether variation in the BDNF Val66Met polymorphism is related to treatment response to exposure-based cognitive-behavior therapy (CBT), a form of extinction learning, in obsessive-compulsive disorder (OCD).

One hundred and six OCD patients from a specialized clinic, who underwent a standardized CBT treatment after partial or non-response to a 12-week pharmacological trial, were genotyped for the BDNF Val66Met and the relationship between genotype and treatment response was analyzed.

Among 98 CBT completers, 36% of those carrying the BDNF Met allele were rated as CBT responders compared to 60% of nonMet allele carriers (P = 0.027). When analyzing the different obsessive-compulsive symptom dimensions, in patients with contamination/cleaning symptoms, the Met allele was associated with a significantly worse CBT response (P<0.0001) and a lower obsessions severity decrease from pre- to posttreatment (P = 0.046).

Genetic variation in BDNF may be associated with treatment response in exposure-based CBT in OCD, especially in those patients exhibiting contamination/cleaning symptoms.

Variables such as the mother's personality, social support, coping strategies and stressful events have been described as risk factors for postpartum depression. Structural Equation Modelling (SEM) analysis was used to examine whether neuroticism, perceived social support, perceived life events, and coping strategies are associated with postpartum depressive symptoms at the 8th and 32nd weeks.

A total of 1626 pregnant women participated in a longitudinal study. Different evaluations were performed 8 and 32 weeks after delivery. Several measures were used: the Edinburgh Postnatal Depression Scale (EPDS), the Diagnostic Interview for Genetic Studies (DIGS), the Eysenck Personality Questionnaire (EPQ-RS), the St. Paul Ramsey life events scale and the Duke-UNC Functional Social Support Questionnaire. The brief COPE scale was used to measure coping strategies. SEM analysis was conducted for all women and in those women with a clinical diagnosis of postpartum depression.

Passive coping strategies were associated with postpartum depressive symptoms at both visits (8th and 32nd weeks). Neuroticism was associated with more passive coping strategies and less active coping strategies. Neuroticism and life stress were positively correlated, and social support was negatively correlated with life stress and neuroticism.

Early identification of potential risk for symptomatology of depression postpartum should include assessment of neuroticism, life events, social support and coping strategies.

Polymorphic variations in the serotonin transporter gene (5-HTT) moderate the depressogenic effects of tryptophan depletion. After childbirth there is a sharp reduction in brain tryptophan availability, thus polymorphic variations in 5-HTT may play a similar role in the post-partum period.

To study the role of 5-HTT polymorphic variations in mood changes after delivery.

One thousand, eight hundred and four depression-free Spanish women were studied post-partum. We evaluated depressive symptoms at 2–3 days, 8 weeks and 32 weeks post-partum. We used diagnostic interview to confirm major depression for all probable cases. Based on two polymorphisms of 5-HTT (5-HTTLPR and STin2 VNTR), three genotype combinations were created to reflect different levels of 5-HTT expression.

One hundred and seventy-three women (12.7%) experienced major depression during the 32-week post-partum period. Depressive symptoms were associated with the high-expression 5-HTT genotypes in a dose–response fashion at 8 weeks post-partum, but not at 32 weeks.

High-expression 5-HTT genotypes may render women more vulnerable to depressive symptoms after childbirth.