Welcome to the EPA 2022 Interactive Programme
The congress will officially run on Central European Summer Time (CEST/GMT +2)
To convert the congress times to your local time Click Here
Fully Live with Live Q&A 
On Demand (available from 4 June) 
ECP Session 
Section Session 
EPA Course (Pre-Registration Required)
Ask the Expert 
Sessions with Voting 
Live TV 
Product Theatre
Recovery of Healthy Sexuality in Patients With Anorexia Nervosa Treated With Enhanced Cognitive Behaviour Therapy (CBT-E): Results From a Two-Year Follow-up Study Highlighting the Role of Avoidant Attachment Style
Abstract
Introduction
There is a known association between the core psychopathological features of anorexia nervosa (AN) and sexual dysfunctions, to the point that the recovery of healthy sexuality could be considered a marker of recovery. However, no studies have evaluated the role of insecure attachment in moderating this recovery during treatment.
Objectives
To evaluate the role of insecure attachment as a possible moderator of the recovery of healthy sexuality in patients with AN treated with Enhanced Cognitive Behaviour Therapy (CBT-E).
Methods
A total of 65 patients with anorexia nervosa were treated with CBT-E in a multidisciplinary environment, after filling out self-administered questionnaires for the evaluation of general (SCL-90-R) and ED-specific psychopathology (EDE-Q), female sexuality (FSFI) and adult attachment style (ECR). The assessment was repeated after one (T1) and two years (T2).
Results
At baseline, all domains of sexual dysfunction were significantly predicted by avoidant attachment. A significant amelioration of both general and eating disorder-specific psychopathology and sexual dysfunctions was observed at all follow-up evaluations with respect to baseline levels. However, only 45% of remitted patients also showed a complete recovery of healthy sexuality: this subgroup reported significantly lower avoidance scores when compared to patients who only recovered from AN. Moderation analysis indicated that sexual desire did not increase in participants with higher levels of avoidant attachment.
Conclusions
This study highlighted the crucial role of avoidant attachment in the relationship between AN and sexual dysfunctions, underlining the importance of assessing adult attachment for a better characterization and treatment. Attachment-focused interventions may be beneficial for a full recovery.
The Effect of Childhood Trauma and Trauma-Focused Psychotherapy on Blood Expression of MED22 in Patients With Major Depressive Disorder
Abstract
Introduction
The only available genome-wide study (Minelli et al., 2018) indicated an association between the neglect CT and MED22, a transcriptional factor gene.
Objectives
To verify how the dysregulation of MED22 could be affected by environmental and genetic factors, we carried out an analysis on these components and a longitudinal study concerning the effect of trauma-focused psychotherapy in MDD patients that experienced CT.
Methods
On a large mRNA sequencing dataset including 368 MDD patients we computed the genetic (GReX) and the environmental (EReX) components affecting gene expression in relation to CT. Furthermore, we measured the expression of MED22 in 22 MDD patients treated with trauma-focused psychotherapy.
Results
The dissection of MED22 expression profiles revealed an association of neglect with environmental and genetic components (p=6x10-3 p=2.6x10-4). Furthermore, in an independent cohort of 177 controls, we also observed a significant association between cis-eSNPs of MED22 and higher neuroticism scores (best p-value: 0.00848) that are usually associated with a decreased amount of resilience to stress events. Finally, the results of psychotherapy revealed a reduction of depressive symptomatology (p<0.001) and 73% of patients resulted responders at the follow-up visit. MED22 expression during psychotherapy showed a change trend (p=0.057) with an interaction effect with response (p=0.035). Responder and non-responder patients showed MED22 expression differences at different trauma-focused psychotherapy timepoints (p=0.15; p=0.012) and at the follow-up (p=0.021).
Conclusions
Our results provide insights suggesting that some biological and clinical consequences of CT depend on genetic background and environmental factors that could induce vulnerability or resilience to stressful life events.
Psychological Maltreatment and Self-Compassion - The Mediating Role of Shame and Perspective-Taking
Abstract
Introduction
Psychological maltreatment such as emotional abuse or neglect is a serious risk factor for poorer mental and somatic health outcomes in life. A higher rate of psychological maltreatment experienced in childhood is a predictor of aversive emotional states such as shame, and can negatively influence factors of mentalization such as perspective-taking capacity in adulthood. However, emotional abuse or neglect are also negative predictors of self-compassion.
Objectives
The purpose of the study was to test two mediating models. We hypothesized, that reduced perspective-taking capacity, as well as higher levels of shame due to psychological maltreatment can be causally linked to lower levels of self-compassion.
Methods
We collected data from 120 healthy subjects (mean age=29.46, SD = 7.55) from Hungary We used Experience of Shame Scale, Interpersonal Reactivity Index, Childhood Trauma Scale, and the Self-Compassion Scale in our cross-sectional questionnaire study.
Results
Psychological maltreatment is a significant negative predictor of self-compassion (b=-0,712; p<0.05), and shame seems to play a mediating role in this relationship (effect size= 0.231; p<0.05). Psychological maltreatment was not a statistically significant predictor of perspective-taking.
Conclusions
Our results highlight that shame has a central role between childhood traumatization and psychological well-being. In the case of early emotional maltreatment we have to focus on shame for higher levels of self-compassion and effective healing in psychotherapy.
Psychotherapy Employed Additionally to Psychopharmacotherapy Is Not Related to Better Treatment Outcome in Major Depressive Disorder
Abstract
Introduction
Although numerous effective antidepressant (AD) strategies are available for the treatment of major depressive disorder (MDD), many patients do not achieve satisfactory treatment response.
Objectives
The aims of the present European, cross-sectional, multicenter, naturalistic study were (1) to determine the proportion of patients suffering from primary MDD who received additional psychotherapy to their ongoing psychopharmacotherapy and (2) to identify the associated socio-demographic and clinical patterns.
Methods
Patients receiving both treatments were compared to those lacking concomitant additional psychotherapy that was manual-driven psychotherapy (MDP) in all cases.
Results
While 68.8% of a total of 1279 MDD patients received exclusively psychopharmacotherapy, 31.2% underwent a psychopharmacotherapy-MDP combination. The latter patient population was rather younger, higher educated, employed, exhibited an earlier mean age of MDD onset, lower severity of current depressive symptoms with lower odds of suicidality and higher rates of melancholic features, and comorbid asthma and migraine, and was generally treated with lower daily doses of their first-line ADs. Whereas agomelatine was more commonly dispensed in these patients, selective serotonin reuptake inhibitors were more often prescribed in MDD patients lacking additional MDP. No significant between-group differences were detected in terms of treatment outcome.
Conclusions
The fact that the employment of additional MDP was not related to better treatment outcome in MDD represents our major and clinically most relevant finding. Generally, MDP was employed in a minority of our patients who experienced rather beneficial socio-demographic and clinical characteristics. This might reflect an inferior accessibility of these psychotherapeutic techniques for patients who are more severely ill and less socio-economically privileged.