European Psychiatry - Volume 33 - March 2016

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S126 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
combination of mood stabilizers, antipsychotics and other seda-
tives. The choice of a specific drug, dose and term is still debated.
Objectives A naturalistic study on a sample of 84 inpatients
affected by acute severemania treatedwith a combination therapy.
Aims To compare efficacy and tolerability of haloperi-
dol/risperidone/quetiapine in association with lithium and/or
valproate.
Methods Eighty-four bipolar inpatients affected by a manic
episode according to DSM-5 criteria. Drugs administered according
to our best practice. Clinical course weekly monitored with Young
Mania Rating Scale (YMRS) for 4weeks. Extrapiramidal side effects
(EPSE) monitored with Saint Hans Rating Scale (SHRS).
Results Twenty-fivemen (29.76%) and 59women (70.24%);mean
age 43.37 ±13.58 years. Mean YMRS score T0 40.27 ± 9.04. Forty-
one patients (48.81%) treated with haloperidol (3.4mg/die); 16
(19.05%) with risperidone (4.3mg/die); 27 (32.14%) with queti-
apine (438mg/die). The 3 groups showed no difference regarding
clinical characteristics and YMRS basal scores. Chi2 analysis con-
firmed an higher response rate (50% of reduction of YMRS final
score compared to T0) with haloperidol ( 2 = 14.88; P = 0.00). The
repeated-measures model analysis showed a significant decrease
(P < 0.05) in YMRS scores in haloperidol vs. risperidone vs. queti-
apine patients for all time points from second week. No statistical
difference for EPSE was found.
Conslusions We suggest that haloperidol could be advisable in
the treatment of severe mania, with rapid efficacy, even with low
doses. Occurrence of EPSE was not considerable during the acute
treatment. Studies with a larger sample size, randomization, fixed
doses, double blind design are needed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW29
Late-onset bipolar disorder: What
else?
C.P. Ferreira ∗ lves , C. Oliveira , M.J. Avelino
Centro Hospitalar Psiquiátrico de Lisboa, SETA, Lisbon, Portugal
∗ Corresponding author.
Introduction Geriatric-onset of a first-episodemania is a rare psy-
chiatric condition, which may be caused by a heterogeneous group
of non-psychiatric conditions. To confirm late-onset bipolar dis-
order (LOBD) diagnosis, secondary-mania causes should be ruled
out.
Objectives To provide a comprehensive review reporting preva-
lence, features, differential diagnosis, comorbidity and treatment
of LOBD.
Methods The literature was systematically reviewed by online
searching using PubMed® . The authors selected reviewpapers with
the words “Late-onset mania” and/or “Late-onset bipolar” in the
title and/or abstract published in the last 10 years.
Results and discussion With population ageing, LOBD is becom-
ing amore prevalent disorder. Clinical presentationmay be atypical
and confounding, making the diagnosis not always obvious. Several
non-psychiatric conditionsmust be considered in an elderly patient
presentingwithnew-onsetmania, namely stroke, dementia, hyper-
thyroidismor infection causing delirium. Only then LOBD diagnosis
may be done, making that an exclusion diagnosis. Comorbidities,
such as hypertension or renal insufficiency are often present in
the elderly and must be taken into account when choosing a mood
stabilizer.
Conclusions LOBD remains a complex and relatively under-
studied disorder with important diagnostic and therapeutic
implications. This diagnosis must be kept in mind for every elderly
patient presenting with new-onset mania. Further investigations
could contribute to a better understanding of LOBD etiopathogen-
esis and to set out better treatment guidelines.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW30
Telemedicine and bipolar disorder
A. García-Alocén ∗ ermudez-Ampudia
M. Martínez-Cengotitabengoa onzález-Ortega
S. Ruiz de Azua orrilla opez onzález-Pinto
1 HUA-Santiago, Psiquiatria, Vitoria, Gasteiz, Spain
2 HUA-Araba, Psiquiatria, Vitoria, Spain
3 HUA, Psiquiatria, Vitoria, Spain
Show the efficacy of an innovate telemedicine psyeducational
invention based on a psychoeducational intervention treatment
with a group of bipolar patients.
Objetives To assess the efficacy of an innovate telemedicine
psyeducational treatment (TPT) based on a psychoeducational
intervention (21 sessions) with an additional support through
telemedicine which has 12 videos versus treatment as usual
(TAU) based on psychiatry reviews. Specifically, the objective was
to evaluate patients’ efficacy of psyeducational treatment with
telemedicine (TPT) in the fuctionalitity, depressive symptoms and
manic symptoms.
Methods Thirty-eight patients with bipolar disorder were
included in the study and randomly distributed in the two
groups. The telemedine treatment is performed through a
web platform provided by Astra Zeneca. In the
web platform is available forums, emails and digital-course with
the sessions worked as a reminder. In order to assess the effec-
tiveness of treatments, FAST scale was administered at baseline
and 6 months after the intervention. To obtain the results we used
coparative data analysis.
Results In patients, we found a low daily functionality. The main
issues were: interpersonal cognitive area (t = –2.611; P = 0.014) and
interpersonal-area (t = –2.617; P = 0.014). We found, at baseline,
that TPT group had worse overall results in daily functionality
(t = –2.876; P = 0.008). After intervention, there is an improvement
in the daily functionality of the TPT group. This improvement
occurred in cognitive area (z = –3.24; P < 0.001), leisure area
(z = –1.85; P = 0.065) and interpersonal area (z = –1.72; P = 0.086).
Conclusions The psychoeducational program combined with
telemedicine shows to be more effective than TAU in the improve-
ment of general patient functioning in bipolar disorder patients.
∗ Corresponding author.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW31
The prevalence of bipolar mood
disorders in the medically ill patients
hospitalized in general hospitals
A. Ghanbari Jolfaei ∗ taei
Mental Health Research Center, Iran University of Medical Sciences,
Psychiatry, Tehran, Iran
∗ Corresponding author.
Introduction Bipolar mood disorders are the eighth cause of dis-
ability in the world. Several studies have shown the prevalence of
bipolar disorders in patients with medical diseases is higher than
healthy controls.
Aims This study aimed to investigate the prevalence of bipolar
disorders in the medically ill patients hospitalized in general hos-
pitals.
Methods In this cross-sectional study, 706 patients (342 men,
49%) admitted to different wards of three general hospitals ran-
domly enrolled to the study. Demographic questionnaire, MDQ