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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. Chi

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.146

EW29

Late-onset bipolar disorder: What

else?

C.P. Ferreira

, S. A

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.147

EW30

Telemedicine and bipolar disorder

A. García-Alocén

1 ,

, C . B

ermudez-Ampudia

2 ,

M. Martínez-Cengotitabengoa

3 , I. G

onzález-Ortega

3 ,

S. Ruiz de Azua

3 , I. Z

orrilla

3 , P. L

opez

3 , A. G

onzález-Pinto

3

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

www.puedoser.es

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.148

EW31

The prevalence of bipolar mood

disorders in the medically ill patients

hospitalized in general hospitals

A. Ghanbari Jolfaei

, S. A

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