European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S135
EW55
Interictal dysphoric disorder – the
bridge between epilepsy and bipolar
disorder
R. Sousa∗, M. Salta , B. Barata , J. Nogueira , J. Vieira , B. Ribeiro ,
R. Ribeiro , S. Mendes , R. Mendes , A. Gamito
Setúbal Hospital Center, Department of Psychiatry and Mental
Health, Setubal, Portugal
∗ Corresponding author.
Introduction Psychiatric disorders are frequent among patients
with epilepsy. The association between epilepsy and mood dis-
orders is recognized since the classical antiquity. Recent studies
demonstrated that the prevalence of bipolar symptoms in epilepsy
patients is more significant than previously expected. In the first
half of the twentieth century, Kraeplin and Bleuler were the first
to describe a pleomorphic pattern of symptoms claimed to be typ-
ical of patients with epilepsy and recently Blumer coined the term
interictal dysphoric disorder to identify this condition. Although
for some authors, the existence of this condition as a diagnostic
entity is still doubtful, for others, it represents a phenotypic copy
of bipolar disorder.
Objectives In thiswork, we start fromthe phenomenological sim-
ilarities between the interictal dysphoric disorder and the bipolar
disorder, to explore the neurobiological underpinnings that sup-
port a possible link between epilepsy and bipolar disorder.
Methods Research of articles published in PubMed and other
databases.
Results Interictal dysphoric patients have features that resem-
ble the more unstable forms of bipolar II disorder and benefit
from the same therapy used in bipolar depression. Epilepsy and
bipolar disorder share features like episodic course, the kindling
phenomenon as possible pathogenic mechanisms and the response
to antiepileptic drugs. The study of possible common biological
processes like neurogenesis/neuroplasticity, inflammation, brain-
derived-neurotrophic-factor, hypothalamus pituitary adrenal axis,
provided promising but not consensual results.
Conclusions Further efforts to understand the link between
epilepsy and bipolar disorder could provide the insight needed to
find common therapeutic targets and improve the treatment of
both illnesses.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW56
Comparison of treatment response of
typical and atypical antipsychotics in
acute mania
C.R. Medici , L.M. Kai , C. Kirkedal , S.P.V. Straszek∗
Aarhus University hospital, Department Q, Risskov, Denmark
∗ Corresponding author.
Introduction The medical treatment of acute mania today mainly
includes atypical and typical antipsychotics, lithium or valproat.
Atypical antipsychotics are often used as first-line treatment, while
typical antipsychotics come with the risk of severe long-term side
effects and less used today. However, typical antipsychotics may
lead to a faster reduction in the severity of mania or a faster remis-
sion of symptoms.
Objective To investigate whether the acute effect of typical
antipsychotics differs from atypical antipsychotics measured by a
daily mania rating-scale (MAS-M) and duration of treatment in a
real-life clinical setting.
Aim To help determine if short-term treatment with typical
antipsychotics may still be of benefit in the acute treatment of
mania.
Methods This is a retrospective case record study. Patients admit-
ted to an acute hospital ward with acute mania between 2012 and
2015 were included (n = 100). The daily use of atypical and typical
antipsychotics will be compared by daily change in Bech-Rafaelsen
Modified Mania Scale (Mas-M) score and time to discharge. The
change inmania over time is presented visually using graph curves.
Results The data extraction and data handling will be executed
in the winter 2015–2016.
Conclusions Any preliminary findings will be presented at EPA
2016.
EW57
The metacognitive functioning in
bipolar patients and in bipolar
alcoholics patients
R. Vecchiotti ∗, L. Meschini , I. Borsella , U. Pianella ,
L. Orsolini , M. Panichi , A. Valchera
1 Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Department of
Psychiatry, Ascoli Piceno, Italy
2 Polyedra, Research, Teramo, Italy
3 Maastricht University, Department of Psychiatry and
Neuropsychology, Maastricht, Netherlands
4 Studi Cognitivi, Psychotherapy, San Benedetto del Tronto, Italy
5 University of Hertfordshire, School of Life and Medical Sciences,
Hatfield, Herts, United Kingdom
∗ Corresponding author.
Introduction Metacognition is described as the set of human
abilities that allows us to recognize and think about own and
other people’s mental states. We use these skills in order to
overcome psychological and interpersonal issues and to cope emo-
tional, cognitive and behavioral suffering. Studies that focusing on
metacognition in bipolar disorder (BD) are still limited and data are
controversial. Our purpose is investigating the difference between
BD patients and BD patients with alcohol addiction (BD + A), in
terms of metacognitive functions. In addition, we want to assess
among BD + A whether the increase in metacognitive functions
mediates the relationship between symptoms at T0 and T1.
Methods Forty patientswere recruited for this study. A set of tests
was performed on each patient to formulate a metacognitive and
clinical evaluation. A single measurement was performed on 20 BD
patients. Two measurements (T0–T1) were carried out on the 20
BD + A patients, after an integrated treatment.
Results Data shown significant differences between these two
groups. As regards the treatment of BD + A patients, differences
were found between T0 and T1. Among the BD + A patients, reduc-
tion in the Beck Cognitive Insight Scale (BCIS-SC, P 0. 042) scores
between T0 and T1, leads to the prediction of symptom improve-
ment.
Conclusions Our results confirm the existence of a specific profile
of metacognitive functioning in these patients. Our results reveal
that the metacognitive functions appear to be predictors of the
improvement in the remission of symptoms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW58
Global functioning in bipolar patients
with cognitive deficits
M. Vrabie ∗, V. Marinescu , A. Talasman , E. Drima ,
I. Miclutia
1 Bucharest, Romania
2 Clinical Hospital of Psychiatry “Al. Obregia”, 7 Ward, Bucharest,
Romania