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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.173

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.174

EW57

The metacognitive functioning in

bipolar patients and in bipolar

alcoholics patients

R. Vecchiotti

1 , 2 , 3 ,

, L. Meschini

4

, I. Borsella

4

, U. Pianella

4

,

L. Orsolini

1 , 2 , 3 , 5

, M. Panichi

1 , 2

, A. Valchera

1 , 2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.175

EW58

Global functioning in bipolar patients

with cognitive deficits

M. Vrabie

1 ,

, V. Marinescu

2

, A. Talasman

3

, E. Drima

4

,

I. Miclutia

5

1

Bucharest, Romania

2

Clinical Hospital of Psychiatry “Al. Obregia”, 7 Ward, Bucharest,

Romania