European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S145
EW85
Mental health transition plans for
older adolescents with autistic
spectrum disorders – clinical profile
of patients from a metropolitan
Borough, North West of England
S. Olety
Pennine Care NHS Foundation Trust, Child and Adolescent Psychiatry,
Rochdale, United Kingdom
Introduction The needs of people with Autistic Spectrum Condi-
tions (ASC) are varied and complex. In order to improve outcomes
for Adults with Autism, it is important to understand and evaluate
the transition planning process and current services for adoles-
cents/young Adults with ASC.
Aims and objectives Aim was to undertake the needs assess-
ment audit of all young people (ages 16–19) open to a Child and
Adolescent Mental Health Service. Objectives was to ensure that
transition/discharge plan was in place for all the open cases and
also identify any gaps in service provision.
Methods A retrospective case-note review of all open cases
(n = 41) aged 16–19 was undertaken. Data was obtained on
diagnosis, co morbid problems, educational status, and transi-
tion/discharge plans.
Results Twenty-two percent of the cases had comorbidmoderate
to severe Intellectual Disability. Transition was not an issue for this
group, with entitlement of support from secondary-care-teams.
Seventy-eight percent of the cases had diagnosis of Asperger’s
Syndrome (AS)/high functioning autism (HFA). Seventy-five per-
cent had co-morbid depressive/anxiety disorders, 12% had ADHD
and 10% presented with repeated self-harm/suicidal behaviour.
Nature of the co-morbid problems/risks did not meet thresholds
for Community Adult Secondary Mental Health Services resulting
in discharge to Primary Health Care Services.
Conclusions Better training to equip primary care staff, such as
General Practitioners is needed to support the growing numbers
of young adults with HFA/Asperger’s syndrome being discharged
to their care. Costs/benefits of providing specialist adult services
for people with HFA and AS to be considered in order to improve
outcomes for adults with autism.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EW86
Safeguarding foster care youth from
overmedication
C. Pataki ∗, C. Thompson , G. Crecelius , J. Tesoro ,
G. Polsky , P. Kambam
1 David Geffen School of Medicine at UCLA, Psychiatry &
Biobehavioral Science, Los Angeles, CA, USA
2 Los Angeles County Department of Mental Health, Juvenile Court
Mental Health Service, Monterey Park, CA, USA
3 Los Angeles County Department of Mental Health, Juvenile Justice
Mental Health Program, Los Angeles, CA, USA
4 University of Southern California School of Pharmacy, Pharmacy,
Los Angeles, CA, USA
∗ Corresponding author.
Introduction There are increasing concerns regarding long-term
psychotropic polypharmacy prescribed for foster care youth 3.5 to
5 times more often than in at-home youth (Kreider et al., 2014).
Polypharmacy risks include weight gain, glucose intolerance and
type 2 diabetes. (De Hert et al., 2011). In view of these risks, novel
interventions are essential to safeguard foster care youth from
overmedication.
Objectives To present guidelines for identification and manage-
ment of polypharmacy in foster care youth.
Aims To demonstrate a novel intervention tomonitor and dimin-
ish polypharmacy and enhance psychiatric care in foster care
children.
Methods Polypharmacy is identified using LA County Juvenile
Court Mental Health Service (JCMHS) Psychotropic Parameters*
to review medication consent forms from treating psychia-
trists. Polypharmacy triggers an in-person JCHMS consultation.
*(Parameters 3.9 for JCMHS PMAF Review, Revised May 2015).
JCMHS Psychotropic Parameters (summary):
– age 0–5 years:
– 2 or > psychotropic medications,
– Any antipsychotic (* except Risperidone in ASD);
– age 6–8 years:
– 3 or > psychotropic medications;
– age 9–17 years:
– 4 or > psychotropic medications;
– All age youth:
– 2 or > psychotropic medications in the same class (antipsy-
chotics, antidepressants, stimulants, mood stabilizers, alpha
agonists).
Psychotropic medication doses in excess of recommended (*LA
County Department of Mental Health Parameters 3.8 for use of
Psychotropic Medications for Children and Adolescents).
Results Approximately 25% of JCMHS annual psychiatric consul-
tations were initiated by JCMHS parameters for polypharmacy.
Corresponding consultations included education and recommen-
dations discussed with treating psychiatrists regarding polyphar-
macy and optimal psychiatric management.
Conclusions JCMHS Psychotropic Parameters is a useful tool to
identify polypharmacy and enhance psychiatric care of foster care
youth.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW87
Clinical and psychopathological risk
factors for the development of
recurrent depression in children at
puberty
T. Proskurina ∗, E. Mykhailova , T. Matkovska ,
N. Reshetovska , A. Matkovska
1 SI “Institute for Children and Adolescents Health Care of the NAMS
of Ukraine”, Psychiatry, Kharkov, Ukraine
2 Kharkiv V. Karazin National University Named, Medical Student,
Kharkov, Ukraine
∗ Corresponding author.
Background and aims The research is aimed at revealing clinical
and psychological predictors of recurrent depression in children.
Our study reflects the relationships of certain clinical and psycho-
logical markers in the development of recurrent depression (RD) in
children at the stage of sexual maturation.
Materials and methods The study included 145 children in pre-
puberty and 200 children in puberty with recurrent depression,
in which manifestation of the first depressive episode occurred at
the age of 7–11 years. The study design included: social, clinical,
psychopathological, anamnestic, somatoneurological and neuro-
psychological monitoring (CDRS-R; MADRS; the Columbia-Suicide
Severity Rating Scale (C-SSRS), Toulouse-Pieronne test to deter-
mine the presence and type of a minimal brain dysfunction, as well
as Luria’s Memorizing 10 words technique).
Results Analysis of the relationships between psychological
trauma factors, which took place in children at the stage of the
first depressive episode, and the risk of the recurrent depression
development in children at puberty has established the significance
of: school bullying (r= 0.13), combination of stress events (r = 0.11),
father flight (r= 0.10), lack of authority and environmental rejection