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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348

S163

Consultation liaison psychiatry and

psychosomatics

EW137

Classical homocystinuria and

psychiatric disturbances – A case

report

T. Abreu

1 ,

, C. Freitas

2

, A.R. Figueiredo

3

1

Centro Hospitalar do Tâmega e Sousa, Department of Psychiatry

and Mental Health, Penafiel, Portugal

2

Centro Hospitalar do Tâmega e Sousa, Department of Psychiatry

and Mental Health, Amarante, Portugal

3

Centro Hospitalar de Trás-os-Montes e Alto Douro, Department of

Psychiatry and Mental Health, Vila Real, Portugal

Corresponding author.

Introduction

Classical homocystinuria (cystathionine beta syn-

thase deficiency) is a rare autosomal recessive disease of

methioninemetabolism that causes accumulation of homocysteine

in the blood and cysteine deficiency. It is characterized by intel-

lectual disability, ectopia lentis, skeleton abnormalities resembling

Marfan syndrome and thromboembolic episodes. The majority of

patients have psychiatric disturbances as depression, behavioral

disorders, personality disorders, obsessive-compulsive disorder

and, less commonly, bipolar disorder and psychosis.

Objectives and aims

To briefly review psychiatric disturbances in

patients with homocystinuria and present a case report.

Methods

Literature research and analysis of patient’s clinical

data.

Results

A 22-year-old male was diagnosed with classical homo-

cystinuria at age 4 due to intellectual disability and renal

alterations. With aging, other problems emerged: epilepsy; pos-

tural tremor; dysesthesia; ectopia lentis; orofacial myofunctional

disorder; asthma; and patellar instability. He went to a special

education program. At age sixteen, he initiated Child Psychiatry

consultations due to anxiety and behavioral changes, as diffi-

culty in controlling impulses, establishing relationships and in the

perception of the self. Nowadays, the patient is followed in psychi-

atric consultations, where he has demonstrated high difficulty to

empathize. He is being treated with vitamin supplements; betaine;

levetiracetam; clobazam; and propranolol, combinedwith a special

diet.

Conclusions

It is not practical to screen every psychiatric patient

for Homocystinuria, but this disease should be considered when

there is a family history, early and/or acute onset, intellectual

disability, atypical symptoms, unusual response to treatment, pro-

gressive cognitive change and other organic disturbances present

in this disorder.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.255

EW138

Personality profile, anxiety, and

sexual satisfaction: A comparison

between implanted penile prosthesis

and intracorporeal injection

H. Dessoki

1 ,

, M. Abas

2

, M. Nasr

3

, O. Sleim

4

1

Beni-Seweif, Egypt

2

Kaser Aini, Andrology, Cairo, Egypt

3

Kasr Aini, Psychiatry, Cairo, Egypt

4

Kase Aini, Andrology, Cairo, Egypt

Corresponding author.

Purpose of the study

To evaluate personality profile, anxiety,

patient satisfaction in patients with erectile dysfunction treated

with penile prosthesis as compared to those on Intracorporeal

Injection (ICI) home therapy.

Patients and methods

A total of 40 male patients complaining of

erectile dysfunction were classified into two equal groups accord-

ing to the line of treatment: Intracorporeal Injection (ICI) and

penile prosthesis. Patients were subjected to the following ques-

tionnaires: Beck Anxiety Scale, Eysenck Personality Questionnaire,

Sexual Satisfaction Scale and International Index of Erectile Func-

tion Questionnaire (IIEF-5).

Results

Results for Beck Anxiety Scale showed statistically signif-

icant difference between both groups (

P

=0.000), while for Eysenck

Personality Questionnaire, no significant difference was found in

Psychoticism (

P

= 0.056), Neuroticism (

P

= 0.169), in Extraversion

(

P

= 0.225), Lie scale (

P

= 0.159), and in Criminality (

P

= 0.378). Sta-

tistically significant difference between both groups was found in

the results of Sexual Satisfaction Scale, (

P

= 0.013) and for the results

of International Index of Erectile Function Questionnaire (IIEF-5),

(

P

= 0.000).

Conclusion

Patients who underwent penile prosthesis implanta-

tion showed lower level of anxiety, better sexual satisfaction and

erectile function, while no significant difference was found when

comparing personality profile five dimensions Psychoticism, Neu-

roticism, Extraversion, Lie scale and Criminality.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.256

EW139

Familial multiple cavernomatosis and

neuropsychiatric symptoms: Is there

any relation?

V. Espirito Santo

1 ,

, R. Almendra

1

, A.R. Figueiredo

2

, A. Almeida

3

,

I. Rego

4

, P. Guimaraes

1

, A.G. Velon

1

1

Centro Hospitalar Trás-os-Montes e Vila Real, Servic¸ o de

Neurologia, Vila Real, Portugal

2

Centro Hospitalar Trás-os-Montes e Vila Real, Servic¸ o de

Psiquiatria, Vila Real, Portugal

3

Centro Hospitalar Trás-os-Montes e Vila Real, Servic¸ o de

Neurologia, Neuropsicologia, Vila Real, Portugal

4

Centro Hospitalar Trás-os-Montes e Vila Real, Servic¸ o de

Neurorradiologia, Vila Real, Portugal

Corresponding author.

Introduction

Cavernomas are clusters of abnormal blood vessels

found in the brain and spinal cord. The familiar form is an auto-

somal dominant disorder associated with the presence of multiple

cavernomas in both locations.

Clinical Case

A 84-year-old man was admitted in our neurologic

department for a sudden onset of difficulty in walking associated

with loss of urinary sphincter control. Past history included a major

depressive disorder with psychotic features since youth, epilepsy

since 33 years old and, at 77 years old, he had a hemorrhagic stroke

resulting from cavernous malformation haemorrhage. Medication

consisted of clopidogrel 75mg id, risperidone 3mg id, venlafaxine

37.5mg bid and clobazam 10mg id. On neurological examination,

he showed psychomotor slowing, dysexecutive syndrome, para-

paresis and hypoesthesiawith sensitive level byD10. Blood testwas

normal. Dorsolumbar spine-TC showed intradural hyperdensity by

D12-L1, probably because of a hemorrhage lesion, that MRI revelled

to be a cavernoma. Brain-MRI demonstrated 3 massive cavernomas

in cortical-subcortical right occipital lobe, left lenticular nucleus

and left pre-central gyrus and countless small infratentorial and

supratentorial cavernomas. We inquired his family and we found

out that one of his daughters also had multiple brain cavernomas,

diagnosed after a hemorrhagic stroke when she was 55 years old.

Conclusion

Familiar multiple cavernomatosis is associated with

neuropsychiatric disorders. We enhance the impact that such a dif-

fuse form of the disease has on the brain network causing atypical