European Psychiatry - Volume 33 - March 2016

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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 ∗, C. Freitas , A.R. Figueiredo
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.
EW138
Personality profile, anxiety, and
sexual satisfaction: A comparison
between implanted penile prosthesis
and intracorporeal injection
H. Dessoki ∗, M. Abas , M. Nasr , O. Sleim
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.
EW139
Familial multiple cavernomatosis and
neuropsychiatric symptoms: Is there
any relation?
V. Espirito Santo ∗, R. Almendra , A.R. Figueiredo , A. Almeida ,
I. Rego , P. Guimaraes , A.G. Velon
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