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S164

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

psychocognitive symptoms. In all cases a detailed neuropsychiatric

family history should be sought and all should be followed regularly

clinically and by MRI.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.257

EW140

Parkinson disease psychosis – A case

report

M.D.C. Ferreira

1 ,

, S . V

aranda

2 , G. C

arneiro

2 , B. S

antos

1 ,

Á. Machado

2

1

Hospital de Braga, Psychiatry, Braga, Portugal

2

Hospital de Braga, Neurology, Braga, Portugal

Corresponding author.

Introduction

Psychosis is one of the most prevalent non-motor

complications in Parkinson’s disease (PD). Risk factors for PD psy-

chosis are advancing age, longer disease duration, severe motor

symptoms, presence of dementia, sleep disorders, depression and

autonomic dysfunction. Treatment is challenging in this setting

because antipsychotic medications are known to worse motor

symptoms.

Objectives

To highlight the therapeutic difficulties in PD-related

psychosis.

Methods

Case description and literature review.

Results

We report a case of a 74-year-old woman with a 9-year

history of PD, who presented a complex psychotic disorder con-

sisting in auditory, olfactory and visual (gulliverian and lilliputian)

hallucinations, persecutory and sexual delusions. Additionally, the

patient presented euthymic mood, without evidence of cognitive

impairment or impulse-control disorder. These symptoms began

after dopamine agonist therapy (ropinirole 4mg/day). Other med-

ical conditions that could justify these symptoms were excluded.

Initially, ropinirole was removed, but without psychotic remission.

Then, she was treated with antipsychotic medication (clozapine

25mg/day) with full psychotic remission and without significant

worsening of motor symptoms.

Conclusions

Clozapine treatment is frequently delayed, mainly

for fear of its side effects, particularly agranulocytosis. However,

this antipsychotic drug presents many benefits regarding the man-

agement of PD-related psychosis, namely few motor effects and

even improvement of motor fluctuations.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.258

EW141

Surgery-first or orthognathic surgery

approach: Psychosocial and physical

changes

E. Gambaro

1 ,

, C. vecchi

2

, C. Gramaglia

2

, A. Losa

2

, M. Giarda

3

,

E. Broccardo

3

, A. Benech

3

, P. Zeppegno

2

1

Azienda Ospedaliera Universitaria Maggiore della Carità di Novara,

Novara, Italy

2

Università del Piemonte Orientale, Medicina Traslazionale, Novara,

Italy

3

Università del Piemonte Orientale, Testa e Collo, Novara, Italy

Corresponding author.

Introduction

Two surgical approaches exist for malocclusion: in

the surgery-first approach the orthognathic surgery precedes the

orthodontic treatment, treating facial esthetics first and then occlu-

sion, whereas in the conventional approach (the orthodontics-first

approach) the orthodontic treatment precedes the orthognathic

surgery, treating occlusionfirst and then facial esthetics. The advan-

tages of the surgery-first approach include the fact that patient’s

dental function, and facial esthetics are restored and improved soon

after the beginning of treatment. Moreover, the entire treatment

lasts only 1 to 1.5 years or less and orthodontic management is

easier to achieve.

Aims

Our study aims to compare patients undergoing surgery-

first or orthognathic surgery approach as for as self-esteem,

satisfaction with their appearance in the pre- and postoperative

care, quality of life and psychosocial changes, are concerned.

Methods

We recruited 50 patients undergoing surgery-first or

orthognathic surgery approach at SC Maxillo-Facciale of Novara

between October 2014 and December 2017. Assessment were

performed at baseline (T0) and at follow-up (T1: 5weeks; T2:

5–6months), with Rosenberg Self-Esteem Scale (RSES), Tempera-

ment and Character Inventory (TCI: only at T0), Short Form Health

Survey 36 (SF-36), Beck Depression Inventory (BDI-II), Resilience

Scale for Adult (RSA), Psychosocial Impact of Dental Aesthetics

Questionnaire (PIDAQ), Oral Health Impact Profile (OHIP-14).

Results

Data collection is still ongoing. We expect to find a bet-

ter quality of life and higher self-esteem in patients undergoing

surgery first approach.

Conclusion

Satisfaction is crucial for patients’ adherence to treat-

ment and to avoid revolving door. Clinical implications will be

discussed.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.259

EW142

Descriptive study of hypothyroidism

in an acute psychiatric unit in

Barcelona

G. Hurtado

, E. Carrió , A.L. Palomo , M. Campillo , G. Mateu ,

A. Farre , J. Marti , R. Sanchez , J.R. Fortuny

Parc de Salut Mar, Institut de Neuropsiquiatria i AddicionsCentre

Emili Mira, Santa Coloma Gramenet, Spain

Corresponding author.

Introduction

Behavioural, psychological and cognitive disturb-

ance have been associated with hypothyroidism, even it has

been suggested that this symptoms may remain despite adequate

replacement therapy with thyroxine.

Objective

To describe prevalence, sociodemographics and clini-

cal features of patients with hypothyroidism in an acute psychiatric

unit.

Aims

To know about the relation between hypothyroidism and

psychiatric symptoms.

Methods

Data base collection of all patients admitted between

2010 and 2014 in the acute unit of our psychiatric hospital in

Barcelona, was analyzed using SPSS program.

Results

In all 3.1% of the 4536 total patients had hypothy-

roidism. Among them, 46% were duplicate cases. Mean age was

53

±

14.27 years. A total of 82.7% were woman. Patients having a

TSH lower than 0.30 were 12%, TSH normal were 60.2%, TSH higher

than 5were 27.8%. Most frequent Levothyroxine dosage was: 75 g

(22.1%), 100 g (19%), 25 g (12.5%) and 125 g (12.5%). Diagno-

sis more frequently associated with hypothyroidism was: Bipolar

(26.5%), Schizophrenia (20%), Depression (15.1%), Unspecified psy-

chosis (10%), Personality disorder (10%), Schizoaffective disorder

(7.2%), Paranoia 4.3%.

Conclusion

Most of patients were stable of thyroid condition

when had been admitted to our hospital. Hypothyroidism could

be a relapse factor, even when treatment is adequate. Affective dis-

orders are more frequently related with hypothyroidism (lithium

has to be consider a confounding factor).

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.260