European Psychiatry - Volume 33 - March 2016

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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.
EW140
Parkinson disease psychosis – A case
report
M.D.C. Ferreira ∗ aranda arneiro antos
Á. Machado
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.
EW141
Surgery-first or orthognathic surgery
approach: Psychosocial and physical
changes
E. Gambaro ∗, C. vecchi , C. Gramaglia , A. Losa , M. Giarda ,
E. Broccardo , A. Benech , P. Zeppegno
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.
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.