European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S173
of diagnostic, inappropriate management and subsequent poor
compliance.
Objectives To present the case of an adult male (a preacher whose
beliefs includemediunity) with delusional ideation ofmystical con-
tent and mood elation, identified during a religious ceremony.
Aims Questioning the frontier between spiritual/religious beliefs
and psychopathology.
Methods A case report is presented and a literature review of the
theme is shortly surveyed.
Results The case reports to a 53 years old man, who during a reli-
gious ceremony presented himself with agitation and disinhibition,
removing all his cloths and living the church naked. Additionally
it was identified the presence of insomnia, heteroaggressiveness,
accelerated speech, mood elation and delusional ideation of mys-
tical and megalomaniac content. Several studies demonstrate the
importance of acknowledging the religious/spiritual beliefs of
patients. This knowledge allows the psychiatry to correctly identify
the existing psychopathology and organize an appropriate inter-
vention plan for the patient.
Conclusions Spiritual and religious beliefs’ influence the way dis-
ease is perceiver and managed. Physician should collect a brief
spiritual story of the patient and learn about the different reli-
gious/spiritual beliefs and practices of their community, in order
to understand the full dimension of the individual illness.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW168
Apotemnophilia: Psychiatric disorder,
neurological disorder or not a disease
at all?
C. Novais ∗ . Peixoto , M. Mota Oliveira , A. Côrte-Real
Centro Hospitalar de São João, Psychiatry Department- Clínica de
Psiquiatria e Saúde Mental, Porto, Portugal
∗ Corresponding author.
Introduction Apotemnophilia or body integrity identity disorder
(BIID) is defined by the uncontrollable desire to amputate one or
more healthy limbs or to be paraplegic.
Objectives/aims We reviewed the available studies of this condi-
tion in order to enhance the comprehension of this disorder and
the possible need of a multidisciplinary assessment.
Methods Relevant papers from 2000 were identified using
PubMed database, with the terms apotemnophilia, BIID and self-
demand amputation.
Results Reports of the phenomenon of amputee attraction trace
back to 1933 in a series of letters and articles published in jour-
nals and magazines by erotically-obsessed persons who wanted
to become amputees themselves. The first scientific report of this
issue only appeared in 1977, when JohnMoney described two cases
that requested an amputation of a healthy limb, a condition he
named apotemnophilia. Would-be amputees – or “wannabes” –
may appear in thousands and they have their own websites. Until
now, the explanation of this phenomenon has been in favor of a
psychiatric etiology: a pathological desire driven by a sexual com-
pulsion. Recently, a neurological explanation has been proposed
and defends that might exist a dysfunction of the right parietal lobe,
leading to a distorted body image and a desire for an amputation.
Conclusions Apotemnophilia is a rare, uncommonly studied con-
dition, which blurs the limits between psychiatry and neurology.
We must be aware that this disorder is more frequent in unusual
places like websites and others. A better understanding of this con-
dition is crucial for the development of effective treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW169
“Makoki”: A view of electroconvulsive
therapy in a Spanish comic of the
early 80s
F. Pavez ∗ lcántara aura arset
1 Hospital General Universitario Reina Sofía, Psychiatry, Murcia,
Spain
2 Fundación Jesús Abandonado, Unidad de Asistencia Psicológica,
Murcia, Spain
3 Unidad Docente de Historia de la Medicina, Departamento de
Ciencias Sociosanitarias, Facultad de Medicina, Universidad de
Murcia, Murcia, Spain
∗ Corresponding author.
Introduction Analysis from cultural products has been previously
reported in psychiatry field. This approach provides an understand-
ing of the social imaginary about psychiatry and its work over a
determined period of time.
Objectives To describe the representations of ECT and insanity in
an Spanish underground comic of the early 80s.
Methods We performed an analysis of complete production
(1979–1994) of “Makoki”, comic by Gallardo and Mediavilla, look-
ing for the aspects related with our interest scope
Results The comic analyzed is inscribed in the field of provocation
and insolence. This is comprehensible in the historical context of
Spanish transition, if we attend to almost forty years of cultural
confinement as a result of a dictatorial regime. This cultural product
could be seen as “politically incorrect” fromthe current perspective,
given that reproduces some stigmatizing topics regarding mental
illness, glorifying its alleged associations with violence and drug
use, in addition to a negative view of ECT, represented as a sadistic
instrument of punishment, control and subjugation (see
Conclusions The material analyzed reproduces the prevailing
social stigma in its epoch about psychiatry and mental illness. The
analysis of cultural products that reflect and built the speeches
about the psychiatry and its action field, can be a useful strategy
to understand the views of the general population in a given era.
Fig. 1 Vignettes of “Revuelta en el frenopático” in Gallardo M,
Mediavilla J. Todo Makoki. Spain: DeBolsillo; 2014.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.