European Psychiatry - Volume 33 - March 2016

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S394 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV137
When a hypochondriasis forced a
patient to emigrate
M. Marinho ∗, A.M. Ribeiro , C. Pinto , M. Esteves ,
M. Vieira-Coelho , M.C. Reis , M. Braganc¸ a
1 São João Hospital Centre, Clinic of Psychiatry and Mental Health,
Porto, Portugal
2 Faculty of Medicine of Porto University, Department of Clinical
Neurosciences and Mental Health, Porto, Portugal
3 Faculty of Medicine of Porto University, Department of
Pharmacology and Therapeutics, Porto, Portugal
∗ Corresponding author.
Introduction Illness anxiety disorder, or hypochondriasis, is one
the most difficult and complex psychiatric disorders to treat.
Objectives To describe a case of a patient with illness anxiety
disorder and summarize the most important aspects on this theme.
Methods Interviews with the patient and literature review
searching the PubMed/MEDLINE were performed.
Results A 42-year-old married man, dentist, Angolan citizen,
who had recently arrived in Portugal, was referred to psychiatry
assessment during his hospitalization in medicine service, after
an exhaustive medical evaluation. He was excessively anxious and
worried about having a severe heart disease because he has grad-
ually become more aware of palpitations and chest pain. Although
negative results of the examinations he was worried that “some-
thing has been missed”. After he had consulted several medical
providers in Luanda, he decided to seek medical advice in Portu-
gal. Patient believed that his symptoms exacerbated with activity
and intake food, so he gradually restricted them. Due to his health
anxiety, he stopped his work and lost 36 kilos. Shortly before the
onset of the clinical picture, his daughter was hospitalized for the
first time.
Conclusion Illness anxiety disorder often begins in early to mid-
dle adulthood. Its core feature is the fear or idea of having a serious
disease, based on the misinterpretation of bodily signs and sen-
sations as evidence of disease, which persists despite appropriate
medical evaluations and reassurance. This patient fulfills the DSM-
5 criteria of Illness anxiety disorder and has a clinical profile similar
to those found in literature.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV138
Psychogenic astasia-abasia: A case
report and a review of the literature
A. Mota
Centro Hospitalar Psiquiátrico de Lisboa, Psychiatry, Lisbon, Portugal
Introduction Psychogenic movement disorders are the result of
a psychiatric rather than a primary neurological disorder. Astasia-
abasia refers to the inability to stand or walk despite having good
motor strength and conserved voluntary coordination.
Objectives Starting from a case report of a patient with an
unusual gait disturbance the author intends to discuss the history
and knowledge evolution on psychogenic gait disorders until the
present time.
Aims To debate the nosology, clinical features, diagnosis and
treatment of psychogenic movement disorders.
Methods Non-systematic review of the literature. Case presenta-
tion with the exhibition of a video showing the patient’s gait.
Case presentation A 48-year-old femalewas admitted to a psychi-
atry ward after attempting to commit suicide by cutting her throat.
On day 3, she suddenly could not walk or stand without help. The
neurological examination revealed some inconsistencies and all
laboratory, electroencephalogram, and imaging studies performed
were normal. After 2 weeks of treatment she started gradually get-
ting better until the full recovery.
Discussion The gait disturbance presented might be regarded as
a form of astasia-abasia. This term was first coined by Paul Blocq
(1888) when he described a group of patients who showed inability
to maintain an upright posture. Similar movement disorders were
previously described as hysteria by authors like Charcot. Nowa-
days, these case descriptions would be likely considered cases of
conversion or psychogenic gait disorder.
Conclusion The etiology of these disorders is still not very well
understood. These patients usually benefit fromamultidisciplinary
approach that includes psychiatry, neurology, physiotherapy,
among others. Pharmacological and non-pharmacological treat-
ments should address the underlying psychiatric condition.
Disclosure of interest The author has not supplied his declaration
of competing interest.
EV139
Psychotherapy anxiety and phobic
disorders
T. Chorna
Kharkov Medical Academy of Postgraduate Education,
Psychotherapy, Kharkov, Ukraine
The aim of the study: the development of a comprehensive sys-
tem of psychotherapy and psychocorrection of anxiety disorders
of neurotic case, based on the study of their clinical structure and
peculiarities of emotional damages.
Methodologies Spielberger, Eysenck Personality Questionnaire
(EPQ), the Hamilton Rating Scale for Depression (HRSD), the study
of accentuation of personality by K. Leonhard.
Scope and contributing research One hundred patients with diag-
nostic categories: F41.0 – Panic disorder (episodic paroxysmal
anxiety, F41.1 – Generalized anxiety disorder, F41.2 – mixed
anxiety-depressive disorder who are on the examination and treat-
ment at the psychiatric unit. A control group included 40 patients.
We performed the exploration of the peculiarities of clinical anx-
iety and patterns of therapeutic effect, based on the influence of
short-term group and individual psychotherapy in the treatment
of anxiety disorders, and evaluation the effectiveness of its recog-
nition.
The development of the methodology of applying a short-term
group and individual psychotherapy in the treatment of anxiety
disorders based on combination relaxation, hypnosis, cognitive-
behavioral techniques in combination on with short-term group
therapy.
In fact, this is a new real model psychotherapy based on integrative
principles. The high efficacy was shown in 82% patients, compared
with 54% efficacy in control group patients.
We will offer a new comprehensive methodology in the treat-
ment of anxiety disorders of neurotic case that will improve the
therapeutic efficacy of the treatment process, reduce the time of
treatment, reduce the period of drug therapy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV140
Respiratory panic disorder in acute
clonazepam treatment and long-term
follow-up
A. Nardi ∗, R.C. Freire , S. Machado , R. Amrein
Federal University of Rio de Janeiro UFRJ, Institute of Psychiatry, Rio
de Janeiro, Brazil
∗ Corresponding author.