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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

1 ,

, A.M. Ribeiro

1 , 2

, C. Pinto

1

, M. Esteves

1 , 2

,

M. Vieira-Coelho

1 , 3

, M.C. Reis

1 , 2

, M. Braganc¸ a

1 , 2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1122

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1123

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1124

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.