European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S395
Objective to describe with prospective methodology the thera-
peutic response to clonazepam in the respiratory panic disorder
(PD) subtype versus the non-respiratory subtype in a long-term
follow-up.
Methods A total of 67 PD outpatients (DSM-IV) were previously
divided into respiratory (n = 35) and non-respiratory (n = 32) sub-
types and then openly treated with clonazepam for 8 weeks. Those
who responded were then treated for 3 years. Demographic and
clinical features were compared in the two groups. The instruments
used to evaluate response were the Clinical Global Impression, the
Sheehan Panic and Anticipatory Anxiety Scale, and the Panic Dis-
order Severity Scale.
Results In the first 8 weeks of treatment (acute phase), the respi-
ratory subtype had a significantly faster response on all the major
scales. During the follow-up and at the end of the study (week
156), there was no difference in the scale scores, and the reduction
in panic attacks from baseline to end-point did not differ signifi-
cantly between the two groups. After the acute phase treatment,
the patients could undergo psychotherapy. In the respiratory sub-
type, the disorder had a later onset, was associated with a high
familial history of anxiety disorder. The non-respiratory subtype
had significantly more previous depressive episodes. Clonazepam
had a safe adverse event profile during both phases of treatment.
Conclusion The respiratory PD subtype had a faster response
to treatment with clonazepam at 8 weeks than did the non-
respiratory subtype and an equivalent response after 6 months
of treatment. The response of clonazepam is clearly maintained
during the long-term follow-up.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV141
Psychiatric factors in alopecia areata:
A case report
E. Palha Fernandes ∗ aciel , P. Pina , A. Fonte
Unidade Local de Sáude do Alto Minho, Psychiatry and Mental Health
Department, Viana do Castelo, Portugal
∗ Corresponding author.
Introduction Alopecia areata is a recurrent nonscarring type of
hair loss that can affect any hair-bearing area and can manifest
in many different patterns. The influence of psychological factors
in the development, evolution and therapeutic management of
alopecia areata is well-documented. Life events and intrapsychi-
cally generated stress can play an important role in triggering of
some episodes. Besides that, alopecia itself can cause psychosocial
distress.
Objectives/aims The authors will present a case of a 47 years old
woman who developed alopecia areata after a big fight with her
sister-in-law and after the death of her father-in-law.
Methods Literature review of alopecia areata and correlation
between alopecia areata and psychological factors. The patient has
been followed inpsychiatry ambulatory consultation, for a periodof
one year, and in dermatology outpatient consultation, for a period
of four years.
Results Stressful life events played an important role in the devel-
opment of alopecia areata. The illness itself had an impact on the
patient’s life, with subsequent deterioration of psychological con-
dition and social withdrawal during the exacerbations. Treatment
with antidepressants positively affected the patient’s adaptation to
the disease and even lead to a better dermatological evolution of
the alopecia.
Conclusions There is a well-established correlation between psy-
chological factors and alopecia areata. Therefore, these patients
should be examined through multidisciplinary approach. The psy-
chological aspect of alopecia areata must be taken in consideration,
as it can be implicated in both pathogenesis and consequence of
the disease.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV142
Clinical staging in panic disorder and
agoraphobia
A. Pavlichenko
Moscow State University of Medicine and Dentistry n.a. Evdokimov,
Psychiatry, Narcology and Psychotherapy, Moscow, Russia
There is an increasing literature about the implementation of
the staging model in many mental disorders. According to this
approach, there are four stages of a psychiatric disorder: prodro-
mal stage, acute manifestations, residual phase, chronic. In this
study, we empirically investigate whether additional clinical vari-
ables such as clinical manifestations and comorbid disorders may
be useful to modify the staging model to panic disorder (PD).
We distinguished inpatient sample (n = 79) with a diagnosis of
“panic disorder” according to the DSM-IV criteria. We propose
that the inclusion of prodromal stage of PD does not make clinical
sense since the different unspecific neurotic symptoms may pro-
ceed to a variety of anxiety and depressive disorders. First stagewas
characterized by the situationally predisposed panic attacks (PA)
with both somatic and cognitive symptoms. Comorbid disorders
included somatoform disorders and generalized anxiety disorder
(GAD). During second stage individuals experienced agoraphobic
avoidance until traveling in public transport. On the other hand,
spontaneous PA were accompanied by the only somatic but not
cognitive symptoms. The most common patterns of comorbidity
were GAD and alcohol misuse. Third stage was associated with
the absence or limited symptom attacks and chronic agoraphobia.
Major depression and obsessive-compulsive disorder might be an
integral part of the clinical manifestations. This study supports that
the staging model in PD might be updated by the detailed descrip-
tion of clinical manifestations and comorbid disorders at each stage
that may help the practitioners to choose the best strategy for the
treatment of a particular patient.
Disclosure of interest The author has not supplied his declaration
of competing interest.
EV143
Pregabalin – mono- or adjuvant
therapy for somatoform disorders
D. Popovic ∗, D. Pavicevic
1 Petrovac na Mlavi, Serbia
2 Clinic of Psychiatry “Dr L. Lazarevic”, Daily Hospital, Belgrade,
Serbia
∗ Corresponding author.
Somatoformdisorders (SD) represent complex interaction between
mind and body, where physical symptom is a symptom of a mental
disorder.
The efficacy estimation of pregabalin (PG) versus combination of
PG and antidepressants (AD) in patient with SD after long-term
treatment with partial response to various AD therapies (SSRI, SNRI,
MAOI, TCAs, SARIs, SNDIs).
These nine months, prospective, open-label study involved 31
patients diagnosed by standard clinical interview as F45 and
comorbid diagnosis F41, F32, F33 or F34 according to ICD-10 cri-
teria. There were two groups: experimental group (EG) on PG-15
patients and control group (CG) on PG + AD-16 patients. The assess-
mentwasmade by 100mmVisual Analogue Scale (VAS) andClinical
Global Impression Scale (CGI) on the baseline and follow ups were