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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1125

EV141

Psychiatric factors in

alopecia areata

:

A case report

E. Palha Fernandes

, J. M

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1126

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1127

EV143

Pregabalin – mono- or adjuvant

therapy for somatoform disorders

D. Popovic

1 ,

, D. Pavicevic

2

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