European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S399
In theOMS study conducted inAmerica, Europe andAsia, the results
confirm the high rates of disorders in patients diagnosedwith bipo-
lar disorder regardless of the country of study.
Case This is a male, 32, who came first to the Provincial Drug
Addiction Service of Huelva in 2009 for cocaine, cannabis and alco-
hol.
In his personal history, he relates a convulsive episode at 14 years
and one manic episode associated with consumption of cocaine in
2002 which began to be treated by a team of Mental Health and
Provincial Center for Addictions.
He entered twice in a therapeutic community in 2009 for treatment
for their disorder dependence on cocaine, alcohol and cannabis.
It has required admission to the Unit Hospitalization twice in 2012,
with the discharge diagnosis of manic episode secondary to drug
consumption.
Conclusions Most epidemiological studies in recent decades note
the high prevalence of comorbidity BD + SUD.
BD-SUD comorbidity is particularly complex because each disorder
affects the evolution of the other and they are frequently multiple
comorbidities. In addition, it implies a worse clinical and functional
outcome as well as poorer therapeutic response.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV154
Case study: Bipolar disease in
treatment with asenapine
A.M. Alvarez Montoya ∗, C. Diago Labrador ,
T. Ruano Hernandez
1 Algeciras, Spain
2 Clinica Virgen del Rosario, Psiquiatria, Algeciras, Spain
3 Consulta Privada, Psicologia Clinica, Málaga, Spain
∗ Corresponding author.
Objectives Analysis of the treatment alternatives for patients
diagnosed with a bipolar disorder of torpid evolution. Revision of
the possible adverse effects of lithium and its impact on the adher-
ence to treatment.
Methods We revise the clinical evolution of a patient diagnosed
with Bipolar disorder type I, with the following characteristics:
at least two maniac episodes per year, consumption of toxic sub-
stances and high sensibility to antipsychotics and euthymics.
Results We will describe the case of a 23-years-old patient diag-
nosed with bipolar disorder type I. During the course of the illness,
benign intracranial hypertension is diagnosed and the treatment
with lithium must be stopped. We replace lithium treatment
by Asenapine monotherapy. The evolution of the patient was
very positive. Taking account of the adverse effects of lithium
and reducing them can facilitate the adherence to treatment
and also benefit early remission and less deterioration in each
episode.
Conclusions It is fundamental to promote a comprehensive
approach to each patient, including psychotherapy, psychoedu-
cation as well as appropriate medication. The knowledge of the
described effects helps us to determinate the appropriate medica-
tion for each patient.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV155
Unipolar mania: Prevalence,
socio-demographic and clinical
correlates
A. Baatout ∗, U. Ouali , F. Nacef
1 Hôpital Razi, Avicenne, Maamoura Nabeul, Tunisia
2 Hôpital Razi, Avicenne, Tunis, Tunisia
∗ Corresponding author.
The concept of unipolarmania (UM) arose fromthe observation that
some patients with bipolar disorder (BD) presentedmanic episodes
in the absence of depressive episodes. The frequency of UM ranges
from 4 to 52% in bipolar populations. The aim of our study was
therefore to add to existing research by establishing the prevalence
of UM in a sample of patients with BD and by studying their socio-
demographic and clinical characteristics.
Of the 100 patients, 67 had been diagnosed with MD phases and 33
with UM. The mean age of the MD group was 43.21 years whereas
it was 39.36 years in the UM group. Males represented 41.8% of the
MD group and 72.7% of the UM group. The two groups were similar
with regards to marital status, level of education and work activity.
Age of illness onset was lower in the UMgroup (mean = 24.45) com-
pared to the MD group (mean = 26). UM group patients had more
relatives with affective illness (42.4% versus 32.8%).
The type of first affective episode was manic in 46.3%, mixed in
11.9%, depressive in 31.3% and not specified in 10.4% of the MD
group whereas it was manic in 93.9% and not specified in 6.1% in
the UM group.
The two groups were similar with regards to the presence or the
absence of psychotic features.
The results of our study show that patients with UM were distinct
frompatientswith a bipolar course of the illness in a range of clinical
aspects.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV156
Severe behavioral disturbances in
bipolar disorder: A case report
S. Benavente López ∗, N. Salgado Borrego ,
M.I. de la Hera Cabero , I. O˜noro Carrascal , L. Flores ,
R. Jiménez Rico
1 Hospital Universitario 12 de Octubre, Psychiatry, Madrid, Spain
2 Hospital Dr. Rodríguez Lafora, Psychiatry, Madrid, Spain
3 Centro San Juan de Dios Ciempozuelos, Psychiatry, Madrid, Spain
∗ Corresponding author.
Introduction Behavioral disturbances are common in psychiatric
patients. This symptom may be caused by several disorders and
clinical status.
Case report We report the case of a 40 year-old male who
was diagnosed of nonspecific psychotic disorder, alcohol depen-
dence, cannabis abuse and intellectual disability. The patient was
admitted into a long-stay psychiatric unit because of behavioral
disturbances consisted in aggressive in the context of a chronic
psychosis consisted in delusions of reference and auditory pseu-
dohallucinations. During his admission the patient received the
diagnosis of bipolar disorder type 1, presentingmore severe behav-
ioral disturbances during these mood episodes. It was necessary
to make diverse pharmacological changes to stabilize the mood
of the patient. Finally, the treatment was modified and it was
prescribed clozapine (25mg/24 h), clotiapine (40mg/8 h), levome-
promazine (200mg/24 h), topiramate (125mg/12 h), clomipramine
(150mg/24 h) and clorazepate dipotassium (50mg/24 h). With this
treatment, the patient showed a considerable improvement of
symptoms, presenting euthymic and without behavioral distur-
bances.
Discussion In this case report, we present a patient with severe
behavioral disturbances. The inclusion of bipolar disorder in the
diagnosis of the patient was very important for the correct treat-
ment and management, because of depressive and manic mood
episodes the behavioral disturbances were exacerbated.
Conclusions Patients with behavioral disturbances could present
psychotic and affective symptoms as cause of them. It is necessary