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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1138

EV154

Case study: Bipolar disease in

treatment with asenapine

A.M. Alvarez Montoya

1 ,

, C. Diago Labrador

2

,

T. Ruano Hernandez

3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1139

EV155

Unipolar mania: Prevalence,

socio-demographic and clinical

correlates

A. Baatout

1 ,

, U. Ouali

2

, F. Nacef

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1140

EV156

Severe behavioral disturbances in

bipolar disorder: A case report

S. Benavente López

1 ,

, N. Salgado Borrego

2

,

M.I. de la Hera Cabero

3

, I. O˜noro Carrascal

3

, L. Flores

3

,

R. Jiménez Rico

3

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