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S404

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

Introduction

Recently, depot aripiprazole was approved as a

maintenance treatment for schizophrenia. However, long-acting

antipsychotics has not been established efficacy in manic episode

or maintenance treatment of bipolar disorder.

Aims

Describe a clinical case of multiresistant bipolar disorder.

Methods

Thirty-nine years old male, diagnosed since 8 years

ago with bipolar disorder, current episode manic with psychotic

symptoms, admitted to Acute Psychiatrist Unit. It was his sev-

enth internment. He was dysphoric, had insomnia, and showed

many psychotic symptoms like grandiose delusions and delusions

of reference. He thought he was a famous painter from nineteenth

century.

His disorder was refractory to mood stabilizers monotherapy and

to many neuroleptic and, like olanzapine 30mg/day, depot risperi-

done, zuclopenthixol, haloperidol, palmitate paliperidone, He was

on treatment with lithium 1200mg/day (lithemia 0.62 prior to

admission) and oral aripiprazole 15mg/day that he was not tak-

ing regularly. Poor compliance to oral treatment. No awareness of

illness.

Results

during the patient admission, we started long-acting

aripiprazole 400mg per 28–30 days. First 3 days he persisted

dysphoric, hostile, and showing delusions of mind being read.

From the fourth day, delusions disappeared and later he was

calmer and more friendly, He was discharged 9 days later fully

euthymic.

For 6 months follow-up, the patient came once a month to com-

munity center for aripiprazole injection and he was taking lithium

regularly. Last lithemia 0.65mEQ/L.

Conclusion

Long-acting antipsychotics, like depot aripiprazole

could be a useful alternative to oral medication, specially when

there is no awareness of illness and there is low adherence to oral

treatment.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1154

EV170

Dementia or mania? A case report

C. Gomez

, V. R

odriguez , B. Pecino , E. Tercelan ,

C. Gomis , L. Gonzalez , C. Ortigosa , M. Anibarro

Hospital de Sant Joan de Alicante, Psiquiatry, Alicante, Spain

Corresponding author.

In the clinical practice, we encounter situations that require precise

differential diagnosis and special treatment. This poster reviews

diagnosis and pharmacotherapy of two cases that point out how

likely is to confuse the diagnosis of two apparently different

pathologies: bipolar disorder and frontotemporal dementia. The

first case presents a 75-year-old man that presented behavioural

changes and insomnia without previous known psychiatric history

other than alcoholism. The family explained a history of episodes

of mood changes going from depression to mania, compatible with

a bipolar disorder never diagnosed, and the neuropsychological

exam performed did not show any cognitive impairments, finally

receiving a diagnosis of bipolar disorder after good response to

lithium treatment. The second case presents a 58-year-old man

with behavioural disturbances and mood fluctuation that changed

from short periods of hypomania with disinhibition and insomnia

to a predominance of hypothymia, apathy and self-care negligence,

which received at the beginning a diagnosis of bipolar disorder and

after the proper complementary testswas shown to be a frontotem-

poral dementia.

When facing behavioural and mood changes in advance age, we

should take into account the considerable percentage of patients

with a final diagnosis of frontotemporal dementia that received

previously a mistaken diagnosis of bipolar disorder and vice versa.

Even though in our practice age can point to a disorder, we should

not forget the importance of a good clinical history and anamnesis

to reach a correct diagnosis as well a organized and carefully

planned treatment approach for each individual patient.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1155

EV171

Manic episode associated with

interferon alpha therapy: A case

report

L. González

1 ,

, C . G

omis

2 , V. R

odriguez

2 , C. G

omez

2 ,

E. tercelan

2 , C. O

rtigosa

2 , M.

Anibarro

2 , L. G

arci

a 2

1

Hospital San Juan Alicante, Psychiatry, San Juan Alicante, Spain

2

Hospital San Juan Alicante, Psychiatry, Alicante, Spain

Corresponding author.

Interferon alpha is a cytokine with antiviral and antineoplastic

action, which is commonly used for treatment of Hepatitis C and B,

malignant melanoma, Kaposi’s sarcoma, kidney cancer and certain

hematologic diseases. It is well-known some of its neuropsychiatric

symptoms such as depressive symptoms, cognitive impairment,

chronic fatigue, dysphoria and anxiety, but there are also other less

common likemania, psychotic symptoms and suicide risk that have

been reported. These symptoms interfere in the quality of life very

significantly, which at the end can affect treatment adherence.

We report a case of a 33-year-old man who was taken to the emer-

gency department by his family referring nervousness, irritability,

verbose, and insomnia during the last 5 days. The patient had not

psychiatric history. He was diagnosed with a malignant melanoma

stage III A a year ago which required to start interferon alpha treat-

ment.

Patient and family tell that symptoms began after forgetting

last interferon dose. In the psychopathology exploration, we

could observe mood lability, delusion ideas of prosecution, which

includes his entire family and autorreferentiality. In the emergency

room the blood test, urine drug test and CT were normal.

During the admission, and in collaboration with the Oncology

service, it was agreed the reintroduction and maintenance of inter-

feron combined with olanzapine up to 30mg/day and clonazepam

up to 6mg/day, which resulted in the resolution of symptoms in

two weeks.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1156

EV172

Sexual behavior in women with

bipolar disorder

F. Guermazi

, F. Charfeddine , K. Mdhaffer , L. Aribi ,

W. Bouattour , E. Elleuch , J. Aloulou , O. Amami

Hedi Chaker University Hospital, Psychiatry, Sfax, Tunisia

Corresponding author.

Introduction

Women with bipolar disorder warrant special con-

sideration with regard to sexual health. The impairment in sexual

function would be frequent but underestimated and contributes to

non-compliance with treatments.

Aims

(1) Evaluate sexuality among a population of women

affected by bipolar disorder.

(2) Determine the factors associatedwith impaired sexual function.

Methods

This is a cross-sectional and descriptive study during

the period ranging from 1st September to 15 October 2015.

It was conducted in 40 women suffering from bipolar disorder.

The exclusion criteriawere: relapse period in sick, age over 60 years

or severe somatic comorbidity.

The evaluation of sexual function was made using the “Sexual

Behavior Questionnaire” (SBQ).