European Psychiatry - Volume 33 - March 2016

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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.
EV170
Dementia or mania? A case report
C. Gomez ∗ 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.
EV171
Manic episode associated with
interferon alpha therapy: A case
report
L. González ∗ omis odriguez omez
E. tercelan rtigosa Anibarro arci
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.
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).