European Psychiatry - Volume 33 - March 2016

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S408 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
A primary school level was found in 34.7% of the cases (n = 17).
Nineteen patients (38.8%) were schooled until the secondary level
and 9 patients (18.4%) followed a university program.
Addiction to smoking was found at 26 patients (53%) whose half
of them had moreover an alcoholic poisoning. The mean age at the
diagnosis was 35.6 years with an inaugural manic episode in 63.4%
(n = 31) of the cases. The average number of relapse was 1.23 and
the mean duration of follow-up was 3.2 years.
Conclusion The knowledge of the profile of the consultants,
their socio-demographic and clinical characteristics would allow
to adapt the offer of care to the request.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV183
Association between the 5-HTTLPR
genotype and childhood impulsivity
in subjects with bipolar II disorder
E.J. Kim
Eulji General Hospital, Department of Psychiatry, Seoul, Republic of
Korea
Objective It has been suggested that the features of childhood
ADHD are significantly associatedwith adult mood disorders. Some
genetic factors may be common to both ADHD and mood disor-
ders underlie the association between these two phenotypes. The
present study aimed to determine whether a genetic role may be
played by the serotonin transporter-linked polymorphic region (5-
HTTLPR) in the childhood ADHD features of adult patients with
mood disorders.
Methods The present study included 232 patients withMDD, 154
patients with BPD, and 1288 normal controls. Childhood ADHD
features were assessed with the Korean version of the Wender
Utah Rating Scale. The total score and the scores of three factors
(impulsivity, inattention, mood instability) from the WURS-K were
analyzed to determine whether they were associated with the 5-
HTTLPR genotype.
Results In the BPD II group, the 5-HTTLPR genotype was signifi-
cantly associatedwith the total score ( P = 0.029) and the impulsivity
factor ( P = 0.004) on the WURS-K. However, the inattention and
mood instability factors were not associated with the 5-HTTLPR
genotype, and the MDD and normal control groups did not exhibit
any significant associations between the WURS-K scores and the
5-HTTLPR genotype.
Conclusion The present findings suggest that the 5-HTTLPR geno-
type may play a role in the impulsivity component of childhood
ADHD in patients with BPD II. Because of a small sample size and a
single candidate gene, further studies investigating other candidate
genes using a larger sample are warranted to more conclusively
determine any common genetic links.
Keywords 5-HTTLPR; ADHD; Biopolar II disorder; Childhood;
Impulsivity; WURS-K
Disclosure of interest The author has not supplied his declaration
of competing interest.
EV184
Thyroid dysfunction in inpatients
with affective disorders
A.M. Leitão Moreira ∗, R. Pacheco Alves , M. Lazaro ,
A.M. Mota , M.A. Nobre
1 Hospital de Dona Estefânia, Centro Hospitalar de Lisboa
Central-EPE, Área de Psiquiatria da Infância e Adolescência, Lisboa,
Portugal
2 Centro Hospitalar Psiquiátrico de Lisboa, Clinica 5 - Perturbac¸ ões
Afectivas e Obcessivo-Compulsivas, Lisboa, Portugal
∗ Corresponding author.
Introduction Thyroid dysfunction has been linked to psychiatric
disorders, particularly to affective disorders. Moreover, aging of
the population receiving mental health care leads to an increased
epidemiological risk of thyroid disease.
Objectives Assess the prevalence of abnormal thyroid function,
and its correlations to clinical factors, in an acute psychiatric inpa-
tients ward dedicated to affective disorders.
Aims Reflect on the clinical relevance of thyroid function screen-
ing on admission in mental health care.
Methods Retrospective, descriptive study, concerning inpatient
episodes from a 12 month period (January to December 2015) in
a ward dedicated to affective disorders, in a tertiary psychiatric
hospital.
Results The prevalence of thyroid dysfunction across all psychi-
atric diagnostic groups was 11%. Preliminary data has shown higher
prevalence in non-elderly women with personality disorder as a
main diagnosis (30%, P = 0.017). Only women were under thyroid
replacement therapy, which was significantly more prevalent in
those diagnosed with bipolar disorder.
Conclusion The relatively high prevalence of thyroid dysfunction
underlines the relevance of its screening in mental health inpa-
tients. Our results were consistent with the known epidemiology of
thyroid disease. Correlations with bipolar and personality disorder
were noted, which can contribute to improve the understanding
of clinical-epidemiological relationships between thyroid disease
and specific psychiatric disorders.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV185
Recognition and treatment of bipolar
mixed states
F. Leite ∗, H. Salgado , C. Olga , P. Carvalho
1 Matosinhos, Portugal
2 Hospital de Magalhães Lemos, Servic¸ o de Psiquiatria, Porto, Portugal
∗ Corresponding author.
Introduction Mixed features refers to the presence of high
and low symptoms occurring at the same time, or as part
of a single episode, in people experiencing an episode of
mania or depression. In most forms of bipolar disorder, moods
alternate between elevated and depressed over time. A per-
son with mixed features experiences symptoms of both mood
“poles” – mania and depression – simultaneously or in rapid
sequence.
Aims and objectives To review the nosological status of bipolar
mixed states and its treatment.
Methods Online search/review of the literature has been carried
out, using Medline/Pubmed, concerning “mixed states”, “affective
disorder”, “bipolar disorder”.
Results The presence of depressive symptomatology during
acute mania has been termed mixed mania, dysphoric mania,
depressive mania or mixed bipolar disorder. Highly prevalent,
mixed mania occurs in at least 30% of bipolar patients. Correct
diagnosis is a major challenge. The presence of mixed features is
associated with a worse clinical course and higher rates of comor-
bidities. There is ongoing debate about the role of antidepressants
in the evolution of such states.
Conclusions Clinical vigilance and careful evaluation are required
to ensure mixed states are not missed in the clinical context. Atypi-
cal antipsychotics are emerging as the medications of choice in the
pharmacological management of mixed states.