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

S409

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1170

EV186

The late-onset bipolar disease: A case

report

A. Lopes

, P. S

ales

Hospital Garcia de Orta, Psychiatry, Almada, Portugal

Corresponding author.

The prevalence of bipolar disorder after 65 years is 0.1 to 0.4%.

Mania represents 4.6% to 18.5% of all psychiatric admissions in

geriatrics in the USA. It has some specificity in terms of clinical

presentation, evolution, prognosis and treatment.

We report the case of a patient who presented a first manic episode

after 65 years. E.H, AP, 67 years old, single, without personal and

familial psychiatric history, addressed to psychiatric emergencies

for psychomotor agitation and euphoric mood. He presented two

months ago a manic access with almost total insomnia, eupho-

ria, psychomotor agitation and delusions of grandeur. The balance

sheet reveals no incorrections (blood count, thyroid balance, serol-

ogy: TPHA, VDRL, hepatitis B and C, HIV). The cerebral CT was

normal. The patient has been received a quetiapine 200mg/day,

olanxapine 10mg/day and valproate 1000mg/day. The evolution

after three weeks was favorable.

The late-onset bipolar disorder is characterized by: a less intense

euphoria, replaced by anger and irritability, a more elements of

persecution, disinhibiting and impulsivity. Respecting to that, this

case is an exception. The most common confounding symptoms

and behavioral disorders. A higher frequency of neurological dis-

eases is noted in elderly subjects with a bipolar disorder and, so,

a neuropsychiatric rigorous evaluation is fundamental to exclude

the possibility of an organic pathology for the manic access. The

prescription of psychotropic drugs in the elderly must be under

monitoring.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1171

EV187

Control of attention in bipolar

disorder: Effects of perceptual load in

processing task-irrelevant facial

expressions

J. Grave

1

, S. Soares

2

, N. Madeira

3 ,

, P. Rodrigues

4

, T. Santos

5

,

C. Roque

6

, S. Morais

6

, C. Pereira

5

, V. Santos

6

1

University of Aveiro, Department of Education, Aveiro, Portugal

2

Center for Health Technology and Services Research CINTESIS-UA,

Department of Education, University of Aveiro, Aveiro, Portugal

3

Coimbra Hospital and University Centre, Department of Psychiatry,

Coimbra, Portugal

4

University of Beira Interior, Department of Psychology and

Education, Covilhã, Portugal

5

Baixo-Vouga Hospital Centre, Department of Psychiatry and Mental

Health, Aveiro, Portugal

6

Coimbra Hospital and University Centre, Psychiatry, Coimbra,

Portugal

Corresponding author.

Bipolar disorder (BD), along with schizophrenia, is one of the most

severe psychiatric conditions and is correlated with attentional

deficits and emotion dysregulation. Bipolar patients appear to be

highly sensitive to the presence of emotional distractors. Yet, no

study has investigated whether perceptual load modulates the

interference of emotionally distracting information. Our main goal

was to test whether bipolar patients are more sensitive to task-

irrelevant emotional stimulus, even when the task demands a high

amount of attentional resources.

Fourteen participants with BD I or BD II and 14 controls, age-

and gender-matched, performed a target-letter discrimination task

with emotional task-irrelevant stimulus (angry, happy and neu-

tral facial expressions). Target-letters were presented among five

distractor-letters, which could be the same (low perceptual load)

or different (high perceptual load). Participants should discrimi-

nate the target-letter and ignore the facial expression. Response

time and accuracy rate were analyzed.

Results

showed a greater interference of facial stimuli at high

load than low load, confirming the effectiveness of perceptual

load manipulation. More importantly, patients tarried significantly

longer at high load. This is consistent with deficits in control of

attention, showing that bipolar patients are more prone to dis-

traction by task-irrelevant stimulus only when the task is more

demanding. Moreover, for bipolar patients neutral and angry faces

resulted in a higher interference with the task (longer response

time), compared to controls, suggesting an attentional bias for

neutral and threating social cues. Nevertheless, a more detailed

investigation regarding the attentional impairments in social con-

text in BD is needed.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1172

EV188

Clinical overlap between behavioral

variant of frontotemporal dementia

and bipolar disorder: A case report

P. Oliveira

1

, C. Roque

2

, V. Santos

1

, N. Madeira

2 ,

1

Coimbra Hospital and University Centre, Psychiatry, Coimbra,

Portugal

2

Faculty of Medicine, University of Coimbra, Psychological Medicine,

Coimbra, Portugal

Corresponding author.

The behavioral variant of frontotemporal dementia (FTD) often

begins with psychiatric symptoms, including changes in personal

conduct and/or interpersonal behavior. Prior to developing cog-

nitive impairment, differentiating FTD from primary psychiatric

disorders might be challenging.

This work presents a case of a manic episode with psychotic fea-

tures in a 61-year-old man, whom personality changes and daily

life difficulties arouse and persist after optimal management of

the active manic and psychotic symptoms. Neuropsychological

assessment detailed severe deficits among visuospatial and plan-

ning performances. Structural neuroimaging (CT-scan) primary

revealed a global pattern of brain volume reduction. Severe per-

fusion deficits on frontal and both parietal lobes were shown

on 99mTc-HMPAO single-photon emission computed tomography

(SPECT). The hypothesis of probable FTD (behavioral variant) was

established.

The present case highlights how putative atypical and late-onset

forms of bipolar disorder (BD) might instead progress to FTD. Sev-

eral links are being advanced between the BD and FTD, for instance

the close involvement of the

C9ORF72

gene in a group of BD patients

which progresses to dementia. These relations have actually been

on focus recently. The field is however still relatively unexplored.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1173