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S410

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

EV189

Significant response to amantadine in

a patient with malignant catatonia: A

case report

M. Maki

1 ,

, O. Kato

2

, J. Kunimatsu

1

, T. Sato

1

, S. Fujie

1

1

National center for global health and medicine hospital, general

internal medicine, Tokyo, Japan

2

National center for global health and medicine hospital, psychiatry,

Tokyo, Japan

Corresponding author.

Purpose

Catatonia is a complication of bipolar disorder, which is

a constellation of symptoms such as catalepsy, mutism, and stu-

por. Standard therapy for catatonia contains benzodiazepines and

electroconvulsive therapy. An uncomplicated catatonia is usually

a benign condition. On the other hand, malignant catatonia is a

life-threatening condition that is complicated with fever, auto-

nomic instability, delirium, and rigidity. The syndrome is typically

fulminant and progresses rapidly within a few days without appro-

priate intervention. Several previous reports suggested that some

catatonia are associated with the overstimulation of N-methyl-

D-aspartate (NMDA) receptor, and that amantadine may have an

effectiveness for catatonia, as a NMDA receptor antagonist. We

report a case of successful treatment formalignant catatonia refrac-

tory to benzodiazepines, by using amantadine.

Materials and methods/case

A 64-year-old Japanese woman with

bipolar disorder was referred to our hospital because of 8-week

prolonged fever. On admission, she was in febrile and stuporous

states. Severe rigidity was observed in her extremities. Blood tests,

lumbar puncture, and blood cultures were all negative. Brain MRI

was normal. Consequently, we reached a diagnosis of malignant

catatonia, and thus we gave additional benzodiazepines for her

catatonic symptoms. However, there was no improvement, and we

finally add a 50mg/day amantadine for her malignant catatonic

state.

Result

Her fever resolved in a few days. Gradual dose-titration

of amantadine led her clinical manifestation to completely disap-

peared.

Conclusion

Amantadine can be a potential option as one of the

pharmacological therapies for refractory malignant catatonia.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1174

EV190

Social functioning and social

cognition in bipolar disorder: Is there

a connection?

V. Maria Iulia

1 ,

, R.C. Delphine

1 , 2 , 3

, H. Audrey

2 , 3

, K. Arthur

1 , 2 , 3 , 4

1

Department of Psychiatry, University Hospital of Reims, Reims,

France

2

University Hospital of Reims, Reims, France

3

Cognition, Health, Socialisation Laboratory, EA 6291, Reims

Champagne-Ardenne University, Reims, France

4

Faculty of Medicine, Reims Champagne-Ardenne University, Reims,

France

Corresponding author.

Introduction

The research interest in social cognition in bipolar

disorder has increased in a significant way in the last decade show-

ing major impairments, especially in mental state reasoning, even

during euthymia (Samamé et al., 2012; Samamé et al., 2015). Social

cognitive processes in humans describe the ways individuals draw

inferences about other people’s beliefs and the ways they weigh

social situational factors in making these inferences (Green et al.,

2008). A causal relationship between social cognition deficits and

global functioning has been already established in schizophrenic

populations (Green et al., 2015). But there is still little information

regarding the relation between social cognition and social func-

tioning in bipolar disorder.

Aims

To review the relationship between general/social func-

tioning and social cognitive impairments in bipolar patients.

Methods

A systematic review of literature was conducted. Rel-

evant articles were identified through literature searches in

PubMed/Medline, EBSCOHost and Google Scholar databases dating

from2000 to 2015 using the keywords “bipolar”, “social cognition”,

“theory of mind”, “mentalizing”, “emotion recognition”, “emotion

processing”, “functioning” and “quality of life”.

Results

The findings of the review will be discussed, regarding

the specificity of the thymic state of the patients and the social

cognition instruments used.

Conclusions

To the best of our knowledge, the present review is

the first to explore specifically the relation between the social cog-

nitiondeficits and the general/social functioning of bipolar patients.

This exploration is of interest for a better comprehension of this

disorder to improve the outcome of the patients.

Keywords

Bipolar disorder; Social cognition; Functioning

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1175

EV191

First episode of bipolar depression

and suicide attempt after bariatric

surgery in a 45-year-old woman

E. Muniz Magalhaes

, R. Gois Campos , L.M. Sarin , J.A. Del Porto

Universidade Federal de São Paulo, Psychiatry, São Paulo, Brazil

Corresponding author.

Introduction

Weight loss positively influences mental health

but findings are mixed in patients undergoing bariatric surgery.

The permanent changes in body image, diet-related stress, and

unmet expectations could increase mental health problems such as

major depression and self-harm behaviors. Mixed symptoms dur-

ing major depressive episode were often misdiagnosed as agitated

depression, and should be regarded as a risk factor for suicide and

rapid cycling course of illness.

Method

Single case report.

Results

A 45-year-old woman, initially diagnosed as a unipolar

depressive episode after bariatric surgery, did not show improve-

ment after SSRI treatment. She had no history of previous episode

but her temperament was described as hyperthymic. Antidepres-

sant worsened irritability, racing/crowded thoughts, heightened

anxiety and aggressive impulses, mood instability, impaired con-

centration, insomnia and she had a suicide attempt (antidepressant

overdose). After mood stabilizer and atypical antipsychotic, symp-

toms fully remitted and she is stable in the last year.

Conclusion

Self-harm emergencies after bariatric surgery are

higher than before surgery. Intentional overdose is considered the

most common self-harm mechanism. Psychiatric follow-up after

bariatric surgery and early recognition of bipolar depression with

mixed features as a distinct condition among the variety of depres-

sive syndromes is essential to reduce the risk of self-harmbehaviors

and improve treatment outcomes. Premorbid temperamental fea-

tures, especially hyperthymic and cyclothymic temperaments, are

often responsible for such mixed depressive presentations.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1176

EV192

Mood disorder in epilepsy: A case

report

R.A. Baena

1 ,

, I. Mesián

2

, L. Mendoza

1

, Y. Lázaro

1

1

Hospital Clinico San Carlos, Psychiatry, Madrid, Spain