European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S411
2 Hospital Ni˜no Jesús, Psychiatry, Madrid, Spain
∗ Corresponding author.
Introduction A lot of studies have described that up to 50% of
patients with epilepsy develop psychiatric disorders: depression,
anxiety and psychotic symptoms. We can classify these symptoms
according to how they relate in time to seizure occurrence, i.e. pre-
ictal/prodromal, ictal, post-ictal or inter-ictal. In this case, we have
a 76 years old woman that develops a maniac-episode previously
that she has an episode.
Objectives Make a review about the prevalence, risk factors of
psychiatric problem in epilepsy (biological, psychosocial and iatro-
genic) and report of clinical case.
Methods Review the bi-directional associations between
epilepsy and bipolar disorder (epidemiological links, evidence
for shared etiology, and the impact of these disorders) with a
integrated clinical approach.
Results Theoretically, epilepsy and bipolar disorder share an
important number of clinical and neurobiological features. Clas-
sic neuropsychiatric literature focused on major depression with
data on bipolar disorder remains limited. However, actually there
are many evidences that mood instability, mixed irritability even
mania is not uncommon in patients with epilepsy.
Conclusions It is important develop more sensitive and spe-
cific screening instruments to identify mood disorder in epilepsy’s
patients. Future research becomes decisive for a better understand-
ing of the similarities between epilepsy and BD, and the treatment
of both.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV193
A case of a varenicline-induced mania
in a patient with the history of
depression
O. Onur ∗, G. Teksin , C. Karsıdag
Istanbul Bakırkoy Research and Training Hospital for Psychiatry
Neurology and Psychiatry, Istanbul, Turkey
∗ Corresponding author.
Introduction Varenicline is an alpha 4 beta 2 nicotinic receptor
partial agonist with dopaminergic effects, approved for smoking
cessation. The complex interactions and modulations of serotonin
and nicotine receptors caused by varenicline may cause mania by
its serotonin agonist activity and by its release of dopamine in the
striatum. We report a case of a varenicline-induced mania with the
history of depression.
Case A 38-year-old female, with the history of depression and
have been using sertraline 50mg/day for a year, admitted for
grandiose delusions, decreased need for sleep, increased amount
and rapid speech, and agitation. These symptoms began 1 week
after she started taking varenicline as prescribed for smoking
cessation. Young Mania Score (YMS) was 32. She discontinued
sertraline and varenicline after 1 week of use but symptoms
of mania continued. The patient smoked about 20 cigarettes
a day for more than 10 years. She had a positive history of
depression in her family. Her lab work up was unremarkable;
including negative urine toxicology and brain CT scan. The patient
met DSM-5 criteria for a manic episode and was started on
olanzapine 10mg/day and quetiapine 100mg/day. The patient’s
symptoms gradually improved within 1 week with attainment of
euthymicmood, improved sleep, and resolutionof grandiosity. YMS
was 7.
Conclusion Based on this case it might be suggested that patient’s
and family’s psychiatric history should be assessed cautiously
before prescribing varenicline for smoking cessation due to devel-
opment of mood symptoms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV194
C-reactive protein levels are related to
suicidality in euthymic patients with
bipolar disorder
M. Pantovic Stefanovic ∗ unjic-Kostic Lackovic
A. Damjanovic , A. Jovanovic , S. Totic-Poznanovic ,
M. Ivkovic
1 Clinic for Psychiatry Clinical Centre of Serbia, Department for
Affective Disorders, Belgrade, Serbia
2 University of Belgrade, School of Medicine, Belgrade, Serbia
∗ Corresponding author.
Introduction Immune alterations are believed to be an impor-
tant part in etiopathogenesis of affective disorders. However, it is
not clear if the altered immune mediators are related to distinct
disorders or particular psychopathology.
Aims The aim of our study was to explore the differences in C-
reactive protein levels (CRP) between euthymic BD patients and
healthy controls, as well as to explore the relationship between
CRP and lifetime presented psychopathology within BD.
Methods The study group consisted of 83 patients diagnosedwith
BD, compared to the healthy control group (n = 73) and matched
according to age, gender, and body mass index (BMI). Lifetime psy-
chopathology has been assessed according to predominant polarity
as well as previous history of suicide attempts and psychotic
episodes.
Results The CRP levels were significantly higher in BD patients
when compared to healthy controls. After covarying for con-
founders, we observed that CRP levels, in euthymic BD patients,
were related to number of previous suicide attempts, but not other
indicators of lifetime psychopathology.
Conclusions BD patients per se, and particularly those with more
suicide attempts, are more likely to present with proinflammatory
state, even when in remission. Previous history of suicide attempts
could bear specifically vulnerable endophenotype within BD. Sys-
temic, longitudinalmonitoring of the course of illness, andpotential
inflammatory mediators that underlie its systemic nature is war-
ranted.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV195
Age at menarche is related to number
of previous depressive episodes in
patients with bipolar disorder
B. Dunjic-Kostic , M. Pantovic Stefanovic ∗, M. Lackovic ,
A. Damjanovic ovanovic otic-Poznanovic
M. Ivkovic
1 Clinic for Psychiatry Clinical Centre of Serbia, Department for
Affective Disorders, Belgrade, Serbia
2 University of Belgrade, School of Medicine, Belgrade, Serbia
∗ Corresponding author.
Introduction Oestrogen fluctuations may be an important factor
in the etiology of bipolar disorder and age at menarche is associated
with the clinical course of BD. Moreover, it is associated with traits
related to mood.
Aims The aim of our study was to explore the differences in age
at menarche between euthymic BD patients and healthy controls,
as well as to explore the relationship between age at menarche and
lifetime psychopathology within BD.