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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1177

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1178

EV194

C-reactive protein levels are related to

suicidality in euthymic patients with

bipolar disorder

M. Pantovic Stefanovic

1 ,

, B . D

unjic-Kostic

1 , 2 , M .

Lackovic

1 , 2 ,

A. Damjanovic

1 , 2

, A. Jovanovic

1 , 2

, S. Totic-Poznanovic

1 , 2

,

M. Ivkovic

1 , 2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1179

EV195

Age at menarche is related to number

of previous depressive episodes in

patients with bipolar disorder

B. Dunjic-Kostic

1 , 2

, M. Pantovic Stefanovic

1 ,

, M. Lackovic

1 , 2

,

A. Damjanovic

1 , 2 , A . J

ovanovic

1 , 2 , S . T

otic-Poznanovic

1 , 2 ,

M. Ivkovic

1 , 2

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.