Table of Contents Table of Contents
Previous Page  417 / 812 Next Page
Information
Show Menu
Previous Page 417 / 812 Next Page
Page Background

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

S413

Objectives

A series of genes are up or down regulated in BMD.

Aims

We present an algebraic model that incorporates multiple

genes in the pathogenesis.

Methods

The suprachiasmatic circadian gene CLOCK/BMAL1 het-

erodimer is regarded as the master oscillator with a curve of y = a

sinx + b.

Light/darkness events (noise < 5%) changes it into a more broken

curve; hence y = (ne

x

+ b) + a sinx. Superimposition of oscillating

(but not non oscillating) functions can change the pattern of peri-

odicity or even abolish it. The master oscillator, just like the cardiac

pacemaker has suppressing effect on 3 slave oscillators.

Alternating reigning of the master and slave oscillators can cause

a dying curve in the form of Y = f(e

t

) g(sin1/t) + (b) where t is

time and f and g are functions typical for master and slave oscilla-

tors and (b) the effect of light/darkness (not negligible anymore).

This causes the disease course unpredictable. Alternate reigning of

master and slave oscillators is due to:

– mutation in the master with longer periodicity or no suppressing

effect on slaves;

– mutation in the slave with shorter periodicity than the master or

less sensitivity to the suppressing effect of the master.

Combination of the above in the form of genetic polymorphism.

Results

Incorporation of many genes can explain many items in

BMD with good predictions of its course.

Conclusions

This model can predict the course of BMD disease

spectrum.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1183

EV199

General results of personality scores

of bipolar patients studied by

MCMI-III during inter-attack periods

and relevance to clinical course

K. Pirkalani

1 ,

, Z . T

alaeerad

2

1

Mehr Medical Group, Internal Medicine, Tehran, Iran

2

Mehr Medical Group, Gynecology, Tehran, Iran

Corresponding author.

Introduction

Physicians and patients’ relatives regard patients

with BMD during inter attack periods with suspicion.

Aims

Evaluation of relevance of personality tests for BMD and

finding correlations in addition to risk factors

Methods

Thirty-three patients were evaluated by way of the

MCMI-III during inter attack interval. They were apparently with-

out prominent signs and symptoms, slept well and were under

treatment with Lithium. They were compared with 45 examinees

that were evaluated for unrelated reasons.

Results

(1) There were overall higher scores in schizotypal, bor-

derline, narcissistic, histrionic and self destructive personalities

among BMD patients compared to the control group.

P

< 0.03.

(2) With the BR score of 72, all patients fulfilled the diagnosis of at

least one of the personality disorders.

P

< 0.1.

(3) Borderline personality had the highest correlation with BMD

and after scheduled interview 22 of 33 patients fulfilled the criteria

for it.

P

< 0.1.

Presence of high scores in apparently contradicting personali-

ties such as obsessive compulsive and histrionic or narcissistic

and dependent or avoidant and histrionic were also encountered.

P

< 0.2.

Conclusions

Though apparently normal functioning during inter

attack intervals BMD patients fulfill the criteria of some personality

disorders. This is in concordance with our idea that BMD spectrum

has correlation with personality disorders in a subgroup that has

mutations in the downstream genes to CLOCK/BMAL1 [glycogen

synthase kinase3-b (GSK3-b), casein kinase I epsilon, NCAN, PER1,

2, 3 or CRY1, 2

. . .

]. They do not show full-blown symptoms but

remain aberrant with subclinical attack like fluctuations.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1184

EV200

The role of medical condition in

perplexity inside psychotic mixed

states in bipolar disorder: Case series

and literature review

M. Preve

, E. Bolla , M. Godio , N.E. Suardi , R. Traber ,

R.A. Colombo

Sociopsychiatric Organization, Psychiatric Clinic, Mendrisio,

Switzerland

Corresponding author.

Introduction

In literature Leonard introduce, after Wernike

(1900) and Kleist (1928), the concept of cycloid psychoses, and

he gives again a weight to the mixed forms in affective disorders

[1–4] . A

lot of different medical conditions cause pychiatric prob-

lems, like hyperammonemia, hyponatiremia, thyroid disfunction,

urinary infections and still others. The aim of our study is to eval-

uate the role of a medical condition in perplexity inside psychotic

mixed states in bipolar disorder (BD). We propouse three different

cases and literature review.

Method

Three patients with perplexity in BDwere assessedwith:

the SCID-P for axis I diagnosis, HRSD, YMRS, internistical examina-

tion, blood test exams and urinanalysis, and first level brain imagin

(CT and/orMRI).We conducted a systematic reviewof the literature

(PubMed, Embase, PsychInfo), using the terms “bipolar disorder”,

“mixed states”, “perplexity” and “medical condition”.

Results

All our patients present: hyperammonemia, reduction of

TSH and presence of infection at the urinanalysis, and a resolu-

tion of perplexity with the normalization of the blood test and

urinanalysis.

Discussion and conclusion

To our knowledge there are not studies

that confirm the relationship between thyroid and epatic dysfunc-

tion, andurinary infectionwithperplexity inpsychoticmixed states

in BD, and the resolution with the normalization of blood and uri-

nary exams. Further research is warranted to replicate our clinical

observations and to confirm our results.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

References

[1] Perugi G, et al. 2014.

[2] Perugi G, et al. 1997.

[3] Perugi G, et al. 2014.

[4] Leboyer M, et al. 2012.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1185

EV201

Psychotic mixed state in bipolar I

disorder due to neurosyphilis: Case

report and literature review

M. Preve

, M.

Godio , N.E. Suardi , R. Traber , R.A. Colombo

Sociopsychiatric Organization, Psychiatric Clinic, Mendrisio,

Switzerland

Corresponding author.

Introduction

The presence of mixed features in bipolar disor-

der (BD) has been associated with a worse clinical course and

high rates of comorbidities including anxiety, personality, alcohol

and substance use disorders and head trauma or other neuro-

logical problems

[1] .

A recent study reports the connection of

neurosyphilis and mania

[2] . T

he aim of our study is to evaluate an