European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S417
can change the symptoms of mania and turn them into a mixed
state symptoms. It also states that rapid cycles can be precipitated
by increased alcohol consumption during rotation from mania to
depression.
Conclusions The association of bipolar disorder with addictive
behaviors is a factor that worsens the prognosis and comorbid alco-
hol itself is associated with a poor prognosis. Close monitoring of
bipolar patients and especially in those who consume alcohol is
very important.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV211
Clinical vignette – aripiprazol long
acting injection monotherapy as
long-term treatment for bipolar
disease
M. Solana ∗, J.M. Oliveira , A. Sousa
1 Centro Hospitalar Psiquiátrico de Lisboa, Psychiatry, Lisbon,
Portugal
2 Centro Hospitalar Barreiro-Montijo, E.P.E, Pychiatry, Barreiro,
Portugal
∗ Corresponding author.
Introduction Over the last decade a number of effective mainte-
nance treatments for bipolar disorder (BPD) have been developed.
Lithium remains the best-established option, but valproic acid,
lamotrigine, olanzapine, and quetiapine are also effective main-
tenance drugs. However, oral administration contributes to lower
adherence rates with these drugs. In the United States and Europe,
aripiprazole is approved for the acute management of manic and
mixed episodes and maintenance in BPD. It presents the advantage
of a low risk of metabolic side effects, sexual dysfunction, and seda-
tion, which can facilitate treatment adherence and help improve
clinical outcomes.
Objectives/aims The authors present an illustrative case onwhich
aripiprazol long acting injection monotherapy was effective as
maintenance treatment in a patient with long history of BPD with
several hospital inpatient admissions and very poor therapeutic
adherence.
Methods Case report based on the patient’s file. Narrative review
of articles available in PubMed about the use of aripiprazol in BPD.
Results For this patient, aripiprazol long acting injection has
proved to be an excellent choice for long-term treatment of
BPD. The once-a-month injection promotes therapeutic adherence,
which in this casewas combinedwith involuntary outpatient treat-
ment, ensuring therapeutic compliance.
Conclusions Aripiprazol has been shown to be safe and effec-
tive in the maintenance treatment in BPD. It shows similar efficacy
and a superior tolerability profile when compared with other well-
established treatments. Further studies are needed, warranted by
its potential advantages, particularly on patients with poor insight
and adherence.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV212
Assessing risky sexual behavior
among patients with bipolar disorder
in euthymic period
N. Staali
Tunis, Tunisia
Introduction Risky sexual behaviors are typically seen in patients
with bipolar disorder, especially during the manic phases.
Disinhibition, impulsivity and risk taking expose these patients to
unplanned pregnancies and sexually transmitted infections.
However, there is a lack of studies regarding these behaviors in
stabilized bipolar patients during euthymia.
Objectives The objective of this study was to look for a risky sex-
ual behavior by evaluating sexual knowledge and sexual behavior
of patients with bipolar disorder in the euthymic phase.
Methods We conducted a descriptive cross-sectional study
including 30 patients diagnosed with bipolar disorder I or II (DSM-
IV).
Data were obtained through a semi-structured interview evalu-
ating the following: sexually transmitted infections, condom use,
multiple sexual partners, sex under the influence of drugs or alco-
hol, and prostitution.
The Young Mania Scale and the Hamilton Depression Scale were
used for clinical assessment.
Results The preliminary results suggest a lack of knowledge lead-
ing to a tendency to risky sexual behavior in both male and female,
married and unmarried patients.
Conclusions Patients with bipolar disorder are exposed to risky
and unsafe sex because of the clinical features of their disease and
associated comorbidities.
Prevention and awareness of sexual risks are unavoidable in the
management of these patients.
Disclosure of interest The author has not supplied his declaration
of competing interest.
EV213
Prevalence of insulin resistance and
diabetes mellitus type II in bipolar
disorders
L. Steardo ∗, A. Tortorella , M. Fabrazzo , G. Del Buono ,
S. Ambrosio onteleone
1 University of Naples Sun, Department of Psychiatry, Naples, Italy
2 University of Salerno, Neurosciences Section-Department of
Medicine and Surgery, Salerno, Italy
∗ Corresponding author.
Introduction Bipolar disorder (BD) is associated with high mor-
bidity and mortality. Patients are symptomatic almost half of their
lives and experience significant disability. One subtype of BD is
associated with a more chronic course, refractoriness to treatment
and poor outcome. Diabetesmellitus type 2 (T2D) and insulin resis-
tance (IR) have been identified as risk factors for this more severe
form of BD.
Objectives and aims We investigated the rates of IR and T2D in
patients with BD and whether this comorbidity is associated with
specific clinical features of BD such as rapid cycling or treatment
resistance.
Methods IR and T2D were screened in patients with BD types
I or II, who were on stable treatment with mood stabilizers. The
response to treatment was assessed by means of the Alda scale.
Results In a preliminary sample, we made a new diagnosis of IR
in 40% of patients. The 1% of this sample had a diagnosis of T2D. The
treatment response was worse in BD patients with comorbid IR or
T2D as compared to those without metabolic abnormalities.
Conclusions These findings show that IR and T2D have high
prevalence in BD patients and have negative impact on treatment
response.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.