European Psychiatry - Volume 33 - March 2016

427 / 812

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S423
In this study we aimed to present and discuss six adolescents who
had received aripiprazole treatment aiming to reduce PRL levels
induced by various second generation antipsychotics.
Methods Six patients were aged between 14 and 17 years. Five
of them were diagnosed as early onset schizophrenia and the
remaining one was diagnosed as bipolar 1 disorder. Risperidone,
amilsulpride, olanzapine and in some cases combinations of these
agents were responsible for hyperprolactinemia as displayed by
basal and fortnightlymeasurements of serumprolactin levels. Arip-
iprazolewere added to current antipsychotics and serumPRL levels
obtained every two weeks were recorded.
Results Aripiprazole was used between 2.5–15mg’s initially and
reached up to 10–30mg per day within 3weeks. In all six cases
serum, PRL levels decreased by 9.1–88.76 percent.
Conclusions Aripirazole seems to be promising in the treatment
of antipsychotic induced hyperprolactinemia in adolescents. Ran-
domized controlled studies necessitate.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV231
Psychiatrc symptoms induced by
montelukast: A case report
E. Aydın As¸ ık ∗, S¸ . Yalın Sapmaz
1 Celal Bayar University Faculty of Medicine, Psychiatry, Manisa,
Turkey
2 Celal Bayar University Faculty of Medicine, Child and Adolescent
Psychiatry, Manisa, Turkey
∗ Corresponding author.
Introduction Montelukast is a leukotrienes receptor antagonist,
which is used, in chronic asthma, exercise induced broncocon-
striction and allergic rhinitis treatment. Montelukast inhibates the
proinflammatory cytokines and leukotriene is released from the
specific cells. Leukotrienes cause mucus secretion, vasodilatation,
broncoconstriction and eosinophilia. This case is about an asthma-
diagnosed child who had acute disturbing behaviour and sleeping
problems after using montelukast treatment.
Case A 5 year-old boy assessed because of symptoms like
breaking the rules, disturbing friends, self-harming, hyperactivity,
distractability, insomnia and nightmares. In his history, when he
was 9months old acute hyperactivity, yelling, naughtiness, insom-
nia, disturbing and self-harming behaviours occurred suddenly
24 hours after intravenous montelukast treatment due to asthma
crisis. While he was still using oral montelukast, his parents had
cut off the treatment. After about 2months, there was decrease
in the symptoms. After using montelukast, these kinds of mis-
behaviour occurred again in a week. The montelukast treatment
was terminated controlled way under a pediatrician consultation.
Turgay DSM-IV Based Distruptive Behaviour Disorders Screening
and Rating Scale were completed by both of the parents in the
first interview and after 2months of cutting off montelukast treat-
ment. While comparing 2 scales and parents’ anamnesis, we found
that impulsivity, oppositional defiant, hyperactivity, distractability,
breaking off the rules, irritability, insomnia and having nightmares
reduced.
Conclusion Montelukast can cause many psychiatric symptoms.
In that case we found sleeping problems and disturbing behaviour
caused or induced by montelukast treatment. As in that case, other
drugs also can cause or enhance psychiatric symptoms. So it is
important to assess the other drugs while assessing the diagnosis
and the treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV232
Affective symptoms and emerging
psychotic disorder in adolescents
X. Benarous
Hôpital Pitié-Salpêtrière, Child and adolescent psychiatry
department, Paris, France
Depressive symptoms are frequently reported during the period
preceding the onset of schizophrenia in adolescents when such
symptoms can be mistaken for those of mood disorder. However,
it is unclear which emotional symptoms should be considered pre-
dictive of schizophrenia onset.
The types of emotional disturbances that may precede
schizophrenic disorder were sought through a review of historical
descriptive studies and seminal works using a phenomenological
approach. Five main types of emotional disturbances have been
found as prodromal symptoms of a schizophrenic disorder: (1)
increased sensitivity to stress, (2) poor or incomplete expres-
sion of emotions, (3) reduced emotion sharing, (4) emotional
detachment, and (5) disconnection between the perception and
expression of emotions. Studies based on phenomenological views
of schizophrenic disorders stressed the chronological sequence
of these symptoms in the same person. For example, the term
“delusional mood” (Wahnstimmung) coined to describe changes
in the perceived atmosphere encompass mood disturbances from
subtle emotional overreactivity to more severe symptoms that
could evoke athymhormia.
Analysis of recent studies among subjects at high-risk for psychotic
transition showed that the presence of mood symptoms at a very
early stage of the disorder is common. While these symptoms pre-
dict a lower level of general functioning, they were not associated
with a higher risk of developing a schizophrenic disorder at follow-
up.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV233
The RDoC roadmap to explore
neurocognitive difficulties of youths
with severely dysregulated mood:
Current findings and prospects
X. Benarous
Hôpital Pitié-Salpêtrière, Child and adolescent psychiatry
department, Paris, France
The Research Domain Criteria (RDoC) has been developed as
a multilevel approach to study neurocognitive impairments
in psychiatry. Considering the high prevalence and the func-
tional impairment associated with disruptive mood dysregulation
disorders (DMMD) in youths, a better understanding of the neurobi-
ological mechanisms underlying such emotional difficulties could
help guide therapeutics.
So far, three key difficulties in the socio-emotional neurocognitive
process have been documented in youths with DMDD:
– a deficit in the recognition of facial emotions has been found
(systems for social process/social communication construct). Func-
tional imagery has shown that such impairment is associated with
a hypoactivity of limbic neural structures, especially the amygdala.
Such findings are in line with those found in adults with depressive
episodes;
– poor flexibility during cognitive tasks (cognitive sys-
tems/cognitive effortful control construct). In particular, these
youths score poorly in neuropsychological tasks associated with
response reversal paradigm measuring the capacity to change
cognitive strategy when the rules of the game change implicitly.
These results partly explain the difficulties facing DMDD youths in
a frustrating context;