European Psychiatry - Volume 33 - March 2016

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S428 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
Conclusions A projective technique as drawing could help us to
discover additional information about our patients, specially chil-
dren andmainly the ones who had problems with the expression of
feelings like ASD children. The act of drawing can be used to under-
stand children’s struggles, their internal world. Moreover it could
also help the children gain insight and review progress through
drawing records.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV247
Cotard syndrome in a young man?
A. Cercos López ∗, M.C. Cancino Botello ,
V. Chavarria Romero , G. Sugranyes Ernest
1 Hospital Universitario de Santa Maria, Psychiatry, Lleida, Spain
2 Consorcio Hospital General Universitario, Psychiatry, Valencia,
Spain
3 Hosiptal del Mar, Psychiatry, Barcelona, Spain
4 Hospital Clinic, Psychiatry, Barcelona, Spain
∗ Corresponding author.
Introduction Anti-NMDA encephalitis normally appears as a
characteristic syndrome with typical symptoms that undergoes
with multiphase evolution. However, it sometimes develops atyp-
ical symptoms so we must perform a careful differential diagnosis.
Objectives To conduct a current review of detection andmanage-
ment of anti-NMDAr encephalitis, and psychiatric manifestations.
Method Systematic review of the literature in English (PubMed),
with the following keywords: “Autoimmune encephalitis”, “psy-
chosis”, and “NMDA receptor”.
Results We present the case of a 15-year-old boy referred to
evaluation for a first psychotic episode. He had no past his-
tory of psychiatric illness or substance abuse. The only relevant
antecedent ismultiple sclerosis in a first degree relative. For the last
months, he presented high levels of anxiety symptoms apparently
related to college stressful events and fluctuating hypoesthesia
of left cranial side. Days later, it appeared autolimited gastroin-
testinal symptoms, headache and fever. During the next days it
appeared psychomotor retardation, choreic movements, suicide
ideation and mood-congruent paranoid and nihilistic ideation,
auditory and visual hallucinations, perplexity and catatonic symp-
toms so he was hospitalized. We observed cognitive functions
impairment, unsteady gait, dysartria, dysphasia, clonus and left
babinsky sign. EEG showed slow waves on right frontal area. CFS
showed protein elevation and immunologic study revealed pos-
itive anti-NMDA antibodies. Treatment with methylprednisolone
and gammaglobuline was started with partial response, needing
addition of rituximab.
Conclusions In this case, we highlight the importance of early
detection and a detailed differential diagnosis, to determine
whether the etiology of psychiatric symptoms in order to achieve
an accurate and early treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV248
Importance of developmental gesture
of handwriting in children to better
understand writing disabilities:
Preliminary study
C. Lopez ∗, L. Vaivre-douret
1 Department of Medicine, University of Paris Descartes, Sorbonne
Paris Cité, 75015 Paris, France
2 Department of Child Psychiatry, INSERM Unit 1178 and CESP, Paris
Descartes university and Paris Sud UVSQ, Paris-Saclay universities,
Necker–Enfants-Malades University Hospital, Assistance
publique–Hôpitaux de Paris, 75015 Paris, France
3 University hospitalo-Institut Imagine Affiliation,
Necker–Enfants-Malades hospital, 75015 Paris, France
4 Department of Pediatrics, Child development, Cochin-Port Royal
University Hospitals of Paris Center, Assistance publique–Hôpitaux de
Paris, 75015 Paris, France
∗ Corresponding author.
Introduction There is currently a resurgence of handwriting dif-
ficulties in school-age children. Researches in literature focus on
kinematics temporal and spatial measures of letters in the writing
process and on clinical performances such as the handwriting scale
(BHK). This assessment doesn’t consider the organization and the
maturation of the handwriting gesture.
Objectives We aim to study the developmental organization of
the handwriting gesture to provide developmental standards of
reference in order to complete performances measures allowing
a better understanding of handwriting disabilities.
Methods Healthy children of elementary school aged between 6
and 11 years old are eligible for inclusion. All children are assessed
with neuropsychological and neuropsychomotor evaluations and
with handwriting assessment (BHK). Two groups are established,
the one with handwriting difficulties and the other one (control
group) without writing disorder or learning disabilities. The chil-
drenwerematched for age, gender and school level. All children are
filmedwith a camera suspended over to observewith specific hand-
writing tasks, the upper limb gesture about segmental organization
of fingers, hand, forearm, arm, shoulder and postural organization.
Results Preliminary findings show significant differences of the
segmental organization of the writing gesture between the two
groups. We will discuss the identified causes of the handwriting
disorders with the analysis of neuropsychomotor and neurological
assessments data in correlation with gesture segmental organiza-
tion.
Conclusion Developmental organization of the writing gesture is
a possible underlying mechanism of handwriting disabilities. Prac-
tically, it appears important to improve news tools of evaluations
with gestural writing consideration and to implement it in inter-
vention process.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV249
The moderating effect of irrationality
on the relationship between
callous-unemotional traits and
conduct problems in teenagers
C. Costea
Universitatea Babes-Bolyai- Facultatea de Psihologie si Stiinte ale
Educatiei, Psihologie Clinica si Psihoterapie, Cluj Napoca, Romania
The main objective of this study was the investigation of the
moderation effect of irrationality on the relationship between
callous-unemotional traits and conduct problems in youths, this
last association having been demonstrated before in scientific
research. The data was collected from 40 patients of a pediatric
psychiatry clinic, during the last 18months.
We used the following instruments for measuring the main vari-
ables of the study: The Youth Self-Report (YSR, Achenbach, 1991)
for the conduct problems, The Inventory of Callous-Unemotional
Traits (ICU, Frick, 2004) and The Child and Adolescent Scale of Irra-
tionality (CASI, Bernard and Cronan, 1999).
The acquired data was analyzed with the SPSS 20 statistical
software. First, we performed the descriptive statistics and then
we conducted the hierarchical multiple regression analysis. The
research design is predictive, moderation type.