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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1231

EV247

Cotard syndrome in a young man?

A. Cercos López

1 ,

, M.C. Cancino Botello

2

,

V. Chavarria Romero

3

, G. Sugranyes Ernest

4

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1232

EV248

Importance of developmental gesture

of handwriting in children to better

understand writing disabilities:

Preliminary study

C. Lopez

1 , 2 ,

, L. Vaivre-douret

1 , 2 , 3 , 4

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1233

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.