European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S429
The results showed a significant positive association between
callous-unemotional traits and conduct problems, a significant
positive association between irrationality and conduct problems,
no significant statistical association between callous-unemotional
traits and irrational beliefs and no significant moderating
effect of irrational cognitions on the relationship between
callous-unemotional traits and conduct problems. Nonetheless,
callous-unemotional traits and irrationality explain 49.5% of the
variance of behavior problems.
The results confirm the need of adapted individualized therapeutic
strategies for children and adolescents with conduct problems, to
address both their callous-unemotional traits and their irrational
beliefs.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV250
Conversion disorder in adolescents: A
review and case report
A. De Cos Milas ∗, M. Garcia Moreno , V. Gómez Macías ,
N.E. Chinchurreta de Lora , N. Rodríguez Criado ,
B. Sánchez Sánchez
1 Hospital Universitario de Móstoles, Child Psychiatry, Madrid, Spain
2 Hospital Universitario Puerta de Hierro, Psychiatry, Majadahonda,
Madrid, Spain
3 Fundación Hospital Alcorcón, Psychiatry, Alcorcon, Madrid, Spain
4 Hospital Universitario de Móstoles, Psychiatry, Madrid, Spain
∗ Corresponding author.
Introduction Conversion disorder (CD) is an uncommon but
highly disabling condition. Affected children and adolescents are
often severely impaired and at risk of serious long-term physical
and psychosocial complications. Despite the enormous personal
suffering and health resource implications of CD, little research has
been done.
Objectives To update our knowledge about CD in adolescents,
with a comprehensive review of the literature with special focus
in prevalence, psychosocial factors, diagnosis, treatment and out-
come.
Aims To present the most relevant data of our review with a
clinical illustration that provides a practical vision of this disorder.
Methods A systematic literature review was performed in MED-
LINE, with particular interest in papers published in the last
10 years. Clinical illustration is provided by a case selected from
an outpatient child and adolescent mental health service.
Results Few reliable prevalence data are available; the range goes
from 0.2 in a German study to 31% in non-western clinical settings.
Diagnosis is based on a constellation of features and treatment
should involve several heath care professionals. CDhas a favourable
outcome in children and adolescents. However, mood and/or anx-
iety disorders are encountered at a considerable rate even after
recovery fromconversion symptoms. Long clinical follow-up seems
appropriate.
Conclusions The expression of emotional distress in the form of
physical complaints is common in children. Nevertheless, the most
severe presentation of physical symptoms is not a common topic
in literature. More research should be done to improve our under-
standing of this disabling disorder.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV251
Hoarding disorder and
obsessive-compulsive disorder
F. De la Torre Brasas ∗, A. Duque Domínguez ,
N. Echeverría Hernández , M.D.M. Lázaro Redondo ,
C. García Montero , M. Otalora Navarro , L. Martín Díaz ,
A. Más Villase˜nor
1 Valladolid, Spain
2 Complejo Asistencial de Ávila, Servicio de Psiquiatría, Ávila, Spain
∗ Corresponding author.
Introduction Hoarding disorder is described in the DSM-5 as a
new clinical entity whose essential characteristic is the persistent
difficulty discarding or parting with possessions, regardless of their
actual value, arguing reasons of utility, aesthetics, attachment or
strong fear of losing Information.
Objectives We present the case of an 11-year-old male patient
brought to the Health Mental office when his mother found in
the school bag debris that he had collected from the garbage, and
useless objects in a bedroom drawer. The patient recognizes the
nonsense of his behaviour but is unable to get rid of these objects
but he allows his mother to do it. He had lowered school perfor-
mance and showed irritable, shy and solitary, difficulties to sleep
and cried often without apparent reason. They also noted since six
months before, strange movements with the neck and eyes.
Methods After ruling out, underlying organic pathology, we
started treatment with sertraline 50mg, aripiprazole 2.5mg and
cognitive behavioural therapy, with complete disappearance of
symptoms including the movement disorder.
Results Obsessive compulsive disorder 300.3 (F42); Hoarding
disorder 300.3 (F42); Provisional Tic disorder 307.21 (F95.0).
Conclusions Hoarding behaviour of strange objects is very
unusual in Hoarding Disorder but more common in the Obsessive-
Compulsive Disorder. In this case report, we consider the possibility
of both disorders.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV252
Early attachment trauma and the
impact on child’s development
D. D’Hooghe
Traumacentre Belgium, Brugge, Belgium
It is important to broaden our vision on attachment trauma, by
pointing out the importance of the quality of parenting as an indi-
cator to develop a secure attachment relationship.
This quality mainly depends on the caregivers’ ability to mentalize,
regulate, contain, play, . . .
The absence of these features causes traumatic stress in the child
and impacts his psychological and neurological development and
the possibility to attach. Thus, it is important that we are aware of
the relationship between early attachment trauma (EAT) and affect
dysregulation and dissociation.
The seriousness depends on the early age of the child, an immature
coping mechanism, the child’s different experience of danger, the
stress level of adverse experiences and the caregiver as the source
of trauma.
We can consider dissociation and affect dysregulation as complex
adaptation to trauma.
In addition, when the child is not able to manage distress, it lacks
the capability to integrate the experiences.
Dissociation and inadequate self-regulation interfere with one
another and impact the development of the sense of self.
By raising awareness amongst caregivers and clinicians about EAT
and the severe consequences, new therapeutic opportunities could
be developed.