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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S437

EV276

Differential diagnosis of recurrent

hypersomnia. Case report of primary

narcolepsy and acute transient

psychotic attack

J. Kıyak

, S. Köse , B. Özbaran

Ege University, Child and Adolescent Psychiatry, ˙Izmir, Turkey

Corresponding author.

Introduction

We report a case of 17-year-old boy with excessive

daytime sleepiness.

Objectives

Case presented in our study is an example of atypi-

cal narcolepsy with coexistence of psychotic symptoms that were

especially prominent during the first attack. Excessive daytime

sleepiness period was followed by psychotic symptoms includ-

ing delusions of reference and persecution, as well as visual and

acoustic hallucinations. However, during the second attack, nega-

tive psychotic symptoms were more prominent.

Aims

Clinicians should not forget that child and adolescent

patients, which demonstrate psychotic symptoms and excessive

daytime sleepiness component, should be evaluated for a diagnosis

of primary hypersomnia.

Method

Patient did not exhibit any comorbidities that would

match with secondary hypersomnia. The initial sleep study did

however reveal increased REM sleep latency (43% of total sleep

time). The result of polysomnographic study was abnormal and

suggestive of narcolepsy. In multi-sleep latency test mean REM

latency was 1.7min, sleep-onset REM (SOREM) was observed 3

times. Between the tests he had no episodes of cataplexy.

Result

Patient was diagnosed with primary hypersomnia-

narcolepsy without cataplexy. We found that mixed symptoms

of narcolepsy and psychotic attack improved with anti-psychotic

agent treatment.

Conclusion

Child and adolescent patients, which demonstrate

psychotic symptoms and excessive daytime sleepiness component,

should be evaluated for a diagnosis of primary hypersomnia follow-

ing a multidisciplinary cooperation of neurologists, pediatricians

and psychiatrists.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1261

EV277

Different expressions of conduct

disorders – childhood versus

adolescent onset type

J. Kosti´c

, M. Stankovic , L. Milosavljevi´c , N. Ili´c

Health Centar-Nis, Department for Child and Adolescent Psychiatry,

Nis, Serbia

Corresponding author.

Introduction

Conduct disorder is a heterogeneous disorder in

terms of etiology, course and prognosis, and currently, there is

no singular model that would describe the development of the

disorder. The results of empirical research on males confirm this

heterogeneity, as they point out that two possible developmental

pathways: childhood-onset and adolescent-onset type.

Aim

This paper presents two clinical picture of conduct disor-

ders: a boy aged ten years with early onset conduct disorder and

a boy aged sixteen years with adolescent onset conduct disorders.

Our emphasis is placed on a different etiology, risk factors for the

development of the disorder, clinical picture and the course of dis-

order. Special attention was focused on therapeutic intervention

and possible prognosis in the two described cases.

Conclusion

Advanced typologies of conduct disorders, as postu-

lated in DSM V classification, is important from the standpoint of a

better understanding this disorders and more effective therapeutic

interventions.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1262

EV278

The role of parental bonding for

self-harm adolescents

A. Kotsopoulou

, A. M

elis

Synchronous Support Center, Psychology, Athens, Greece

Corresponding author.

This study explores how the Greek adolescents understand self-

injury and whether they have self- harm episodes. For the purpose

of this study the questionnaire of the CASE study and the parental

bonding instrument was used. The main research question is to

explore the reasons that lead an adolescent to self-harm. More

specifically if the relationship with their parents and the func-

tion of the family plays a role for leading a teenager to self harm.

One hundred Greek 14–17 years old participated in the study. The

results show that 71% adolescents state that there is high mother

care and 62% high mother protection and 63% high father care

and 50% high father protection. Significant associations were made

for self-harmers and the rest of the sample. There are statistically

significant differences between those participants who self-harm

and their parental bonding (

2

(2,

n

= 100) = 7.59,

P

< 0.05) regarding

their mother protection. It seems that those with low mother pro-

tection are self-harming. Similarly, there are statistically significant

differences between low father care and self harm behavior (

2

(4,

n

= 100) = 10.35,

P

< 0.05). It is interesting to see what they perceive

about this parental bonding and how the engage into this type of

self-harming behavior, but also to explore whether their parents

are aware of this behavior.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1263

EV279

How stressful life events influence

adolescents to self-harm

A. Melis

1

, A. Kotsopoulou

2 ,

1

Synchronous Support Center, Psychology, Athens, Greece

2

Athens, Greece

Corresponding author.

This study explores how 100 Greek adolescents both males and

males deliberately harm themselves and how the stresfull life

events they experience influence their decision. The CASE study

(2008) questionnairewas given 14–17 years old adolescents to self-

report on the situations they are experiencing and the episodes of

self-harm. There were statistically significant differences for those

stressful life events and students who reported to self-harm. It

seems that “having problems keeping up with school work” is

statistically significant between those who self harm and those

who do not (

2

(2,

n

= 100) = 14.3,

P

< 0.05), “having any serious

arguments or fights with either or both of their parents” (

2

(2,

n

= 100) = 8.5,

P

< 0.05) with 44% of self harmers reporting having

problems in the past 12 months. Furthermore, statistically signif-

icant differences were found for been “physically abused” (

2

(2,

n

= 100) = 8.4,

P

< 0.05) with adolescents who self harm being 21%

of the sample. Regarding deaths and suicides they have experienced

many questions were statistically significant: In reporting a death

of someone close to them the results were statistically significant

between those who self harm and the rest (

2

(2,

n

= 100) = 3.9,

P

< 0.05), as well as the suicide attempt or deliberate self harm of a

close friend (

2

(2,

n

= 100) = 0.2,

P

< 0.05), the worries of the sexual

orientation (

2

(2,

n

= 100) = 12.2,

P

< 0.05), the “force to engage in

sexual activities against their will” (

2

(2,

n

= 100) = 10.6,

P

< 0.05)

and finally their report of having experiences a distressing event