European Psychiatry - Volume 33 - March 2016

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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.
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.
EV278
The role of parental bonding for
self-harm adolescents
A. Kotsopoulou ∗ 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.
EV279
How stressful life events influence
adolescents to self-harm
A. Melis , A. Kotsopoulou ∗
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