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S440

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

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1271

EV287

How does psychotropic medication

consent work for youth in foster care

C. Pataki

1 , 2 ,

, C . T

hompson

3 , 4 , G .

Crecelius

2 , J. T

esoro

2 , 5 ,

G. Polsky

2 , P. K

ambam

2

1

David Geffen School of Medicine at UCLA, Psychiatry &

Biobehavioral Science, Los Angeles, California, USA

2

Department of Mental Health, Juvenile Court Mental Health Service,

Monterey Park, California, USA

3

David Geffen School of Medicine at UCLA, Psychiatry &

Biobehavioral Science, Los Angeles, California, USA

4

Department of Mental Health, Juvenile Justice Mental Health

Program, Los Angeles, California, USA

5

University of Southern Californa School of Pharmacy, Pharmacy, Los

Angeles, California, USA

Corresponding author.

Introduction

It is well known that youth in foster care are at high

risk for psychiatric disorders, recently reported in up to 89%, with

over 55% exhibiting ADHD in one sample (Linares et al., 2013). Psy-

chotropic medication use was reported in 59% of foster care youth

within a 2-month period (Brenner et al., 2013). The psychotropic

medication consent process in Los Angeles for dependent children

is multidisciplinary, starting with the treating psychiatrist’s writ-

ten authorization request to Children’s Dependency Court. Once

received, it is distributed to the child’s attorney, social worker, and

Juvenile Court Mental Health Service (JCMHS). JCMHS reviews and

provides recommendations to the judicial officer who ultimately

approves, modifies, or denies consent.

Objectives

To present the steps and reasoning in the process

of review, consultation, recommendations and decisions in psy-

chotropic medication consent for dependent youth.

Aims

To provide an understanding of the multidisciplinary

review process involved in determining psychotropic medication

consent in foster care youth.

Method

Presentation of a timeline, forms and guidelines used in

the process including the “Psychotropic Medication Authorization

Form” (PMA) (Judicial Council of California, 2008).

Results

Categories of recommendations and approvals provided

to the judicial officer will be presented and rationales for in-person

consultations.

Conclusion

The psychotropic medication consent process for

foster care youth is a complex multidisciplinary process which

includes a clinically significant set of recommendations from

JCMHS to the judicial officer to aid in making informed decisions

regarding psychotropic medication.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1272

EV288

Catatonic features in adolescence:

Interfaces with affective disorders

I. Peixoto

1 ,

, C. Santos

1

, M. Sousa

2

, S. Pimenta

1

1

Hospital Dona Estefânia, Child Psychiatry, Lisbon, Portugal

2

Centro Hospitalar Lisboa Norte, Child Psychiatry, Lisbon, Portugal

Corresponding author.

Introduction

Catatonia is a potentially life-threatening but treat-

able neuropsychiatric syndrome. The prevalence of catatonia in

children and adolescents is probably underestimated since inves-

tigation on this matter is still lacking. Different studies have led

to the recognition of catatonia as a separate psychiatric entity, as

reflected in DSM-5, renewing interest on this subject. While in the

adult population there is evidence highlighting the strong asso-

ciation between catatonia and affective disorders, this has been

poorly reflected in child and adolescent psychiatry literature. In

fact, most of the research in this population focuses on associations

with organic, psychotic or developmental disorders.

Objectives

We aim to illustrate the diagnostic challenges when

facing an adolescent with catatonia encompassing psychiatric, neu-

rologic and immunologic factors known as possible causes for this

condition. We aim to explain the diagnostic procedure and the pos-

sible clinical results of this workup, as well as raise the discussion

around treatment options.

Methods

We used a clinical case vignette of a 14-year-old ado-

lescent, presenting with a stress-induced catatonic syndrome and

depressive symptoms without any prior organic or psychiatric

condition. We reviewed the most relevant literature in order to

contextualize our clinical case.

Results and conclusion

Catatonia is an under-recognized con-

dition in children and adolescents without a prior medical or

psychiatric condition, especially when associated with affective

disorders. The inclusion of catatonia as a specific syndrome in the

psychiatric nosography may help its recognition. Case reports on

this matter are therefore especially important as a way of pushing

clinical investigation on this matter forward.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1273

EV289

Autism-plus spectrum disorders:

Interfaces with psychosis

I. Peixoto

, R. Velasco Rodrigues , C. Marques

Hospital Dona Estefânia, Child Psychiatry, Lisbon, Portugal

Corresponding author.

Introduction

Despite categorical differentiation, autistic and

psychotic disorders are historically related diagnostic entities

and there is still much controversy regarding their limits and

developmental course. Particularly in children, the presence of

idiosyncratic fears, difficulties in the social sphere and thought

disorder are important factors in the differential diagnosis. There

are some research-derived clinical constructs that operational-

ize symptomatology aiming to highlight the interfaces and the

overlap between such disorders. Their clinical implications can be

extremely relevant in the face of the limits of current nosology.

Objetives

To phenomenologically describe differentiating

parameters and high-risk clinical profiles for the development of

psychosis in children with autism spectrum disorder.

Methods

Selective reviewof the literature in PubMed (MEDLINE).

Illustration with a clinical case vignette.

Results

The clinical case reflects well the difficulties posed in

the differential diagnosis due to the multiple interfaces between

autism and psychosis. Constructs such as “multiple complex devel-

opmental disorder” or “multidimensionally impaired syndrome”

allow a clearer and more practice-friendly characterization of such

individuals.

Conclusion

The constelation of symptoms identified in these cri-

teria may become useful through the definition of subgroups of

autism spectrum disorder individuals with complex psychopathol-

ogy. Studies in this regard are still scarce, but the validation and

reproduction of the positive results observed in the near future can

help optimize the clinical approaches in these children.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1274