European Psychiatry - Volume 33 - March 2016

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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.
EV287
How does psychotropic medication
consent work for youth in foster care
C. Pataki ∗ hompson Crecelius esoro
G. Polsky ambam
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.
EV288
Catatonic features in adolescence:
Interfaces with affective disorders
I. Peixoto ∗, C. Santos , M. Sousa , S. Pimenta
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.
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.