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

S441

EV290

Rage as a hidden aspect in pediatric

obsessive-compulsive disorder

I. Peixoto

, C. Marques

Hospital Dona Estefânia, Child Psychiatry, Lisbon, Portugal

Corresponding author.

Introduction

Pediatric obsessive-compulsive disorder (OCD) is

a multifaceted clinical entity. Rage attacks have been repeatedly

described in the phenotype of anxiety disorders in children and

adolescents. It has been acknowledged that anxious youthwho dis-

play rage have more severe clinical profiles and increased levels of

dysfunction in most domains, consistent with the notion that rage

is a marker of more severe psychopathology. However, this matter

remains largely underappreciated in pediatric OCD. Namely, the

role and functions of rage in pediatric OCD in relation to family

accommodation and illness severity have highly relevant clinical

management and treatment implications.

Objectives

We aim to discuss how does rage look like in pedi-

atric OCD, what are its associated features and its contributions

to additional functional impairment. We examine the central role

of family accommodation mediating clinical outcomes and review

highly relevant diagnostic and treatment challenges.

Methods

Selective reviewof the literature in PubMed (MEDLINE).

Illustration with a clinical case vignette.

Results and conclusions

Rage attacks are relatively common in

pediatric OCD, have a negative impact on illness presentation, and

contribute to functional impairment above and beyond obsessive-

compulsive symptom severity. We hereby illustrate that rage may

contribute to family accommodation of symptoms, which may fur-

ther affect and perpetuate obsessive-compulsive symptomseverity

and impairment. There is a need to avoidmisdiagnosis and to prior-

itize psychotherapeutic interventions and psychopharmacological

treatment approaches. This provides important insights regarding

the clinical validity of this component of OCD, aiming to capture

further the attention of the clinical and research community.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1275

EV291

Encopresis: A medical and family

approach

I. Pe˜nuelas Calvo

1 ,

, J. Sevilla Llewellyn-Jones

2

,

L. Poggio Lagares

3

, C. Cervesi

4

, A. Sareen

5

, A. Gonzalez Moreno

1

1

Hospital Universitario Virgen de la Victoria, Psychiatry, Málaga,

Spain

2

Hospital Universitario Virgen de la Victoria, Psychology, Málaga,

Spain

3

Universidad Complutense de Madrid, Facultad de Psicología, Social

Psychology, Madrid, Spain

4

Institute for Maternal and Child Health- IRCCS “Burlo Garofolo”,

Psychiatry, Trieste, Italy

5

The Zucker Hillside Hospital - North Shore - Long Island Jewish

Health System, Psychiatry Research, New York, USA

Corresponding author.

Introduction

Encopresis is a not very common disorder. The

prevalence of this disorder is about 1.5% after the age of 5 years

old and decreased even more as age increased, being very rare in

adolescence.

Aim

Here we present a clinical case of an 11-year-old girl, with a

diagnosis of functional encopresis with constipation and overflow

incontinence for 4 years.

Method

In this case, we followed a program consisted of 12

sessions combining different techniques that are on experimen-

tal phase. The program we designed consist of toilet training,

stablishment-token economy- of a diet high in fiber with a

progressive remove of laxative medication and a family interven-

tion with both parents that got divorced 4 years ago.

Results

Having both parents the same frame the patient’s prob-

lem easily started to decrease. In follow-up (6 and 12 months), we

observed good toilet habits and not constipations episodes.

Conclusions

Even though all the techniques used were in experi-

mental phase, we considered that because of the chronicity of this

problem a multidisciplinary approach was the best option.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1276

EV292

Brain development in attention deficit

hyperactivity disorder: A

neuroimaging perspective review

V. Pereira

, P. de Castro-Manglano , C. Soutullo Esperon

Clinica Universidad de Navarra, Psychiatry and Medical Psychology,

Pamplona, Spain

Corresponding author.

Introduction

Attention deficit hyperactivity disorder (ADHD) is a

challenge in child and adolescent psychiatry. In the recent decades

many studies with longitudinal designs have used neuroimaging

with ADHD patients, suggesting its neurodevelopmental origin.

Objectives

Study the findings of neuroimaging (MRI, fMRI, DTI,

PET) techniques on ADHD patients from a longitudinal point of

view, looking also for the potential influence of treatments and

other predictors (i.e. genetics).

Aims

To provide a global perspective of all the recent findings

on ADHD patients with the neuroimaging technics, focusing on

longitudinal measurements of the changes in brain development.

Methods

We conducted a reviewof the literature in the databases

Pubmed and ScienceDirect (terms ADHD, neuroimaging, MRI, fMRI,

DTI, PET, functional connectivity, metilphenidate and cortical thick-

ness). We focused on studies using neuroimaging techniques with

ADHD patients, looking at their populations, methodologies and

results.

Results

The studies found abnormalities in the structure of grey

matter, activity and brain connectivity in many neural networks,

with particular involvement of the fronto-parietal and Default

Mode Network. There is also convergent evidence for white matter

pathology and disrupted anatomical connectivity in ADHD. In addi-

tion, dysfunctional connectivity during rest and during cognitive

tasks has been demonstrated.

Conclusions

This evidence describeADHDas a braindevelopment

disorder, with delays and disruptions in the global development of

the central nervous system that compromises grey and white mat-

ters, most evident in the prefrontal cortex, parietal and posterior

cingulate cortices, as well as basal ganglia, damaging activity and

structural and functional connectivity of various brain networks,

especially the fronto-striato-parietal and default mode network.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1277

EV293

Emotion regulation strategies in

adolescents with mitral valve prolapse

E. Pervichko

, Y. Zinchenko

Lomonosov Moscow State University, Faculty of Psychology, Moscow,

Russia

Corresponding author.

Introduction

Two thirds of adolescentswithmitral valve prolapse

(MVP) show signs of anxiety disorders. They display difficulty in

emotion regulation (Van Der Ham et al., 2003; Scordo, 2007).