European Psychiatry - Volume 33 - March 2016

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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.
EV291
Encopresis: A medical and family
approach
I. Pe˜nuelas Calvo ∗, J. Sevilla Llewellyn-Jones ,
L. Poggio Lagares , C. Cervesi , A. Sareen , A. Gonzalez Moreno
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.
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.
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).