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

S449

Objectives

We report a case of undiagnosed pheochromocytoma

in a 29-year-old woman with a two year history of anxiety. We

undertook a literature review.

Methods

PubMed search using “pheochromocytoma”, “anxiety”

as key words. Follow by a manual review of identified publication.

We report a case of a 29-year-oldwith a two-year history of anxiety

pharmacologically treated without success. She presents episodes

of acute anxiety accompanied, sometimes, by nausea or headache,

without high blood pressure. She presented a previous medical

history of thyroid carcinoma. The patient was referred to the

endocrinology service for thyroid review, postulated as potential

source for drug resistance. High catecholamine levels were found

and pheochromocytoma diagnosis was confirmed histopathologi-

cally.

Results

The releasing catecholamine in blood can lead to a

number of symptoms that can include paroxysmal hypertension,

headache, palpitations, anxiety, chest/abdominal pain, nausea.

Hypertension may not be the main symptom. These symptoms can

be misinterpreted as psychiatric disorders, in particularly anxiety

disorders. Elevated urinary catecholamine suggested the diagnosis

of pheochromocytoma.

Conclusions

Pheochromocytoma should be included in the differ-

ential diagnosis of anxiety disorders, especially if pharmacological

treatment is not effective. The suspected cases should be investi-

gated, even in the absence of hypertension, due to the potential

morbidity of untreated pheochromocytoma.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1299

EV315

Ganser syndrome: Review and case

report

R. Faria

, D. Brandão , T. Novo , L. Quintela , A. Fonte

Unidade Local de Saúde do Alto Minho, Departamento de Psiquiatria

e Saúde Mental, Viana do Castelo, Portugal

Corresponding author.

Introduction

First described by Sigbert Ganser in 1987, Ganser

syndrome consists in a rare condition, characterized by the fol-

lowing four clinical features: approximate answers, dulling of

consciousness, conversion symptoms and hallucinations.

Objectives

To present a case suggestive of Ganser Syndrome and

to review the literature with particular regard to the aetiology of

this condition.

Methods

Literature review, using computerized databases

(MEDLINE

®

, Medscape

®

). Articles were selected based on the

content of their abstract and their relevance.

Results

A 58-year-old woman was admitted to a Psychiatric

Unit of a General Hospital for presenting behavioural abnormal-

ities of acute onset. During hospitalization, the patient displayed

indifference, incoherent speech with approximate answers, motor

abnormalities and auditory psedudohallucinations. The patient

was evaluated by a neurologist and various exams were performed

(blood tests, CT, MRI, EEG) that showed no significant abnormal-

ities. Pharmacological treatment consisted of antidepressant and

antipsychotic medications. During the follow-up, there was a slow

but gradual improvement of symptoms. Six months after hospital-

ization the patient decide to end up the follow-up.

Conclusions

Little is still known about Ganser Syndrome. The four

aetiological perspectives consider: hysterical origin, malingering or

factitious disorder, psychotic origin and organic origin. The lack of

reports and information about Ganser syndrome made it worth-

while reporting this case.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1300

EV316

Evolution of diagnostic frequency in

schizophrenia spectrum disorders in

Acute Psychiatric Unit in Barcelona

M. Grifell

1 ,

, L. Galindo

1

, M. Campillo

1

, L. Gonzalez

1

,

A. Palomo

1

, C. Diez-aja

1

, A. Grau

1

, L. San-Emeterio

1

, M. Ibarra

1

,

R. Sanchez

1

, L.M. Martín

1

, L. García

1

, O. Orejas

1

, T. Salvador

1

,

H. Manteca

1

, V. Pérez

1 , 2

1

Parc de salut mar, Institut de neuropsiquiatria i addiccions,

Barcelona, Spain

2

Centro de investigación Biomédica en Red de Salud Mental

CIBERSAM G21, Psychiatry, Barcelona, Spain

Corresponding author.

Introduction

Several studies have suggested variations in the

prevalence of schizophrenia spectrum disorders diagnosis across

time. This could be due to a change in diagnostic practice moti-

vated either for changes in DSM criteria as for local culture factors.

The aim of this study is to explore the evolution of the schizophre-

nia spectrum disorders. We hypothesize that we would observe

a transference from the schizophrenia diagnosis to psychosis not

otherwise specified.

Methods

A retrospective review of all psychiatric discharges in

acute unit in the INAD of Parc de Salut Mar of Barcelona, between

2002 and 2014 was performed, relating each discharge to its axis I

psychiatric diagnostic. AnANOVA analysiswas used to calculate the

differences between themonths and the frequency of the diagnosis.

Conclusion

We have not been able to observe any transference

between diagnoses across years. We observe a decrease of the

proportion of schizophrenic spectrum disorders in its prevalence

at discharge from 2012 to 2014. The proportion of not other-

wise specified psychosis remains quite constant as a third of the

schizophrenia diagnoses.

Disclosure of interest

The authors report no conflict of inter-

est in this study. LG is funded by the Instituto.de.Salud.Carlos.III

(CM14/00111).

Further readings

Castagnini, A., Berrios, G. E. (2009). Acute and transient psy-

chotic disorders (ICD-10 F23): a review from a European

perspective. Eur Arch Psychiatry Clin Neurosci 259(8):433–43.

http://dx.doi.org/10.1007/s00406-009-0008-2 .

Mundt, A. P., Fakhriddinov, S., Fayzirahmanova, M., Aichberger, M.

C., Ivens, S., Schouler-Ocak, M., Ströhle,A. (2011). Use of psychiatric

inpatient capacities and diagnostic practice in Tashkent/Uzbekistan

as compared to Berlin/Germany. Soc Psychiatry Psychiat Epidemiol

46(12), 1295–302.

http://dx.doi.org/10.1007/s00127-010-0299-7

.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1301

EV317

Disruptive mood dysregulation

disorder in adults: A case report

O. Kilic

1 ,

, E. Demirbas Cakir

2

, A.E. Tufan

2

1

Beykent University, Psychology, Istanbul, Turkey

2

Abant Izzet Baysal University Izzet Baysal Mental Health Research

and Training Hospital, Child and Adolescent Psychiatry, Bolu, Turkey

Corresponding author.

Introduction

Disruptive mood dysregulation disorder (DMDD)

defined by DSM-V is characterized by severe and recurrent temper

outbursts and persistently irritable or angry mood.

Objectives

Our aim is to attract attention to an adult case with

DMDD since the literature is lacking adult manifestations.

Case report

A 18-year-old boy have been on follow-up in our

outpatient clinic since he was 12 with complaints of being increas-

ingly irritable and angry during most of the day. He had temper

tantrums six or seven times per week involving verbal rages, phys-

ical aggression and throwing things to friends and familymembers.

There had never been a distinct period lasting more than one day