

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.2016.01.1299EV315
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.2016.01.1300EV316
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 , 21
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.2016.01.1301EV317
Disruptive mood dysregulation
disorder in adults: A case report
O. Kilic
1 ,∗
, E. Demirbas Cakir
2, A.E. Tufan
21
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