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S464

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

understanding as a vehicle for change. A variety of interventions

are described to facilitate this process and are illustrated in case

presentations.

This presentation is a synthesis of a number of papers on active

engagement of the patient in psychodynamic psychotherapy. Two

DVDs that illustrate this approach in consultations with patients

are available for presentation. One is a three-session psychotherapy

with an eight-month follow-up. The patient interviews are edited

and may be the focus of separate sessions.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1346

Comorbidity/Dual pathologies

EV362

Tardive dyskinesia: When one should

suspect of another diagnosis?

R. Almendra

1 ,

, A.R. Figueiredo

2

, V. Espirito Santo

1

, A. Almeida

1

,

P. Guimarães

1

, A.G. Velon

1

1

Centro Hospitalar Trás-os-Montes e Alto Douro, Neurology, Vila

Real, Portugal

2

Centro Hospitalar Trás-os-Montes e Alto Douro, Psychiatry, Vila

Real, Portugal

Corresponding author.

Introduction

Tardive dyskinesia is a collection of symptoms

related to the side effects of neurolepticmedications that canmimic

other types of disorders. Accurate diagnosis can be challenging, as

there is no single test for tardive dyskinesia.

Case report

Female patient, 64 years old, with personal history

of Chronic Myeloid Leukaemia and psychosis since forth decade,

currently medicated with quetiapine 350mg/day, risperidone IM

50mg 15/15 days and trazodone 150mg/day (previously medi-

cated with haloperidol, amisulpride and olanzapine). She started

with involuntary movements interpreted as tardive dyskinesia

after 2 years on neuroleptic treatment. The difficult control of

involuntary movements motivated the reference to ambulatory

Neurology department. The review of personal history suggested

a family history of involuntary movements and psychiatric illness.

Physical examination showed generalized choreic movements. The

analytical and imagiologic study was unremarkable. The presence

of family history and involuntary movements atypical to be classi-

fied as tardive dyskinesia supported a genetic test for Huntington’s

disease who detected a CAG expansion with 43 repetitions in

HTT

gene. Despite treatment with amantadine and riluzole she main-

tains disease progression and evident cognitive deterioration.

Conclusion

The diagnostic process of involuntary movements

may involve more than one physician and requires the review of a

detailed medical history, a physical examination and a neuropsy-

chological evaluation in order to determine whether one is indeed

suffering from tardive dyskinesia or a different neurological disor-

der.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1347

EV363

Toxic consumption among patients

suffering delusional disorder

C.M. Carrillo de Albornoz Calahorro

, A. Porras , M. Guerrero ,

J. Cervilla Ballesteros

Hospital Universitario San Cecilio, Unidad de Salud Mental, Granada,

Spain

Corresponding author.

Introduction

Several epidemiological studies describe the asso-

ciation between substance abuse and appearance of psychotic

symptoms. There is a higher prevalence of psychotic symptoms

among cannabis and cocaine consumers compared to the general

population.

The cannabinoid receptors regulate the release of dopamine and

cocaine has a strong inhibitory action on reuptake of the same.

This may explain the greater proportion of subjects moderately or

heavily dependent on cocaine or cannabis experience symptoms of

psychotic sphere.

Objectives/Aims

Describing the profile of drug consumption

among a group of patients diagnosed with delusional disorder.

Methods

Our data come from a case register study of delusional

disorder in Andalucía (Spanish largest region). By accessing digital

health data, we selected 1927 cases who meet criteria DSM 5 for

delusional disorder collecting different toxic consumption habits.

Results

It was found that 1070 (93.4%) of patients diagnosed as

delusional disorder according DSM 5 did not consume cannabis,

compared to 75 (6.6%) who do so. Among patients diagnosed as

“other psychoses”, 243 (85%) did not use drugs and 43 (15%) con-

sume other drugs of different types of cannabis.

Conclusion

In our sample, we found that the use of drugs such as

cannabis and cocaine is less common among patients diagnosed

with delusional disorder compared with other individuals diag-

nosed as “other psychosis”.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1348

EV364

Psychosis, cause or consequence of

substance use disorder

M.C. Cancino Botello

, M.D.L.A. Canseco Navarro ,

A. Pe˜na Serrano , F. Molina López , J.M. Hernández Sánchez

Consorcio Hospital General Universitario, Psychiatry, Valencia, Spain

Corresponding author.

Introduction

The use of psychostimulants, such as amphetamines

and cocaine in psychotic patients is 4 times more frequent than

non-psychotic ones. It is believed that people with psychosis may

use substances as a self-treatment for negative symptoms. How-

ever, early onset of substance use disorder can develop psychotic

and/or negative symptoms, leading to confusion between primary

or secondary psychosis.

Method

Systematic review of the literature in English (PubMed)

and patient’s clinical record. Keywords: “Substance use disorder”;

“psychosis”.

Objectives

to highlight the importance of an adequate charac-

terization of psychotic symptoms in patients with substance use

disorder.

Case

A 29-year-old man, with psychostimulants and cannabis

abuse since adolescence and very short abstinence episodes. Later

on, he developed paranoia symptoms that slightly improved once

he decreased drugs dosage, but they were still present even on

complete abstinence. Over the last year he has showed negative

and psychotic symptoms that have been worsening with aggres-

sive behavior during the last months, so he had to be hospitalized.

During this period, he has been treated successfully with aripipra-

zol depot once monthly. His evolution has been positive, it has