European Psychiatry - Volume 33 - March 2016

468 / 812

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.
Comorbidity/Dual pathologies
EV362
Tardive dyskinesia: When one should
suspect of another diagnosis?
R. Almendra ∗, A.R. Figueiredo , V. Espirito Santo , A. Almeida ,
P. Guimarães , A.G. Velon
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.
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.
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