European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S469
EV378
Temporal epilepsy and psychosis -
Comorbidities
V. Klaric ∗, D. Klaric
1 Zadar general hospital, department of psychiatry, Zadar, Croatia
2 Zadar general hospital, department of internal medicine, Zadar,
Croatia
∗ Corresponding author.
Introduction The simultaneous presence of temporal epilepsy
and psychosis includes a careful approach to diagnosis and titration
of medication.
Aim To achieve remission of comorbid diseases resistant to ther-
apy.
Methods Psychotherapy interview and support, laboratory mea-
surements, EEG, cerebral CT and MRI scan, psychological testing.
Results The patient was a girl 16 years of age. In 2011, she started
experiencing auditory hallucinations of disturbing content, ideas of
persecution, and she feared that people were going to kill her, all
of which were bothering her deeply. In the family anamnesis, her
grandmother and aunt both suffer from schizophrenia. In the first
neurological assessment, there were no abberations. The patient
was treated with high doses of various antipsychotics, but the hal-
lucinations became unbearable to the extent that she was about
to commit suicide. Anticonvulsive therapy was planned, and in
the meantime, a second neurological assessment was performed,
which confirmed the coexistence of temporal epilepsy. Combined
therapy consisting of anticonvulsive and antipsychotic medication
markedly abated the hallucinations. However, the patient began to
feel cramping of the right arm, as well as experiencing the negative
symptoms of psychosis. She wasn’t functioning normally anymore,
she was distinctly adynamic, depressive, with a lack of initiative,
and poor memory and concentration. Psychological testing con-
firmed significant cognitive, emotional and personality disorders
(of organic source).
Conclusion Treatment of the overlapping symptoms of tempo-
ral epilepsy and psychosis is complex, along with the presence of
intellectual deterioration.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV379
Schizophrenia or attention deficit
hyperactivity disorder: drug abuse as
a cause of wrong diagnosis
Y. Lazaro ∗, M.P. Iba˜nez , A. Muro
1 Hospital Clínico San Carlos, Psychiatry, Madrid, Spain
2 Parc Sanitari Sant Joan de Déu, Psychiatry, Barcelona, Spain
∗ Corresponding author.
Introduction It is common to find patients with overlapping
attention deficit hyperactivity disorder (ADHD) and substance
abuse disorder, specially alcohol, cannabis and cocaine. The anx-
iety, impulsivity and even psychosis derived from consumption
often induce wrong diagnosis of patients, due to the camouflage
of the basic psychopathology of ADHD.
Objectives Analyze a clinical case in order to point out the diffi-
culty of diagnosis existent in ADHD patients with substance abuse
disorder comorbidity.
Aims To gain insight in the psychopathology of ADHD patients,
to make the right discernment and to improve the quality of their
lives.
Methods Thirty-four-year-old man, ex-drug user of cannabis and
cocaine, diagnosed with paranoid schizophrenia several years ago
on an outpatient basis. Currently in prison, with regular follow-up
by psichiatry in the last year. The toxic withdrawal, the collec-
tion of medical history and the successive consultations finally
orientated the diagnosis to ADHD-combined subtype, receiving
treatment with atomoxetine instead of antipsychotics. After few
months of observation, we confirmed an excellent general clinical
response and a better adaptation to the prison environment.
Results Psychoticismdisappearedwithdrug abstinence. Antipsy-
chotics were interrupted due to the absence of psychopathology
of schizophrenia. Free of psychotropic drugs, ADHD symptoms
became apparent.
Conclusions Due to ADHD comorbidity, it is important to pay
attention to the profile to make the right discrimination between
different entities for therapeutic and prognosis implications.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Further reading
Daigre C, et al. Attention deficit hyperactivity disorder in cocaine-
dependent adults: a psychiatric comorbidity analysis. Am J Addict
2013;22(5):466–73.
EV380
Clinical aspects of depression in
Parkinson’s disease
F. Leite ∗, H. Salgado , O. Campos , P. Carvalho ,
M. Pinto da Costa , P. Queirós , C. Cochat
1 Matosinhos, Portugal
2 Hospital de Magalhães Lemos, Psychiatry, Porto, Portugal
∗ Corresponding author.
Introduction Parkinson’s disease is the most common neurode-
generative movement disorder in the elderly population. The
disease is clinically characterized by major motor symptoms that
include bradykinesia, rigidity, tremor and postural instability. In
addition to the motor symptoms, Parkinson‘s disease is character-
ized by emotional and cognitive deficits, which reduce quality of
life independently from motor manifestations.
Objectives/Aims To discuss the clinical manifestations of depres-
sion in Parkinson’s disease according to the most recent scientific
literature.
Methods Online search/review of the literature has been carried
out, using Medline/Pubmed, concerning, “Parkinson’s disease” and
“depression”.
Results Depression is the most frequent psychiatric disorder in
Parkinson’s disease. In up to 30% of the cases, the depressive
symptoms precede the development of motor symptoms. Inde-
pendently of the age of appearance, duration and severity of the
motor symptoms, depression is generally an integral part of the
disease. Depression in Parkinson’s disease is generallymild ormod-
erate, with premature loss of self-esteemand volition. Although the
high rates of suicidal ideation, suicide is rare. There is also a high
prevalence of panic attacks and anxiety.
Conclusions It is difficult to correctly identify depression in
Parkinson’s disease as some symptoms assigned to Parkinson’s dis-
ease itself can in fact be the clinical manifestation of a depressive
disorder. On the other hand, depressive symptoms may not be
recognized as such, but considered manifestations of Parkinson’s
disease.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV381
Huntington’s disease-comorbidity
M. Ortega Garcia ∗, V. Marti Garnica ,
C. Martinez Martinez , P. Blanco del Valle , R. Gómez Martinez ,
P. Garcia Acebes , S. Garcia Marin , C. Franch Pato
1 CSM Cartagena, Hospital Santa Lucia, Cartagena, Spain