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

S469

EV378

Temporal epilepsy and psychosis -

Comorbidities

V. Klaric

1 ,

, D. Klaric

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1363

EV379

Schizophrenia or attention deficit

hyperactivity disorder: drug abuse as

a cause of wrong diagnosis

Y. Lazaro

1 ,

, M.P. Iba˜nez

2

, A. Muro

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1364

EV380

Clinical aspects of depression in

Parkinson’s disease

F. Leite

1 ,

, H. Salgado

2

, O. Campos

2

, P. Carvalho

2

,

M. Pinto da Costa

2

, P. Queirós

2

, C. Cochat

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1365

EV381

Huntington’s disease-comorbidity

M. Ortega Garcia

1 ,

, V. Marti Garnica

1

,

C. Martinez Martinez

2

, P. Blanco del Valle

3

, R. Gómez Martinez

4

,

P. Garcia Acebes

5

, S. Garcia Marin

6

, C. Franch Pato

7

1

CSM Cartagena, Hospital Santa Lucia, Cartagena, Spain