European Psychiatry - Volume 33 - March 2016

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S472 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV388
Psychotherapeutical treatment at
non-specific phobia as comorbidity in
schizoaffective disorder; case report
and refflection
V. Oreskovic ∗, S. Jonovska , V. Sendula Jengic , S. Zudenigo ,
M. Lukac
1 Psychiatry hospital Rab, Department of acute psychiatry and
intensive care, Rab, Croatia
2 Psychiatry hospital Rab, Department of addictions, Rab, Croatia
3 Psychiatry hospital Rab, Forensic psychiatry, Rab, Croatia
∗ Corresponding author.
The aim of this case report is to present importance of psy-
chotherapy in treatment of schizoaffective disorder. Method used
in psychotherapy setting is Open dialogue, approached and used in
school of cybernetics and system therapy. As significant and clini-
cal operabile comorbidity to schizoaffective disorder, appears one
non-specific phobia that never before got respectable therapeuti-
cal attention. Phobia got more serious patognomonic importance
during last psychotic deterioration while inpatient had suffocated
by solid food and ended up in intensive care unit. After her
vital psychophysical condition was stabilized, hospital psychiatric
treatment was suggested as next step. That included combined
psychopharmacotherapy, occupational therapy and two times a
week individual psychotherapy. In clinical interview was noticed
a solid food phobia - rare and non-specific phobia. So, initial psy-
chology testing has been made. Next 8 weeks, client had passed
two times a week in 45 minutes duration individual psychother-
apy setting based on open dialogue. Eight weeks after client talked
about fears and gave them personal interpretation which created
a non-psychotic sense and new therapy meaning, almost analog
to heteroanamnestic data. Another psychology testing has been
repeated. Results have shown that nature of swallowing pertur-
bances has strictly psychological background.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV389
Between Scylla and Charybdis: Where
does the treatment of Addison’s
disease in late-life depression go first?
S. Petrykiv ∗, M. Arts , L. de Jonge
1 GGZ Friesland, Emergency Psychiatry, Leeuwarden, Netherlands
2 UMC Groningen, Old Age Psychiatry, Groningen, Netherlands
3 UMC Groningen, Epidemiology, Groningen, Netherlands
∗ Corresponding author.
Introduction Older adults with adrenocortical insufficiency,
including Addison’s disease (AD), are at an increased risk for devel-
oping late-life depression. Treatment of AD with glucocorticoid
replacement therapy may exacerbate depressive symptoms and
may complicate treatment of late-life depression.
Objectives To present a case with algorithm of decision-making
in a particular case of glucocorticoid induced depression in patient
with syndrome of Addison.
Aims To report a case-study, describing treatment of Addison’s
disease in LLD.
Methods A case report is presented and discussed, followed by a
literature review.
Results A 77-year-old female, diagnosed with Addison’s dis-
ease, was referred with persistent fatigue, weakness, weight loss,
sleep disturbances, and depressive symptoms over the previous 6
months. She was taken losartan 100 mg/day, zolpidem 10 mg/day,
fludrocortisone 100 g/day, and hydrocortisone 35 mg/day. There
was no personal or family history of psychiatric problems. Clinical
examination was normal aside from skin hyperpigmentation. After
initial minimal dose reduction of glucocorticoids, Addison’s disease
remained under control. One week later, her depressive symptoms
disappeared without administration of antidepressants.
Conclusion The association between glucocorticoid replacement
therapy and late-life depression is not well understood. The current
case shows that treatment of glucocorticoid-induced depression in
subjects with Addison’s disease is achievable by minimal adjust-
ments in glucocorticoid regiment. However, collaboration with
endocrinology is of vital importance to prevent an Addison’s crisis.
Pharmacokinetic dose-finding studies are required to find optimal
glucocorticoid adjustment strategy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV390
ADHD “Symptomatic contamination”
in dual pathology (I): general analysis
of the “Sym Con” sample
J.M. Zoido Ramos ∗, F.J. Pino Calderon , J.R. Gutierrez Casares
1 Servicio Extreme˜no de Salud, CEDEX “Los Pinos”, Badajoz, Spain
2 Servicio Extreme˜no de Salud, ESM Montijo-Puebla, Montijo, Spain
3 Servicio Extreme˜no de Salud, Hospital Perpetuo Socorro, Psichiatría,
Badajoz, Spain
∗ Corresponding author.
Introduction The links betweenADHD and SUD are demonstrated
in the scientific literature. The existence of dual diagnosis affects
both prognosis and clinical-therapeutic assessment.
Objective and aims Describe the general characteristics of a sam-
ple of patients with SUD (n = 162) who seek treatment for their
addiction, based on the presence of symptomatic contamination by
ADHD, compared to a sample of adults (n = 246) without addictive
pathology (parents of children with different risk for ADHD).
Methods We assessed using different scales the properties of the
sample (visual analogical [general state of health, sadness, anxi-
ety, irritability, suspiciousness], WURS, BDI and Exploratory List of
ADHD symptoms).
Results The average age in the group of parents was 40.59 ver-
sus 35.88 on the SUD group, with 42% and 87% males respectively.
SUD group presented worse general state, with higher average of
sadness, anxiety, irritability and suspicioness, as well as WURS and
exploratory symptoms of ADHD, as shown in
Conclusions The SUD group had higher ADHD symptomatic con-
tamination respect to Parents group. These results are preliminary
and are pending more thorough analysis as part of a more exten-
sive and complex study, requiring further confirmation in future
studies.
Table 1 Informe.