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

S479

by participants, a significant step in patient experience and

outcomes.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1393

EV409

Occult abdominal infection and

psychiatric symptoms: A case report

M. Bairrão

1 ,

, G . P

ereira

1 , J.M

. Jara

2 , M.H

. Esteves

1

1

Lisbon Psychiatric Hospitalar Center, Psychiatry, Lisbon, Portugal

2

Lisbon Central Hospitalar Center, Psychiatry, Lisbon, Portugal

Corresponding author.

Introduction

The clinical presentation of numerous infectious

processes can include diverse psychiatric symptoms. Subtle cog-

nitive dysfunction or mood change (e.g., irritability), depression,

psychosis and delirium are the most likely symptoms to occur and

may result from a small focus of chronic infection.

Aims

Disclose an unusual clinical case with psychiatric symp-

toms as the first presentation of an occult infection.

Methods

The reviewwas based on scientific documentation pub-

lished in PubMed database, journals and reference textbooks. We

used the following terms as keywords

“infection”, “occult infection” and “psychiatric symptoms”.

Results

We present the case of a 48-year-old woman without

psychiatric history until January 2015, time when she had insid-

iously developed personality changes with emotional instability.

Five months latter, during her stay in urgency department after her

second suicide attempt, her dysphoricmood, defiant behaviour and

persistent suicidal ideationwere interpreted as a personality disor-

der that has led to a compulsory admission. Forty-eight hours after

the admission, she became febrile with fluctuation of conscious-

ness and ended up being transferred with sepsis to an intensive

care unit. The carried out investigation has shown an occult abdom-

inal infection, i.e. peritoneal abscesses without isolated infectious

agent. With the resolution of the infectious process, the psychiatric

symptoms subsided and she returned to her premorbid personality

level.

Conclusions

Infectious diseases can firstly present with psychi-

atric symptoms. Timely investigation of the underlying etiology for

psychiatric symptoms that persist after conventional psychiatric

treatments is crucial for appropriate intervention and full recovery

of the patient.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1394

EV410

Speechless soma: The trauma’s

language in the psychosomatic

J. Becker

1 ,

, G.A. Da Silva

2

, A. Dal Sasso

3

1

Universidade de Coimbra, Master’s Degree in social and cultural

psychiatry, Coimbra, Portugal

2

Fundac¸ ão Universitária Mário Martins, psychology, Porto Alegre,

Brazil

3

Fundac¸ ão Universitária Mário Martins, Student of psychotherapy,

Porto Alegre, Brazil

Corresponding author.

The study begins by approaching the psychological traumatism

concept, recognizing it as an important precipitating of psychoso-

matic disorders. Based on studies of anthropologists, psychiatrists

and psychoanalysts, we present trauma as a consequence of an

unexpected event from where is originated intense fear, an abrup-

tion, which disorganizes and incapacitates the victim. The Institut

Psychosomatique de Paris (IPSO)workswith the theory that trauma

is an excessive disorganization in the mental apparatus and the

psychosomatic disease is the alternative that the body finds to

discharge excitation, is an attempt to resolve a conflict. The psy-

chosomatic patient is characterized by difficulty to qualify his

affections, it is observed in his super adapted speech and his

linear thought, which, together, differ him from neurotic and psy-

chotic patients. Considerations about the child development and

the affects qualification are made to introduce the importance of

this primitive period, but we pretend to demonstrate that they

are not determinants to produce psychosomatic symptoms. When

the psychological pain is intense and constant, it provokes a split

between mind (psyche) and body (soma) and, in the place of the

elaboration and representation about the experience, explodes psy-

chosomatic disorders.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1395

EV411

General hospital inpatients with

delirium: A cross-sectional pilot study

of patients referred to a consultation

liaison psychiatry service

P. Buvanaswari

Changi general hospital, psychological medicine, Singapore,

Singapore

Introduction

A significant number of referrals to consultation-

liaison psychiatry are for delirium, which is often mistaken for a

primary psychiatric illness. Delirium is associated with poor out-

comes, particularly when it is not recognised.

Aims

To identify the rate of missed delirium and the factors asso-

ciated with it, so as to inform interventions aimed at reducing the

proportion of patients whose delirium is missed.

Objectives

To perform a cross-sectional survey of inpatients

referred to a consultation-liaison psychiatry service in a general

hospital who have an eventual diagnosis of delirium, in order to

determine the proportion of patients with missed delirium and

characteristics of such patients.

Methods

Data was collected retrospectively for a sample of 30

inpatients with delirium who had been referred to a consulta-

tion liaison psychiatry service, and analysed for associations with

missed delirium.

Results

Only a third of patients with delirium were accurately

diagnosed before referral, and there was a mean delay of about

4 days between delirium onset and psychiatry consultation. Mis-

diagnosed patients were most commonly thought to have either

dementia or a mood disorder. The factors most closely associated

with missed delirium were: being of Chinese ethnicity, not having

any history of psychiatric problems, not having fluctuations in the

mental state, not having agitated behaviour, and being of younger

age. None of these associations were statistically significant.

Conclusion

Two-thirds of patients with delirium in this sample

weremisdiagnosed before referral. Further study is needed to iden-

tify factors which may contribute to missed delirium.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1396

EV412

Anxiety and depression in

haemodialysis patients in relation to

dialysis adequacy and nutritional

status

L. Cui Xi

1 ,

, G. Michael

2

, Z. Chen

3

, N.H.M. Anuar

4

, K.H.M. Yong

5

,

R. Tagore

6

1

Changi general hospital, psychiatry, Singapore, Singapore