European Psychiatry - Volume 33 - March 2016

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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.
EV409
Occult abdominal infection and
psychiatric symptoms: A case report
M. Bairrão ∗ ereira . Jara . Esteves
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.
EV410
Speechless soma: The trauma’s
language in the psychosomatic
J. Becker ∗, G.A. Da Silva , A. Dal Sasso
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.
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.
EV412
Anxiety and depression in
haemodialysis patients in relation to
dialysis adequacy and nutritional
status
L. Cui Xi ∗, G. Michael , Z. Chen , N.H.M. Anuar , K.H.M. Yong ,
R. Tagore
1 Changi general hospital, psychiatry, Singapore, Singapore