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S546

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

EV614

Preventing self-harm and reducing

suicidal ideation through an

expedited regular supportive

psychotherapy and assertive case

management – protocol for a

three-arm partial randomised

controlled trial

V. Agyapong

1 ,

, T. Behre

2

, M. Juhas

1

, A. Greenshaw

1

1

University of Alberta, Department of Psychiatry, Edmonton, Canada

2

QE II Hospital, Department of Psychiatry, Grande Prairie, Canada

Corresponding author.

Aim

To conduct a three-arm partial randomised controlled trail

to evaluate the effectiveness of expedited regular supportive psy-

chotherapy and assertive case management for patients presenting

with suicidal ideation or self-harm to the emergency department

(ED).

Hypothesis

We expect expedited regular supportive psychother-

apy plus assertive case management will reduce the suicidality

and/or suicidal behaviour in patients by at least 20% at 4 weeks

compared to patients receiving only assertive case management or

routine care and these differences will be sustained at 6 months.

Methods

This will be a longitudinal, prospective, three-arm con-

trolled single-rater-blinded partial randomized clinical trial with

a recruitment period of 12 months and an observation period of

6 months for each participant. Patients in the intervention group

will receive regular face-to-face or over the phone brief support-

ive psychotherapy during weekdays following presentation to the

ED with suicidal ideation or self-harm until patients are actively

enrolled in regular community mental health services with active

case management by the therapist. Patients in the control and the

assertive outreach arms will each receive the usual follow-up ser-

vices offered routinely to regular patients and assertive outreach

patients respectively who present to the ED with suicidal ideation

or self-harm.

Results

Recruitment will commence in February 2016 and we

expect the results of the study to be available by September 2017.

Conclusion

If our hypothesis is proved correct, our intervention

will be a new model for caring for patients with self-harm and

suicidal ideation and is expected to reduce suicide rates.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1599

EV615

Parasomnias and panic attacks: A case

report

S. Benavente López

1 ,

, N. Salgado Borrego

2

,

C. Hernández Durán

3

, E. Muro Fernández de Pinedo

3

,

A.P. García Marín

3

, L. Pérez Ordo˜no

3

, A. Sainz Herrero

3

,

A.M. Sanz Paloma

3

, R. Barbosa Requena

3

,

L.T. Vázquez Rodríguez

3

, G. Rodrigo Borja

3

, J. Vila Santos

3

,

F. Jiménez Morillas

3

, S. Bermejo Lorero

3

, M.L. Castro Arias

3

1

Hospital Universitario 12 de Octubre, Psychiatry, Madrid, Spain

2

Hospital Dr. Rodríguez Lafora, Psychiatry, Madrid, Spain

3

Hospital Universitario 12 de Octubre, Emergency department,

Madrid, Spain

Corresponding author.

Introduction

Parasomnias are a category of sleep disorders in

which abnormal events occur during sleep, due to inappropriately

timed activation of physiological systems.

Case report

We report the case of a 41-year-old female who has

no psychiatric history. The patient went to emergency department

because when she was starting to sleep, in the first state of sleep,

she felts a sensation of paralysis in all her body, with incapacity for

breathing, chest oppression and tactile hallucinations like some-

thing or someone was touching her entire body. Due to that, the

patient awoke frightened, with high levels of anxiety, with heart

palpitations, shortness of breath, trembling, choking feeling, sweat-

ing, nausea and fear of dying. When the patient arrived to the

emergency department, she was suffering a panic attack, thinking

that she could have some kind of neurological disease or she was

suffering a heart attack. After treating the panic attack with 1mg

of lorazepam, all the symptoms subsided gradually.

Discussion

In this case report, we present a patient with a new-

onset parasomnia, with hypnagogic hallucinations and a panic

attack at the awakening. It is known that stress factors are closely

associated with parasomnias, as we can see in this case because the

patient was moving and she was sleeping in a new place.

Conclusions

Parasomnias are very frequently present in general

population and they can trigger intense anxiety status that can lead

to panic attacks.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1600

EV616

Hyperthyroidism and psychotic

symptoms: A case report

S. Benavente López

1 ,

, N. Salgado Borrego

2

, L. Arroyave Villa

3

,

C. Hernández Durán

3

, E. Muro Fernández de Pinedo

3

,

A.P. García Marín

3

, L. Pérez Ordo˜no

3

, A.M. Sanz Paloma

3

,

R. Barbosa Requena

3

, M. Gil Mosquera

3

, N. Bermejo Cabanas

3

,

R. Franco Sánchez-Horneros

3

, I. Fernández Marín

3

,

A. Rodríguez Miravalles

3

, M.L. Castro Arias

3

1

Hospital Universitario 12 de Octubre, Psychiatry, Madrid, Spain

2

Hospital Dr. Rodríguez Lafora, Psychiatry, Madrid, Spain

3

Hospital Universitario 12 de Octubre, Emergency department,

Madrid, Spain

Corresponding author.

Introduction

Hyperthyroidism may lead to high anxiety status,

emotional lability, irritability, overactivity, exaggerated sensitivity

to noise, and fluctuatingmood, insomnia and hyporexia. In extreme

cases, they may appear delusions and hallucinations as psychiatric

symptoms.

Case report

We report the case of a 53-year-old female who was

diagnosed of hyperthyroidism and generalized anxiety disorder.

The patient went to emergency department because of high levels

of anxiety, with heart palpitations, trembling, shortness of breath

and nausea. She was presenting auditory hallucinations and delu-

sions as psychiatric symptoms. An urgent thyroid profile was made

and it was observed the next results: TSH< 0.005; T4:4; T3:21.

Due to a severe thyroid malfunction, the patient was admitted

and treated with antithyroid agent, improving the psychiatric and

somatic symptoms.

Discussion

In this case, a patient diagnosed of hyperthyroidism

and generalized anxiety disorder presented very severe psychiatric

symptoms, with hallucinations and delusions. These symptoms

may be produced by primary psychiatric disorders, but is very

important to look for thyroid alterations, because if they are the

cause, the acute treatment of thyroid malfunction is the correct

management of the patient.

Conclusions

Hyperthyroidism is very common in general popu-

lation, being infradiagnosed most of times. In patient with anxiety

or other psychiatric symptoms, it is very important to make a thy-

roid function tests before the diagnosis of a psychiatric disorder. In

extreme cases, hyperthyroidism status may lead to severe psychi-

atric and somatic complications.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1601