European Psychiatry - Volume 33 - March 2016

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S548 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV621
Gender difference among psychiatric
patient’s profile in emergency
department
M. Gonc¸ alves ∗ eixeira , R. Diana , A. Craveiro
Centro Hospitalar e Universitário de Coimbra, Centro de
Responsabilidade Integrada em Psiquiatria e Saúde Mental, Coimbra,
Portugal
∗ Corresponding author.
Introduction Over the past 40 years, services for psychiatric
patients have become increasingly deinstitutionalized, shifting
away from inpatient facilities. As a result, patients seek other
avenues for treatment, including outpatient facilities and commu-
nity resources. Unfortunately, those resources have also become
increasingly constrained by widespread budget cuts, leaving
patients with the health care system’s last remaining safety
net—the emergency department (ED).
Because EDs are seeing increasing numbers of patients, hospi-
tal administrators have recognized the importance of improving
throughput and the quality of care delivered in EDs.
The aim of this report is to investigate the gender difference
among patient’s profile in psychiatric emergency room, assess-
ing the socio-demographic and clinical characteristics, reasons for
attendance and practices.
Methods Retrospective and observational study, conducted at
Centro Hospitalar e Universitário de Coimbra, during a threemonth
period. Statistical analysis of data with “SPSS 21”.
Results During the three months period, a total of 2309 patients
were admitted in Psychiatric ED, 1485 female and 824 male.
Regarding clinical data, the authors are expecting to find different
psychopathology among male and female, as well as psychi-
atric comorbidities, diagnoses after discharge, treatment conducts,
social support and different rates of psychiatric comorbidities.
Conclusions Factors such as patient’s vulnerability, defined by
socio-demographic elements, characteristic as the type and sever-
ity of theirmental illness, social support, treatment adherence, with
significant implications of prognosis, costs and care. The conducted
study enabled us to outline a profile of male and female psychiatric
patients in ED.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV622
Delay in medical emergency care to
patients with psychiatric symptoms
P. García González ∗, E. González Martínez , S. Puerta ,
A. Capllonch Carrión
1 Complejo Asistencial Benito Menni, Unidad Hospitalización Breve,
Ciempozuelos, Madrid, Spain
2 Hospital Universitario 12 de Octubre, Servicio de Psiquiatría,
Madrid, Spain
∗ Corresponding author.
Patients with mental illness not only have a higher prevalence of
physical disorders compared with the general population, but are
also less likely to receive proper medical care.
We report a case of a 62-year-old woman who was hospitalized in
our psychiatry hospitalization unit due to behavioural disturbances
and mild psychotic symptoms. During hospitalization, she pre-
sented a syncope with an important drop in oxygen saturation
requiring continuous oxygen administration to maintain an ade-
quate saturation. As our unit is placed in a monographic psychiatry
hospital, she is derived to themedical emergency unit of a local gen-
eral hospital for attention. Due toher behavioral symptoms, shewas
difficult to treat in the emergency department, which resulted in
an approximate delay of five to six hours. Intervention of the psy-
chiatry emergency team was necessary to encourage the general
medical team to perform a full clinical examination, being finally
diagnosed with bilateral pulmonary embolism and admitted to a
general medicine hospitalization unit.
We review related literature regarding the delay in medical care
for psychiatric patients. Patients withmental disorders are likely to
not receive propermedial care. Programs addressing stigmatization
of patients with mental disorders among physicians and a better
coordination between medical and psychiatry emergency teams
are some of the solutions proposed to address this problem.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV623
Neuroleptic malignant syndrome.
Differential diagnosis
M.J. Gordillo Monta˜no ∗, G. Carmen , R. Ana , G. Elena
1 Los Santos De Maimona, Spain
2 Hospital Juan Ramón Jimenez, Spain
3 Spain
∗ Corresponding author.
Neuroleptic malignant syndrome is one of the most dangerous
complications of antipsychotic therapy, rare but very serious, espe-
cially with first-generation neuroleptics. It is a medical emergency,
an early diagnosis will be necessary and include general supportive
measures and symptomatic drug therapy.
Objectives NMS is a diagnosis of exclusion that typically occurs
between 24–72 hours. Rare after twoweeks, except that the deposit
may extend this period. The course is between 7 and 10 days.
Methods We will present a case in which we see the difficulties
that arise in daily clinical practice.
Results The most characteristic symptoms are engines, such as
stiffness (“lead pipe”), dystonia, tremor, nystagmus, opisthotonos,
bradykinesia, dysphagia, dysarthria, lethargy, convulsions, trismus,
oculogyric crisis. Changes the state of consciousness (confusion,
delirium and stupor or coma). Hyperthermia, above 38.5 ◦C (up to
41). Autonomic instability (hypertension, postural hypotension and
variability in blood pressure, tachycardia, tachypnea, salivation,
sweating, pale skin, and urinary incontinence).
Conclusions It is particularly difficult to make the differential
diagnosis with malignant catatonia, by the common features
that both products, which are indistinguishable in a quarter of
cases, conceptualise the NMS as a form of drug-induced malig-
nant catatonia. This resembles by muscle rigidity, hyperthermia,
and akinesia. His appearance is preceded by emotional disorders,
psychotic symptoms, depressive symptoms, impaired function-
ing prior patient, acute anxiety and agitation, which occurs about
twoweeks before. Subsequently choreiformstereotypies, primitive
hyperkinesias, spasms and rhythmic and cyclic armmovements. In
catatonia, hyperactivity and hyperthermia typically occur prior to
the administration of the neuroleptic.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.