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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1605

EV621

Gender difference among psychiatric

patient’s profile in emergency

department

M. Gonc¸ alves

, J. T

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1606

EV622

Delay in medical emergency care to

patients with psychiatric symptoms

P. García González

1 ,

, E. González Martínez

2

, S. Puerta

2

,

A. Capllonch Carrión

1

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1607

EV623

Neuroleptic malignant syndrome.

Differential diagnosis

M.J. Gordillo Monta˜no

1 ,

, G. Carmen

2

, R. Ana

3

, G. Elena

3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1608