European Psychiatry - Volume 33 - March 2016

583 / 812

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S579
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV716
Serine racemase in inhibitory neurons
at striatum and it might be involved
in schizophrenia’s pathophysiology
with D1 and D2 receptors
S. Takagi ∗, D. Balu , J. Coyle
1 Tokyo Medical and Dental University, Psychiatry, Tokyo, Japan
2 Harvard Medical School, Department of Psychiatry, Boston, USA
∗ Corresponding author.
Introduction There is substantial evidence that hypofunction of
the N-methyl-d-aspartate receptor (NMDAR) is a core pathophysi-
ological mechanism underlying schizophrenia. d-serine and serine
racemase (SR) (NMDAR co-agonist and it’s producer) are thought
to be involved in schizophrenia’s pathophysiology as NMDAR func-
tion moderators. Our laboratory showed that excitatory neuron
specific SR knock out (SRKO) mice still have just 50% reduction of
SR whereas full SRKOmice had no SR. Furthermore d-serine and SR
are found in inhibitory neurons not only in excitatory neurons with
immunohistochemistry methods. Because NMDAR has excitatory
functions, the existence of d-serine and SR in inhibitory neurons
and their functions are of interest.
Aims To elucidate the existence and roles of d-serine and SR in
inhibitory neurons.
Methods Inhibitory neuron marker, GAD65, specific conditional
SRKO (GAD65 SRKO) mice were made by Cre-lox recombina-
tion method. The GAD65 SRKO mice were analyzed by HPLC
for d-serine concentration, western blotting for SR expression,
immunohistochemistry for SR positive cell’s character identifica-
tion and behavioral testing.
Results GAD65 SRKO had about 50% reduction of SR in striatum
but no reduction in hippocampus and frontal cortex. d-serine of
GAD65 SRKO mice was not different fromWT mice. Immunohisto-
chemistryworks revealed SR is inmediumspiny neuron of striatum
and has colocalization with DARRP-32, D1 receptor, and D2 recep-
tor.
Conclusions SR is expressed in inhibitory neurons at least in
striatum. It might be involved in schizophrenia’s pathophysiology
because it colocalizes with D1 and D2 receptors.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Geriatric psychiatry
EV717
Catatonia and dementia
M. Almeida ∗ ama Pereira
Centro Hospitalar Baixo Vouga, Departamento de Psiquiatria e Saúde
Mental, Aveiro, Portugal
∗ Corresponding author.
Introduction Catatonia, described by Kahlbaum in 1874, is usu-
ally seen as a type of schizophrenia, but it can also occur in a wide
range of other psychiatric/organic disturbances. There is a docu-
mented association between dementia and catatonia, in all phases
of cognitive impairment.
Aims Literature review and discussion about Catatonia, regard-
ing a case report.
Methods Clinical interviews and literature review in PUBMED
database.
Results (case report) Female patient, 89 years old, without psy-
chiatric history, was diagnosed with dementia 5 months prior to
episode. On admission, she presents with prostration, mutism and
refusal to eat/drink. Laboratory studies were normal and TC-CE
shows signs of an old stroke in left temporo-parietal region and
diffuse signs of ischemic leucoencephalopathy. At psychiatric eval-
uation, she was stuporous, unreactive to pain, mute, not following
verbal commands, keeping her eyes closed and resisting attempts
to open her eyelids. She had global rigidity, axial and limbs, and
maintains the postures the examiner puts her into for long peri-
ods. She was already given chlorpromazine, without improvement.
Then she takes diazepam 10mg iv, with remission of the state.
Conclusions Although catatonia usually presents with drama,
clinicians often forget to consider it in differential diagnosis, prob-
ably because of its traditional association with schizophrenia. A
promptly diagnostic is crucial to provide adequate treatment,
avoiding drugs that can worsen/perpetuate the clinical state. Some
authors even support the idea that motor features associated
with end-line dementias may correspond to lorazepam-responsive
catatonia, in which treatment may have a tremendous impact
worldwide.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV718
Mini-Mental State (MMS) evaluation
of dementia in psychiatric patients
admitted to a long stay ward
N. Amel∗, L.P. Isabelle , G. Aurelie , H. Marc , A. Mohammed ,
I. Ziad
USLD La Roseraie, EPS Maison-blanche, Seine-Saint-Denis,
Neuilly-Sur-Marne, France
∗ Corresponding author.
Normal 0 21 false false false FR X-NONE X-NONE MicrosoftInterne-
tExplorer4.
MMS scores for 41 psychiatric patients were analyzed at admission
and regularly throughout their stay.
Results Their average age at admission was 65.7. Thirty-six
patients had a diagnosis of chronic psychosis, two with bipolar
disorders, one with frontotemportal dementia, two with Korsakoff
syndrome.
At admission, 21 (51%) patientsshowed mild cognitive deteriora-
tion (score = 18–26), 12 (29%) moderate deterioration (12–17), 6
severe deterioration (0–11), 2 had normal scores (27–30). Over the
following years, 28 patients were reassessed:
– 12 (42%) were stable, 7 (25%) had a fluctuating score, 5 (18%)
improved;
– 4 (14%) deteriorated over their successive MMS evaluations;
– age, socio-cultural level and psychiatric diagnosis were not asso-
ciated with change in MMS scores;
– average change between initial and final assessment was +6.0
points for patients with improved score, –7.75 for those showing
deterioration;
– 1.28 for those with fluctuating scores, –1.0 for stable patients.
Analysis Unstable psychiatric disorders associated with somatic
pathologies influenced MMS scores for all patients, particularly
for those with MMS deterioration or fluctuation even if this phe-
nomenon could also be observed to a lesser extent in stable
patients. By contrast, patients whose MMS scores improved over
time were more mentally stable and had no current somatic prob-
lems. Multidisciplinary teamwork is important for patients with
deteriorating MMS scores.
Conclusion By illustrating the impact of somatic and psychiatric
factors on dementia, the present study underlines the value of