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

S585

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1719

EV735

Comorbidity and polypharmacy in

elderly living in nursing homes

A.R. Ferreira

1 ,

, S . M

artins

2 , L. F

ernandes

3

1

PhD Program in Clinical and Health Services Research/PDICSS,

Health Information and Decision Sciences Department, Faculty of

Medicine of University of Porto, Porto, Portugal

2

Center for Health Technology and Services Research/CINTESIS,

Faculty of Medicine of University of Porto, Porto, Portugal

3

Center for Health Technology and Services Research/CINTESIS,

Faculty of Medicine of University of Porto, Psychiatry Service - CHSJ

Porto, Porto, Portugal

Corresponding author.

Introduction

The ageing process is characterized by a high level

of complexity, due to the co-occurrence of multiple chronic dis-

eases (comorbidity) that often results in the concomitant use of

multiple drug therapies (polypharmacy) for treatment and prophy-

laxis. Institutionalized elderly may be regarded as the paradigm

of this complexity because of their multiple chronic diseases and

decreased functional and cognitive functions.

Objective

To explore and characterize the prevalence of comor-

bidity and polypharmacy in a sample of institutionalized elderly.

Methods

A cross-sectional study was conducted with an elderly

sample recruited from three Portuguese nursing homes. Clini-

cal information was obtained through interview and by review

of residents’ medical records. The Anatomical Therapeutic Chem-

ical/ATC classification was used to indicate the main group of

medicines used, and polypharmacy was categorized into minor

(2–4 medicines) or major (

5). Comorbidities were coded using

the individual body systems of Cumulative Illness Rating Scale for

Geriatrics/CIRS-G.

Results

The sample included 175 elderly with a mean age of 81

(sd = 10) years and institutionalized for an average of 7 (sd = 11)

years. Residents presented a mean of 9 (sd = 4) co-morbid med-

ical conditions, mostly psychiatric (80.8%), vascular (76.7%) and

endocrine/metabolic (70.3%). Major polypharmacy was verified for

73.9% of residents. The mean number of medicines was 7 (sd = 3),

most commonly for cardiovascular (86.0%) and nervous system

(79.1%) and for blood and blood-forming organs (69.2%).

Conclusions

As in other studies in similar settings, polypharmacy

was fairly common. These results convey an important message

considering that polypharmacy has been associated with negative

clinical outcomes that could otherwise be preventable by reducing

the number of prescribed medicines.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1720

EV736

A case report of a Capgras’ syndrome

in elderly

C. Moreno Menguiano

, M.

Gutierrez Rodriguez ,

F. Garcia Sanchez , S. Bravo Herrero

Hospital Universitario de Móstoles, Psiquiatría, Móstoles, Spain

Corresponding author.

Introduction

Capgras syndrome is the most frequent delusional

misidentification syndrome (DMS) which was first described in

1923 by Capgras and Reboul-Lachaux as ‘L’illusion des sosies’. Con-

sists of believe that close relatives have been replaced by nearly

identical impostors. It can occur in the context of psychiatric dis-

orders (schizophrenia, major depression) such organic, in which

onset of delirium is usually later coinciding with neurological dam-

age or neurodegenerative disease.

Case report

Woman 73-year-old diagnosed of schizophrenia

since more than thirty years ago. Her family talk about general

impairment of the patient in the last two years. She needed a couple

of psychiatric hospitalizations because of her psychiatric disease,

and probably onset of cognitive impairment. In this context, we

objectified the presence of a Capgras syndrome.

Objectives

To review the literature available about Capgras syn-

drome in elderly and illustrate it with a clinical case.

Methods

Review of literature about Capgras syndrome in elderly

by searching of articles in the PubMed database of the last five years

to illustrate the exposure of a single case report.

Results

The etiology of this syndrome is not yet well understood.

Advanced age is frequently found Capgras syndrome with or with-

out the concomitant presence of an obvious cognitive impairment.

Conclusions

Since it is a complex process an etiological model

that combines cognitive and perceptual deficits, organic impair-

ment and psychodynamic factors should be proposed. And it is

important to make a correct differential diagnosis that allows us

to carry out the best possible treatment.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1721

EV737

From the Asperger’s syndrome to the

Diogenes syndrome

C. Padovan

1 ,

, J. Laurent

1

, Dr M. Herrmann

2

,

G. Chesnoy-Servanin

1

, Dr J.M. Dorey

3

1

Centre hospitalier Le Vinatier, pôle Est, Consultation Mémoire,

service du Dr Dorey, Bron, France

2

Centre hospitalier Le Vinatier, pôle Est, service de psychiatrie du

sujet âgé, service du Dr Dorey, Bron, France

3

Centre hospitalier Le Vinatier, pôle Est, Consultation Mémoire,

service de psychiatrie du sujet âgé, service du Dr Dorey, Bron, France

Corresponding author.

The Diogenes and Asperger’s syndromes share social cognition

deficits and a disturbance in social functioning. Our objective is to

discuss the close relationship between these two clinical entities. In

routine clinical practice of aging people, the Asperger’s syndrome

is rarely seen in medical consultation because symptoms may be

confused with other psychiatric diseases more prevalent in aging

population. The aim is to discover if Asperger’s syndrome could be

the comorbidity of another symptom, such as Diogenes syndrome

or if it is a primary syndrome engendering other symptoms, such as

Diogenes syndrome. In this perspective, the Asperger’s syndrome

could be seen as a misunderstood syndrome in aging people. We

report the case of a patient whose Diogenes syndrome was dis-

covered during a social intervention visit by a nurse, following a

medical consultation for a breach of trust issue and behavioural dis-

orders. The neuropsychological assessment of this patient revealed:

– normal intellectual, memory and instrumental functioning;

– a difficulty in a problem solving task only for the task involving

the use of a context to answer;

– an impairment in an emotional recognition task.

During the psychiatric examination, the relationship was strange.

The patient exhibited symptoms that mimic those of people having

an Asperger’s syndrome. In aging people, the Asperger’s syndrome

should be routinely screened in case of self-neglect, domestic

squalor, excessive social withdrawal, hoarding, a lack of concern

for one’s living condition and a lack of shame.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1722