European Psychiatry - Volume 33 - March 2016

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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.
EV735
Comorbidity and polypharmacy in
elderly living in nursing homes
A.R. Ferreira ∗ artins ernandes
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.
EV736
A case report of a Capgras’ syndrome
in elderly
C. Moreno Menguiano∗ 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.
EV737
From the Asperger’s syndrome to the
Diogenes syndrome
C. Padovan ∗, J. Laurent , Dr M. Herrmann ,
G. Chesnoy-Servanin , Dr J.M. Dorey
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.