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Page Background

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

S589

Methods

Despite the treatment is individualized, we present

some recommendations of action in alcohol poisoning.

General measures

Clinical examination and vital signs (blood

pressure, temperature, pulse and breathing rates, O

2

sat lev-

els, capillary glycemia). In moderate or severe ones: hemogram,

biochemistry, coagulation, acid-base and electrolyte status, elec-

trocardiogram, chest X-ray, urine tox. Initial treatment of basic

support (ABC) and complications control. Psychiatric evaluation is

necessary when suicidal thoughts are present. Alcohol abuse pro-

duces lack of inhibition and common sense, more aggressiveness

and impusivity, and even an increased risk of suicide.

Conclusions

These patients are often hostile with health person-

nel, but when blood alcohol level diminishes, they improve their

attitude and they show hopelessness, guilty and self-hate feel-

ings. It is necessary that emergency staff to become aware of the

importance of suitable psychiatric evaluation. Psychopathological

exploration must be as wide as possible; the patient must be re-

evaluated when the poisoning has reverted. These patients are not

self-critical and they have reduced their cognitive capacities; some

of them have behavioral disturbances that usually disappear when

the poisoning is in remission.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1732

EV748

Pregnancy: Challenges in

psychopharmacological therapy

F. Vieira

, J. Teixeira Silva , A. Vieira Araújo

Centro Hospitalar e Universitário de Coimbra, Psychiatry, Coimbra,

Portugal

Corresponding author.

Introduction

The pregnant psychiatric patient on or requiring

psychotropic medication presents an unusual clinical dilemma.

Clinicians may only rarely treat patients who are pregnant or plan-

ning to be pregnant and may be unfamiliar with the current state

of the literature and what can and cannot be concluded from it.

Although ethical considerations have precluded adequately con-

trolled studies with pregnant woman, the rate of psychotropic use

together with the prevalence of certain psychiatric conditions dur-

ing pregnancy underscore the need for treatment guidelines to help

clinicians manage pregnant patients with psychiatric disorders.

Objectives

Review the safety, on the mother and fetus, of the use

of psychopharmacological therapy during pregnancy.

Aims

We aim to provide guidance on the psychopharmacologic

treatment of pregnant women.

Methods

Pubmedwas used to search for relevant Portuguese and

English language articles relating to psychopharmacological drug

use during pregnancy up to October 2015. The search terms used

were “psychopharmacological”, “psychotropic” and “pregnancy”.

Reference lists of the identified articleswere further used to identify

other studies.

Results

If treatment is deemed necessary, monotherapy at the

lowest possible dose should be prescribed. More robust safety data

is available for older psychotropic drugs, which, most of the times,

should be employed in preference to newer agents with unestab-

lished safety.

Conclusions

Appropriate risk-benefit analysis of untreated men-

tal illness versus medication exposure, within in the context of the

available evidence, should guide clinical decision-making.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1733

Intellectual disability

EV749

A case of catatonia,

Klebsiella

pneumoniae

lung infection and

intellectual disability: Differential

diagnosis

A. Ballesteros

1 ,

, L. Montes

2

, W. Jaimes

3

, B. Cortés

4

,

F. Inchausti

5

, P. Alex

6

, J. Collantes

7

1

Red de Salud Mental Gobierno de Navarra, CSM Estella, Estella,

Spain

2

Red de Salud Mental de Navarra Gobierno de Navarra, Complejo

Hospitalario de Navarra, Pamplona, Spain

3

Hospital de Donostia Osakidetza, Psychiatry, Donostia, Spain

4

Consulta privada Dr. B. Cortés, Psychiatry, Salamanca, Spain

5

Proyecto Hombre de Navarra, Comunidad Terapéutica Proyecto

Hombre de Estella, Estella, Spain

6

Greater Manchester West Mental Health NHS Foundation Trust,

Psychiatry, Manchester, United Kingdom

7

Consulta privada de psicología, Psicología, Madrid, Spain

Corresponding author.

Introduction

In DSM-V, catatonia is individualized as a disease

of its own. The priority is to look first for organic causes like

intoxication. We present a clinical case diagnosed with intellectual

disability (ID) and catatonia.

Objective

To study a case of catatonia which underwent test-

ing using Bush-Francis Catatonia rating scale (BFCRS) prior/after

clinical intervention. We therefore study catatonia’s etiology in ID

population.

Aims

To study the etiology of catatonia (and its clinical compli-

cations) in ID.

Method

Our patient is 48-year-old female with DI. Considering

her clinical features of catatonia (using BFCRS) and clinical exami-

nation (fever and hypoxia), the case orientated towards a secondary

diagnosis. Work-up tests revealed pneumonia in the lower lobe of

the right lung (chest radiography showed opacities and blood tests

showed Leuokocytosis with a left shift). The case further received a

course oral levofloxacin (500mg/day) and haloperidol was stopped.

Valproic acid was also added to a dose of 600mg/day, which led to

clinical improvement. Remaining psychotropic treatment (dulox-

etine 60mg/day, lorazepam 15mg/day, diazepam 35mg/day) was

not modified.

Results

After 1 month, the patient improved according to BFCSR

score.

Conclusions

We presented a case of presence of catatonia in other

psychiatric conditions and undiagnosed general medical condi-

tions. Haloperidol is contraindicated those circumstances and it

may have worsened her clinical state (it should be used cautiously

in DI). Other medications (gabaergic drugs) should be considered

in such settings and rare causes related to hypoxia cannot be ruled

out

( Table 1 ).

Table 1

BFCSR

Prior treatment

After treatment

First 14 items

23 points

14 points

Total score

29 points

18 points

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1734