European Psychiatry - Volume 33 - March 2016

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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, O2 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.
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.
Intellectual disability
EV749
A case of catatonia, Klebsiella
pneumoniae lung infection and
intellectual disability: Differential
diagnosis
A. Ballesteros ∗, L. Montes , W. Jaimes , B. Cortés ,
F. Inchausti , P. Alex , J. Collantes
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
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.