European Psychiatry - Volume 33 - March 2016

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S616 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV832
From obsessivity to bipolarity and vice
versa. A literature review
P. Cano Ruiz ∗ a˜nas Fraile Gómez Peinado
P. Sanmartin Salina
1 HNSPS, Psychiatric, Albacete, Spain
2 Universidad de Alcalá, Systems Biology, Alcalá de Henares, Spain
∗ Corresponding author.
Introduction The prevalence of obsessive symptoms in bipolar
patients is currently under discussion. Last years, different cases
of antidepressant-induced mania and hypomania in patients with
OCD have been described.
Several authors have reported that patients with OCD and bipolar
disorder have more depressive episodes than patients with only
OCD.
Objective To know the relationship between OCD and other bipo-
lar spectrum disorders.
Method Bibliographical review on comorbidity between obses-
sive symptoms and bipolarity.
Results Some longitudinal analysis have shown that patients
firstly diagnosed with OCD have an increased risk for subsequent
diagnosis of all other conditions, especially for bipolar and schizoaf-
fective disorder, for those whose risk is of up to 13 times higher.
The handling of a patient with bipolar disorder and OCD implies
some difficulty, because of themain treatment of anxiety disorders,
the antidepressants, alters the course of manic-depressive illness,
accelerating cycles.
Conclusions OCD is etiologically related to bipolar spectrum dis-
orders and schizophrenia. Therefore, it is necessary to continue the
investigation of possible involved genes and approaches for clinical
practice.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Further readings
Cederlöf, M., Lichtenstein, P., Larsson, H., Boman, M., Rück,
C., Landén, M., & Mataix-Cols, D. (2014). Obsessive-compulsive
disorder, psychosis, and bipolarity: a longitudinal cohort andmulti-
generational family study. Schizophrenia bulletin, sbu169.
Vega Davila, D. (2010). La complejidad de la comorbilidad:
Trastorno Bipolar y Trastorno Obsesivo Compulsivo. Psiquiatria.
com, 14.
EV833
Dual target repetitive transcranial
magnetic stimulation in the treatment
of comorbid obsessive-compulsive
disorder in patients with anorexia
nervosa: Preliminary results of two
case reports
N. De Schryver ∗ .D. Lemmens , C. Baeken ,
D. Van den Abbeele
Universitair Ziekenhuis Gent, Psychiatry, Gent, Belgium
∗ Corresponding author.
Introduction Obsessive-compulsive disorder (OCD) is a fre-
quently reported comorbid disorder (20–30%) in patients with
anorexia nervosa (AN). Increasing evidence suggests that repet-
itive transcranial magnetic stimulation (r-TMS) may be effective
in the treatment of refractory OCD and to a lesser extent in AN.
Hereby, different target areas: supplemental motor area (SMA) and
orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex in AN.
We report two patients with enduring AN and comorbid treatment
resistant OCD treated with r-TMS.
Methods Both female patients (34 and 26 years respectively)
were hospitalized at the Eating Disorder Unit at the Ghent Univer-
sityHospital. Treatment responseswere evaluatedwith Yale Brown
Obsessive Compulsive Scale (Y-BOCS) and weight gain. Inhibitory
continuous thetaburst stimulation (cTBS) of the SMA followed by
cTBS of the OFC was conducted during 20 sessions, 5 sessions a
week, during 4 weeks. Stimulation intensity was respectively 100%
and 80% of the motor treshold.
Results After cTBS treatment Y-BOCS score of both patients
decreased (31 to 24 and 31 to 23 respectively). Only one patient
showed a 10% increase of weight. The treatment was well tolerated.
No significant side effects were reported.
Conclusion Treatment resistant comorbid OCD in patients with
AN may be succesfully treated with cTBS.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV834
Reactive anxiety to ruminations of
thinking
T. Delgado Durán ∗, F.J. Márquez Ligero
1 Hospital Costa de la Luz, Psychiatry, Huelva, Spain
2 Unidad de Gestión clínica Huelva, Psychiatry, Huelva, Spain
∗ Corresponding author.
The anxiety that accompanies an obsessive-compulsive disorder
with predomination of ruminations of thinking, is a symptom
of elevated prevalence in the population that makes up abstract
labor which accesses for an opposition of hard consecution. The
characteristics of the personality of such patients, like perfection-
ism, control, the analysis of every minimal step they take and of
every decision they make, the difficulty for them to find an unex-
pected event, collaborates so they can have a greater accessibility
to accomplish objectives they contemplate, like the case of opposi-
tions for a position in a farm, court or education. However, as such
objectives are being met, everything evolves correctly, the fact of
not being able to accomplish given purposes, carry on to the appear-
ance of the symptom. Themajority of these patients, such symptom
is anxiety, reaching such intensity, which limits the development
of their daily activities in a correct manner, and in many cases, it
obligates them to resign their position. To develop this case, I will
expose the case of a 50 year old male, a justice professional, with
clinical anxiety of growing intensity in the months previous to the
first interview, appears with a reactive character a ruminations of
thinking by the impossibility of an adequate agreement of the given
working activity. The poster explains how the symptoms appear,
howthey are treated andwhat the evolution of the clinical profile is.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV835
Obsession or delusion
T. Delgado Durán ∗ Márquez Ligero
E. Romero Guerrero
1 Huelva, Spain
2 Unidad de Gestión Clínica Huelva, Psychiatry, Huelva, Spain
∗ Corresponding author.
Obsession, in cases, reaches an elevated intensity creating part of a
clear obsessive compulsive disorder with predomination in rumi-
nations of thinking, accompanied by reactive anxiety that such
alterations cause. A narrow line exists that separates such disor-
der with its symptoms accompanied by alterations in the content
of thinking that exists in another syndrome like the persistent