European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S617
delusional disorders. Through two clinic cases and in a compara-
tive form, it is analyzedwhat are the aspects that make it difficult to
come up with an adequate distinguishing diagnostic, which are the
marks topoint out inorder to achieve it, once established, what sim-
ilarities and differences we observe in the adequate treatment of
both disorders. It is about a proposal not usual in our daily practice
of a consultation outpatient of a psychiatrist, but in these moments
it is what is presented, we have to stand up, to not fall for the error.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV836
Skin picking – A case report
A. Fonseca ∗, A. Poc¸ as , A. Batista , R. Araújo
Centro Hospitalar de Leiria, Psiquiatria, Leiria, Portugal
∗ Corresponding author.
Introduction Compulsive skin picking and trichotillomania are
both impulse control disorders, characterized by the need or urge
to touch, scratch, scrub, friction, rub, bite, press or dig in the skin;
it is often an answer to minimum skin defects or to mild acne. The
resulting tissue damage can be moderate to severe.
Objective Case report of a woman with Skin picking resistant to
treatment.
Methods Clinical observation.
Results 43-year-old woman who was admitted in emergency in
June 2014 because of her skin lesions. After observation by Der-
matologist she was sent to the Psychiatric due to injuries caused
by her. She referring compulsion to scratch, bite and tear the skin
since she was 3 years old. After introduction of psychotropic drugs,
the patient was referred to the Psychiatric consultations. After 1
year consultation there is some clinical improvement.
Conclusion Despite clinical advances in psychiatry, the Skin Pick-
ing disease is still little known today, requiring more research and
knowledgement in terms of phenomenology and of treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV837
Obsessive-compulsive disorder in
childhood and adolescence
C. Freitas ∗, M.C. Ferreira , T. Correia , I. Portinha , Z. Correia
1 Centro Hospitalar do Tâmega e Sousa, Departamento de Psiquiatria
e Saúde Mental, Penafiel, Portugal
2 Hospital de Braga, Servic¸ o de Psiquiatria, Braga, Portugal
3 Centro Hospitalar do Porto, Departamento de Psiquiatria da
Infância e da Adolescência, Porto, Portugal
∗ Corresponding author.
Obsessive-compulsive disorder (OCD) is a severemental illness that
causes significant stress in children and adolescents. It is possi-
ble to infer three distinct etiologies – neurobiology, environment
and dysfunctional interpretative patterns. Certain characteristics
are attributable to OCD with onset in childhood or adolescence as
higher prevalence in males, increased frequency of isolated com-
pulsions (more cleaning, repeating and checking), higher rate of
aggressive obsessions and more common accumulation behaviors.
There are several psychiatric comorbidities associated with OCD
like anxiety disorder andmajor depression. The first-line treatment
in OCD is the association of a selective serotonin reuptake inhibitor
(SSRI) and individual psychotherapy.
The authors reviewed the clinical records of patients diagnosed
with OCD observed in a child and adolescence psychiatry liaison
consultation between April and September 2015, inclusive, aiming
to characterize the sample, to describe the typical clinical picture
and to evaluate the existence of physical and/or psychiatric comor-
bidities, comparing the results with those expected in literature.
The typical patient profile found was a 12-year-old male, liv-
ing with relatives, with no neonatal complications, with stable
home environment, without family psychiatric history, with asso-
ciated medical comorbidities, with age of onset symptoms at 10.5
years-old, with only an obsession (contamination), with only a
compulsion (cleaning or checking), with psychiatric comorbidities,
treated with SSRI and without psychologyaccompaniment.
There are some limitations that must be taken into account because
the sample was taken from a liaison psychiatry consultation, but in
general terms, the results were similar to those described in the
literature.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV838
An approach to comorbidity between
obsessive-compulsive disorder and
schizophrenia
A. Gomez Peinado∗, S. Ca˜nas Fraile , P. Cano Ruiz
Hospital Nuestra Se˜nora del Perpetuo Socorro, Psychiatry, Albacete,
Spain
∗ Corresponding author.
Introduction An association has been observed between obses-
sive symptoms in Obsessive Compulsive Disorder (OCD) and
psychotic symptoms in schizophrenia, being sometimes difficult to
establish a clear limit between them. The term “schizo-obsessive
disorder”was proposed to describe the resulting disorder of comor-
bidity of OCD and schizophrenia, although it has not been definitely
settled.
Objective To analyze the incidence of coexistence of OCD and
schizophrenia symptoms and the way it modifies the treatment
and prognosis of the illness.
Method Reviewof some articles published inMental Health jour-
nals such as “Salud Mental” and “Actas Espa˜nolas de Psiquiatría”.
Results Some studies about psychotic patients have determined
15% as the average of comorbidity of OCD and schizophrenia. The
probability of having OCD is six times bigger if there is psychotic
pathology associated.
The fact that obsessive and psychotic symptoms get together in
some patients shades the prognosis bringing more negative symp-
toms, more depressive humor, a larger cognitive impairment, more
resistance to treatment and more relapses than we can observe in
OCD and schizophrenia isolated.
The pharmacological treatment usually consists in neuroleptic plus
anti-obsessive drugs, together with cognitive-behavioral therapy.
Sometimes, when there is a very bad evolution, it is required to
consider psychosurgery as one necessary option, even though its
use in this context is not much widespread.
Conclusions The simultaneous presence of OCD and schizophre-
nia is more common than we could expect only by chance and
makes the prognosis worse, being difficult to find a truly effective
treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV839
Childhood OCD: The importance of an
integrated approach
M.F. Molina López ∗, J.M. Hernández Sánchez ,
M.C. Cancino Botello , A. Pe˜na Serrano
1 Valencia, Spain