European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S623
memantine presents as good therapeutic option, showing improve-
ment in several cognitive domains. Metilphenidate steel needs
investigation but the evidence is that has positive impact in the
improvement of fatigue and concentration. There are lack of studies
using Gingko Biloba, but reveals high toxicity inducing gastroin-
testinal symptoms and risk of intracranial haemorrhage.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV856
The sedation could consist in a
therapeutic strategy in advanced
cancer conditions
A. Tamarindo , C. Vogel , G. Hida , D. Malheiros , J. Ropero ,
S. Taniguchi ∗
1 Albert Einstein Hospital, Basic Sciences, Brazil
2 Albert Einstein Hospital, Oncology, Brazil
3 Albert Einstein Hospital, Health Economics, Brazil
4 University Federal of ABC, Department of Mathematics
Computation and Cognition, Brazil
∗ Corresponding author.
Introduction The sedation could consist in a therapeutic strategy
in advanced cancer conditions.
Objective To study the drugs administered to patients under Pal-
liative Care Sedation (PCS) audits effects on vital signs.
Methods Our retrospective study included 101 oncological
patients with mean age of 66.5 ±13.4 years old and mean weight
of 48.5 ±3.36 kg, under PCS. The data were analysed applying the
test of Wilcoxon.
Results The drugs administered to these patients under
PCS were morphine 55mg/kg/day associated to midazo-
lam 52.5mg/kg/day (Morph/Midazo) or the association of
morphine 55mg/kg/day, midazolam 52.5mg/kg/day and neu-
roleptics such as chlorpromazine 54.5mg/kg/day or haloperidol
13.25mg/kg/day (Morph/Midazo/Neurol). The values of vital
signs of these patients when the sedation was initiated were:
systolic blood pressure 116.55 ± 16.98mmHg, diastolic bloodpres-
sure73.17 ± 10.55mmHg, heart rate 83.41 ±16.25bpm, respiratory
rate 19.39 ±3.97 rpm and body temperature 35.91 ±0.57 ◦C. No
significant differences between these groups were observed.
Vital signs measures were collected 48 hours before the patient’s
death. Significant reduction in systolic blood pressure 77.5mmHg,
diastolic blood pressure 43.3mmHg were observed in the group
(Morph/Benzo/Neurol). The Wilcoxon test for independent sam-
ples to a significance level of 5% we obtain a P-value of 0.01. The
sedation period was 2.56 ±0.23 days.
Conclusion Neuroleptic, a central nervous system (CNS) depres-
sant drug, when associated to other two depressants (mor-
phine/midazolam), conducted to the patient’s vital signs reduction.
Considering the short period of time between the beginning of
sedation and the patients’ death; and that palliative sedation should
not include the hastening of patients’ death, we suggest a better
drug association criteria.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV857
Symptom burden in cancer patients
and caregiving experience
J. Teixeira Silva ∗, M. Gonc¸ alves , Z. Santos
Centro Hospitalar e Universitário de Coimbra, Psychiatry, Coimbra,
Portugal
∗ Corresponding author.
Introduction Cancer patients typically experience multiple phys-
ical and psychological symptoms that may result from the disease
or from treatment. Themost common are pain, depression, anxiety,
fatigue, insomnia, breathlessness, nausea, constipation, diarrhea
and anorexia. The high symptom burden profoundly affects the
patient but also the caregiver, which frequently experiences anxi-
ety and depression.
Objectives Identify a correlation between patient symptoms and
caregiver emotional disturbances.
Aims The aim of the present study was to improve the iden-
tification of vulnerable family caregivers who could require
psychotherapeutic and psychopharmacological support.
Methods For this purpose, all eligible patients and caregivers
were approached during a regularly scheduled patient clinic visit
at a Portuguese psycho-oncology unit. Data was collected using the
Memorial Symptom Assessment Scale-Short Form and Depression
Anxiety Stress Scale-21. Sociodemographic and clinical data were
also collected. Statistics were performed with SPSS.
Results High levels of psychopathology in caregivers were asso-
ciated with female caregiver sex and worse patient physical and
emotional well-being. Uncontrolled pain was related with high
scores in DASS-21.
Conclusions Cancer patient’s caregivers experienced high levels
of anxiety and depression associated with worse patient well-
being. The psychological stress of caregiving has a negative impact
not only on the health of the caregivers but also on cancer patients.
Early interventions directed at patient symptoms and caregiver
support may improve quality of life in this population.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Pain and treatment options
EV858
Pain management in context of
emotionally unstable personality
disorder
E. Dobrzynska ∗, N. Clementi
1 Cygnet Health Care, Cygnet Hospital Kewstoke,
Weston-super-Mare, United Kingdom
2 NHS Grampian, Royal Cornhill Hospital, Aberdeen, United Kingdom
∗ Corresponding author.
Introduction Emotionally unstable personality disorder (EUPD) is
characterised by Pain Paradox. The response for acute, self-induced
pain seems to be attenuatedwhile chronic, endogenous pain is usu-
ally intolerable. Pain management of this group of patients poses
many difficulties, including discrepancies between subjective and
objective pain assessment, patients’ demands for strong analgesics
and impact on relationship with other professionals.
Objectives and aims The purpose of the study was to review pain
management options for persons diagnosed with EUPD and com-
plaining of chronic pain.
Methods MEDLINE and PsycINFO databases were searched for all
English-language articles containing the keywords “chronic pain”,
“pain management”, “borderline personality disorder”, and “emo-
tionally unstable personality disorder”.
Results Seventeen relevant papers were identified. Suggested
first step in pain management was ongoing clarification with EUPD
patients that analgesics are unlikely to fully treat their pain and
support of non-pharmacological approaches to pain, including
cognitive-behavioural strategies. Regarding pharmacology, liberal
use of non-addicting analgesics was recommended with highly