European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S625
subgroup. Health care costs in the high symptom severity subgroup
were significantly higher than those of the low symptom severity
subgroup (P < 0.001).
Conclusions Our findings exhibit the necessity for subgroup-
specific treatment services for improving pain management and
reducing health care costs in the elderly.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV862
Ziconotide and amnesia: A case report
S. Marini ∗, V. Lalli , A. Costantini , F. Gambi
1 University G. d’Annunzio, neurosciences and imaging, Chieti, Italy
2 SS Annunziata hospital, health urgent and emergency care, Chieti,
Italy
∗ Corresponding author.
Introduction Ziconotide is a new class of non-opioid analgesic
that selectively blocks the neuron-specific (N-type), voltage-gated
calcium channels, preventing the release of substance P and calci-
tonin gene-related peptide.
Methods A literature search was conducted in September 2015
using Pubmed and Scopus databases. No articles speaking about the
direct correlation between ziconotide and amnesia were found.
Discussion A 56-year-old female patient, in treatment with
ziconotide for chronic phantom pain syndrome, reported amnesia
and dysgeusia symptoms. No psychiatric pathologies were diag-
nosed except for the high anxiety state correlated to the amnesia
for recent events. The ziconotide treatment was reduced from 2,4
g/day to 1,5 g/day. Clonazepam was prescribed to treat the
anxiety state. The subject clinical conditions did not require hospi-
talization.
Conclusions It is recommended that patients in treatment with
ziconotide be monitored for changes in mood, suicidality ideation,
thoughts or consciousness. Ziconotide could have serious neuro-
logical or psychiatric signs/symptoms Amnesia is a rare
side effect of intrathecal administration of ziconotide. Severe psy-
chiatric adverse effects may require ziconotide discontinuation,
treatment with psychotropic agents and/or acute hospitalization.
Table 1
Psychiatric disorders Nervous system disorders
Hallucinations Dysgeusia
Delusions Dizziness
Confusional state Dysarthria
Anxiety Ataxia
Insomnia Nystagmus
Cognitive disorder Areflexia
Mood disorder Burning sensation
Suicidality ideation Hypoaesthesia, paraesthesia
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV863
Psychiatric disorders in patients with
atypical facial pain
V. Medvedev ∗, V. Frolova , Y. Fofanova , A. Drobyshev
1 People’s Friendship university of Russia, Chair of psychiatry-
psychotherapy and psychosomatic pathology, Moscow, Russia
2 Moscow State university of medicine and dentistry, Chair of
maxillofacial and plastic surgery, Moscow, Russia
∗ Corresponding author.
Objective Maxillofacial surgeons and dentists often (up to 10%)
deal with the phenomenon of atypical facial pain (AFP) – painful
condition of maxillofacial area without clear organic pathology.
Psychiatric studies of this disorder are almost lacking.
Aim The aim of this study was to define psychopathological dis-
orders in patients with AFP and to set up psychopharmacological
treatment strategies.
Methods The study used clinical psychopathological and psycho-
metric (Pain measurement scales: Brief Pain Inventory, VAS, Pain
Catastrophizing Scale) methods. We included patients with AFP
examined in the clinic in December 2014 - September 2015.
Results Study sample consists of 54 patients with AFP: 45
women (83.3%), 9 men (16.7%), 18-70 years old (39.5± 14.7 years).
In 67.8% of patients (33 women, 4 men), AFP was associated
with affective disorders; among them, recurrent major depres-
sive disorder was verified in 9.2% (4 women, 1 men), single
depressive episode – in 33.6% (15 women, 3 man), bipolar II
depression – in 3.6% (2 women), cyclothymic disorder – in 7.1%
(4 women), dysthymia – in 14.3% (8 women). In 10.8% of patients
(6 women), AFP was considered as a symptom of somatoform
pain disorder. In 21.4% (6 women, 5 men), AFP was related with
schizotypal personality disorder. Psychopharmacological agents
used were SSRIs (fluvoxamine, escitalopram), SNRIs (venlafaxine,
duloxetine), agomelatine and antipsychotics (quetiapine, amisul-
pride, alimemazine). The pain subsides in 87,04% of patients and
the severity of pain decreased in 12.96% of patients.
Conclusion Patients with AFP should be examined by psychia-
trist in order to determine psychopathological disorders and to
elaborate psychopharmacological treatment strategies.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV864
Psychosemantics of pain in patients
with coronary artery disease
E. Pervichko ∗ inchenko ak
1 Lomonosov Moscow State university, faculty of psychology,
Moscow, Russia
2 Moscow State university of medicine and dentistry, faculty of
general medicine, Moscow, Russia
∗ Corresponding author.
Introduction It is known for a fact that a number of psychological
factors may affect heart pain perception in patients with coronary
artery disease (CAD). However, psychosemantics of pain in CAD
patients was hardly ever explored.
Objective To study the features of pain psychosemantics in CAD
patients.
Methods There were applied McGill Pain Questionnaire
(Melzack, 1975); the psychosemantic technique “Classifica-
tion of sensations” (Tkhostov, Efremova, 1989); the 20-item
Toronto Alexithymia Scale (Bagby, Taylor, Parker, 1994); and
State-Trait Anxiety Inventory (Spielberger et al., 1983). Fifty-four
CAD patients took part in the study, the mean age was 55.9± 7.6
years. CAD duration was 5.8 ±2.6 years.
Results CAD patients with the high level of trait anxiety (28%)
choose greater variety of descriptors for pain definition, reveal-
ing an impaired ability to differentiate between emotional states
and physical sensations. They show higher scale values for McGill
Pain Questionnaire. Patients with high indices of alexithymia (31%)
require significantly fewerwords for descriptionof painful anddan-
gerous perceptions within the “Classification of sensations”. This
may testify to a certain bafflement in verbal description of the pain.
With that, intensity of alexithymia does not correlate significantly
with the high level of state and trait anxiety ( P> 0.05). The method
of “Classification of sensations” revealed that patients with trait
anxiety, as well as those with alexithymia, define the pain with