European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S56–S71 S61
practice due to shortness of time and resources; tendency of col-
leagues from other disciplines to disregard setting features related
to time and space (inadequate rooms, e.g. too busy or noisy); limited
time for face-to-face discussion of cases or problems; conflicts with
patients/relatives/colleagues, and fear of reciprocal manipulation.
Discussion Moving on the interface between psychiatry and the
somatic disciplines, CL specialists need to develop special skills,
not only those strictly technical, but also those “soft skills” includ-
ing relational abilities and flexibility. Understanding the systemic
aspects of referrals in the relationship between physician, staff and
patients is usually essential in the process of consultation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
W15
Psychotherapeutic interventions in
consultation-liaison psychiatry
implications for psychiatric trainees
K. Koelkebeck
University of Muenster, School of Medicine, Department of Psychiatry
and Psychotherapy, Muenster, Germany
In clinical reality, psychiatric trainees working in consultation and
liaison psychiatry (CLP) face a lot of obstacles to gain satisfac-
tory results from their work on somatic wards. Specifically, the
deliverance of psychotherapeutic interventions in every-day CLP
is a topic of discussion. The talk will present a case of a young
anorectic patient that will exemplify the difficulties in delivering
psychotherapeutic treatment in every-day clinical work and will
outline common difficulties, specifically in relation to interactions
with staff of somatic units. The presentation will be wrapped-up
by suggestions on how to deal with the most common problems.
Disclosure of interest The author has not supplied his declaration
of competing interest.
W16
Psychopharmacological treatments
strategies in consultation-liaison
psychiatry: Clinical vignette and pros
and cons
G. Mattei ∗, N. Colombini , S. Ferrari , G.M. Galeazzi
1 University of Modena and Reggio Emilia, Department of
Clinical-Diagnostic Medicine and Public Health, Modena, Italy
2 Castelfranco Emilia Community Mental Health Center, Mental
Health Department, Modena, Italy
∗ Corresponding author.
Introduction Multimorbidity and polipharmacotherapy are cru-
cial features influencing the psychiatrist’s prescription in the
consultation-liaison psychiatry (CLP) setting.
Aims to provide an example of computer-assisted decision-
making in psychotropic prescriptions and to provide hints for
developing pharmacological treatment strategies in the CLP setting.
Methods Case report. A clinical vignette is presented, followed by
a review of available online computer-assisted prescription soft-
ware.
Results A woman in her seventies was repeatedly referred for
psychiatric consultation. Eleven differentmedicationswere admin-
istered daily, because of multimorbidity. A diagnosis of distymia
was established, with comorbid mixed pain (partly fulfilling the
criteria of somatic symptom disorder) and substance use disor-
der (opioids). After the first assessment, six follow-up visits were
needed during hospitalization. Mirtazapine and benzodiazepines
were introduced. Beside the pharmacological intervention, conflict
mediation was performed in the relationship with the patient, her
relatives, the ward personnel and the GP, to develop a long-term
rehabilitation project. Pros and cons of online computer-assisted
prescription software were discussed together with the ward per-
sonnel, as well.
Conclusions Computer-assisted decision-making in psychotropic
prescription is becoming more common and feasible. The use of
available software may contribute to safety, effectiveness and cost-
effectiveness of clinical decision-making. Risks are also possible:
depending for example from regional differences in prescription
indications, different guidelines, pharmacogenomics, frequency
with which databases are updated, sponsorships, possible conflicts
of interest, and real clinical significance of highlighted interactions
– all issues the clinician willing to benefit from this modern tools
should pay attention to.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
W17
Drugs pharmacokinetics interactions
with cardiac and renal disease
patients in consultation-liaison
psychiatry
D. Telles ∗, A. Barbosa
Hospital de Santa Maria, Consultation-Liaision Department, Lisbon,
Portugal
∗ Corresponding author.
The prevalence of psychiatric disturbances in patients with cardio-
vascular disease is elevated. For example the prevalence of major
depression can reach 15–20% and of anxiety disturbances 5–20%.
When we treat psychiatric symptoms in cardiovascular disease
we must have in mind four particular effects of psychiatric drugs:
(1) disturbances of atrial-ventricular conduction; (2) QTc interval
prolongation that can lead to torsade de pointes and ventricular
fibrillation; (3) hypertension; (4) changes in platelet aggregation.
On the other hand, there is a great prevalence of psychiatric disease
in patients with renal disease. For example, about 5–25% of the
patients with advanced renal disease have major depression.
Renal disease patients can evidence changes in several pharmacoki-
netic parameters such as: (1) biodisponibility; (2) distribution; (3)
metabolism; (4) excretion. Therefore, when we treat these patients
we have to keep in mind the effect of psychiatric drugs over the
renal functioning, but also the effect of the deficient renal function
in the pharmacokinetics of the drugs.
I this presentation we intend to reveal what are the main concerns
when we prescribe psychiatric drugs in patients with cardiovascu-
lar and renal disease.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
How should psychopharmacotherapy be learned
by residents in psychiatry – proposals of
psychopharmacology curricula
W18
The present situation of
psychopharmacology teaching
suggests the need for a European
curriculum
P. Baumann ∗, G. Laux
1 Department of Psychiatry (DP-CHUV), Prilly-Lausanne, Switzerland