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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.948

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.949

W16

Psychopharmacological treatments

strategies in consultation-liaison

psychiatry: Clinical vignette and pros

and cons

G. Mattei

1 ,

, N. Colombini

2

, S. Ferrari

1

, G.M. Galeazzi

1

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.950

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.951

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

1 ,

, G. Laux

2

1

Department of Psychiatry (DP-CHUV), Prilly-Lausanne, Switzerland