European Psychiatry - Volume 33 - March 2016

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S654 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
Introduction The prevalence and impact of allergic diseases con-
tinues to grow, yet the etiology remains unclear. Adverse childhood
experiences (ACEs) have shown to influence the risk of various
chronic diseases, but little research has been done on the risk of
allergic diseases, and only on asthma.
Objective To conduct a prospective study that assess the relation-
ship between ACE and risk of various allergic diseases.
Aims To examine the association between ACE and risk of allergic
diseases in the context of: (1) relevant ACE and allergic disorder
grouping; (2) temporal association; (3) dose-response relationship.
Methods A prospective population-based study linking Danish
register data on 1.1 mio parent-child pairs. With objectives, mea-
sures of ACE and allergic diseases survival analyses with relevant
covariates adjusting will be used to estimate relative risk of allergic
diseases when exposed to ACE.
Results This studywill provide results on the relative risk of aller-
gic diseaseswhen exposed toACE compared to thosewithout, while
also describing the temporal and dose-reponse of the relationship.
Conclusion This preliminary study will help to further advance
our understanding on ACE influence on physical health, specifi-
cally in regards to immune-related disorders. As such, this study
may help to build a framework for future prevention and treatment
initiatives of allergic disorders.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV954
Isolated psychiatric presentation of
anti N-methyl-d-aspartate receptor
encephalitis: A case report
P. Azevedo ∗, F. Monteiro , A.P. Correia , A. Norton ,
A.M. Moreira
1 Magalhães Lemos hospital, inpatient unit C, Porto, Portugal
2 Magalhães Lemos hospital, department of neurology, Porto, Portugal
∗ Corresponding author.
Introduction Anti N-Methyl-D-Aspartate receptor (NMDAR)
encephalitis is an autoimmune disorder with a presentation that
includes acute behavioral changes, psychosis, cognitive impair-
ment and autonomic instability. In some cases, there are isolated
psychiatric symptoms without neurological involvement.
Aims To raise awareness of the disorder among psychiatrists,
considering it a differential diagnosis in a first psychotic episode
since a prompt diagnosis and treatment can dramatically affect the
outcome.
Objectives To summarize the latest literature about this field and
to present a case report.
Methods A brief review of the latest literature was performed on
PubMed using the keywords “anti N-methyl-D-aspartate receptor
encephalitis”, “anti-NMDA encephalitis”, “psychiatric symptoms”.
Results A 20-year-old male was admitted to our inpatient unit
with bizarre delusions of grandious and religious content, somatic
hallucinations, sleep cycle inversion and strange behaviour. These
symptoms had been present for 1 week and remitted after 10
days of treatment with risperidone. On follow-up, he developed
anhedonia, apathy and blunt affect. Brain MRI showed multiple
hyperintense changes in T2 and T2-FLAIR, highly suggestive of
demyelinating lesions. The cerebrospinal fluid showed mild lym-
phocytic pleocytosis, mildly increased proteins, oligoclonal bands
and anti-NMDAR antibodies of intrathecal production. He was
treated with corticoids and the antipsychotic was discontinued. No
neurologic symptoms were ever present.
Conclusion This is an atypical case of anti-NMDAR encephali-
tis because of its isolated psychiatric presentation. Most patients
develop neurological symptoms 2 to 3 weeks after onset of psychi-
atric symptoms. Monosymptomatic syndromes arise in less than
5% of patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV955
A phenotype of resiliency?
Cross-sectional psychobiological
differences between caregivers who
are vulnerable vs. resilient to
depression, and controls
F.S. Bersani ∗, O. Wolkowitz , E. Epel
1 Sapienza university of Rome, department of neurology and
psychiatry, Roma, Italy
2 University of California San Francisco, department of psychiatry,
San Francisco, USA
∗ Corresponding author.
Introduction Being a caregiver of chronically ill children is a
source of chronic-psychological stress affecting general physi-
cal and mental health. However, there is tremendous variance
among caregivers: some may develop stress-related depression,
whereas others are more “resilient”. The objective of the study was
to phenotypically differentiate on psychobiology caregivers who
developed depressive symptoms (“vulnerable”) vs. those who did
not (“resilient”) from each other and from age-matched controls.
Methods Forty-five mothers of chronically-ill children and 18
controls have been examined. Caregiverswere divided via amedian
split of Center for Epidemiological Studies Depression Scale scores
in “resilient” (RCs) and “vulnerable” (VCs). We assessed cogni-
tive, affective, metabolic, neuroendocrine and oxidative markers at
rest and in response to a laboratory social stressor. ANCOVAs and
Bonferroni post-hoc tests were used to examine between-group
differences.
Results Although RCs compared to VCs had similar levels of
objective parenting-related burden (P = 0.51), they had lower sub-
jective distress (P < 0.01) and higher levels of positive affect
(P = 0.04). Although RCs compared to controls had higher levels
of objective parenting-related burden (P = 0.04), they had greater
cortisol suppression post-dexamethasone ( P= 0.05), lower F2-
isoprostanes/vitamin E ratio (P < 0.01) and lower fasting insulin
levels (P = 0.06).
Discussion Our results suggest that caregivers with higher
resiliency demonstrate more salutary stress-related functioning in
comparison with less resilient caregivers and, more surprisingly,
non-caregiver controls. These findings might be interpreted in the
spirit of Nietzsche’s quote “What does not kill me, makesme stronger ”
and of the idea that successfully overcoming adversitymay bemore
psychobiologically beneficial than not having been exposed to any
adversity.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV956
Psychiatric symptoms as onset of
anti-NMDAR encephalitis
M.C. Cancino Botello ∗, A. Cercos López , V. Chavarria Romero ,
G. Sugranyes Ernest
1 Consorcio hospital general universitario, psychiatry, Valencia, Spain
2 Hospital universitario de Santa María, psychiatry, Lleida, Spain
3 Hospital del Mar, psychiatry, Barcelona, Spain
4 Hospital clinic, psychiatry, Barcelona, Spain
∗ Corresponding author.
Introduction Every more often, there is evidence that shows a
relationship between psychiatric symptoms and autoimmune dis-
orders. Such is the case of anti-NMDAR encephalitis, in which it