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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S655

has been recently described the development of psychotic symp-

toms. Anti-NMDAR encephalitis is an autoimmune disorder that

involves IgG autoantibodies against the NMDA receptor subunit

GluN1. This last fact could support the relationship with the gluta-

matergic model of schizophrenia.

Objective

To conduct a current review to deepen the detection

and management of anti-NMDAR encephalitis, due to the fre-

quent existence of psychiatric symptoms at onset, which have

contributed to the difficulty of diagnose.

Method

Systematic review of the literature in English (PubMed),

with the following keywords: “Autoimmune encephalitis”, “psy-

chosis”, and “NMDA receptor”.

Results

Autoimmune encephalitis appears more frequently in

children and young adults and it is characterized by a prodro-

mal period, in which there usually are non-specific symptoms of

headaches or fever. Next, it could progress to cognitive deficits,

seizures, catatonic symptoms and psychosis. However, sometimes

in the rarest clinical presentations, there is nothing but psychiatric

symptoms at the onset of encephalitis, which leads to misdiagnose

and lack of proper treatment. This fact has stimulated the curios-

ity of the psychiatry scientific community, since the anti-NMDAR

encephalitis may mimic the glutamatergic model of schizophrenia.

Conclusions

To make an accurate and detailed diagnostic formu-

lation in people with psychiatric symptoms as onset of any disorder

is essential to determine whether it is a primary psychiatric disor-

der or symptoms associated to another disease.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1941

EV957

New-onset psychosis in patient with

untreated HIV

A.T. Carter (MD)

, A. Bulbena (MD) , N. Dunn (MD) ,

R. Gersh (MD) , R.G. Swift (MD)

Metropolitan hospital center, psychiatry, New York City, USA

Corresponding author.

Introduction

An infection by the human immunodeficiency virus

(HIV) causes damage to the central nervous system directly and

indirectlywhich can result in different psychiatric syndromes asso-

ciated with the onset and progression of the infection including

cognitive impairment, dementia, depression, mania, obsessive-

compulsive disorder, and psychosis. We present the case of a

patient that came to the outpatient psychiatric clinic with acute

psychotic symptoms in the context of HIV infection and antiretrovi-

ral treatment non-adherence. She reported new onset of disruptive

auditory hallucinations and paranoid delusions; at that time, all her

laboratories (including for infectious disease) were within normal

limits except for decreased level of CD4+ T cells and high viral load.

She denied any illicit substance use and her head CT was negative

for any acute disease. Patient required a brief psychiatric hospital-

ization where she was started on low doses of risperidone and her

symptoms resolved after her CD4+ T cells and the viral load val-

ues improved secondary to the antiretroviral treatment. A review

of the literature shows that psychiatric symptoms are common in

patients infected with HIV. Whether these complications are due to

the direct or indirect effects of HIV careful diagnosis and treatment

are necessary.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1942

EV958

Limbic encephalitis – notes for

psychiatric clinical practice

F. Couto Gomes

Centro hospitalar psiquiátrico de Lisboa, psychiatry, Lisboa, Portugal

Introduction

Limbic encephalitis is a neuropsychiatric syndrome

with an autoimmune basis, treatedwith. Differential diagnosiswith

psychotic and mood disorders is thus essential for effective treat-

ment and the best outcome possible.

Objectives

To systematize up-to-date clinical procedures to

identify possible limbic encephalitis cases and conduct proper eval-

uation and treatment of those cases.

Aims

To improve differential diagnosis between limbic

encephalitis and psychotic and mood disorders, in psychiatric

clinical practice.

Methods

Systematic review.

Results

Limbic encephalitis presents sub-acutely with con-

vulsions and mood, cognitive and perceptive alterations. EEG,

neuroimaging, antibody testing and liquor analysis can be use-

ful in diagnosis, and the later also in treatment response

prediction. TPO, NMDA receptor, AMPA receptor, GABA-B recep-

tor and K+ channel antibodies are etiological factors for this

neuropsychiatric syndrome. Treatment consists of corticoids,

immunoglobulin, plasmapheresis, rituximab, cyclophosphamide,

azathioprine, mycophenolate, or the treatment of an underlying

tumor.

Conclusion

Proper diagnosis of limbic encephalitis may prevent

disease progression and may improve outcome, according to its

etiology.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1943

EV959

Psychoneuroimmunology

alternations as a comorbidity of

post-traumatic stress disorder in

veterans – case report

F.

Ð

erke

1 ,

, L. Filipovic-Grcic

1

, M. Braˇs

2

, V. Djordjevic

2

1

University of Zagreb school of medicine, student society for

neuroscience, Zagreb, Croatia

2

University of Zagreb school of medicine, centre for paliative

medicine, medical ethics and communication skills, Zagreb, Croatia

Corresponding author.

Post Traumatic Stress Disorder (PTSD) is defined as an extensive

response to a major traumatic event. Psychoneuroimmunology

represents an integrative approach in tackling and understand-

ing various human diseases and disorders such as cardiovascular,

autoimmune and physical complaints/chronic pain. Psychosocial

context influences brain stress response pathways and modifies

stress-related behavior. In this case report, we observed 5 patients,

veterans from Croatian War of Independence (1990-1995), who

suffer from PTSD. They have altered stress reactivity, as well as

distinct expression for genes involved in immune activation. Those

patients have been found to exhibit a number of immune changes

including increased circulating inflammatory markers, increased

reactivity to antigen skin tests, lower natural killer cell activity,

and lower total T lymphocyte counts. The traumatic event (Croa-

tian War of Independence) generates downstream alterations in

immune function. This case report imply that immune dysfunction

caused by PTSD may mediate or facilitate somatic conditions.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1944