Table of Contents Table of Contents
Previous Page  660 / 812 Next Page
Information
Show Menu
Previous Page 660 / 812 Next Page
Page Background

S656

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

EV960

Possible anti-inflammatory role of

perivascular macrophages in a model

of depression induced by chronic mild

stress in rats

A. Sayd

1 ,

, K. MacDowell

1

, L. Monteagudo

1

, D. Martin

1

,

J.L. Madrigal

1

, J.C. Leza

1

, J.R. Caso

1

, L. Orio

2

, B. Garcia-Bueno

1

1

Complutense university, pharmacology, Madrid, Spain

2

Complutense university, psychobiology, Madrid, Spain

Corresponding author.

Perivascular macrophages (PVM) are hematopoyetic cells that

migrate to the brain perivascular space modulating the interac-

tions between the immune and central nervous systems (CNS).

Previously, their depletion with the icv administration of the pro-

apoptotic drug clodronate encapsulated in liposomes increased

the vascular production of the proinflammatory prostaglandin E

2

(PGE

2

), the release of ACTH, corticosterone and fever, induced by

the intravenous administration of Lipopolysaccharide (LPS). Fur-

ther studies also demonstrated a decrease in the synthesis of the

anti-inflammatory prostaglandin 15d-PGJ

2

.

With this background, we decide to deeper explore themechanisms

involved in the anti-inflammatory profile of PVMby depleting them

in a model of depression induced by chronic mild stress (CMS)

exposure in rats.

Our results showed an increase of the proinflammatory cytokines

TNF , IL-1 and IL-6 at mRNA levels in the prefrontal cortex of the

groups of animals where the PVM were depleted, as well as in the

protein levels of the pro-inflammatory nuclear factor NF- B, the

enzymatic pro-inflammatory enzymatic sources iNOS, COX-2 and

m-PGES-1 and their product PGE

2

. A concomitant decrease of the

15d-PGJ

2

mediator was also observed. In addition, we also checked

whether the depletion of PVMs could regulate the expression of

molecules implicated in the leukocyte traffic and infiltration in the

CNS in our CMS model. Thus, the mRNA levels of the chemokines

MCP-1, fractalkine and the adhesion molecule VCAM appeared

increased in the animals without PVMs.

In summary, our results could suggest a potential anti-

inflammatory role for PVMs in a depression model chronic

stress-induced as CMS.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1945

EV961

Management and psychiatric

manifestations of anti-NMDA receptor

encephalitis, a case report

R. Gallego

, A. Flores

La Paz hospital, psychiatry, Madrid, Spain

Corresponding author.

Introduction

Anti-NMDA receptor (NMDAR) encephalitis, for-

mally recognized in 2007 by Dalmau et al, is an autoimmune

disorder with a complex presentation that includes psychiatric

symptoms, memory deficits, and autonomic instability. The exact

incidence is unknown but age, gender, and ethnicity may all play

a role. Presence of antibodies against the GluN1 subunit of the

NMDAR in the CSF and serum confirm the diagnosis of NMDAR

encephalitis.

Case report

We report the case of a previously healthy, 19-year-

old woman, 6 weeks pregnant. She had a generalized tonic-clonic

seizure followed by psychiatric symptoms, including insomnia,

emotional lability, delusions, and disorganized behavior. During

the course of the disease, she demonstrated speech impairments

and catatonic features associated with abnormal movements.

She was provided lorazepam1mg twice a day to treat her catatonic

symptoms, her insomnia and her speech improved. Olanzapinewas

introduced, reaching a dose of 20mg/day for managing psychosis

and agitation.

Discussion

NMDA-R encephalitis is a novel disorder with promi-

nent psychiatric manifestations that is widely underdiagnosed.

Neuroleptics may be helpful for managing psychosis and agitation,

but may exacerbatemovement abnormalities. Benzodiazepines are

helpful for agitation, insomnia and catatonia associated with this

condition.

Conclusion

Earlier recognition of this illness is crucial as prompt

diagnosis andmultidisciplinary treatment, can potentially improve

prognosis. There is an increasing need for psychiatrists to become

aware of the disorder and consider it in their differential diag-

nosis, specially in patients with new onset psychosis, history of

encephalitis or subtle neurological symptoms. Careful selection of

psychopharmacological interventions may reduce suffering.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1946

EV962

Psychiatric correlates in deficit of

immunoglobulins

R. Hernandez Anton

1 ,

, S. Gomez Sanchez

1

, G. Isidro Garcia

1

,

E. Rybak Koite

1

, A. San Roman Uria

2

, T. Ballesta Casanova

1

,

J.A. Blanco Garrote

1

, C. Noval Canga

1

, M. Hernandez Garcia

1

,

L. Rodriguez Andres

1

, P. Gutierrez Garcia

3

, A. Alonso Sanchez

1

1

HCUV, PSQ, Valladolid, Spain

2

Complejo asistencial de Zamora, PSQ, Zamora, Spain

3

Hurh, MFYC, Valladolid, Spain

Corresponding author.

Introduction

Many neurological, oncological and autoimmune

diseases may have psychiatric symptoms; these diseases some-

times start with these symptoms, so the diagnosis may be confused

and the treatment is delayed.

Objective

Review the relationship between the secondary

immune deficiency and increased predisposition to infectious

processes and the psychopathological conditions which manifest

themselves in some cases in these situations.

Methods

A 17-year-old male patient, who began psychiatry con-

sultations when he was 3 years old due to psychomotor delay and

behavior disorders. He was diagnosed with ADHD and mild men-

tal retardation. Medical history: Viral encephalitis; Perthes disease;

recurrent urinary tract infections; intestinal giardiasis; Alport syn-

drome. He’s being treated with aripiprazole 5mg (1/2-0-0).

The patient presents an episode of perplexity, psychotic anguish,

auditory hallucinations and paranoid delusion. The patient pre-

sented an infectious process with general malaise, diarrhea and

vomiting during previous days.

Results

The patient was assessed by the Departments of inter-

nal medicine, neurology and psychiatry. A cerebral TAC, lumbar

puncture, EEG and urine porphyrins were requested. The secondary

immune deficiency makes the patient more vulnerable in an infec-

tious process.

Discussion

The diagnosis of psychotic disorder due to medical

condition may be transient or recurrent. Treating of the medical

condition often gets resolution of psychosis, although the symp-

toms can persist in some cases. There is often a prodomo of viral

syndrome weeks before the rest of symptoms appear. The differ-

ential diagnosis should be made with primary psychotic disorders,

affective disorders, confusional syndromes, impulse control disor-

der or sleep disorders, neuroleptic malignant syndrome, serotonin

syndrome and substance-induced psychotic disorders.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1947