European Psychiatry - Volume 33 - March 2016

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S660 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
Introduction Amyotrophic lateral sclerosis (ALS) is a progressive
and fatal neurodegenerative disorder that affects motor neurons in
the cerebral cortex, brainstem and spinal cord. The progressive loss
of motor function creates profound changes on patient’s lives and
their caregivers.
Objective Assessment of eventual existence of psychopathology
in ALS patients and their caregivers.
Methods Literature review using the terms: ALS, Amyotrophic
Lateral Sclerosis, psychopathology, psychiatric disorder; depres-
sion; anxiety, caregivers.
Results Moderate depressive or anxious symptoms are often
observed. The results are not consistent, some studies showing
that major depression is less common that in general population,
others that is mildly increased. Some studies show that depres-
sive symptoms are related to poorer QoL and with faster disease
progression, others suggests no correlations. Coping strategies,
cognitive appraisal and social support are important factors to
psychological adaptation to ALS. After the diagnosis, high lev-
els of anxiety can be observed. Psychopathological features are
observed at this time, and generally depression does not increase as
death approaches. Beyond loss of physical functions, it seems that
patients’ neurobehavioral symptoms, such as aggressiveness, dis-
inhibition and impulsivity, cognitive impairment, and also lack of
social support have a negative effect on caregivers’ mental health.
Concordance between patient and caregiver distress was found.
Conclusions It is important to assess potential psychological dis-
tress in ALS patients and their caregivers, given that cope with
disease can affect its course. Caregivers’ needs should be addressed,
to benefit their well-being and consequently patients’ QoL. There
are few studies about psychopharmacotherapy and/or psychother-
apy in these patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV973
Paraphrenia: Evolution of the concept
C. Freitas ∗ . Figueiredo breu ueirós
1 Centro Hospitalar do Tâmega e Sousa, Departamento de Psiquiatria
e Saude Mental, Penafiel, Portugal
2 Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento
de Psiquiatria e Saúde Mental, Vila Real, Portugal
∗ Corresponding author.
Paraphrenia was identified as a psychopathological entity charac-
terized by chronic delirium, described next to schizophrenia, but
with rich and fanciful elaborations, without social and cognitive
impairment associated. Despite having been extensively described,
paraphrenia fell into disuse. With this work, the authors intend to
carry out a literature review on the concept of paraphrenia, since
its first report to the extinction from the current practice of psy-
chiatry. The term paraphrenia (para “near” phrenia “pathological
mental state”) was first noted by Kahlbaum in 1863, who identified
dementia and subdivided it into three types: “neofrenia”, “para-
phrenia hebetica” and “senilis paraphrenia”). Magnan andManager
suggested the concept of “chronic hallucinatory psychosis” in 1963,
while Kraepelin started jobs with similar characteristics, defin-
ing the concept of paraphrenia. Kraepelin distinguished dementia
praecox from the later onset dementia, despite considering them
closer to one another than any of them to paranoia. Paraphrenia
would be characterized by less formal disturbances of thought and
greater preservation of affection. In 1911, with “schizophrenia”
expression, Bleuler broke with Kraepelin concept, as Mayer, who
reviewed Kraepelin patients, concluding that more than half had
progressed to a diagnosis of schizophrenia. At this time, paraphre-
nia was virtually abolished from the practice of psychiatry. Despite
the observations made over the years, the concept of paraphrenia
have revealed that the description proposal does not correspond
to an isolated and distinct psychiatric condition, several times, in
clinical practice we have encountered with patients presenting
diagnostic criteria for schizophrenia but with the evolution of the
disease showing no significant deterioration in several areas.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV974
Folie à deux: Shared or “infected”
madness? About a case report
M.Á. Soriano ∗ arcia
1 Universitary Hospital, Mental Health service, Málaga, Spain
2 Valle del Guadalhorce Mental Health Center, Universitary Hospital,
Málaga, Spain
∗ Corresponding author.
The shared madness or Folie à deux was described in France in the
nineteenth century by Charles Lasage and Pierre Falret, as a con-
dition where a person (the primary) builds a delusional system,
sharing it with another (the secondary), who must be very close
to the first affected, becoming delirious with the same subject.
Several theories attempt to explain the phenomenon that chal-
lenges theories of personality structures, rooted in relational and/or
environmental features of psychosis. Theoretically, there are many
attempts to classify this psychotic experience: in some manuals
they distinguish various types of partners: the simultaneous psy-
chosis, where the two people start to became delirious at once;
imposed psychosis, in which the disorder arises first with one, then
going on to “healthy” individual and symptomatology disappears
after being separated; and communicated psychosis, where the first
transmitted the psychotic experience to the second, and he or she
develops his or her own delusion not interrupted even while sepa-
rated. Other classifications about sharedmadness not only between
two people, but three, and four, even a whole family show us how
complicated the delirium systems can become. In our paper, we
will discuss the different theories explaining this rare psychiatric
condition based on a case about two brothers of 35 and 37, who live
together with the rest of the family, and also come together to the
same mental health center, although with different psychiatrists.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV975
Which type of management is most
suited for patients with a diagnosis of
false self personality (FSP) within a
psychodynamically-oriented
institutional day hospital? A study
G. Giorgio ∗, F. Marmo
Fondazione Villa Camaldoli, Psychodynamic Day Hospital Integrated
Psychodynamic Psychiatric Department, Naples, Italy
∗ Corresponding author.
Introduction Our work team have already found that our Insti-
tutional Psychiatric Open Light Treatment (IPOLT) model allows
the patient affected by severe mental illness (SMI) to more eas-
ily express her/his personal coping skills rather than behaving
passively thanks to the “real free spaces” separating a structured
intervention from another. Our work consisted in evaluating how
patients with FSP respond to IPOLT.
Objectives This paper describes observations of psychotic
patients operating from the position of FSP in order to evaluate
how they respond to IPOLT compared with other patients accord-
ing to three standards (day hospital attendance, psychotic episodes
and hospital admissions).