European Psychiatry - Volume 33 - March 2016

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S662 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
late onset psychosis includes organic and mental precipitants in its
differential diagnosis.
Objectives To present a case of late onset schizophrenia.
Methods Medline search and review of the clinical history and
the related literature.
Results We present the case of a 71-year-oldwomanwith organic
medical history of rectumadenocarcinoma in 2008 that underwent
radiotherapy, chemotherapy and surgical resection with success-
ful results. According to the psychiatric history, this patient has
needed two admissions to the psychiatry ward, the first of them
in 2012, (when the delusional symptoms started), due to deregu-
lated behaviour in relation to persecutory delusions and auditory
pseudo-hallucinations. In 2012, she was diagnosed with late onset
schizophrenia. Blood tests (hemograme, biochemistry) and brain
image were normal. Despite treatment with oral amisulpride and
oral paliperidone and due to low compliance, delusional symptoms
have remained. We started treatment with long-acting injectable
papliperidone 75mg/28 days having reached clinical stability.
Conclusions Late onset psychosis is due to a wide range of clinical
conditions. In this case, our patient had no organic precipitants. The
evolution and presentation of delusional symptoms in this patient
made us think of late onset schizophrenia as main diagnosis.
Keywords “Schizophrenia” ;“Psychosis” ;“Late onset
schizophrenia”
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Further reading
Colijn MA et al. Psychosis in later life: a review and update. Harv
Rev Psychiatry 2015;23(5):354-67.
Reinhard MM. Late-life psychosis: diagnosis and treatment. Curr
Psychiatry Rep 2015;17(2):1.
EV979
Major depressive disorder with
psychotic symptoms in elderly. A case
report
J.M. Hernández Sánchez ∗ . Cancino Botello
M.F. Molina Lopez , M.Á. Canseco Navarro , S. Arnés González ,
M. Mu˜noz Carril , J.A. Monzó
1 Valencia, Spain
2 Hospital General de Valencia, Psychiatry, Valencia, Spain
3 Hospital General de Valencia, Emergency Medicine, Valencia, Spain
4 Hospital General de Valencia, Internal Medicine, Valencia, Spain
∗ Corresponding author.
Introduction The proportion of elderly people and affective syn-
dromes aremore andmore common indeveloped countries. Elderly
people have physiological conditions that may limit our interven-
tion.
Objectives To present a case of a major depressive disorder with
psychotic symptoms in a 72-year-old woman.
Methods Medline search and review of the clinical history and
the related literature.
Results We present the case of a 72-year-old woman with psy-
chiatric history of a major depressive disorder 14 years ago with
ad integrum restitution after pharmacological treatment. In 2015,
our patient was admitted to the psychiatry ward due to major
depressive symptomatology (apathy, anhedonia, global insomnia,
weight loss) that associated mood-congruent delusions (nihilistic,
ruin, guilt, catastrophic) with deregulated behaviour. The patient
was resistant to combined pharmacological treatment with arip-
iprazole, desvenlafaxine, mirtazapine and lorazepam, therefore, we
decided to administer ECT, with successful results after 5 sessions.
Brain tomography, blood and urine testswere normal. Clinical signs
of dementia were not present.
Conclusions Inpatients with deregulated behaviour; it is impor-
tant to rule out organic causes, especially in elderly, in whom
dementia, brain tumors or metabolic disturbances may simulate
psychiatric syndromes.
Keywords “Major depressive disorder” ;“Psychosis” ;“Late onset
psychosis”
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Further readings
Colijn MA et al. Psychosis in later life: a review and update. Harv
Rev Psychiatry 2015;23(5):354-67.
Reinhard MM. Late-life psychosis: diagnosis and treatment. Curr
Psychiatry Rep 2015;17(2):1.
EV980
The interpretation of anhedonia in a
structure of affective disorders and
schizophrenia
P. Kananovich
Mental Health Research Center of the Russian Academy of Medical
Sciences, Department of endogenous mental disorders and affective
states, Moscow, Russia
Objective To identify clinical and psychopathological features of
anhedonia in the framework of affective disorders or schizophre-
nia, as well as patterns of a process, development of the criteria of
differential diagnosis and prognosis.
Material and methods Using psychopathological method, we
examined 37 patients (average age was 27.6 + 1.2 years).
Results Itwas studied that anhedonia appears to be a non-specific
symptom, but with differences in terms of its dynamics and charac-
teristics, which are realized in differences regarding to prognostic
significance of the phenomenon. We selected 3 main types of anhe-
donia: an anhedonia in the framework of depression in affective
disorders (1), in the framework of depression at the prodromal
stages of schizophrenia with preservation and further intensifica-
tion its particular components (2), an anhedoniawithout associated
mood disorders (or their minor expression) in the framework of
schizophrenia, registered at initial stage and persisted in the future
(3). In affective pathology, anhedonia was observed in a structure
of a manifest depressive state with its further reduction in remis-
sion. In schizophrenia, anhedonia appeared at prodromal stages
as a structural part of depression or without associated mood dis-
orders, with a following persisting retention of its components at
the later non-manifestation states, suggesting reflection affinity
of anhedonia to schizophrenia. Anhedonia without concomitant
mood disorders in schizophrenia correlated with ɑ poorer outcome
and more severe psychotic symptoms.
Conclusions The presented differences in a structure of anhedo-
nia allow to speak about its correlation with a risk of manifestation
of endogenic pshychosis, the course of illness and its prognosis.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV981
Obsessive versus delusional jealousy:
Destruction in a form of creation – A
review
R. Almeida Leite∗ onde , T. Queirós Santos , M. Almeida ,
T. Azevedo Santos , A. Mesquita Figueiredo
Baixo Vouga Hospital Centre, Psychiatry and Mental Health
Department, Aveiro, Portugal
∗ Corresponding author.
Introduction Jealousy is a complex emotional state and some
degree is considered normal in mature love, but when does it
become destructive in a relationship? There’s a thin line between