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

S667

to indicate that AD is a transient disorderwith a tendency to sponta-

neous remission. However, some studies have shown that patients

with AD often develop major psychiatric disorders, presenting a

higher rate of psychiatric morbidity, e.g., higher suicide rates.

Aim

The aim of this study was to analyze the clinical and

sociodemographic characteristics, as well as some possible per-

sonal vulnerability factors in patients with AD.

Method

This longitudinal study was carried out on 80 outpa-

tients diagnoses with AD at a Mental Health Unit, who were

followed up for 3 years. It was analyzed different clinical and

sociodemographic characteristics.

Results

Significant differences between groups were found in

some of the variables considered.

Conclusions

The results add empirical evidence to a controversial

and little-researched diagnostic category and provide guidelines

for assessment and intervention. They also may contribute to

improve diagnostic classifications.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1980

EV996

Soft neurological signs in

schizoaffective disorder – Indicator of

psychotic spectrum or diagnostic bias

(case report)

V. Vukovic

1 ,

, S. Nikolic Lalic

1

, J. Mitic

2

, M. Stojanovic

3

1

Special hospital for psychiatric disorders “dr Slavoljub Bakalovic”,

Affective disorders and borderline states unit, Vrˇsac, Serbia

2

Special hospital for psychiatric disorders “dr Slavoljub Bakalovic”,

Unit for geriatric psychiatry, Vrˇsac, Serbia

3

Special hospital for psychiatric disorders “dr Slavoljub Bakalovic”,

Acute psychosis unit “P”, Vrˇsac, Serbia

Corresponding author.

Introduction

Neurological soft signs (NSS) refer to a group of

neurological deficits with no apparent pathognomonic supstrate

and comprise phenomena such as disorders of simple motor

coordination, sensory integration, as well as disinhibition sings.

Schizophrenia and other neuropsychiatric disorders are associated

with a higher prevalence of NSS.

Case summary

A 21-year-old male presented to our hospital

with symptoms including anxiety, delusions, mood alterations,

insomnia, and hypomania. Neurological assessment revealed pres-

ence of soft neurological signs. Personal history was positive for

hypoxic birth injury and psychiatric heredity. During his stay,

the patient showed not only partial response to treatment dur-

ing several months, but also extrapyramidal symptomatology (limb

hypertonia, decreased associated movements during walking, arm

dropping, and rigidity of the neck, as well as elevated blood levels

of CK, CRP, and high body temperature). There was no progression

of NSS. The addition of valproate to antipsychotic treatment led to

mild improvement. An MRI exam indicated presence of lesions in

the white mass.

Discussion

Although NSS have been more frequently associated

with schizophrenia, especially in patients with dominant nega-

tive symptoms, there are findings, which suggest their presence

in schizoaffective and bipolar disorders. Their presence is often

an indicator of poor outcome, they can resemble EPS, and their

association with frequency and severity of EPS is unclear.

Conclusion

The presence of NSS is not enough to discriminate

schizoaffective disorder, a “vague” diagnosis from others in what is

considered the psychotic spectrum.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1981

EV997

Kraepelin’s ghost: Late onset

schizophrenia, dementia

(non)praecox, or paraphrenia? (case

report)

V. Vukovic

1 ,

, S. Nikoli´c Lali´c

2

, T. Voskresenski

3

, S. Joki´c

4

1

Belgrade, Serbia

2

Special hospital for psychiatric disorders “dr Slavoljub Bakalovic”,

Affective disorders and borderline states unit, Vrsac, Serbia

3

Special hospital for psychiatric disorders “dr Slavoljub Bakalovic”,

Neurology unit, Vrsac, Serbia

4

Special hospital for psychiatric disorders “dr Slavoljub Bakalovic”,

Acute psychosis unit, Vrsac, Serbia

Corresponding author.

Introduction

It is difficult to establish whether a patient has late

onset schizophrenia or frontotemporal dementia. The object of the

following case report is to point out the difficulty of making a dif-

ferential diagnosis between these two entities.

Case summary

A 49-year-old female patient was admitted to our

hospital after presenting with auditory and visual hallucinations,

formal thought disorder, persecutory delusions, ideas of reference,

insomnia. Memory, executive function and attentional tasks were

severely compromised. Computerized tomography showed incipi-

ent frontal lobe atrophy. There were no significant abnormalities

found in blood and urine samples or physical and neurologi-

cal examinations. After showing no response to olanzapine, and

extrapyramidal side effects to fluphenazine, risperidone was initi-

ated which subsequently led to complete withdrawal of positive

symptoms.

Discussion

Patients presenting with psychotic symptoms after

the age of 40 presented a diagnostic quandary, as they were less

likely to present with negative symptoms, formal thought disor-

der or affective blunting, and more likely to have systematised

delusions and visual hallucinations. Frontotemporal dementia is a

disorder that can present itself with cognitive decline and a large

range of psychiatric symptoms. The risk of late onset schizophrenia

is greater in women, possibly implicating a causative role of female

sex hormones. Atypical antipsychotics risperidone and olanzapine

seem to be an adequate treatment.

Conclusion

Schizophrenia is a heterogeneous diseasewith a large

variety of clinical manifestations. Special care should be given to

patients with age over 40, including neurocognitive assessment,

laboratory and hormone tests, and a long-term follow-up.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1982

EV998

The importance of descriptive

psychopathology in differential

diagnosis of dissociative disorders:

A case report

C.A. Welte-Santana

, L. Oliveira , L. Carvalho de Toledo ,

N. Merola Fontoura , M. Ribeiro Garcia de Rezende ,

C. Lima de Melo , A.F. Macedo de Queiroz

Hospital Municipal Jurandyr Manfredini, Ambulatório de Psiquiatria,

Rio de Janeiro, Brazil

Corresponding author.

Introduction

Some kinds of hallucinations are misdiagnosed due

to primary psychotic disorders. Hallucinations can be classified into

3 categories: true hallucinations, pseudo-hallucinations and hallu-

cinosis. True hallucinations are different from the others due to

incapacity of insight of the unreal and pathologic character of the

phenomenon.