European Psychiatry - Volume 33 - March 2016

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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.
EV996
Soft neurological signs in
schizoaffective disorder – Indicator of
psychotic spectrum or diagnostic bias
(case report)
V. Vukovic ∗, S. Nikolic Lalic , J. Mitic , M. Stojanovic
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.
EV997
Kraepelin’s ghost: Late onset
schizophrenia, dementia
(non)praecox, or paraphrenia? (case
report)
V. Vukovic ∗, S. Nikoli´c Lali´c , T. Voskresenski , S. Joki´c
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.
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.