European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S689
use of ECT with anesthesia, muscle relaxation and hardware anal-
ysis of the EEG in the Republic of Belarus may be effective against
drug-resistant forms of mental and behavioral disorders.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1063
A review of transcranial magnetic
stimulation for treating negative
symptoms of schizophrenia
J. Oliveira ∗ obreira . Moreira . Aleixo
S. Brissos
1 Centro Hospitalar Psiquiátrico de Lisboa, Neuropsychiatric and
Dementia Unit, Lisbon, Portugal
2 Centro Hospitalar Psiquiátrico de Lisboa, First Psychotic Episode
Unit, Lisbon, Portugal
3 Centro Hospitalar Psiquiátrico de Lisboa, Schizophrenia and
Schizoaffective Disorders Unit, Lisbon, Portugal
∗ Corresponding author.
Introduction The finding of prefrontal dysfunction in schizophre-
nia patients with negative symptoms (NS) has raised interest
in using transcranial magnetic stimulation (TMS), which can
modulate prefrontal function and dopamine release, as potential
treatment for NS.
Objective To briefly review current literature concerning the use
of TMS as treatment for NS.
Aims To assesswhether current evidence supports the use of TMS
for NS.
Methods Narrative review of articles found through a PubMed
database search using the keywords “transcranial magnetic stimu-
lation”, “schizophrenia”, and “negative symptoms” between 1998
and 2015.
Results Up to date, reviews of randomized sham-controlled stud-
ies found positive effects of TMS in NS. However, they exposed
several methodological difficulties. More recent studies, reviewed
in this poster, tried to overcome these, using results from multi-
ple centers, larger samples and blinding. Various TMS techniques
were studied, differing in frequency, motor threshold (MT), stim-
ulus location, and treatment duration. Overall, TMS continues to
show promising results in reducing NS; particularly rTMS 10Hz,
for at least 15 sessions on the left dorsolateral prefrontal cortex
(DLPFC) at a 110% MT.
Conclusions TMSmay be a useful treatment for NS for patients not
responding to pharmacological treatment alone. Studies remain
difficult to compare due to different measures of outcome (PANSS
and SANS being themost commonly used) and techniques. Further-
more, possible modulators of response include duration of illness,
cognitive symptoms amelioration, medication and their dose, and
different NS may respond differently to TMS. More studies are
needed to better understand the utility of TMS in NS.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1064
Posterior vitreous detachment and
electroconvulsive therapy: Insights
from a case
F. Pavez∗, A. Alcántara , N. López , A. García , M. Sánchez ,
M. Roca , E. Moral , J. Russo
Hospital General Universitario Reina Sofía, Psychiatry, Murcia, Spain
∗ Corresponding author.
A case of bilateral posterior vitreous detachment after electrocon-
vulsive therapy (ECT) has been reported previously in the literature.
There is not enough evidence about ocular side effects of this
treatment. The literature supports a slight increase in intraocu-
lar pressure (IOP), although no ocular complications have been
reported in normal, glaucomatous or postsurgical eyes. In this
case report, we describe a 73-year-old female patient suffer-
ing a recurrent depressive disorder, who was admitted to acute
psychiatric unit because a treatment-resistant major depressive
episode (after an adequate trial of antidepressant drugs and tran-
scranial magnetic stimulation) and clinical suspicion of visual
delusions by her reference psychiatrist. The nonpsychiatric his-
tory consisted of hypertension, glaucoma and ulcerative colitis
in treatment with azathioprine and mesalazine. After a careful
examination in the emergency room, we consulted to ophthalmol-
ogist because miodesopsias and glaucoma history. The IOP was
normal, but a bilateral posterior vitreous detachment (PVD) was
identified. Because this entity is not an absolute contraindication
for ECT, and there is scarce evidence, we informed the patient
and her family. After that, and through informed consent, we
decided to undergo ECT. After fourteen sessions, the patient could
be discharged because significant clinical benefit and no ocular
complications. Outpatient continuation ECT was indicated.
Conclusions ECT can be a safe treatment choice in cases of PVD.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1065
Maintenance electroconvulsive
therapy for catatonia
R. Perez∗, M.D.L.D. Perez , A. Hidalgo , J. Prados , C.P. Gonzalez ,
M. Soto , B. Herrejon
Hospital provincial de toledo, Psiquiatría, Toledo, Spain
∗ Corresponding author.
Introduction We describe a case of a woman admitted to the psy-
chiatric unit with characteristics of excited catatonia. Two years ago
she had an episode of catatonia triggered by social and economic
problems presented with mutism, psychomotor retardation and
compromised oral intake. She recovered with 15 ECT sessions and
was discharged in a stable state on quetiapine, divalproex sodium,
venlafaxine and diazepam. This time she was treated with 13 ECT
sessions and was discharged on previous maintenance treatment.
Three weeks after her condition gradually deteriorated again. She
recovered with 7 ECT sessions and was derived to our ECT mainte-
nance program.
Objective To describe and discuss the use of maintenance elec-
troconvulsive therapy (m-ECT) in catatonia.
Methods Clinical case report and PubMed search with the key-
words “catatonia” and “maintenance electroconvulsive therapy”.
Results Catatonia is characterized by motor disorders, mutism
and negativism, autonomic dysfunction is also possible, sharing
symptoms and severity with neuroleptic malignant syndrome. In
the DSM 5 catatonia is as a specifier of a primary disorder (Tr. Psy-
chotic, affective, substances or unspecified) and not a schizophrenia
subtype. Benzodiazepines are most utilized as first-line treatment
for catatonia, and/or electroconvulsive therapy (ECT). The role of
antipsychotics is unclear. Use of maintenance ECT in responders
appears beneficial.
Conclusion Catatonia guidelines recommend ECT treatment if
benzodiazepines are not effective. Maintenance ECT is a good
option in long-term prevention of recurrent catatonia. More spe-
cific research is required.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.