European Psychiatry - Volume 33 - March 2016

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S690 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV1066
Electroconvulsive therapy in
depressed older adults with
unrepaired abdominal aortic
aneurysm: Safety first!
S. Petrykiv ∗, M. Arts , L. de Jonge , P. Michielsen
1 GGZ Friesland, Emergency Psychiatry, Groningen, Netherlands
2 GGZ Friesland, Geriatric Psychiatry, Leeuwarden, Netherlands
3 UMC Groningen, Epidemiology, Groningen, Netherlands
4 GGZ Westelijk Noord Brabant, Psychiatry, Bergen op Zoom,
Netherlands
∗ Corresponding author.
Introduction It is not clear whether electroconvulsive therapy
(ECT) is a safe procedure in depressed older adults with unrepaired
abdominal aortic aneurysm (AAA). ECT is potentially incriminating
to the cardiovascular system due to a transiently elevation of blood
pressure and heart rate during the seizure.
Objectives To report a case of an older adult presenting a psy-
chotic depression complicated by an unrepaired AAA.
Aims To report a case study, describing the safety of ECT in
patients with unrepaired AAA.
Methods A case report and retrospective review was conducted.
Results A75-year-oldmalewas admitted to hospital for the treat-
ment of a psychotic depression. Treatment was complicated since
for one year he was diagnosed with an AAA (diameter 4.7 cm).
In collaboration with vascular surgeons and anesthesiologists we
decided to start ECT. After fourteen ECTs an improvement of mood
was achieved. Post-ECT we noticed an AAA expansion of 0.1 cm.
Conclusions Our findings indicate that ECT may be a safe proce-
dure for patients diagnosed with unrepaired AAA. Published data
suggest that the risk for aortic aneurysm rupture during ECT is
low. However, multidisciplinary collaboration among psychiatrists,
anesthesiologists and vascular surgeons is essential for a positive
outcome.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1067
Adverse effects in repetitive
transcranial magnetic stimulation –
prevention and management
G. Sobreira ∗, M.A. Aleixo , C. Moreia , J. Oliveira
1 Centro Hospitalar Psiquiátrico de Lisboa, First Psychotic Episode
Unit, Lisboa, Portugal
2 Centro Hospitalar Psiquiátrico de Lisboa, Schizophrenia and
Schizoaffective Disorders Unit, Lisboa, Portugal
3 Centro Hospitalar Psiquiátrico de Lisboa, Neuropsychiatry and
Dementia Unit, Lisboa, Portugal
∗ Corresponding author.
Introduction Repetitive Transcranial Magnetic Stimulation
(rTMS), through modulation of cortical activity, has become
an invaluable tool in experimental and clinical neurosciences.
Although this form of noninvasive treatment is considered safer
than other means of brain stimulation it has been associated with
adverse effects (AE).
Objective Tomake a brief review, concerning the AE of rTMS, their
prevention and management.
Aims To understand and be able to deal with the most common
AE associated with rTMS.
Methods A PubMed database search, using as keywords “Tran-
scranial magnetic stimulation”, “Repetitive Transcranial magnetic
stimulation”; “adverse effects”; “management” and “guidelines”
between the year 1998 and 2015.
Results AE caused by rTMS are rare. They can be classified
into severe (seizures) and mild (syncope, and transient hearing
impairment, acute psychiatric changes, headache, local pain, neck
pain, toothache, paresthesia and cognitive/neuropsychological
changes) and into early and late AE. In order to obviate and avoid
them, guidelines have been created; some state that to apply rTMS
the technician needs to obtain the patient’s informed consent and
assess the risks/benefit ratio. Tomeet these criteria, screening tools
have been created, and since then the number of AE has reduced.
Conclusions Even though rTMS is considered safer than other
forms of brain stimulation it is still associated with AE. In order
to avoid them, screening tools have been created allowing the clin-
ician to assess the risks and benefits of applying this technique.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1068
Electroconvulsive therapy (ECT)
treatments in late-onset
schizophrenia: Report of a case
M. Valverde Barea ∗, F. Cartas Moreno , M.E. Ortigosa Luque
1 USMC-Jaén Sur, Servicio de Psiquiatria, Jaen, Spain
2 USMC-Ubeda, Servicio de Psiquiatria, Jaen, Spain
∗ Corresponding author.
Female patient, 66 years old, who goes to the doctor because of
behavioral disorders and delusional injury 8 months of evolu-
tion. She showed no personal history of psychiatric disorders. In
the psychopathological examination some relevant symptoms are
seen delusions of prejudice with their immediate surroundings,
self-referential regarding neighbors andwalls. Delusional interpre-
tations of sexual content. Punitive pseudo hallucinations hearing
which are identifies with her daughters and sex with her son-
in-law. Behavioral disorders consisting of going out naked into
the street overnight and rebuking pedestrians; furthermore, she
showed heteroaggressivity towards objects. Logical psychotropic
treatment is initiated as indicated by the guidelines having no
effect. Electroconvulsive therapy being tested an effective result.
The late-onset schizophrenia symptoms should be taken into
account in people with psychotic symptoms start at an advanced
age, but is most prevalent at younger ages. Electroconvulsive
therapy (ECT) may be used as an adjunct to drug therapy or as
second-line treatment in patients with affective or psychotic disor-
ders resistant to treatment with psychotropic drugs. It is essential a
differential diagnosis with dementia symptoms previously estab-
lished, given that part of the late-onset schizophrenia evolves to
dementia.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Psychotherapy
EV1069
Social media group parallel to
dialectical behavior therapy skills
training group, the pros and cons
A. Abdelkarim ∗, D. Nagui Rizk , M. Esmaiel , H. Helal
1 Alexandria Faculty of Medicine, Neuropsychiatry, Alexandria, Egypt
2 Alexandria Faculty of Arts, Psychology, Alexandria, Egypt
∗ Corresponding author.
Introduction In the past few years, social media has gained a
high popularity as a dynamic and interactive computer-mediated