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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

1 ,

, M. Arts

2

, L. de Jonge

3

, P. Michielsen

4

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2051

EV1067

Adverse effects in repetitive

transcranial magnetic stimulation –

prevention and management

G. Sobreira

1 ,

, M.A. Aleixo

1

, C. Moreia

2

, J. Oliveira

3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2052

EV1068

Electroconvulsive therapy (ECT)

treatments in late-onset

schizophrenia: Report of a case

M. Valverde Barea

1 ,

, F. Cartas Moreno

2

, M.E. Ortigosa Luque

1

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2053

Psychotherapy

EV1069

Social media group parallel to

dialectical behavior therapy skills

training group, the pros and cons

A. Abdelkarim

1 ,

, D. Nagui Rizk

1

, M. Esmaiel

2

, H. Helal

2

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