European Psychiatry - Volume 33 - March 2016

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S712 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV1136
Neurological symptoms in
schizophrenia: A case report
S. Benavente López ∗, N. Salgado Borrego ,
M.I. de la Hera Cabero , I. O˜noro Carrascal , L. Flores ,
R. Jiménez Rico
1 Hospital Universitario 12 de Octubre, Psychiatry, Madrid, Spain
2 Hospital Dr. Rodríguez Lafora, Psychiatry, Madrid, Spain
3 Centro San Juan de Dios Ciempozuelos, Psychiatry, Madrid, Spain
∗ Corresponding author.
Introduction Patients with epilepsy and schizophrenia could
present atypical clinical presentationswith neurological symptoms
that are not frequently presented in schizophrenia.
Case Report We report the case of a 41-year-old male who
was diagnosed of schizophrenia and was admitted into a long-
stay psychiatric unit. He started at 33 years old with a depressive
disorder. After prescribing venlafaxine, symptoms did not remit
and the patient started to present apathy, anhedony, impover-
ished speech, social isolation and blunted affect. Then, the patient
started to present behavioral disturbances consisted in regressive
behavior, aggressive behavior, inappropriate language, echolalia,
sexual disinhibition, impulsivity, worsening of executive func-
tions and soliloquies. A neurological study was made with CT
scan and electroencephalography, and no evidences of neurologi-
cal abnormalities were found. After that, clozapine was prescribed,
with an improvement of some symptoms like apathy, anhedony
and aggressive behavior, but persisting the impulsivity, regres-
sive behavior, inappropriate language, sexual disinhibition and
echolalia.
Discussion Patients with schizophrenia and epilepsy could not
respond appropriately to antipsychotic drugs. In this patient,
the psychiatric symptoms more frequently seen in schizophrenia
responded well to clozapine, but neurological symptoms did not
improve with the standard treatment, causing a severe disability to
the patient that was the main reason for his prolonged admission.
Conclusions It is recommended to make a detailed neurological
exploration in all psychiatric patients, in order to explore atypical
symptoms and comorbidities that could reveal new diagnosis and
therapeutic objectives.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1137
Obsessive symptoms in schizophrenia:
A case report
S. Benavente López ∗, N. Salgado Borrego ,
M.I. de la Hera Cabero , I. O˜noro Carrascal , L. Flores ,
R. Jiménez Rico
1 Hospital Universitario 12 de Octubre, Psychiatry, Madrid, Spain
2 Hospital Dr. Rodríguez Lafora, Psychiatry, Madrid, Spain
3 Centro San Juan de Dios Ciempozuelos, Psychiatry, Madrid, Spain
∗ Corresponding author.
Introduction Schizophrenia could be presented with obsessive
thoughts or an obsessive-compulsive disorder. It is known that
some antipsychotics like clozapine could cause obsessive symp-
toms or worsen them.
Case Report We report the case of a 53-year-old male who
was diagnosed of schizophrenia. The patient was admitted into
a long-stay psychiatric unit due to the impossibility of outpa-
tient treatment. He presented a chronic psychosis consisted in
delusions of reference, grandiose religious delusions, and auditory
pseudohallucinations. He often presented behavioral disturbances
consisted in auto and heteroaggressive behavior, being needed the
physical restraint. Various treatments were used, including cloza-
pine, but obsessive and ruminative thoughts went worse. Because
of that, clozapine dose was lowed, and it was prescribed sertra-
line and clomipramine. With this treatment the patient presented
a considerable improvement of his symptoms, ceasing the auto
and heteroaggressive behavior, presenting a better mood state, and
being possible the coexistencewith other patients. Psychotic symp-
toms did not disappeared, but the emotional and behavioral impact
caused by them was lower.
Discussion This case report shows howa patientwith schizophre-
nia could present severe behavioral disturbances due to obsessive
symptoms. If obsessive symptoms are presented, clozapine must
be at the minimum effective dose and antidepressants with a good
antiobsessive profile.
Conclusions Obsessive symptoms could be presented as a part
of schizophrenia. Clozapine could worsen this symptoms and it is
necessary to adjust its dose to the minimum effective dose.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1138
Treatment of schizophrenia with
aripiprazole may contribute to
improved functions
A. Björner ∗, N. Erixon-Lindroth , S. Öberg Jansdotter ,
A. Flatla
1 Gothenburgh, Sweden
2 Otsuka Pharmaceuticals, Scandinavia, Stockholm, Sweden
3 Bristol-Myers Squibb at time of study, Stockholm, Sweden
4 Bristol-Myers Squibb, Oslo, Norway
∗ Corresponding author.
Introduction The goals with modern treatment of schizophrenia
are to achieve remission of clinical symptoms, prevent relapse, and
to restore the patients’ functions.
Objectives/aims The objective of this study was to investigate the
impact of treatment with the partial dopamine agonist aripiprazole
on functions, measured as time spent forwork or studies, inpatients
with schizophrenia or schizoaffective disorder.
Methods Retrospective data on employment and study activ-
ities were collected for all patients between 18–65 years with
schizophrenia or schizoaffective disorder at an open care psychosis
clinic in Sweden ( n = 104). Possible impact of treatment with arip-
iprazole and of other variables, such as age, gender, and disease
severity, was analysed.
Results Among patients who worked or studied at Day of admis-
sion (n = 36), the probability of maintaining or increasing time for
work or studies was significantly higher in patients treated with
aripiprazole compared with patients who were not (88% versus
53%; P = 0.020). This difference remained significant after control-
ling for severity of symptoms, age and sex. A secondary analysis,
including all patients (independent of work or study status at Day
of admission) also showed a significant difference in favour of arip-
iprazole (53% versus 26%, P = 0.005).
Conclusions The results indicate that patients treated with arip-
iprazole (monotherapy or add-on) have higher probability of
maintaining functional capacity. A plausible explanation might be
aripiprazole’s favourable effect on cognitive functions.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.