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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S727

3

Hospital de Santo António dos Capuchos, Internal Medicine, Lisbon,

Portugal

Corresponding author.

Introduction

Anti-N-methyl-D-aspartate receptor (anti-NMDAR)

encephalitis is a treatable autoimmune disease of the CNS with

prominent neuropsychiatric features that primarily affects young

adults and children.

Objective

To present the diagnosis course of a case of anti-

NMDAR encephalitis in a patient with previous diagnosis of

Schizophrenia.

Methods

Analysis of the patient’s clinical records and of a

PubMed database review, using “anti-NMDAR encephalitis” as key-

words.

Results

We report a single case of a 33-year-old man diagnosed

with Paranoid Schizophrenia in 2009 that after 1 year of treat-

ment abandoned follow-up. Six years later, the patient presented to

the psychiatric emergency department with persistent headaches,

abnormal behavior and loss of motor skill. He was admitted to

the psychiatric ward with a presumptive diagnosis of “Catatonic

Schizophrenia” and began to manifest fluctuating catatonic symp-

toms (captured in video). Neuroleptics and benzodiazepines were

tried without success. There was a clinical deterioration with

autonomic dysfunction, breathing instability and seizures. Com-

plementary exams revealed: EEG with slow base activity; brain

MRI with right temporal pole and right frontobasal lesions com-

patible with head trauma; CSF with pleocytosis; and positive

anti-NMDAR antibodies. Occult neoplasmwas excluded. Treatment

with high-dose steroids, intravenous immunoglobulins, followed

by cyclophosphamide resulted in relevant clinical improvement.

Conclusions

As early detection of antibodies may allow for ear-

lier treatment of anti-NMDAR encephalitis, which is associated

with better outcomes, we believe the present case underscores the

importance of cliniciansmaintaining vigilance for neuropsychiatric

symptoms that have not adequately responded to therapy.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2168

EV1184

Study of the contributory factors to

metabolic abnormalities in resistant

schizophrenia

S. Ramos Perdigues

1 ,

, A. Mane Santacana

2

, P. Salgado Serrano

2

,

E. Jove Badia

3

, X. Valiente Torrelles

3

, L. Ortiz Sanz

3

,

J.R. Fortuny Olive

3

, V. Perez Sola

2

, F. Dinamarca

3

1

Nuestra Se˜nora de Jesus, Spain

2

Hospital del Mar, Psychiatry, Barcelona, Spain

3

Centre Dr. Emili Mira, Psychiatry, Santa Coloma de Gramanet, Spain

Corresponding author.

Introduction

Schizophrenia is a developmental disorder that

includes non-psychiatric abnormalities [2]. Metabolic abnormali-

ties prior to antipsychotic treatment exist. The clozapine metabolic

profile causes clozapine underuse in resistant schizophrenia [1].

Objectives

To correlate metabolic profile with psychiatric sever-

ity and compare the correlations between clozapine/non-clozapine

patients.

Aims

To determine possible contributory factors to metabolic

abnormalities in schizophrenia.

Methods

We cross-sectionally analyzed all

patients

from a Spanish long-term mental care facility (

n

= 139).

Schizophrenic/schizoaffective patients were selected (

n

= 118).

N= 31 used clozapine. We paired clozapine and non-clozapine

patients by sex and age and assessed metabolic and psychopatho-

logic variables.

We compared psychopathologic variables between patients

with/without cardiometabolic treatment and the differences

between clozapine/non-clozapine groups.

Results

We analyzed: 27 clozapine/29 non-clozapine patients.

A total of 67,9% males with a mean age of 51.3 (SD 9.6) years.

In the whole sample TG negatively correlated with Negative-CGI

(

r

:

0,470,

P

: 0.049) and HDL-cholesterol correlates with Global-

CGI(

r

: 0,505,

P

: 0.046). Prolactin correlated with the number of

antipsychotics (

r

: 0.581,

P

: 0.023) and IMC (

r

: 0.575,

P

: 0.025).

Clozapine group took less antipsychotics [Fisher (

P

: 0.045)] and had

higher scores in total BRPS scale [

t

-Student (

P

: 0.036)]. They did not

use more cardiometabolic treatment. There were no psychopatho-

logical differences between cardiometabolic treated/non-treated

patients. In the non-cardiometabolic treated group (

n

= 35/62,5%),

IMC negatively correlated with positive and total BPRS, positive,

cognitive and global-CGI. We found negative correlations between

metabolic parameters and psychopathology in clozapine (40%) and

non-clozapine subgroups (60%). In the cardiometabolic treated

group (

n

= 21/37,5%), we did not find these correlations in either

of clozapine (61.9%) or non-clozapine (38.1%) subgroups.

Conclusions

Severity [2], prolactine [3] and treatment [1] could

play a role in metabolic parameters. In our sample we found

negative correlations between psychopathological and metabolic

parameters.

References not available.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2169

EV1185

Awareness of illness and psychosis

R. Remesal Cobreros

1 ,

, R. Alonso Díaz

2

,

E. Cortázar Alonso

2

, M. Andrés Villa

3

1

Hospital Juan Ramón Jiménez, Salud Mental, Aljaraque-Huelva,

Spain

2

Hospital Juan Ramon Jimenez, Salud Mental, Huelva, Spain

3

Universidad de Huelva, Psicología, Huelva, Spain

Corresponding author.

Introduction

One of the characteristics of Karl Jaspers approach to

clinical practice was the importance he gave to the subjective expe-

rience by the patient. Patient’s self-observation is one of the most

important sources of knowledge of the psychic life of the patient.

The lack of awareness of illness is quite common in psychotic spec-

trum.

Aim

The aim of this paper was to examine and compare a group

of patients diagnosed with psychosis disorder with another group

with other mental disorders, in relation to their mental and emo-

tional suffering,

Sample

The sample was composed by 118 subjects with both

sexes. It was divided into two groups: patients with a diagnosis

of psychotic disorder and another one with other mental disorders.

Instrument

Inventory SCL-90-R, which evaluating a wide range

of psychological and psychopathological symptoms was used.

Statistics analysis

Two groups were compared with respect to

perceived psychopathological symptoms.

Results

Statistically significant differences were observed

between both groups. Patients with psychotic disorders showed

lower scores in most clinical scales. It reflects less emotional

suffering and psychological distress perceived in this group against

the other. It could be related to the lack of awareness of illness by

psychotic patient.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2170