European Psychiatry - Volume 33 - March 2016

731 / 812

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.
EV1184
Study of the contributory factors to
metabolic abnormalities in resistant
schizophrenia
S. Ramos Perdigues ∗, A. Mane Santacana , P. Salgado Serrano ,
E. Jove Badia , X. Valiente Torrelles , L. Ortiz Sanz ,
J.R. Fortuny Olive , V. Perez Sola , F. Dinamarca
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.
EV1185
Awareness of illness and psychosis
R. Remesal Cobreros ∗, R. Alonso Díaz ,
E. Cortázar Alonso , M. Andrés Villa
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.