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

S785

EV1369

Burden of disease in treatment

resistant schizophrenia

S. Bandali

1 ,

, V. Bisht

1 , 2

,

D. Ho (Consultant Forensic Psychiatrist)

1

,

A. Kotze (Psychiatric trainee)

1

, J. Asubiaro

1

,

R. Aigbogun (Staff Grade Psychiatrist)

1

1

Psychiatric Trainee, South Essex NHS Partnership Trust SEPT,

Wickford, United Kingdom

2

South Essex NHS Partnership Trust SEPT, Consultant Forensic

Psychiatrist, United Kingdom

Corresponding author.

Background

Treatment resistant schizophrenia (TRS) accounts

for up to 20% of cases diagnosed with schizophrenia1

[1] . T

his rep-

resents a large proportion of disease burden and nowhere is this

more so true than in forensic services where there is not only a

larger presence of such cases but often it is closely linked with their

offending behaviour and risk of future offending.

Aim and objectives

Building on our service evaluation on treat-

ment resistant schizophrenia in 2014, we are aiming to compare

the burden of disease encountered by patients suffering from treat-

ment resistant schizophrenia to a matched cohort of non-resistant

patients suffering from schizophrenia within South Essex Part-

nership Trust (SEPT) secure services. Specifically we will also be

looking to compare burden of disease between our male and female

patients.

Methodology

A list of eligible patients suffering from TRS and

non-TRS patients will be identified from the SEPT Mobius System

(Live electronic Patient Records). The cohorts will be matched for

age, gender, and diagnosis. Data with regards to length of hospital

admission and number of violent incidents will be extracted from

the electronic notes. Each patient will be administered the Positive

and Negative Syndrome Scale (PANNS) in addition to the Clinical

and Global Impression scale (CGI) by a medically trained doctor.

The results will then be collated and analysed for statistical sig-

nificance. They will initially be published in a poster format and

subsequently submitted as a journal article.

Results

To Follow.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

Reference

[1] Kane J, Honigfeld G, Singer J, et al. Clozapine for the

treatment-resistant schizophrenic. A double-blind comparison

with chlorpromazine. Arch Gen Psychiatry 1988;45:789–96.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2354

EV1370

Excerpt from the history of the

“Hochschulpsychiatrie Erlangen”

(1818–2016): On the history of a

connection between University and

Institutional Psychiatry, Unique in

Germany (1903–1974)

B. Braun

1 ,

, J. Kornhuber

2

1

Psychiatry and Psychotherapy, Erlangen, Germany

2

Psychiatry and Psychotherapy, Friedrich-Alexander-University

Erlangen-Nürnberg, Erlangen, Germany

Corresponding author.

Objective

To examine the more than 70-year history of a connec-

tion between University and Institutional Psychiatry.

Method

Relevant archival material as well as primary and sec-

ondary literature were examined.

Results

As early as 1818 Johann Michael Leupoldt (1794–1874)

held a seminar on “madness” as an assistant professor in Erlan-

gen. But the University Psychiatric Clinic did not begin until 1903

within the association of the mental asylum founded on a contract

agreement between the Friedrich-Alexander, University Erlangen

and the County Senate of Middle-Franconia. The history of the

“Hochschulpsychiatrie Erlangen” reflects part of the history of

German psychiatry. The plans to accomplish independence were

doomed to impracticability by the social-political situation before,

during and after the First and also Second World Wars. Clinic

patients were registered as “Institutional residents”, the Clinic had

no income of its own, the Head of Department and Director of the

Clinic was formally considered as the “senior doctor of the asylum”.

Discussion

The complicated duty dependence of the Head of

Department on the Director of the asylumundoubtedly contributed

to their decades spanning “mésalliance tradition”. A public scan-

dal arose in 1978 from an accusation of dereliction of duty to

the government of Middle-Franconia because of lacking protection

of patient documentation and medications during the relocation

of the former institution departments to the newly constructed

Regional Hospital on the Europakanal.

Outlook

Cooperation between the University Clinic and the

Regional Hospital exists in altered formtoday. The Psychiatric Clinic

can thus include patients from the Regional Hospital in scientific

studies.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2355

EV1371

ADHD, one of the most challenging

mental disorders in adult

psychopathology

M.C. Cancino Botello

, J.M. Hernández Sánchez , F. Molina López ,

M.D.L.A. Canseco Navarro , A. Pe˜na Serrano

Consorcio Hospital General Universitario, Psychiatry, Valencia, Spain

Corresponding author.

Introduction

In 40 to 60% of children with ADHD, the disor-

der persists into adulthood. Nevertheless, diagnosis in adulthood

sometimes becomes a challenge because, even the etiology is not

very clear yet, ADHD shares several clinical features or may coexist

with other psychiatric disorders. This issue leads to confusion and

also to a delayed treatment or a wrong treatment, causing negative

effects on patient outcomes.

Objective

To highlight the importance of making an accurate dif-

ferential diagnosis and to consider the coexistence of other mental

disorders, in the diagnosis of a patient with ADHD.

Methods

Systematic reviewof the literature in English (Pubmed).

Keywords: “adult ADHD”; “bipolar disorder”; “substance abuse”;

“personality disorders”.

Results

Adult ADHD has a prevalence in Europe of 3,4% and

it seems to appear more frequently in developed countries. In

adults, the clinical presentation differs from children. There often

are symptoms of impulsivity, attention deficit, restlessness, and

emotional dysregulation and risk behavior, causing difficulties in

everyday functioning. The coexistence of substance abuse and the

similarity between bipolar disorder and personality disorders with

ADHD, translate in a difficult diagnosis, especially for patients with

mild presentations.

Conclusions

So far, the authors conclude that a detailed clinic his-

tory plus the validated scales for adult ADHD are the most reliable

tools for diagnosis. Neuroimaging and EEG studies do not provide

conclusive data to consider them as diagnostic methods.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2356