European Psychiatry - Volume 33 - March 2016

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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 ∗, V. Bisht ,
D. Ho (Consultant Forensic Psychiatrist) ,
A. Kotze (Psychiatric trainee) , J. Asubiaro ,
R. Aigbogun (Staff Grade Psychiatrist)
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 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.
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 ∗, J. Kornhuber
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.
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.