European Psychiatry - Volume 33 - March 2016

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S798 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV1412
Post-thalamic stroke apathy, a review
and case report
C. Nu˜nez Sande ∗, T.M. Torres Rincon , J.L. Fernández Hierro
1 Servicio de Psiquiatría XXIV Vigo, Servicio de Psiquiatría XXIV Vigo,
Vigo, Spain
2 Servicio de psiquiatría XXIV Vigo, Servicio de psiquiatría XXIV, Vigo,
Spain
3 Servicio de Psiquiatría XXIV Vigo, Unidad de Hospitalización
Psiquiátrica, Vigo, Spain
∗ Corresponding author.
Introduction Apathy is commonly defined as lack of, or
diminished, emotion, interest, concern, interest and motivation
manifesting as poor engagement with others and loss of pleasure
in usual interests. Occurs in various medical condition (stroke, HIV,
dementia and Parkinson disease) and other psychiatric disorders. It
has been relatedwith thalamus stroke, and seen on clinical practice
as a blunted emotional response and indifference.
Objective We have tried to link cases of apathy associated with
thalamic stroke and systematically review the literature for similar
case reports.
Methods We have searched MEDLINE, EMBASE, IBIDS, and the
Cochrane Collaboration Database until October 2015. Published
case reports of apathy in persons who had suffered a brain stroke
were selected.
Results Support the evidence in the literature of the multidimen-
sional nature of apathy and correlate the psychiatric manifestation
with the neurological findings. We find similar case reports that
could support the anatomical subtract of the apathy and it’s also
correlated with the previous data reports.
Conclusions These findings are discussed and interpreted in the
seeking of regarding the neurobiological substrate of apathy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1413
A case of neurosarcoidosis presenting
with isolated psychotic symptoms
O. Onur ∗, E. Carpar , Y. Altunkaynak
1 Istanbul Bakırkoy Research and Training Hospital for Psychiatry
Neurology and Ne, Psychiatry, Istanbul, Turkey
2 Istanbul Bakırkoy Research and Training Hospital for Psychiatry
Neurology and Ne, Neurology, Istanbul, Turkey
∗ Corresponding author.
Neurosarcoidosis (NS) is a neurologic manifestation of sarcoidosis,
a rare multisystemic granulomatous disease. Although psychiatric
symptoms have been reported to occur in 20% of patients with NS,
isolated NS without any signs of systemic disease is a rarity.
Case A 56-year-old female admitted to psychiatry clinic due to
complaints of forgetfulness, visual and auditory hallucinations,
inability to go outside alone, washing hands in closet cabin, dif-
ficulty finding words for the last one year, progressing in last
four months. Personal and family background was unremarkable.
Vital signs and physical examination revealed no abnormalities. In
neuropsychiatric examination, Glasgow Coma Scale score was 15
without any meningeal irritation signs or gait abnormalities. Cra-
nial nerves, extrapyramidal, motor, cerebellar, and sensory systems
were intact. All aspects of orientation (time, place and person) were
impaired. She scored12 points out of 30 inMiniMental Test. Speech
was non-fluent with looseness of associations. Impaired recall,
abstract thinking, judgment, behaviour planning and attention
were noted. Visiospatial disorientation and contructional dressing
apraxia were revealed. MR Imaging reported a T2-weighted signal
intensity change in nodular fashion suggesting a granulamatous
lesion. Differential diagnoses included granulomatous diseases,
neoplasms, infections and Behcet’s disease. After necessary exclud-
ing evaluations were undergone, a diagnosis of NS was made due
to increased angiotensin converting enzyme levels in cerebrospinal
fluid. The clinical picture responded well to prednisone treatment
and symptoms resolved within one month.
Conclusion Increased awareness is essential to identify rare gran-
ulamotous diseases as a differential diagnosis in encountering
psychotic symptoms accompanying demantial clinic presentation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1414
Neurocognitive mechanisms behind
mindfulness
J. Perestrelo ∗, B. Teixeira
Centro Hospitalar de Vila Nova de Gaia/Espinho, Psychiatry, Porto,
Portugal
∗ Corresponding author.
Introduction Clinical applications of mindfulness have become
widespread since the introduction of the mindfulness-based stress
reduction (MBSR), a treatment program originally developed for
the management of chronic pain. Neuroimaging techniques have
allowed uncovering the neural mechanisms behind Mindfulness
techniques.
Objective To review some of the psychological and neural mech-
anisms behind mindfulness practice in order to explore the unique
factors that account for its positive impact on emotional regulation
and health.
Aims Psychological and neural mechanisms behind mindfulness
practice are reviewed.
Methods A literature review of the theme is surveyed. Several
articles were searched on Medline with the keywords “mindful-
ness”, “meditation”, “neurobiology” and “neurocognitive”.
Results Mindfulnessmay achieve effective outcomes in the treat-
ment of anxiety, depression, and other psychopathologies through
the contribution of emotional regulation. Cognitive reappraisal has
been suggested as a core cognitive control skill whereby mindful-
ness practice may regulate emotions. It seems that a neural circuit
comprising the prefrontal cortex (PFC), the anterior cingulate cor-
tex (ACC), the amygdala (A), and the insula (I) are involved in the
unique processes of mindful emotion regulation.
Conclusions Recent models of mindfulness allow for more rig-
orous examination and operationalization of the method to guide
research. Increasingly investigators are focusing on the impact that
mindfulness has on emotional regulation, which accounts for the
effects on mental health.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1415
Influence of clinical and
organizational changes in the use of
mechanical restraint. Eight-year
retrospective analysis in Mental
Health Hospital Unit of Jerez de
Frontera
J. Pérez Revuelta ∗, Y. Montero Beltran , L. Fernandez Cepillo ,
T. Molina Molina , R. Guerrero Vida , J.M. Villagran Moreno
1 Hospital del S.A.S. de Jerez, Clinical Management Unit of Mental
Health, Jerez de la Frontera Cádiz, Spain
2 Servicio Andaluz Salud, Macarena Mental Health Unit, Sevilla, Spain
∗ Corresponding author.