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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169


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Psychiatric symptomatology as the

initial presentation of brain cancer

A. Fornelos

, P. Macedo , A. Figueiredo , M. Roque

Psiquiatria e Saúde Mental, Centro Hospitalar Trás-os-Montes e Alto

Douro, Vila Real, Portugal

Corresponding author.

Glioblastoma multiforme is the most common primary adult brain

tumor. Clinically, non-specific psychiatric symptoms may arise

as their first and only manifestation, prior to any neurological

deficits. The most form of psychiatric presentation of neurologi-

cal diseases are depressive complaints, although these may also be

accompaniedby behavioral and/or cognitive, anxious andpsychotic

symptoms. By explaining this case report we aim to emphasize the

importance of considering the diagnosis of an organic brain dis-

ease, even when only primary psychiatric symptoms are evident.

The bibliographic research was made using PubMed and Scielo,

and analysis of the electronic patient process. Man of 68 years

with a history of hypertension, nephrectomy, splenectomy and left

brachial plegia after a car accident. He had been previously seen by

a psychiatrist for a 6-month history of depressive symptoms, which

had been successfully treated. He later developed new behavioral

changes such as heteroaggressiveness, social maladjustment and

disfasia, for which he was sent to the emergency room. Brain-CT

scan displayed a left front temporal expansive injury. Admitted

to the Neurology Department for further diagnostic investigation.

Subsequent MRI, detected massive infiltrative lesion with signifi-

cant mass effect and cystic/necrotic area. The anatomopathology

disclosed a glioblastoma grade IV. This case reinforces the impor-

tance of carrying a imagiologic workup in cases like this, especially

on patients with atypical presentation of psychiatric symptoms.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Differential effects of MGluR5

receptor blockade on behavior,

schizophrenia-relevant gene

expression and neuronal activation

patterns from development to aging


P. Gass

1 ,

, D. Inta


, A. Luoni


, M.A. Riva



Psychiatry and Psychotherapy, Central Institute of Mental Health,

Mannheim, Germany


University of Milan, Center of Neuropharmacology, Milano, Italy

Corresponding author.


The glutamate system is implicated both in mood

disorders and schizophrenia. Mice lacking metabotropic mGlu5

receptors (mGluR5 KO) display schizophrenia-like abnormalities.

Additionally, mGluR5 antagonists represent promising alternative

anxiolytics/antidepressants. However, the underlying age-specific

molecular/cellular mechanisms are only partially understood.


We aimed at identifying molecular alterations associ-

ated with a genetically induced mGluR5 deletion, which results in

a schizophrenia-like phenotype. Additionally, we investigated age-

specific effects of mGluR5 antagonists on emotional behaviour and

c-fos activation.


For analysis of mRNA and protein levels we per-

formed Real-time RT-PCR and Western blot investigations of

brains from mGluR5 KO and wild-type mice. Additionally we

used classical behavioral tests for determining anxiety- and

depression-like changes triggered by the mGluR5 antagonist

2-Methyl-6-(phenylethynyl)pyridine (MPEP). Finally, we used pro-

filing of c-Fos expression, as marker of neuronal activity, induced

by MPEP from postnatal day 16 (P16) to adulthood (P90).


We found reduced expression levels of reelin, GAD65,

GAD67, parvalbumin, as well as NMDA and AMPA receptor

subunits in mGluR5 KO mice, especially in the prefrontal cor-

tex (PFC). We measured age-specific alterations in emotional

behaviour of mGluR5 KO mice, with marked increase of anxi-

ety during aging. There was a remarkably conserved activation

of the paraventricular nucleus of the hypothalamus, implicated

in stress regulation, by MPEP at all investigated ages, whereas

the extended amygdala was specifically activated in adulthood



Our animal data provide new insights into the poten-

tial role of mGluR5 in neurochemical and behavioural changes

associated with schizophrenia and mood disorders during the life-


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Influence of personal meaning

organization and 5-HTTLPR genotype

on cortisol stress reactivity in healthy


A. Marini

1 ,

, C. Turchi


, E. Skrami


, R. Gesuita


, M. Giordani



B. Nardi



Psychiatric Unit, Department of Experimental and Clinical Medicine,

Università Politecnica delle Marche, Ancona, Italy


Section of Legal Medicine, Department of Biomedical Sciences and

Public Health, Polytechnic University of Marche, Ancona, Italy


Center of Epidemiology, Biostatistics and Medical Information

Technology, Polytechnic University of Marche, Ancona, Italy


Psychiatric Unit, Department of Experimental and Clinical Medicine,

Polytechnic University of Marche, Ancona, Italy

Corresponding author.


Reactivity to acute psychosocial stress in the frame-

work of a physiological multidimensional pattern affects several

individual-level systems that include genetic factors and features

related to personality development. The 5-HTTLPR genotype has

been implicated in themodulation of susceptibility to environmen-

tal stimuli.


In the present study, 91 healthy young women were

investigated (i) for their reactivity to a standardized psychosocial

laboratory stressor (TSST), as measured by changes in salivary cor-

tisol; (ii) in terms of 5-httlpr genotype and (iii) in terms of their

personality profile according to the post-rationalist personal mean-

ing organizations (PMOs), which are considered as adaptive modes

of response to environmental stressors.


Participants were divided into three 5-HTTLPR geno-

type groups (s/s; s/l, and l/s). The quantitative and qualitative

variables that may affect circulating cortisol were compared among

the three groups. Amultiple linear quantile regression analysis was

then performed to evaluate the effect of the personality profile, as

Outward/Inward PMO, and 5-HTTLPR genotype on themedian level

of cortisol, considered as dependent variable.


Comparison of the variables that may affect circulating

cortisol no significant differences. Salivary cortisol changed signif-

icantly in the course of the TSST. Reactivity to stress was affected

by personality profile and the 5-HTTLPR genotype and also by body

mass index and age.