European Psychiatry - Volume 41 - April 2017

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S254 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0433
Pain perception in children with
autism (prospective study of 40 cases)
A. Kachouchi ∗ aid (Dr) .N. Fadoua . Benali
P.A. Imane . Fatiha . Fatima
1 University hospital Mohammed VI, Department Of Psychiatry,
Marrakech, Morocco
2 Avicenne military hospital, Chlid and adolescent psychiatry service,
Marrakech, Morocco
∗ Corresponding author.
Introduction Recent studies show a different mode of expression
of pain associated with disorders of verbal and nonverbal commu-
nication, body schema and some cognitive impairment in autistic
children.
The aim of our study was to evaluate the reactivity of an autistic
child in a slightly painful stimulation in a standardized situation
where there is a dual relationship with an adult.
Methods We conducted a study, on 40 children with autism. The
diagnosis of autism was established following a multidisciplinary
assessment including scale ADIR (Autism Diagnostic Interview
Revised) and ADOS (Autism Diagnostic Observation Schedule).
Severity of autism was assessed by the CARS (Childhood Autism
Rating Scale). All subjects were submitted to a pinchwith a clothes-
pin camouflaged by the palm of the hand of the examiner. The
reactivity to pain was assessed by the NCCPC (Non-communicating
children’s pain checklist).
Results All children have responded to pain, 57.5% had moder-
ate to severe pain and 42.5% had mild pain. The evaluation of the
expression of pain according to the items of the NCCPC showed that
95% of children responded with motor responses, 90% responded
with vocal productions, only half of the children (55%) presented
facial expressions and 12. 5% of the children showed physiological
indices. The analysis of the type of motor and vocal reactions was
not moving toward pain in almost all children (removal or protec-
tion of the area of the body affected, the precise location of the
painful area are almost absent in our sample).
Conclusion These results are in favor of a different mode of
expression of pain in children with autism.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0434
Mental disorders in patients with
temporomandibular pain-dysfunction
syndrome
V. Medvedev ∗, V. Frolova , Y. Fofanova
PFUR University, Chair of Psychiatry- Psychotherapy and
Psychosomatic Pathology, Moscow, Russia
∗ Corresponding author.
Introduction Maxillofacial surgeons and dentists often deal
with the phenomenon of temporomandibular pain-dysfunction
syndrome–painful condition of maxillofacial area without clear
organic pathology. Psychiatric studies of this disorder are almost
lacking. The aim of this study was to determine the prevalence of
psychiatric disorders in patients with temporomandibular pain-
dysfunction syndrome and to define the psychiatric diagnosis
(ICD-10).
Methods Study sample consists of 57 patients (44 women and 13
men) with temporomandibular pain-dysfunction syndrome aged
older than 18 years, who gave inform consent. The study used clin-
ical psychopathological, psychometric (HADS, HDRS, State-Trait
Anxiety Inventory, Hypochondria Whitley Index, Visual Analog
Scale for Pain).
Results Psychiatric disorderswere revealed in 48 patients (84.2%)
with temporomandibular pain-dysfunction syndrome–39 women
and 9 men aged 18-65 years (mean age 39.6 ± 15.4 years). Affec-
tive disorders was diagnosed in 56.3%, personality disorders in
20.8%, schizotypal personality disorder in 12.5% and schizophrenia
in 10.4%. Among affective pathology mild and moderate depressive
episodes prevailed (59.3%). The severity of pain (VAS) in patients
with affective disorders was higher than in patients with other
psychiatric conditions.
Conclusion This study shows high prevalence of psychiatric
disorders in patients with temporomandibular pain-dysfunction
syndrome and proves the feasibility of a psychiatrist participate
in the complex treatment of these patients. The use of psychome-
tric method allows to improve the timeliness of the detection of
patients who require further clinical psychopathological examina-
tion in order to determine the need of pharmacotherapy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0435
Burning mouth syndrome: Problem in
the mouth?
S. Petrykiv ∗, L. de Jonge , M. Arts
1 University Medical Center Groningen, Department of Clinical
Pharmacy and Pharmacology, Groningen, The Netherlands
2 Leonardo Scientific Research Institute, Department of Geriatric
Psychiatry, Groningen, The Netherlands
3 University Medical Center Groningen, Department of Old Age
Psychiatry, Groningen, The Netherlands
∗ Corresponding author.
Introduction Burning mouth syndrome (BMS) is characterized by
an intraoral burning sensation for which nomedical or dental cause
can be found. Sporadic evidence suggests that drug induced con-
ditions may evoke BMS. Intriguingly, we observed a patient who
developed BMS after induction of citalopram.
Objectives & aims A case report of patient with BMS from our
psychiatric ward will be presented here, followed by a literature
review on drugs induced BMS.
Methods Based on a recent literature search, we present a first
case report of BMS that was apparently induced in patient shortly
after beginning of citalopram. We performed a systematic search
through PubMed, EMBASE and Cochrane’s Library to find more
cases of psychotropic induced BMS.
Results Ms. A. was a 72-year old woman meeting DSM-IV diag-
nostic criteria for melancholic depression, who was observed in a
clinical setting. We started citalopram 10mg. 1dd1, with 10mg.
1dd1 increase over 7 days to 20mg, 1dd1. The following day, she
displayed a persistent burning painful sensation in the mouth.
Other than BMS oropharyngological syndromes were excluded
after consultation with qualified medical specialists. Citalopram
therapy was discontinued, and nortrilen treatment was initiated.
BMS symptoms resolved over four days. Twelve case reports have
linked BMS to the use antidepressants and anxiolytics.
Conclusion Contrasting the statement that no medical cause can
be found for BMS, we found that psychotropics may evoke the
syndrome. Compared to other psychotropic drugs, antidepressant
medication has the strongest association with BMS.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.