European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S405–S464 S419
Conclusions The result suggests the involvement of myelin dam-
age in the pathogenesis of mania, Li offers protection against such
damage.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0046
Valproate used during pregnancy:
What should be done?
J.N. Beezhold ∗ agard arabajiu
1 Norfolk and Suffolk NHS Foundation Trust, Central Norfolk Acute
Service, Norwich, United Kingdom
2 UEA, Norwich Medical School, Norwich, United Kingdom
3 Norwich School, Sixth form, Norwich, United Kingdom
∗ Corresponding author.
Background Sodium valproate can cause serious developmental
disorders in unborn babies if taken while pregnant, especially in
the first trimester.
Aim To review recent literature and advice or treatment for
women who have or are using valproate whilst pregnant.
Design Literature review.
Methods Literature review using Pubmed with search terms:
‘bipolar’; ‘pregnant’; ‘valproate’ and following up references.
Results There are several small methodologically flawed studies
that attempt to address this question and will be reprised. Three
key population register studies found high rates of malformations.
A retrospective study of longer-term outcomes found high rates of
developmental issues. There are several relevant treatment guide-
lines, including from the National Institute for Health and Clinical
Excellence (NICE). There is a 40% risk of developmental disorder, a
10% risk of congenital malformations and a 3% risk of IQ deteriora-
tion.
Conclusions Avoid valproate in women of childbearing age if at
all possible, and consider effective contraception if used. If already
pregnant then consider, with involvement from the patient, stop-
ping or minimizing the dose of sodium valproate. Assess the risks
and benefits of using sodium valproate during pregnancy versus
stopping the treatment for the first trimester as symptoms of the
disorder may return. Seek advice from a perinatal psychiatrist. Add
5mg of folic acid daily for the remainder of the pregnancy.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0047
Assessment of psychotic symptoms in
bipolar disorder
F. Cazan ∗, R. Paunescu , A. Tamas
1 Clinical Emergency Hospital for Children Cluj-Napoca, Psychiatry,
Cluj-Napoca, Romania
2 University of Medicine and Pharmacy Cluj-Napoca, Neurosciences,
Cluj-Napoca, Romania
∗ Corresponding author.
Introduction Bipolar disorder is a disabling condition character-
ized by the presence of manic, depressive, hypomanic or mixed
episodes, affective symptoms that may coexist with several types
of psychotic features.
Objectives The purpose is to evaluate the frequency of psychotic
symptoms among bipolar disorder.
Method The study included 55 bipolar patients admitted in the
Psychiatry Clinical Hospital from January 2012 until May 2013.
Inclusion criteria were represented by diagnosis of bipolar dis-
order, manic or depressive episode, according to DSM-IV-TR and
ICD 10 criteria. Clinical instruments used to assess the sever-
ity of the current affective episode were Young Mania Rating
Scale (YMRS) for manic patients and Hamilton Depression Rating
Scale-17 items – (HDRS) for the depressive ones. Psychotic symp-
toms were evaluated with the Brief Psychiatric Rating Scale-18
items – (BPRS).
Results Out of the 55 patients, 32 had psychotic symptoms upon
admission to the hospital. BPRS results showed delusions of guilt,
inutility, hypochondriac and nihilistic delusions for the depressed
patients. Delusions of grandiosity and megalomania accounted for
most of psychotic symptoms in manic patients. A smaller number
of patients showed delusions of invention and reform. Perception
disturbances such as auditory hallucinations were present in both
diagnosis categories but in a higher percentage in depressive bipo-
lar patients.
Conclusions Even if less frequently than in schizophrenia or
schizoaffective disorder, psychotic symptoms are present in bipolar
disorder. They influence the general functioning and the outcome
of patients diagnosed with this illness.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0048
Profile of depression in women
attending antenatal clinics in Blantyre
District, Malawi
G. Chorwe-Sungani ∗, J. Chipps
1 Kamuzu College of Nursing, Community and Mental Health,
Blantyre, Malawi
2 University of the Western Cape, School of Nursing, Bellville, South
Africa
∗ Corresponding author.
Introduction Depression is one of major health problems affect-
ing pregnant women in low resource settings. It can lead to poor
uptake of antenatal services. Data about prevalence of antenatal
depression and associated risk factors remain scanty in Malawi.
The study settings were eight selected antenatal clinics in Blantyre
district, Malawi. The aim of this study was to assess prevalence of
antenatal depression and associated risk factors among pregnant
women attending antenatal clinics in Blantyre district, Malawi.
Methods This was a quantitative study which used a random
sample of 97 pregnant women. Ethical approval was granted by
relevant bodies. Descriptive and inferential statistics were used to
analyse data.
Results Prevalence of antenatal depression in Blantyre district
was 25.8% (n = 25). Risk factors associated with antenatal depres-
sion included: “being distressed by anxiety or depression for more
than two weeks during this pregnancy”; “feeling that pregnancy
has been a positive experience”; “having a history of feeling miser-
able or depressed for two weeks or more before this pregnancy”;
“relationship with partner is an emotionally supportive one”;
“experiencing major stresses, changes or losses in the course of
this pregnancy”; “having history of physical abuse when growing
up”, and “having concerns about being or becoming a mother”.
Conclusion This study has shown that antenatal depression is
prevalent in Malawi. It suggests that psychosocial interventions
targeting pregnant women may be necessary to reduce ante-
natal depression and associated risk factors. However, further
research regarding ways for assisting pregnant women to build and
strengthen their psychosocial support structures is needed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.