European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S405–S464 S425
Results Ninety-four percent of patients are taking mood sta-
bilizer treatment (68% lithium, 24% valproate, 1% and 1%
carbamazepine and lamotrigine). Four percent take lithium and
valproate in combination. Forty-eight percent of patients are tak-
ing some antipsychotic (atypical about 90%). Of these, only 10% in
injectable form, and 5% take both oral and injectable antipsychotics.
Conclusions The diminished use of injectable antipsychotics, well
below recent publications, draws the attention. You can probably
explain this lowproportion of injectablemedication becausewe are
generally dealing with stable patients with a long-term disorder.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0064
Misdiagnose bipolar disorder: About a
case report
C. Novais ∗, M. Marinho , M. Mota Oliveira , M. Braganc¸ a ,
A. Côrte-Real , S. Fonseca
Centro Hospitalar de São João, Psychiatry Department, Clínica de
Psiquiatria e Saúde Mental, Al. Prof. Hernâni Monteiro, Portugal
∗ Corresponding author.
Introduction Early stages of bipolar disorder are sometimes mis-
diagnosed as depressive disorders. This symptomatology can lead
to misinterpretation and under diagnosis of bipolar disorders.
Objectives/aims To describe a patient with a new diagnosis of
bipolar disorder after 23 years of psychiatric care.
Methods We report a case of a 66-year-old man, with a previ-
ous psychiatric diagnosis of recurrent depressive disorder for the
last 23 years, after a hospitalization in a psychiatric inpatient unit
because of a major depressive episode. In subsequent years, he
was regularly followed in psychiatric consultation with description
of recurrent long periods of depressed mood requiring therapeu-
tic setting, alternating with brief remarks of not valued slightly
maladjusted behaviour. At 65, he came to the emergency roompre-
sentingwith observable expansive and elevatedmood, disinhibited
behaviour, grandiose ideas and overspending, leading to his hospi-
talization with the diagnosis of a manic episode. In the inpatient
unit care, we performed blood tests, cranial-computed tomogra-
phy (CT) and a cognitive assessment. His medication has also been
adjusted.
Results Laboratory investigations were unremarkable. Cranial-
CT showed some subcortical atrophy of frontotemporal pre-
dominance, without corroboration by the neuropsychological
evaluation. The patient was posteriorly transferred to a residen-
tial unit for stabilization, where he evolved with major depressive
symptoms that needed new therapeutic adjustment. Later he was
discharged with the diagnosis of bipolar disorder.
Conclusions Our case elucidates the importance of ruling out
bipolar disorder in patients presenting with depressive symptoms
alternating with non-specific maladjusted behaviour, which some-
times can be a challenging task.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0065
A case report of comorbid
Munchausen type factitious disorder
with bipolar II disorder
A. Kotsi ∗, P. Argitis , A. Chimarios , P. Platari , C. Kittas ,
A. Karabas , E. Vantzios , K. Paschalidis , V. Mavreas
1 University Hospital of Ioannina, Psychiatric Clinic, Ioannina, Greece
2 Psychiatric Hospital of Thessaloniki, 2nd Psychiatric Clinic,
Thessaloniki, Greece
∗ Corresponding author.
We present an uncommon case of a 46-year-old woman suffering
from Munchausen type factitious disorder comorbid with bipolar
II disorder.
The patient was diagnosed with major depression disorder 4 years
ago during her hospitalization in the internal medicine department
after a suicide attempt and SSRI was prescribed.
Since the onset of the disorder the patient started complaining for
physical symptoms, migrating from hospital to hospital seeking
pathological and surgical interventions, fabulating her medical his-
tory. In the last 3 years, the patient visited the emergency room of
university hospital of Ioannina 85 times and she was hospitalized
in internal medicine or surgical clinics 16 times, performing 19CR,
11 CT and 4MRI.
Many times, she turned to the police suing the treating doctors.
During her hospitalizations she refused psychiatric evaluation.
Twelve months ago the patient finally visited a psychiatrist, bipo-
lar II disorder was diagnosed and administrated quetiapine with
good results to both, mood and ER visits (7 visits in one year and 1
hospitalization).
During the analysis of her mood switches, we observed non-
euphoric hypomanic episodes and association of the hypomanic
phase with the factitious behavior.
This case report reinforces the importance of maintaining a clini-
cal suspicion of major psychopathology coexistence with factitious
disorder.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0066
Social cognition and bipolar disorder:
A preliminary study
F.D.R. Ponte ∗, T.D.A. Cardoso , F.M. Lima , M. Kunz ,
A.R. Rosa
1 UFRGS, Psychiatry, Porto Alegre, Brazil
2 UFRGS, Pharmacology, Porto Alegre, Brazil
∗ Corresponding author.
Aim To assess the clinical outcomes associated with social cog-
nition impairment in euthymic patients with bipolar disorder.
Method It was a cross-sectional study with convenience sample.
The diagnose of bipolar disorder was performed by psychiatrist,
using DSM-IV criteria, at bipolar disorder program – Hospital de
Clinicas de Porto Alegre (Brazil), where the sample was recruited.
The social cognition was assessed by psychologists using the Read-
ing the Mind in the Eyes Test.
Results We included 46 euthymic BD patients: BD I (n = 39),
women (n = 32), age (49.11± 13.17), and years of education
(10.56± 3.80). Patients with social cognition impairment were not
different of patients without social cognition impairment regarding
socio demographic factors (gender, age, educational level, mari-
tal status, and employment status). Patients with social cognitive
impairment showed higher rates of BD I patients (P = 0.036) and
higher proportion of hospitalization in the first episode (P = 0.033),
as compared to patients without social cognition impairment.
Conclusion This is a preliminary study demonstrating that BD
patients with social cognition impairment showworse clinical out-
comes. Severe BD onset seems to be an important predictor of
social cognition impairment. However, more studies are needed
investigating social cognition impairment in subjects with bipolar
disorder.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.