European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S405–S464 S427
University of Medicine and Pharmacy “Victor Babes”, Neuroscience,
Timisoara, Romania
∗ Corresponding author.
Introduction Differentiating between bipolar (BD) and schizoaf-
fective disorder (SAD) can be challenging, especially during early
stages of the illness.
Objectives Comparing clinical profiles and socio-demographic
characteristics of patients diagnosed with BD and SAD.
Methods The study, conducted between 2014–2016, included 67
inpatients from the Timisoara Psychiatric Clinic, diagnosed with
either BD (n = 35) or SAD (n = 32), according to ICD-10 criteria.
The following parameters were analyzed: number of episodes,
number of times hospitalized, onset age, frequency and nature of
psychotic symptoms, family history of psychiatric disorders and
socio-demographic characteristics (age, sex, marital status). Data
were obtained by direct interview and patient files. Symptom
severity was measured with Brief Psychiatric Rating Scale (BPRS).
Results There were no significant differences between the two
samples regarding age or sex distribution. Schizoaffective patients
were more frequent unmarried (P = 0.007). Onset age was signifi-
cantly lower in SAD patients (22.41 years for SAD, 28.36 years for
BD). SAD patients had the highest number of episodes and needed
more frequent hospitalization. Bipolar patients had higher per-
centage of family history of affective disorders when compared
to schizoaffective patients (41% versus 36%). Hallucinations were
more frequently found in schizoaffective patients than in bipolar
patients (P = 0.004). We found no significant differences between
the two samples regarding the presence or the type of delusions.
The SAD sample had significantly higher BPRS total scores than
bipolar patients (P= 0.035).
Conclusions Although this study revealed numerous similarities
between BD and SAD, it also identified differences that may be
helpful in establishing the correct diagnosis.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0071
Temporality in mania:
Phenomenological, neurobiological
and therapeutic consequences
M. Schwartz ∗ Moskalewicz chwartz Wiggins
1 Texas A&M Health Science Center College of Medicine, Round Rock,
Texas, USA
2 Psychiatry and Humanities in Medicine, West Lake Hills, USA
3 Texas A&M Health Science Center College of Medicine, Psychiatry,
Round Rock, TX, USA
4 George Washington University College of Medicine, Psychiatry,
Washington DC, USA
5 University of Louisville, Philosophy, Louisville, Kentucky, USA
∗ Corresponding author.
Manic disturbances of temporality are underemphasized in
present-day accounts. For example, they are not included among
criteria for manic episodes in DSM or ICD. Nonetheless, as already
claimed by Binswanger (1964), aberrant temporality is core to
the disorder. Persons with mania live almost exclusively in the
present and hardly into the future. Especially in the larger scheme
of things, their future is already here. There is no “advancing,
developing or maturing,” anticipations have been achieved, all
that I strive for is present – if you will just get out of my way!
A half century ago, Binswanger spelled out this temporal foun-
dation for mania and summed up consequences. The manic self,
not living into the future, “is not, to borrow a word, an existential
self.”
This presentationwill describe phenomenological characteristics of
such a manic self and then present correlating findings from con-
temporary neuroscience. Importantly, such findings clarify present
and future therapeutic interventions. Of critical importance is
manic chronobiology: clocks in our brains afford receptor sites for
the lithium ion. At these sites, lithium potently inhibits the cir-
cadian rhythm regulator glycogen synthase kinase 3 and alters
the biological cascade that follows. By taking a close look, we
can comprehend implications for mania as well as for treatment
with lithium: Neurobiologically, lithium disrupts manic rhythm
dysregulation and restores a more “normalized” temporality. The
consequence is no less than the return of the existential self.
A receptor mechanism of action for lithium additionally portends
future specific and safer treatment options “after lithium.”
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0072
Putting it all together: How
disordered temporality is core to the
phenomenology and neurobiology of
mania
M. Schwartz ∗, E. Schwartz , M. Moskalewicz
1 Texas A&M Health Science Center College of Medicine, Psychiatry
and Humanities in Medicine, West Lake Hills, USA
2 George Washington University College of Medicine, Psychiatry,
Washington DC, USA
3 University of Oxford, Faculty of Philosophy, Oxford, United Kingdom
∗ Corresponding author.
Disturbances of temporality in mania, underemphasized in
present-day accounts, are nonetheless core to understanding both
the phenomenology and the neurobiology of the disorder:
– phenomenology: already in 1954, Binswanger had articulated
that persons with mania live almost exclusively in the present
and hardly at all into the future. Especially in the larger scheme of
things, their future is already here. There is no “advancing, devel-
oping or maturing,” anticipations have already been achieved, and
all that I strive for is basically present if you will just get out of my
way! A half century ago, Binswanger summed up the consequence
of manic temporality: the manic self, not living into the future, “is
not. . . an existential self.” This presentation will further describe
phenomenological characteristics of such a self in mania;
– findings from contemporary neuroscience correlate remark-
ably well with the above phenomenology, importantly clarifying
present and future therapeutic interventions. Of critical impor-
tance in mania, clocks in our brains afford receptor sites for the
lithium ion. Once bound to the receptor, lithium potently inhibits
the circadian rhythm regulator glycogen synthase kinase 3 (GSK3)
and profoundly alters the biological cascade that it initiates. In this
presentation, by taking a close look, step-by-step, we will clarify
how lithium disrupts mania rhythm dysregulation and restores a
more “normalized” temporality. The consequence is no less than
the return of the existential self. We will also briefly glance, in this
presentation, at the window that lithium cellular efficacy offers for
treatment options “after lithium.”
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0073
Antidepressants induced mania in
patients with diagnosed unipolar
depression: Case report and literature
discussion
M. Silva ∗, M. Ribeiro , A.R. Figueredo , L. Castelo Branco
1 CHTMAD – E.P.E., Psychiatry Department, Felgueiras, Portugal
2 CHMAD – E.P.E., Psychiatry Department, Vila Real, Portugal