European Psychiatry - Volume 41 - April 2017

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S428 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S405–S464
3 CHTMAD – E.P.E., Psychiatry Department, Vila Real, Portugal
∗ Corresponding author.
The association of antidepressant therapy with mania in people
being treated for unipolar depression reinforces the importance
of further clarification of this effect, since it has a huge implica-
tion in treatment approach and outcome. With this main objective,
authors propose to make retrospective sociodemographic and clin-
ical characterization of a group of patients with antidepressant
inducedmania in diagnosed unipolar depression, admitted in inpa-
tient unit of Psychiatry and Mental Health Department of Centro
Hospitalar de Trás-os-Montes e Alto Douro. Authors also aim to
identify features that may increase the risk for mania or hypoma-
nia in people who present with an episode of depression, which can
guide clinical orientation and improve outcome.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0074
Clinical differences between unipolar
and bipolar depression
S. Smaoui ∗ Charfi , M. Maâlej Bouali , L. Zouari , N. Zouari ,
J. Ben Thabeut , M. Maâlej
Hedi Chaker University Hospital, Psychiatry, Sfax, Tunisia
∗ Corresponding author.
Introduction Epidemiological studies indicate that the majority
of patients with bipolar disorder are diagnosed many years later.
Unipolar depression represents the most frequent misdiagnosis.
Objectives This study aimed to examine the symptom profiles
of depressed patients in order to identify clinical specificities of
bipolar depression.
Methods A total of 31 depressed patients were recruited from
psychiatry outpatient department of Hedi Chaker university
hospital in Sfax (Tunisia), during October and November 2016.
Unipolar and bipolar patients were compared on a broad range of
parameters, including sociodemographic and clinical character-
istics. Depressive symptoms were rated using the Montgomery
Asberg Depression Rating Scale (MADRS) and Bipolar Depression
Rating Scale (BDRS).
Results The total sample comprised 31 patients with 16 men
and 15 women. It involved 20 with unipolar depression and 11
with bipolar depression. Patients with bipolar depression hadmore
family history of bipolar disorder (P= 0.037) and a triggering fac-
tor had been identified less often ( P= 0.03). MADRS scores were
similar in bipolar and unipolar patient (median score 28.22 versus
28.36; P = 0.964). BDRS scores were significantly higher in bipolar
depressed patients (median score 33 versus 25; P = 0.01). Themixed
subscale (item 16 to 20) scores were particularly higher (median
6 vs. 1.2; P≤ 0.01) especially concerning irritability (P = 0.001).
Increased motor drive (P = 0.004) and agitation (P = 0.008).
Conclusion Our findings suggest that the presence of mixed
symptoms is very important to recognize depressed patients as
having a bipolar disorder. We also recommend routine use of the
BDRS for patients presenting for treatment of depression.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0075
A case report of patient who had two
manic episodes with psychotic
features induced by nasal
decongestant
A. Kandeger , R. Tekdemir ∗, B. Sen , Y. Selvi
Selcuk University, Department of Psychiatry, Konya, Turkey
∗ Corresponding author.
Objective Phenylephrine, pseudoephedrine and ephedrine are
the sympathomimetic drugs that have been used most com-
monly in oral preparations for the relief of nasal congestion. These
drugs stimulate the central nervous system that is affected by
the alpha and beta adrenergic agonism. Sympathomimetic agents
used in the treatment of flu and common cold with ephedrine and
pseudoephedrine are case reports. That the manic and psychotic
episodes are triggered. In this article, we would like to present a
bipolar manic disorder with two manic episodes and both of them
triggered by influenza drugs.
Case A 25-year-oldman patient was admitted to psychiatric out-
patient clinic with increasing complaints such as increasing energy,
speaking much, decreasing sleep, increasing the libido after using
the flu drug that prescribed to him containing phenylephrine. Also,
2 years ago, he has manic attack triggered after the flu drug.
Discussion In recent years the study of epilepsy and bipolar dis-
order in common suggests that bipolar disorder may affect the
kindling phenomenon. In our case, two of reasons in the neurobio-
logy of developingmanic attacks the kindling phenomenon is likely
to be effective. First, the possibility of using cold medicine contain-
ing ephedrine or pseudoephedrine in the first manic episode, in
the second manic episode having spent the attack with FAQ stimu-
lant effect of lower phenylephrine. Second, in the first episode after
using the 5–6 tablets developingmanic attacks. In the second attack
to be triggered with just 2 doses may indicate the effect of kindling.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
e-Poster viewing: child and adolescent psychiatry
EV0076
Posttraumatic stress disorder
symptoms and related factors after
circumcision operation performed
with general or local anesthesia
B. Kozanhan , C. Kocao˘glu , M. Gunduz , O.F. Akca ∗
1 Meram Training and Research Hospital, Anesthesia and
Reanimation, Konya, Turkey
2 Meram Training and Research Hospital, Pediatric Surgery, Konya,
Turkey
3 Selcuk University, Pediatric Surgery, Konya, Turkey
4 Necmettin Erbakan University Meram School of Medicine, Child and
Adolescent Psychiatry, Konya, Turkey
∗ Corresponding author.
Objective Elective circumcision operation for male children can
affect their psychological status.
Aim We aimed to investigate the traumatic effect of the circum-
cision procedure and the predictive factors that could contribute to
this effect.
Method One hundred and thirty-four children who admitted to
urology and child surgery clinics to perform a circumcision pro-
cedure were included in the study. The whole group was divided
into two groups including general anesthesia (GA) ( n = 71) and
local anesthesia (LA) (n = 63) groups. The procedure was performed
under general and local anesthesia in the relevant groups. All of
the participants filled the Child Depression invenTory (CDI), State
(SA), and Trait (TA) Anxiety andChildhoodAnxiety Sensitivity index
(CASI) before the operation, and the Child Posttraumatic Stress
Reaction index (CPSRI) 1 month after the operation.
Results CDI, CASI and TA scores of the children were similar
in both groups, however, SA scores of the LA group were higher
than GA group (P< 0.001), and CPSRI scores of the GA group were