European Psychiatry - Volume 41 - April 2017

434 / 916

S430 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S405–S464
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0080
Clinical case: Gynecological side
effects caused by methylphenidate
A. Ballesteros ∗ . Rosero , F. Inchausti , E. Manrique , H. Sáiz ,
C. Carrión
Red de Salud Mental de Navarra, Psychiatry, Pamplona, Spain
∗ Corresponding author.
Introduction Methylphenidate drugs is prescribed in attention
deficit disorder and hyperactivity. Among its rare side effects,
include alterations in the gynecological. We report a clinical case
and review current evidence regarding the tolerability this drug in
this area.
Methods We performed a PubMed search of articles published
in English of different types (case reports or case/controls studies).
We collected the clinical practice guidelines conclusions regarding
adverse drug reactions.
Case presentation Our patient is a 14-year-old male diagnosed of
ADHD treated with methylphenidate (0.8–1 mg\kg). He developed
bilateral and asymmetric gynecomastia under this treatment plan
so a referral was made to rule out other causes of this event. After
performing several work up tests, it was concluded that this clinical
presentation was caused by methylphenidate. Hence, we initiated
crossed titration swapping this drug to atomoxetine. Four months
later, he was mentally stable and he experimented a volumetric
decrease as concerns his gynecomastia.
As regards methylphenidate, in 2009 a couple of cases in which
alterations in the sexual sphere presented with the oros presenta-
tion were reported. There are series of reported pharmacological
side effects (gynecomastia) and also denoted an improvement of
the same months after drug discontinuation.
Conclusions Gynecological clinic secondary to the use of psy-
chotropic drugs in ADHD is uncommon. In line with our case, the
current evidence suggests a drug suspension as adverse effects are
usually reversible (although itmay take severalmonths to complete
recovery). Further studies are needed to understand the mecha-
nisms underlying these tolerability issues.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0081
Clinical case: Phelan–McDermid and
pharmacological management
A. Ballesteros ∗, Á.S. Rosero , F. Inchausti , E. Manrique , H. Sáiz ,
C. Carlos , Z. María
Red de Salud Mental de Navarra, Psychiatry, Pamplona, Spain
∗ Corresponding author.
Introduction The Phelan–McDermid syndrome is a chromosomal
disorder consisting of a selection on chromosome 22q13.3 associ-
ated psychiatric and emotional level, behavioral and traits of autism
spectrumdisorders. During the neurodevelopmental such chromo-
somal deletion, which associated with haplo insufficiency Shank 3
causes alterations in the synaptogenesis altering the balance of acti-
vating and inhibitory transmission. Throughout the various studies,
it is considered that this syndrome has a psychiatric disorder bipo-
lar like.
Case presentation Here, we present s 13-year-old female diag-
nosed with autism spectrum disorders in childhood and presented
regression with catatonia features and behavioral disorders. Inter-
estingly, she presented mutation/microdeletion of the SHANK3
gene, inducing a premature stop codon in exon 21. Different
pharmacological treatments (antipsychotics at high doses and
benzodiazepines) failed to improve clinical symptoms and lead
to multiple adverse events. In contrast, lithium therapy reversed
clinical regression, stabilized behavioral symptoms and allowed
patients to recover their pre-catatonia level of functioning. After the
first menstruation there was a cycling psychiatric worsening with
a similar clinical pattern so risperidone as adjunctive therapy. As
a result of this, this patient recovered clinical and socio-functional
stability.
Conclusions They are previous cases where there affective and
behavioral improvement after use of mood stabilizer molecules
such as valproate or lithium. There is also evidence of the bene-
fit of risperidone low to have a beneficial effect on the balance of
activatory and inhibitory transmission level doses of NMDA recep-
tors.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0082
Is there a relationship between Gilles
de la Tourette and psychosis? A case
report considering the continuum
psychosis perspective and
vulnerability model
R. Barbagelata ∗, J.E. Mu˜noz Negro
Campus de la Salud Hospital, Psychiatry, Granada, Spain
∗ Corresponding author.
Introduction There has been no evidence so far about significant
relationship between Gilles de la Tourette and psychosis. Perhaps
a continuum psychosis perspective and the vulnerability model
could improve the comprehension of our patients.
Objectives To describe a case in which motor and obsessive
symptoms evolve to schizophreniform symptoms and important
psychosocial deterioration.
Methods Single case report and literature review.
Results A 20-year-old man, with clinical record of Gilles de la
Tourette, and a psychosis episode 6months before, is brought by his
familywith a syndrome consistent inmotor retardation, whispered
speech, poor visual contact, social withdrawal, hygiene neglect,
abulia, apathy and blunted affect. In the one-year tracing concep-
tual disorganization and poor idea association are in the first place.
Within child history, we found symptoms congruent with Gilles
de la Tourette, obsessive symptoms and others that may be called
mild psychotic symptoms (which did not fit in any diagnosis at
that moment). We also found a pathological relationship between
his parents and among him, as well as a poor economic and social
condition.
Conclusions According to the continuum perspective, psychotic
symptoms could be found within the obsessive spectrum. Related
to the vulnerability model, we found in our case external fac-
tors that affected the clinical evolution: family dynamics affected,
communication deviation, social and economic impairment, social
withdrawal and vital aim loss. These factors should be attended in
first place, as they are not only related with the triggering of illness
but they also are the main way to recovery.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0083
Features of pubertal patients with
schizophrenia neurocognitive profile
Y. Barylnik ∗, S. Pakhomova , D. Samoylova , J. Abrosimova ,
E. Kolesnichenko , S. Sizov , E. Bachilo , A. Antonova , M. Deeva ,
N. Filippova