European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S405–S464 S459
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0173
The WHO ICD-11 classification and
diagnosis of mental disorder in people
with disorders of intellectual
development (PWDID): An
international study on clinical utility
S.E. Cooray ∗,
Dr. R. Alexander (Honorary Senior Lecturer, Consultant Psychiatrist) ,
Professor G. Weber , Professor S. Bhaumik ,
Dr. A. Roy (Consultant Psychiatrist, Chair) , Dr. M. Roy ,
Dr. A. Bakheet (Consultant Psychiatrist) , Dr. J. Devapriam ,
J. Mendis , Dr. A. Javed
1 Royal College of Psychiatrists UK, Faculty of Psychiatry of
Intellectual Disability, Radlett, United Kingdom
2 Department of Health Sciences, University of Leicester, Partnership
in Care, Leicester, United Kingdom
3 University of Vienna, Faculty of Psychology, Department of Health,
Development and Intervention, Vienna, Austria
4 Department of Health Sciences, University of Leicester,
Leicestershire Partnership NHS Trust, Leicester, United Kingdom
5 Faculty of Psychiatry of Intellectual Disability, Royal College of
Psychiatry, Coventry, United Kingdom
6 Warwickshire Partnership Trust, London, United Kingdom
7 Royal College of Psychiatrists, Faculty of Psychiatry of Intellectual
Disability, London, United Kingdom
8 University of Khartoum, Department of Psychiatry, Khartoum,
Sudan
9 Royal College of Psychiatrists UK, Faculty of Psychiatry of
Intellectual Disability, Leicester, United Kingdom
10 National Institute of Mental Health Sri Lanka, Department of
Psychiatry, Angoda, Colombo, Sri Lanka
11 Institute for Mental Health, Fountain House Institute for Mental
Health, Lahore, Pakistan
∗ Corresponding author.
Introduction Constituting 2% of the population, PWDID are a
vulnerable group with a higher prevalence of mental disorders
than the general population. ICD diagnostic criteria often rely on
adequate cognitive functioning and hence diagnosis of mental dis-
orders in PWDID can be difficult, consequently leading to inequity
of treatment, prognosis and stigma. Our study critically analysed
the available evidence base and explored the feasibility of applying
modified diagnostic criteria within the context of cumulative iter-
ative iteration. We present the outcome using diagnosis of DID and
anxiety disorder as examples.
Aims Address current shortcomings in ICD classification
regarding PWDID by contributing effectively to the WHO ICD-
11 consultation process in collaboration with international
stakeholders.
Objectives Facilitate accessibility of ICD-11 criteria for diagnosis
of mental disorders capable of engendering robust evidence based
epidemiological data and healthcare in PWDID.
Methods We evaluated current evidence via a systematic litera-
ture search utilising PRISMA guidelines and developed pragmatic
guidelines to adapt ICD diagnostic criteria in PWDID. A brief
screener [Glasgow Level of Ability and Development Scale (GLADs)]
for detecting DID was also studied internationally within the con-
text of clinical utility (n = 136).
Results The evidence base relating to mental disorders in PWDID
is poor, significantly hampered by difficulties in applicability of
diagnostic criteria. The GLADs appears to be a promising screening
tool with good clinical utility for detecting disorders of intellectual
development (DID) particularly where resources are scarce.
Conclusions Pragmatic modifications to ICD-11 diagnostic crite-
ria and the GLADS tool facilitates its clinical utility for PWDID and
contributes significantly to enhancing research based evidence,
and, ultimately their health access and well-being.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0174
Body dysmorphic disorder:
Classification challenges and variants
De Uribe-Viloria∗ lonso-Sanchez , S. Cepedello Perez ,
M. Gomez Garcia , M. De Lorenzo Calzon , H. De La Red Gallego ,
A. Alvarez Astorga , G. Medina Ojeda ,
F. De Uribe Ladron De Cegama
Hospital Clinico Universitario De Valladolid, Psychiatry, Valladolid,
Spain
∗ Corresponding author.
Introduction The main feature of body dysmorphic disorder
(BDD) is impairing preoccupation with a physical defect that
appears slight to others. Previously, its delusional and nondelu-
sional variants were sorted in two separate categories, but owing
to new data suggesting that there are more similitudes than differ-
ences between them, DSM-5 now classifies both as levels of insight
of the same disorder.
Objectives To enunciate the similarities and differences between
the two variants of BDD.
Aims To better understand the features and comorbidity of BDD,
so as to improve its management and treatment.
Methods Taking DSM-5 and DSM-IV-TR as a reference, we have
made a bibliographic search in MEDLINE (PubMed), reviewing
articles no older than 5 years that fit into the following key-
words: body dysmorphic disorder, delusions, comorbidity, DSM-IV,
DSM-5.
Results Both the delusional and nondelusional form presented
many similarities in different validators, which include family and
personal history, pathophysiology, core symptoms, comorbidity,
course and response to pharmacotherapy.
Conclusions The new classification of delusional and nondelu-
sional forms of BDD as levels of insight of the same disorder, which
places them closer to the obsessive-compulsive spectrum than to
the psychotic one, not only improves treatment options, but also
reinforces the theory that delusions are not exclusive of psychotic
disorders, setting a precedent for the understanding and classifica-
tion of other disorders with delusional/nondelusional symptoms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0175
Underestimation of autism spectrum
disorders according to DSM-5 criteria:
A pilot study
R. Ferrara ∗ Esposito
1 École doctorale de Lausanne, Department of Biology and Medicine,
Roma, Italy
2 Università “Sapienza” Roma, Medicina sociale, Roma, Italy
∗ Corresponding author.
Introduction Recent studies on autism concern the number
of individuals diagnosed with pervasive developmental disorder
(PDD) according to DSM-IV-TR who may no longer qualify for diag-
noses under the new DSM-5 autism spectrum disorder (ASD). ASD
is diagnosed using the impairments in two dimensions:
– the social and communication dimension;