European Psychiatry - Volume 41 - April 2017

473 / 916

25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520 S469
EV0201
The very special way of eating for a
man with a very short bowel
syndrome and an ileostomy
I. Christodoulou ∗, F. Tsiompanou , N. Peitsidis , G. Dounias ,
I. Tsakiridis , V. Kelesidou , A. Paraskevas
G. Papanikolaou General Hospital, B’surgical Department,
Thessaloniki, Greece
∗ Corresponding author.
Aim of this study is to present the extraordinary case of a 45-year-
old man with very short bowel syndrome and ileostomy, who is
currently engaged in a long hospitalizationmodule of life because of
the constant need for parenteral nutrition which he has developed
due to Crohn’s disease treatments. Case presentation: A Russian
young man, with low education, a borderline intellectual function-
ing and a low socio-economic status, was operated numerous times
due to breakouts of Crohn’s disease. For the last year, he stays
mostly in the hospital. Practically he needs constant intravenous
parenteral nutrition due to his very short bowel syndrome, other-
wise he cannot live outside the hospital. The patient was advised
by his surgeon to eat any kind of food but had the limitation to
drink not more than 500ml of water per day, (the rest of water was
taken IV). During the first months, the patient seemed willing to
do anything needed, but when he started to get tired, he started
to drink more than 2 litres of water per day, ignoring his doctor’s
advice. One of his main problems was that he was able to see that
eggs, meat and other food he was eating were very soon appearing
in the ileostomy bag and this led him to think that he would die
soon. Neither the patient himself nor his wife and relatives asked
for help from supervisory bodies of the National Health System and
are not at all aware of his need for transplantation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0202
The interesting case of a woman who
gets eating satisfaction through a
gastrostomy tube
I. Christodoulou ∗, F. Tsiompanou , N. Peitsidis , G. Dounias ,
I. Tsakiridis , V. Kelesidou
G. Papanikolaou General Hospital, B’surgical Department,
Thessaloniki, Greece
∗ Corresponding author.
Aim of this study is to show how people are getting accustomed
to alternative ways of eating in cases of illness and eating disabil-
ity. Case report presentation: A 60-year-old woman was admitted
in the Intensive Care Unit due to an acute upper airway obstruc-
tion. The woman was tracheostomized before entering the ICU and
presented a large goiter and thus she was operated two days later
and a thyroidectomy was executed. Post-operatively, it was diag-
nosed that a tracheo-esophageal fistulawas present and the patient
was obliged to live with a gastrostomy for months. During the first
attempts for eating via a nasogastric tube at first and later via a gas-
trostomy, she had various problems with enteric nutrition, most
prominent of which was osmotic diarrhea. The patient asked soon
to stop eating enteral nutrition and preferred to eat food of her
choice according to her appetite. She insisted that she was able to
receive eating satisfaction, even by eating through a gastrostomy,
because her bowels gave to her a positive feedback with the form
of abdominal comfort after lunches. She said that the only food that
would not harm her was real food and she chose food on her own
with the help of her sister. This woman never presented any kind of
psychiatric disorder in the past, neither she lost her courage inside
hospital, although she was forced to live with a tracheostomy and
a gastrostomy for more than 6 months.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0203
Psychogenic headache and analysis of
65 cases with craniocervical junction
malformation operated
S.C. Vasconcelos ∗ M.A. Holanda E. Melo . Silva
S.A. Araújo-Neto , E.J. Silva Neto
1 Federal University of Paraíba UFPB, Public Health Nursing, João
Pessoa, Brazil
2 Federal University of Paraíba UFPB, Department of internal
medicine, João Pessoa, Brazil
3 Federal University of Paraíba UFPB, Department of anatomy, João
Pessoa, Brazil
∗ Corresponding author.
Introduction Craniocervical junction (CCJ) malformations are
common pathologies in Northeast of Brazil, predominating Basilar
Invagination (BI) and Chiari Malformation (CM), sometimes asso-
ciated to syringomielia (SM).
Aims Analyse the headache pattern in cases with CCJ malforma-
tion operated.
Methods Retrospective study of 65 cases with CCJ malformation,
operated between 1994 and 2015, with analysis of headache pat-
tern.
Results Of 65 cases operated, 29 patients (44.6%) had BI and CM,
26 (40%) had BI, CM and SM, 2, only CM and 1, CM and SM. Of
all patients, 39 (49.2%) presented headache and 43 (66.1%), nuchal
pain. Among those who presented BI and CM, 12 (41.4%) presented
headache and nuchal pain association. Of 26 with BI, CM and SM
associated, 11 (42.3%) presented headache and nuchal pain asso-
ciation. We notice yet the presence of brachycephaly in 44 cases
(67,7%) and brevis collis in 42 (64.6%). Headache, nuchal pain,
brachycephaly and brevis collis were all present in 9 patients (31%)
of BI and MC group, and in 8 (30.8%) of IB, CM and SM group.
Conclusions Several denominations referred to psychogenic
headache: muscle contraction headache, stress headache and,
finally, tension headache, well defined in the classification of
International Headache Society (IHS) with clear diagnosis crite-
ria. Bilateral location, predominantly occipital, is an important
differential diagnosis with holocranial headache or occipital sec-
ondary to craniocervical malformations, and when associated to
brachycephaly and brevis colis, should be carefully investigated.
Diagnostic failure in symptomatic or neurological deficit’ patients
can sequelae due to chronic compression of structures adjacent to
CCJ.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0204
Delusional hyperthyroidism-A case
report
M. Cotter ∗ omingues mado assano
1 Centro Hospitalar Médio Tejo, Psiquiatria, Guimarães, Portugal
2 Centro Hospitalar Médio Tejo, Psiquiatria, Leiria, Portugal
3 Centro Hospitalar Médio Tejo, Psiquiatria, Coimbra, Portugal
∗ Corresponding author.
Introduction Disorders of endocrine function are among themost
common etiology of psychiatric illness.
The link between psychosis and hyperthyroidism is still poorly
report an unusual presentation of hyperthyroidism
as a psychotic state. Careful history, physical examination, and lab-
oratory investigation, including thyroid function tests, should be