European Psychiatry - Volume 41 - April 2017

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S474 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520
Objective To describe the comorbidity between PD and substance
abuse disorders.
Methods Systematic review of the literature on the subject. The
databases consulted were Dialnet, Pubmed and Cochrane.
Results The various studies allow estimating that between 65%
and 90% of subjects treated for substance abuse or dependence
have at least one concomitant PT. Studies show a higher prevalence
of Cluster C for alcohol consumption and Histrionic, Narcissistic,
Boundary and Antisocial Disorders (Cluster B) for illegal drugs,
mainly cocaine. Cluster B is the one that the literature has most
related to substance use. It is also the group in which there is
a greater predominance of impulsivity, which would be worth
remembering its role as a vulnerability factor for addictions.
Conclusions What the research has shown is that a good deal
of the problems that accompany substance use come from dys-
functional patterns of behavior that are maintained over time with
high stability and can justify, in part, both the persistence of The
addictive behavior as the difficulty of handling the patients who
present them. At present, although the high comorbidity between
TP and substance use is sufficiently documented, many questions
still remain to be solved.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0218
Treatment difficulties in the
pathology of the frontal lobe
A. Isac ∗, B. Cristina , L. Viorel
1 Children’s Emergency Hospital, Child and Adolescent Psychiatry,
Cluj-Napoca, Romania
2 “Iuliu Hatieganu” University of Medicine and Pharmacy
Cluj-Napoca, Neuroscience Department- Psychiatry and Child and
Adolescent Psychiatry Compartment, Cluj-Napoca, Romania
∗ Corresponding author.
Frontal lobe lesions may present as mood disorders, with apathy,
emotional flattening and indifference towards the environment,
refered to as “pseudodepression”. A 14-year-old adolescent is
transferred from a pediatric ward for frontal headaches, sleepi-
ness, apathy, food refusal, irritability and marked weight loss
(BMI = 14 kg/sqm). The patient has a history of Socialized Con-
duct Disorder, with extremely low compliance towards treatment.
When admitted he is cooperating partially, has an influenced gen-
eral state and refuses to drink liquids. He is sad, impulsive, with
low frustration tolerance, negativist, oppositionist, with voluntary
urine emissions and marked sleepiness. There are clinical signs
of dehydration and an intermittent convergent strabismus in the
left eye. Laboratory tests show an inflammatory syndrome, nitrate
retention, dyselectrolytemia. Neurologically: exaggerated tendon
reflexes, frust bipyramidal syndrome, slight ptosis of the left eye;
electroencephalogram–slow activity (lesion?) in left deviations. A
consult with the Infectious Disease unit renders a diagnosis of
headache syndrome and frontal sinusitis. The MRI is suggestive
for a left frontal infectious expansive process (abscess) and mas-
sive maxillary–ethmoidal–frontal sinusitis. Combined parenteral
antibiotics and pathogenetic treatment are initiated and the patient
undergoes neurosurgery with the evacuation of the tumor. A cystic
formation of 6/5/1, 5 cm, containing an opalescent yellow liquid is
found at the histopathological exam. Streptococcus spp. is iden-
tified by the bacteriological exam. The evolution is good under
treatment, with a slight accentuation of the behavioural symptoms.
This case illustrates the importance of correct differential diagnosis,
the psychiatric diagnosis being one of exclusion.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0219
Psychiatric comorbidities in temporal
lobe epilepsy: A case study
L. Jouini∗, U. Ouali , R. Zaouche , R. Jomli , Y. Zgueb , F. Nacef
Razi hospital, “A” psychiatry department, Tunis, Tunisia
∗ Corresponding author.
Introduction Psychiatric disorders frequently occur in patients
with temporal lobe epilepsy (TLE) (70%). This combination further
reduces the quality of life of patients as diagnosis is difficult and
therapeutic opportunities are often missed.
Objectives The aimof this case study is to show the possible asso-
ciation between TLE and psychiatric semiology and its therapeutic
implications.
Methods Presentation of the clinical case of Mr BH who experi-
enced psychosis like symptoms, was finally diagnosedwith TLE and
put under anti-epileptic drugs.
Results Mr BH, aged 22, with no family or personal history,
was admitted for aggressive behavior, self-harm, pyromania, and
depression. Three years prior to onset of psychiatric symptoms, he
reports episodes of pulsatile- left-temporal headache followed by
hypertonic movements of the neck. Symptoms were intermittently
followed by total amnesia or impaired consciousness. The patient
explained symptoms by an inner presence that he called “his twin”
and to whom he attributed those behaviors contrary to his will.
The discovery of bilateral hippocampal atrophy in magnetic reso-
nance imaging with a normal electroencephalography suggested
the diagnosis of TLE with post-ictal psychotic disorders. Patient
was put initially on diazepamand olanzapine with partial improve-
ment. Association of valproate led to progressive but then complete
disappearance of symptoms and so confirmed our diagnosis.
Conclusions It is often difficult to attach psychiatric symptoms to
epilepsy. The diagnosis should be done on a set of clinical, radio-
logical and electrical arguments.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0220
Clinical features of PTSD in patients
with TBI
O. Khaustova ∗, O. Smashna
1 Bogomolets national medicai university, psychosomatic medicine
and psychotherapy, Kiev, Ukraine
2 SHEI Ternopil state medical university namede after I. Ya.
Gorbachevskyy MHC of Ukraine, psychiatry, Ternopil, Ukraine
∗ Corresponding author.
Objective Modern scientific researches about interaction
between TBI and PTSD are characterized by few amounts and
contradiction of conclusions.
Method Twenty-eight personswith TBI were examined bymeans
of questionnaires and structured clinical interviews. 17 patients
were suffering from PTSD. We compared clinical features in
patients with isolated TBI and group with both disorders.
Results Four groups of symptoms were analyzed–sleep, emo-
tions, cognition and personality features. Disorders of sleep were
presented with violation of REM cycle, nightmares, hyperexcita-
tion, increase watchfulness during the sleep. Emotional disorders
were expressed as labilitywithout external irritations; an excessive
emotional reaction is on small events, agitation, irritability, inade-
quacy of emotional reactions and apathy (loss of desire to think, to
feel, and/or to operate). Cognitive disorders included deceleration
of psychomotor reactions, difficulties of searching of words in com-
munication, problems of switching of attention, rigidity, difficulties
in planning, decision of multistage tasks, violation of operative
memory, executive dysfunction. Features of personality disorders
were loss of initiation and self-control, decline of spontaneity, sur-