European Psychiatry - Volume 41 - April 2017

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S482 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520
EV0238
Benzodiazepines abstinence
syndrome with psychotic symptoms:
Case report
N.I. Nú˜nez Morales ∗, M. Gómez Revuelta ,
B. González Hernández , M. Laborde Zufiaurre ,
A. Aranzabal Itoiz , O. Porta Olivares , G. Montero González ,
M. Zubia Martín , J. Gavi˜na Arenaza ,
A.M. González Pinto Arrillaga
1 Hospital Universitario de Álava, psychiatry, Vitoria, Spain
2 H. U. Marqués de Valdecilla, psychiatry, Santander, Spain
3 H. Zamudio, psychiatry, Zamudio, Spain
∗ Corresponding author.
Introduction Several studies point to the importance that the
complex formed by GABA and the benzodiazepine receptor
play for cerebral dopaminergic transmission and, hence, to the
pathophysiology of psychotic symptoms. The decrease in GABA
neuratransmisión or the hypofunction of the system in the hip-
pocampus, cortex and other limbic prefrontal or subcortical regions
has consequences as emotional dysregulation, cognitive impair-
ment and development of positive psychotic symptoms.
Objectives We intended to show an additional practical exam-
ple to the limited literature available based on a case linking the
emergence of psychotic symptoms due to acute benzodiazepine
withdrawal.
Methods We present the case of a 21 year old man who was
sent to the emergency room of our hospital after an episode
of aggressiveness on the street. The patient showed a psy-
chotic schizophrenic syndrome with significant emotional and
behavioural impact with aggressive and bizarremovements. In par-
allel, restlessness, sweating, tremor, increased blood pressure and
tachycardia were observed. Symptoms had started abruptly two
hours earlier. The patient companion explained that he usually took
Alprazolam at an of over 40mg per day. He had decided to give up
this consumption abruptly four days earlier.
Discussion GABAergic deficits cause the imbalance between
excitatory and inhibitory neurotransmission that may relate the
pathophysiology of psychotic symptoms. The dysfunction of the
GABAergic cortical interneurons could affect to the modulating
response from the association cortex, which, could also relate with
the appearance of these symptoms.
Conclusion This case could relate a decrease in GABAergic trans-
mission with the appearance of psychotic symptoms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0239
Mood disorders in HIV infection
L. Martínez , E. Boix , L. González , R. Esteban ,
E. Davi , P. Flores , C. Masferrer , C. Macías ,
O. Orejas ∗
1 Neuropsychiatry and addictions institute INAD- Parc de salut Mar,
psychiatry hospitalization, Barcelona, Spain
2 Consorci Sanitari del Maresme, psychiatry hospitalization,
Barcelona, Spain
∗ Corresponding author.
Introduction Psychiatric disorders, particularly mood disorders,
have a profound effect on the use of and adherence to highly
active antiretroviral therapy (HAART) among patients with human
immunodeficiency virus (HIV) infection.
HIV infection and mood disorders have features in common, and
each is a significant risk factor for the other.
Objective The objective is to highlight the clinicians on the impor-
tance of screening and treating affective disorders among patients
with HIV infection.
Methods Two cases of HIV infected patients with comorbidmood
disorder and torpid evolutions by poor adherence to treatment are
reported.
A brief literature review on this subject is done.
Results Major depression has been shown to alter the function of
killer lymphocytes in HIV-infected patients and may be associated
with the progression of HIV disease.
HIV-positive patients with mental disorders are less likely to
receive and adherence to antiretroviral therapy.
First case-report: a man 52 years old, HIV-positive since 1985 with
a comorbid bipolar disorder, with recurrent depressions and poor
adherence to both treatment with a rapidly exitus laetalis.
Second case-report: man 45 years old, HIV-positive since 1992with
a comorbid depressive disorder, non-adhered to both therapy and
HIV-associated dementia.
Conclusions Depressive disorders are common in HIV infection.
Antiretroviral regimens for HIV-infected patients require strict
adherence. Untreated depression has been associatedwithmedica-
tion nonadherence. Understanding the contribution of depression
and its subsequent treatment on antiretroviral therapy adher-
ence might direct clinicians toward earlier identification and more
aggressive treatment among this population.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0240
The EFPT-PSUD survey
I. Rojnic Palavra ∗, L. Orsolini , M. Potocan ,
Q. Diego , M. Martens , J. Levola , L. Grichy ,
T.M. Gondek , M. Casanova Dias , M. Pinto da Costa ,
S. Tomori , S. Mullerova , E. Sonmez , M. Borovcanin ,
V. Banjac , P. Marinova , I.K. Pakutkait ˙e , J. Kuiters ,
A.L. Popescu , E. Biskup , S. Naughton , A. San Roman Uria
1 Croatian institute of public health, Croatian institute of public
health, Zagreb, Croatia
2 Psychopharmacology- drug misuse and novel psychoactive
substances research unit, school of life and medical sciences, Hatfield,
United Kingdom
3 University of Ljubljana, psychiatric clinic Ljubljana, Ljubljana,
Slovenia
4 King’s College london, institute of psychiatry, London, United
Kingdom
5 Tartu university, Tartu, Estonia
6 Hospital district of Helsinki and Uusimaa, hospital district of
Helsinki and Uusimaa, Helsinki, Finland
7 GH Saint-Louis–Lariboisière–F.-Widal, Pôle de psychiatrie et de
médecine addictologique, Paris, France
8 Wroclaw medical university, Wroclaw, Poland
9 Barnet Enfield and Haringey mental health NHS trust, Barnet Enfield
and Haringey mental health NHS trust, London, United Kingdom
10 Hospital de Magalhes Lemos, Porto, Portugal
11 University hospital centre Mother Theresa, psychiatry service
Tirana, Tirana, Albania
12 Charles university, Prague, Czech Republic
13 Marmara university, department of psychiatry, Ankara, Turkey
14 University of Kragujevac, department of psychiatry, Kragujevac,
Serbia
15 Clinical center Banjaluka, Banjaluka, Bosnia and Herzegovina
16 Alexandrovska university hospital, Sofia, Bulgaria
17 Vilnius university, clinic of psychiatry, Vilnius, Lithuania
18 University medical centre Groningen, Groningen, The Netherlands
19 University of medicine and pharmacy of Târgu Mures, Târgu
Mures, Romania
20 University Hospital of Basel, Basel, Switzerland
21 Mater Misericordiae university hospital, Dublin, Ireland
22 Castilla y Leon Health Care System, Zamora, Spain
∗ Corresponding author.