European Psychiatry - Volume 41 - April 2017

492 / 916

S488 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520
Present days are characterized by increased level of various psy-
chosomatic disorders among different populations in economically
developing counties. Moreover every mental disease contains
somatic symptoms and these symptoms may interfere in whole
picture, change the diagnostic schedule. In case of mild disor-
ders patient’s reaction to somatic disease was mostly hysteric:
exaggeration of pathological sensations, suggestibility and self-
suggestibility. Whole picture of the neurosis was very colourful,
dynamical, with instable pathological manifestations, intention to
draw one’s attention.
Transition to long-term variant of dynamics mental disorder was
accompanied by concentration on the smallest somatic sensa-
tions, seeking benefit from a disease state, “flight into the illness”,
nosophilia. We identified prominent increase of hypochondriac
symptoms in the group of patients with long course of dissocia-
tive disorders (33.4%) as compared with the group of acute and
sub-acute course of the disorder (11.4%).
In patients with long course of dissociative disorders we observed
accumulation of somatic pathology, in most cases one patient
suffered from different somatic diseases. Increasing of rate of
hypertension (31.33%) and different dishormonal disorders (37.5%)
was the most prominent.
In psychological “portrait” of the patients with psychosomatic
disorders we identified the great number of combinations
of pathocharacterologic traits, creating the patient’s “facade”,
complicating interactions and compliancewith physicians and psy-
chiatrists.
Interactions between features of mental disorders and somatic dis-
orders, psychological stress appear to us to be rather close. Presence
of the somatic process leads to chronificationof the neuroses, “flight
into the illness”, decrease of dependence of clinical dynamics on
psychogenics.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0257
Irreversible silent
Z. Azvee
Beaumont hospital, Liaison psychiatry, Dublin, Ireland
Objectives Lithium is a well-known substance used in treat-
ment of mood disorders. It has a narrow therapeutic index with
recognised adverse effects on renal and thyroid function. Clinical
guidelines published by the national institute for health and clin-
ical excellence in the United Kingdom (NICE) recommend renal
and thyroid function checks before lithium is prescribed, as well as
ongoing monitoring of renal function, thyroid function and serum
lithium levels. Lithium-induced drug toxicity is frequently seen in
clinical practice. While the ongoing monitoring serves to moni-
tor reversible side effects of Lithium provided its discontinued,
rarely patients develop a persistent neurological side effect known
as a syndrome of irreversible lithium-effectuated neurotoxicity
(SILENT).
Method This is a case report on a patient where the patient devel-
oped SILENT syndrome after being treated with Lithium, long term
for bipolar disorder.
Results This case supports the biological mechanism of SILENT
syndrome. It also caused a huge implication in the patient’s care.
Conclusions As clinicians, we are well aware of following treat-
ment guidelines for Lithium. This case report was written to raise
awareness regarding a “SILENT” albeit significantly debilitating
syndrome of Lithium use.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0258
The sofa is better than Freud
G. Buffardi
UOSM 13, ASL Caserta, Aversa, Italy
When it comes to the therapeutic dialog between doctor and
patient, psychiatrist or psychotherapist and user, there are sev-
eral factors that are taken into consideration, though some of these
aren’t of a specific psychological model, they fulfill an important
role both in the management of the relationship itself as well as in
the care.
Their importance in the therapeutic relationship is such that a doc-
tor or a therapist cannot simply manage them by “common sense”,
or follow his own propensity for dialogue: he must know them
well and he needs a training on their own management with the
same precision that is needed for the specific psychological model
training.
Contrary to widespread belief we think that education on non-
specific factors has to be desirable and that the ability to manage
them can be implemented both by a deeper understanding as well
as by dedicated training tools.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0259
Suspension of judgement: A tool for
non-invasive therapeutic relationship
G. Buffardi
UOSM 13, ASL Caserta, Aversa, Italy
∗ Corresponding author.
We often refer to our ability to perceive the other mind as a gift
of our experience that helps us in our work. But to use this insight
as a guidance counselor in the treatment process is sometimes a
harbinger of relational mistakes that affect the success of the treat-
ment.
The specialist, psychiatrist or psychotherapist (but also other aid
professionals), has to learn the process of the suspension of judg-
ment “epochè”, described in Jaspers’ psychopathology.
To foster learning of “epochè” we developed some exercises that
help the young therapist in training. We believe they are also par-
ticularly useful for the training of students who are undergoing
specialized training to become psychiatrists.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0260
Neurosyphilis presenting with
affective psychosis and Parkinsonism:
A case report
H.S. Butt ∗, C.W.P. Hopkins
Prospect Park hospital- Berkshire NHS trust, Rose ward, reading,
United Kingdom
∗ Corresponding author.
Introduction A 38-year-old gentleman was admitted to an inpa-
tient psychiatric unit with a first episode of fluctuating affective
psychosis. He initially presented as manic although subsequently
evolved a severe depressive episode, with prominent bizarre,
affect-incongruent delusions throughout this period. Upon admis-
sion, anisocoria was evident, although this was attributed to a
past head injury. Over the course of his admission he devel-
oped emergent Parkinsonism, initially ascribed to prescription of
aripiprazole. Givenhis anisocoria andworsening Parkinsonism, fur-
ther investigation was undertaken. While his MRI brain scan was
unremarkable, his serum and CSF specimens tested positive for