European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520 S491
EV0267
Misdiagnosis of loin pain hematuria
syndrome as a somatization disorder
L. De Jonge ∗, S. Petrykiv , J. Fennema , M. Arts
1 Leonardo scientific research institute, geriatric psychiatry, Bergen
op Zoom, The Netherlands
2 University of Groningen–university medical center Groningen,
department of clinical pharmacy and pharmacology, Groningen, The
Netherlands
3 GGZ Friesland, geriatric psychiatry, Leeuwarden, The Netherlands
4 University of Groningen–university medical center groningen,
department of old age psychiatry, Groningen, The Netherlands
∗ Corresponding author.
Introduction Loin pain hematuria syndrome (LPHS) is a rare kid-
ney disease with a prevalence of −0.012%. Its clinical features
include periods of severe uni-or bilateral lion pain, accompanied
by (microscopic) hematuria. It is often misdiagnosed as a psychi-
atric condition, particularly under the heading of a somatization
disorder.
Objectives We describe the case of a patient who developed
depressive symptoms after decades of suffering from severe inter-
mittent bilateral loin pain.
Aims To report a case-study, describing LPHS as a cause of severe
chronic pain and persistent depressive symptoms.
Methods A case-study is presented and discussed, followed by a
literature review.
Results A 55-year-female was referred to a psychiatrist for her
depressive symptoms and persistent periods of severe unilateral
or bilateral lion pain and intermittent hematuria for over 25 years.
There shewas diagnosedwith a depression and somatization disor-
der. She received amitriptyline for many years, without any effect.
Finally, the patient opted for a second opinion in an academic hos-
pital in Belgium where it was quickly discovered. After surgery,
including renal denervation and kidney autotransplantation, her
somatic problems and depressive mood disappeared.
Conclusions The awareness of LPHS is still very limited in
medicine. This may lead to incorrect diagnoses, including psy-
chiatric disorders such as somatization disorder. More awareness
could lead to earlier diagnosis and prevent the consequences of
severe debilitating pain.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0268
Lithium toxicity after bariatric surgery
L. De Jonge ∗, S. Petrykiv , J. Fennema , M. Arts
1 Leonardo scientific research institute, geriatric psychiatry, Bergen
op Zoom, The Netherlands
2 University of Groningen- university medical center Groningen,
department of clinical pharmacy and pharmacology, Groningen, The
Netherlands
3 GGZ Friesland, geriatric psychiatry, Leeuwarden, The Netherlands
4 University of Groningen- university medical center Groningen,
department of old age psychiatry, Groningen, The Netherlands
∗ Corresponding author.
Introduction Bariatric surgery is globally increasingly being
applied in patients with morbid obesity to achieve permanent
weight reduction. More than fifty percent of these patients have
a psychiatric disorder in their history and over thirty percent take
psychotropic medication. The prevalence of bipolar disorder in
patients who undergo bariatric surgery is around four percent, and
most of them are treated with lithium.
Objectives & aims To report and discuss the effect of bariatric
surgery on changes in lithium absorption.
Methods We present all published case studies and literature
review on lithium toxicity after bariatric surgery.
Results To date; only two case-reports were published with dra-
matic changes in lithium level after vertical sleeve gastrectomy and
Roux-en-Y bariatric surgery. Within a period of two to five weeks,
the patients were presented to the emergency department with
signs of dehydration and acute kidney failure.
Conclusion Clinicians should be aware of dramatic and possibly
even life-threatening pharmacokinetic changes in drug absorption
that may occur after bariatric surgery. Careful monitoring and even
reduction of lithium dosage before and after surgery could poten-
tially prevent serious complications.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0269
Depression in people with multiple
sclerosis
F. Ellouze ∗, W. Bouali , B. Hidouri , S. Younes , M. Nasr
1 CHU Tahar Sfar, Psychiatry, Mahdia, Tunisia
2 CHU Tahar Sfar, neurology, Mahdia, Tunisia
∗ Corresponding author.
Introduction Depression is the most common syndrome associ-
ated with Multiple Sclerosis (MS) with a high prevalence during a
lifetime.
Objectives To assess the prevalence of depression in patients
treated in neurology for MS.
Methods We performed a retrospective study on 17 patients
diagnosed with MS and confirmed with the criteria of Mac Don-
alds 2010 with a follow-up in the neurology department of the EPS
Mahdia for a period of nine years (2006–2014), then addressed to
a psychiatric consultation for depression.
Results In total 17 patients were hospitalised in the neurology
department during the study. Ages ranged from 20 to 39 years
with an average of 33 years. The average course of the disorder
is 5 years. We objectified a female predominance with 82%, a pro-
fessional activity was found in 76% of patients. The comorbidities
found are mainly hypertension, diabetes and asthma, respectively
in 11%, 5% and 5%. Depressionwas clinically confirmed in 9 patients,
that to say, 52% of our sample addressed in the psychiatric con-
sultation, whose 6 received an antidepressant (fluoxetine) and 3
received paroxetine. An anxiolytic was given to the half of these
patients.
Conclusion The association between MS and depression would,
therefore, be neither fortuitous nor only related to non-specific fac-
tors of any chronic disease. Specifying the relative share of these
explanatory factors is probably one of the challenges for future
researches in this area.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0270
The impact of type D personality on
the quality of life and on
microangiopathic and
macroangiopathic complications in
outpatients with type 2 diabetes
mellitus
V.R. Enatescu ∗, I. Papava , R.S. Romosan , A. Grozavu ,
V. Enatescu , I. Enatescu , L. Diaconu
1 “Victor Babes” university of medicine and pharmacy Timisoara,
psychiatry, Timisoara, Romania