European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520 S495
determine the formation of specific experience IDPs. The most
common are psychogenic depression, anxiety and somatoform dis-
orders.
Methods We had observed 60 IDPs aged 18 to 80 years: medical
history, current complaints and mental state.
Results We allocated 3 groups: persons of retirement age with
severe chronic physical illness or disability on physical illness (1
group); persons with disabilities to mental disease (group 2) and
persons without chronic diseases or disability (relatively healthy,
caring for the sick) (group 3). Group 1 patients have anxiety (51.4%)
and depression (42.8%) syndromes; 25.7% of subjects showed sui-
cidal thoughts and intentions; 25.7% have some PTSD symptoms,
including avoidance, overexcited, emotional numbness, pointing to
adjustment disorder. In group 2 patients, changes were not found
in mental state. Despite traumatic events delusional story does not
change, recurrence and relapse rating was stable. In some cases,
patients begin to abuse alcohol. In 3 group 31.3% persons experi-
enced depression, 25%-anxiety symptoms, combined with a severe
somatic symptoms; 12.5% showed suicidal thoughts; in 18.7% were
diagnosed adjustment disorders. So among IDPs the individuals
with severe medical conditions are most vulnerable population in
the formation of stress-related and neurotic disorders.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0280
Psychological distress following
spinal cord injury
R. Kinson ∗, J. Tan , D. Hussain , P.S. Looi , L. Tan
TTSH, Psychological Medicine, Singapore
∗ Corresponding author.
Introduction There is limited data on psychological burden fol-
lowing spinal cord injury (SCI) in Singapore.
Aims (1) To describe the prevalence of depression and anxiety at
admission for inpatient rehabilitation and (2) describe the baseline
characteristics that predict the development of anxiety or depres-
sion in patients following SCI.
Methodology We retrospectively reviewedmedical records of SCI
patients at admission from01-06-2013 to 31-12-2015. TheHospital
Anxiety and Depression Scale (HADS), ASIA score and demograph-
ics were collated.
Results A total of 157 subjects were included, 62.4% (n = 98) were
male with a mean age of 56.7 years. 43.4% (n = 68) had a traumatic
SCI with 73.9% (n = 116) having had spinal surgery. The average
length of stay was 46.6 days with most discharged to their own
homes. Ten subjects screened positive for anxiety (6.4%) and 16
for depression (10.2%). 13.4% (n = 21) screened positive for anxiety
and/or depression. Two third (n = 95) had injuries at the cervical
level and 14% (n = 22) scored ASIA A/B. 45.9% (n = 72) was referred
to the psychologist. A significantly higher proportion of subjects
(P < 0.05) who screened positive had a past psychiatric history, were
prescribed antidepressants at admission and during rehabilitation.
Significant differences were noted in primary caregiver (nursing
home vs. others) following discharge when comparing those that
screened positive vs. negative however there were no significant
differences between baseline demographics, neurological level and
ASIA score.
Conclusion Psychological burden following SCI is significant.
Standardized screening and psychological support is warranted
with special attention to those with a past psychiatric history.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0281
Delirium: “The out of the track” of
physicians
M. Mangas ∗, G. Alcobia Santos , Y. Martins , A. Matos Pires
1 Hospital José Joaquim Fernandes, Mental Health and Psychiatric
Service, Beja, Portugal
2 Hospital do Espírito Santo de Évora, Internal Medicine Service,
Évora, Portugal
∗ Corresponding author.
Introduction Delirium is an acute clinical syndrome with diverse
and multi-factorial etiologies. It has high prevalence in hospital-
ized patients and it is associated with serious adverse outcomes,
increasing morbidity and mortality. Delirium requires a differential
diagnosis with a wide range of mental disorders.
Aim To evaluate cases referred to liaison psychiatry in Hospi-
tal José Joaquim Fernandes, in regard to the frequency, cause and
misdiagnoses of delirium.
Methods A retrospective analysis of liaison psychiatric referral
from January to August 2016.
Results The overall referral consisted of a total of 111 cases.
Delirium was the second most frequent referral (21.6%), after
depression. Half of patients had an advanced age (71–90 years). A
total of 44.8% of patients with delirium were misdiagnosed and the
referral causes were “depression”, “dementia”, “aggressive behav-
ior”, “agitation” and “schizophrenic psychosis”. The majority of
patients were referred by internal medicine. The most frequent
underlying conditions were: postoperative (27.6%), respiratory dis-
eases (24.1%) and sepsis (17.2%).
Discussion/conclusion Delirium is one of the most frequent diag-
noses in liaison psychiatry. This study supports the statement that
delirium is often not recognized and that is misdiagnosed as a
primary psychiatric illness, mainly, dementia or mood disorder.
Although delirium is classified in ICD-10 as a psychiatric diagno-
sis and clinically manifests with a wide range of neuropsychiatric
abnormalities, it is secondary to a medical/surgical disorder that
requires urgent approach by the respective specialty.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0282
Postictal psychosis – A complex
challenge
M. Marinho ∗, J. Marques , M. Braganc¸ a
1 São João Hospital Centre, Clinic of Psychiatry and Mental Health,
Porto, Portugal
2 Local Healthcare Unit of Matosinhos, Clinic of Psychiatry,
Matosinhos, Portugal
∗ Corresponding author.
Introduction Patients with epilepsy have 6–12 times higher risk
of suffering from psychosis, with a prevalence of about 7–8%, and
the coexistence of these two conditions is associatedwith increased
morbidity andmortality. The psychosis of epilepsy is generally split
into two groups: interictal psychoses and postictal psychosis (PIP),
and the latter has been estimated to represent 25% of all types.
However, many of these episodes remain under-recognized and/or
are often misdiagnosed.
Objectives To provide an overview of PIP.
Methods Literature review based on PubMed/Medline, using the
keywords “epilepsy” and “psychosis”.
Results PIP has been recognized since the 19th century, when
Esquirol described postictal “fury”. Although its etiology and
pathogenesis remain poorly understood, several risk factors and
etiopathogenic mechanisms have been suggested and analysed. An
essential step in PIP management is its accurate and early diagno-
sis. Generally, before the onset of PIP there is a lucid period of one