European Psychiatry - Volume 41 - April 2017

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S496 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S465–S520
to six days after the seizure(s). PIP frequently has a polymorphic
presentation, tends to be affect-laden and symptoms often fluctu-
ate. It is of limited duration and frequently responds very rapidly
to low doses of benzodiazepines and antipsychotics. However, the
propensity of the antipsychotics to provoke seizures and the risk
of pharmacokinetic interaction with anti-epileptics are important
considerations. Recurrence rates range 25% to 50%.
Conclusions Given the negative impact of PIP in morbidity and
mortality among these patients, it is crucial that neurologists and
psychiatrists are able to adequately recognize and treat this clinical
condition.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0283
Coordinating primary care and mental
health
V.Martí Garnica ∗, M.D. Ortega Garcia , M.A. Bernal Lopez ,
J.R. Russo de Leon , S. Marin Garcia
1 Servicio murciano de slaud, csm San Andres, Murcia, Spain
2 Servicio murciano de salud, csm Cartagena, Murcia, Spain
3 Servicio murciano de salud, Hospital Reina Sofia, Murcia, Spain
4 Servicio murciano de salud, csm Lorca, Murcia, Spain
∗ Corresponding author.
Through the analysis of a case report to analyze the importance of
the coordination between primary care and mental health service
for a better management of an outpatient. It is known that primary
care is the gateway to the patient in the health system. Therefore,
the role of physicians headers is essential for diagnosis, for the start
of drug treatment and referral to specialized care. It is known that
one of every four patients have mental health problems. To meet
the standards of primary care, physicians should ensure personal-
ized assistance, integrated, continuous and permanent. Therefore,
in relation to the accessibility of patients, it is essential to establish
the diagnosis as soon as possible and initiate appropriate treat-
ment to alleviate the symptoms of this type of psychiatric disorders
and should track patients and their caregivers. For all this, it is
essential that there is proper coordination between primary and
specialty care in mental health. The interdisciplinary approach in
these situations can assist the patient and family from a holistic
perspective. This approach strengthens and reinforces the subse-
quent treatment, not only care but also evolutionary. Thus arises
the interdisciplinary work as an opportunity to access the new and
complex this social situation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0284
Association of blood pressure with
anxiety and depression in a sample of
primary care patients
A. Sacchetti attei ∗ ursi S. Padula ioli
S. Ferrari
1 University of Modena and Reggio Emilia, Diagnostic-Clinical and
Public Health Medicine, Modena, Italy
2 Association for Research in Psychiatry, Castelnuovo Rangone, Italy
3 University of Modena and Reggio Emilia, Department of
Biomedical-Metabolic and Neural Sciences, Modena, Italy
4 Società Italiana di Medicina Generale, Firenze, Italy
5 Local Health Agency, Department of Primary Care, Modena, Italy
∗ Corresponding author.
Introduction According to international scientific literature, and
as summarized in the guidelines of the International Society of
Hypertension, lowering of blood pressure can prevent cardiovas-
cular accidents. Some studies suggest that hypertension, anxiety,
and depression might be inversely correlated.
Objective To investigate whether blood pressure is associated
with anxiety and depression.
Methods Cross-sectional design. Male and female primary care
patients were enrolled, aged 40–80. Criteria of exclusion adopted:
use of antidepressants or antipsychotics; previousmajor cardiovas-
cular event; psychosis or major depression; Type 1-DM; pregnancy
and hereditary disease associated to obesity. Anxiety and depres-
sion symptoms were assessed using HADS. Waist circumference,
hip circumference, blood pressure, HDL, triglycerides, blood sugar,
hypertension, albumin concentrations and serum iron were also
assessed.
Results Of the 210 subjects, 84 were men (40%), mean
age was 60.88 (SD ± 10.88). Hypertension was found to cor-
relate significantly to anxiety (OR = 0.38; 95% CI = 0.17–0.84),
older age (OR = 3.96; 95% CI = 1.88–8.32), cigarette smoking
(OR = 0.35; 95%CI = 0.13–0.94), high Body Mass Index (OR = 2.50;
95% CI = 1.24–5.01), Waist-hip ratio (OR = 0.09; 95% CI = 0.02–0.46)
and the Index of comorbidity (OR = 16.93; 95% CI = 3.71–77.29).
Conclusions An inverse association was found between anxi-
ety and hypertension, suggesting the need to clinically manage
these two dimensions in a coordinated way. Other findings are
well known and already included in prevention campaigns. Fur-
ther research is needed, also to better understand and explain the
causative pathways of this correlation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0285
Impact of classification systems
(DSM-5, DSM-IV, CAM and DRS-R98)
on outcomes of delirium
G. McCarthy ∗ eagher Adami
1 NUI Galway and HSE West, Sligo Leitrim Mental Health Service,
Sligo, Ireland
2 University of Limerick, Psychiatry, Limerick, Ireland
∗ Corresponding author.
Introduction Previous studies showed different classification sys-
tems lead to different case identification and rates of delirium. No
one has previously investigated the influence of different classifi-
cation systems on the outcomes of delirium.
Aims and objectives To determine the influence of DSM-5 criteria
vs. DSM-IV on delirium outcomes (mortality, length of stay, insti-
tutionalisation) including DSM-III and DSM-IIR criteria, using CAM
and DRS-R98 as proxies.
Methodology Prospective, longitudinal, observational study of
elderly patients 70+ admitted to acute medical wards in Sligo
University Hospital. Participants were assessed within 3 days of
admission using DSM-5, and DSM-IV criteria, DRS-R98, and CAM
scales.
Results Two hundred patients [mean age 81.1 ±6.5; 50% female].
Rates (prevalence and incidence) of delirium for each diagnostic
method were: 20.5% (n = 41) for DSM-5; 22.5% (n = 45) for DSM-
IV; 18.5% (n = 37) for DRS-R98 and 22.5%, (n = 45) for CAM. The
odds ratio (OR) for mortality (each diagnostic method respectively)
were: 3.37, 3.11, 2.42, 2.96. Breslow-Day test on homogeneity
of OR was not significant x2= 0.43, df: 3, P = 0.93. Those iden-
tified with delirium using the DSM-IV, DRS-R98 and CAM had
significantly longer hospital length of stay(los) compared to those
without delirium but not with those identified by DSM-5 criteria.
Re-institutionalisation, those identified with delirium using DSM-
5, DSM-IV and CAMdid not have significant differences in discharge
destination compared to those without delirium, those identified