European Psychiatry - Volume 41 - April 2017

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S554 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S521–S582
EV0459
Reconceptualization of recovery from
anorexia nervosa: Patients’
perspective
M. Jarrige
Toulouse University Jean-Jaurès, CERPPS, Toulouse, France
Outcome research has not found a consistent definition of recov-
ery from anorexia nervosa by consensus of experts, or by empirical
validation. Therefore, medical criterion of recovery varies between
studies and results are not comparable. This poster refers to a study
of 44 participants treated for anorexia nervosa and who believe
they have recovered. The purpose of this study is to reconceptual-
ize recovery from patients’ perspective. The Free Association about
Recovery – Questionnaire (FAR-Q) is a new tool by which to explore
and understand the anorexic’s account of recovery. Content anal-
ysis reveals four subjective definitions of recovery: (1). Return to
the social normality; (2). Cohabit with eating disorder; (3). Self-
acceptance; (4). Rebirth. This study assesses patients’ stages of
recovery process and gives recommendations to health profession-
als.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0460
Long-standing Pica with compulsive
features in a woman with iron and
zinc deficiency
C. Kwok ∗, H.Y. Lee
Singapore General Hospital, Psychiatry, Singapore
∗ Corresponding author.
Introduction Pica is the consumption of non-nutritive sub-
stances, which is inappropriate to the individual’s cultural practices
or developmental level. It is frequently associated with mental
retardation, and occasionally observed in pregnant women and
children.
Objectives We describe a case of long-standing pica in a woman
with no co-morbid psychiatric condition.
Case Madam NA is a 27-year old married Malay housewife, with
4 sons and 4 miscarriages. Her mother had addiction problems.
She sought help from the Eating Disorders Clinic, Singapore Gen-
eral Hospital, for uncontrollably eating uncooked rice. This started
at age 8, when she was left alone at home with no food. Since then,
she had been eating up to 10 cups of raw rice daily. She was unable
to leave the house without carrying a bag of raw rice; if she for-
got, she would feel intense discomfort and would need to return
to get the rice. She persisted in eating raw rice despite it causing
friction in her marriage. When she tried to stop, she would get
irritable and crave it. This behavior only ceased during her preg-
nancies but would restart soon after delivery. There was no other
psychiatric history. Blood investigations showed anemia, with iron
and zinc deficiency, as well as newly diagnosed Grave’s disease.
After iron and zinc supplementation, her raw rice intake decreased
substantially.
Conclusions We report an unusual case of long-standing pica
with compulsive features in a young woman with no psychiatric
co-morbidity, which improved during pregnancy andwith iron and
zinc supplementation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0461
Eating disorders in Malays in
Singapore
V. Kwok ∗, H.Y. Lee , S.M. Tan , W.S.A. Chee , K. Ann ,
N.R. Binte Kamaruzaman
1 Sengkang Health, Psychiatry, Singapore
2 Singapore General Hospital, Psychiatry, Singapore
3 Singapore General Hospital, Nursing, Singapore
∗ Corresponding author.
Introduction The prevalence of eating disorders has been increas-
ing in the Asian countries. Malays in Singapore are at the crossroads
because they are largely traditional in practice and almost all are
Muslim, but are exposed to western culture. Studies found that
Malays at increased risk of eating disorders but yet those that
present for treatment are very small, and this study aims to study
Malays with eating disorders to unveil this contradiction.
Methods All Malay patients presenting to Singapore General
Hospital (SGH), which hosts the only specialized eating disorder
programme in Singapore, between 2003 and 2014 were identified
and medical records studied retrospectively.
Results Malays constitute only 42 out of 1340 patients treated
in the same period. The mean age at presentation is 18.81 years
(SD = 5.54) and the majority are students (78.6%). A total of 92.9%
are single. There are more cases of bulimia nervosa than anorexia
nervosa (45.2% vs. 26.2%). In total, 54.8% have psychiatric co-
morbidities, the most common is depression (31.0%), 38.1% have a
history of deliberate self-harm and 21.4% attempted suicide. A total
of 52.4% reported teasing as a trigger, while 16.7% were triggered
by being overweight.
Discussion There is only a small number ofMalays that presented.
Fasting is commonlywhichmay be confusedwith restriction. Other
factors could be lack of awareness. The higher prevalence of bulimia
nervosa suggests that purging is recognized as abnormal. High
prevalence of co-morbidities suggests that family members recog-
nize co-morbidities better. Outreach programs for Malay will help
increase awareness.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0462
Use of atomoxetine in eating
disorders. A case report
R. Landera Rodríguez ∗, M. Juncal Ruiz , L. Sánchez Blanco ,
G. Pardo de Santayana Jenaro , O. Porta Olivares ,
M. Gómez Revuelta , I. Madrazo del Río Hortega ,
M. Pérez Herrera , D. Abejas Díez , J. González Gomez
1 Hospital Universitario Marqués de Valdecilla, Psychiatry,
Santander, Spain
2 Hospital Universitario Álava-Sede Santiago, Psychiatry,
Vitoria-Gasteiz, Spain
∗ Corresponding author.
Introduction Eating disorders (EDs) are an important public
health problem and not all patients respond adequately to psy-
chotherapy. In the last decade, researchers report a significant
comorbidity of EDs and attention-deficit/hyperactivity disorder
(ADHD), especially binge eating disorder and bulimia nervosa.
Some studies postulate the hypothesis of a common neurobiologi-
cal substrate, such as noradrenergic pathways among others.
Objectives To revise the possible use of atomoxetine, a highly
selective noradrenergic reuptake inhibitor, for the treatment of
EDs.
Methods We describe the effect of atomoxetine in a young
woman with purging disorder and history of ADHD in childhood
added to cognitive behavioural therapy (CBT).