European Psychiatry - Volume 41 - April 2017

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S632 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S583–S644
regulation and impulse control, with a high reactivity and vulner-
ability to stress. It has been hypothesized that these patients may
have a dysregulation of the neuroendocrine system.
Aims The goal of this work is to systematically review the scien-
tific knowledge regarding the role of the neuroendocrine system in
the physiopathology of BPD.
Methods The literature was reviewed by online searching
using PubMed®. The authors selected scientific papers with the
words “borderline personality disorder” and “neuroendocrine”/
“endocrine” in the title and/or abstract, published in English.
Results and discussion There is scientific evidence for an enhanced
cortisol release and HPA axis hyperactivity in BPD. The dexametha-
sone suppression test has been used in BPD, finding high rates of
non-suppressors in that sample. There also seems to be a reduced
volume of the amygdala and anterior cingulate cortex, suggesting
an involvement of those regions in the emotional disturbances in
BPD. Symptoms of impulsivity, aggression and suicidal behavior
seemto be stronglymediated by the serotonergic system. The avail-
able research suggests a serotoninergic dysfunction in BPD, with
lower levels of serotonin in those patients.
Conclusions There seems to be several neuroendocrine changes
related to BPD, namely a hyperactivity of the HPA axis with
stimulated cortisol release together with disturbances of the sero-
tonergic system. Also some brain structural alterations in BPD are
scientifically depicted. Further studies are needed to clarify the
neurobiology of BPD improving both psychotherapeutic and psy-
chopharmacological treatment in these patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0702
Zoophilia in a patient with
Parkinson’s disease
A. Fornelos∗, M. Roque
Centro Hospitalar Trás-os-Montes e Alto Douro, Psiquiatria e Saúde
Mental, Vila Real, Portugal
∗ Corresponding author.
Introduction Parkinson’s disease (PD) is a neurodegenerative
brain disorder characterized by Bradykinesia, muscle rigidity
and resting tremor. Non-motor symptoms like neuropsychiatric
manifestations can also cause significant morbidity. Common
medications used in anti-Parkinsonian treatment such as dopa-
minergic agonists, may help motor symptoms but can also cause
or contribute to adverse behavioral manifestations. These include
dementia, depression, anxiety, insomnia, psychosis and paraphilic
disorders. There are sporadic reports of zoophilia in association
with dopaminergic therapy.
Objectives Report of a clinical case of PD and zoophilia.
Aims clinicians must be aware of paraphilic disorders, namely
zoophilia, in patients with dopaminergic medication.
Method Search of the Pubmed database was conducted for arti-
cles published that had “zoophilia [All Fields] and Parkinson [All
Fields]”, resulting in 3 eligible articles through October 2016. The
patient’s clinical records were also reviewed.
Case Report A 77-year-old man, living in a rural area and with a
loweducational background, with akinetic–rigid PD in an advanced
stage and followed by neurology since 2003. His family physi-
cian sent him to a psychiatric assessment for hyper-sexuality with
zoophilia. The psychiatrist found that these behaviors had begun
a week after levodopa was increased along with the introduction
of selegiline. The psychiatrist has introduced quetiapine with sig-
nificant decrease of the hyper-sexuality and the end of zoophilic
episodes.
Conclusion Despite hyper-sexuality is found in just 2–6% of PD
patients in connection with dopaminergic treatment. This case
report emphasizes how crucial it is to evaluate PD patients’ sex-
uality as well as to explain these adverse effects to the families
involved.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0703
Association between multiple
sclerosis and depression
A. Fornelos ∗ spírito Santo Silva Roque
1 Centro Hospitalar Trás-os-Montes e Alto Douro, Psiquiatria e Saúde
Mental, Vila Real, Portugal
2 Centro Hospitalar Trás-os-Montes e Alto Douro, Neurologia, Vila
Real, Portugal
∗ Corresponding author.
Introduction Multiple Sclerosis (MS) is considered an autoim-
mune inflammatory disease and it is the most common
demyelinating disease of the central nervous system. Although its
aetiology remains unknown, it has been considered to be mul-
tifactorial. MS tends to be more commonly diagnosed in young
Caucasian women. It has been described four clinical courses:
relapsing-remitting MS, primary progressive MS, secondary pro-
gressive MS and progressive remitting MS based on the temporal
sequence in which the symptoms arise. Clinic is also very differ-
ent because it depends on the sites where the lesions occur. The
most frequent signs and symptoms are motor and visual deficits,
paraesthesia, gait ataxia, diplopia, dizziness and bladder dysfunc-
tion. Depressive symptomatology is also among the most common
symptoms of MS.
Objectives Show the importance of depressive symptomatology
in patients with MS.
Aims Evaluation the connection between MS and depression.
Methods Search for articles concerning MS and depression on
Pubmed and Scielo databases from July 2014 throughOctober 2016.
Results Psychiatric manifestations, and especially depressive
symptoms, affect almost 40% of MS patients in remission, and about
90% of those in a flare-up. This may be due to the diagnosis itself,
with its large amount of symptoms and its variable progression,
but also due to side effects of therapy. It gives a major contribute
to suicidality (7.5%) when compared to the general population.
Conclusion A combined approach and treatment is in order to
diminish the incapacity caused by both these illnesses in every
single patient.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0704
Case report of progressive
supranuclear palsy (PSP)
B. Garcia
Benito Menni, Psychiatry, Barcelona, Spain
This is a case of an old man, affected by progressive supranuclear
palsy (PSP), admitted due to behavioral alteration in long-term
home. Medical background PSP’s diagnosis in 2008. Debuts in
the form of lower limb tremor, Bradykinesia and tendency to
fall. Hypomimia, hypotonia, rigidity and slight postural tremor in
upper limbs. Partial response to anti-Parkinson drugs. Psychiatric
background, premorbid personality prone to cognitive rigidity,
dichotomous thinking and impulsiveness. Join in acute unit from
February to May 2012, where it is oriented as a depression of
adaptive features. Several antidepressants were tested with partial
response (venlafaxine, reboxetine, mirtazapina, bupropion, sertra-
line). Current episode patient, who comes presenting behavioral
alteration with poor tolerance to the limitations imposed by the
disease and passive aggressive behaviors. His wife reports dif-