European Psychiatry - Volume 41 - April 2017

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S656 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S645–S709
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Acknowledgements This study was supported by the grants of the
Haesong Geriatric Psychiatry Research Fund of the Korean Mental
Health Foundation.
EV0771
The widowhood effect–mortality and
adverse health effects when losing a
spouse in old Age
C.B. Kristiansen ∗ . Bojesen , P. Munk-Jørgensen , K. Andersen
University Hospital Odense, Psychiatric Research Department,
Odense, Denmark
∗ Corresponding author.
Introduction Losing one’s spouse is a major life event which is
associated to an increased risk ofmental healthproblems as depres-
sion and sleep-disorders. There is also an increased risk of adverse
effects on physical health, and even an increased risk of mortality.
A phenomena called “the widowhood effect” Though this is well-
known clinically, few studies have established the extent of the
problem in old age.
Objectives This study aims to examine the risk of mortality asso-
ciated to widowhood in old age, and adverse health effects both
regarding physical and mental health.
Methods Anationwide register-based case control study. All Dan-
ish people aged 65 years and above who became widowed in
the period of 2000–2010 are included. A background population
sample of 4:1 is matched on age and gender. By using the per-
sonal identification number a linkage between registers containing
information regarding health service use, pharmacologic use and
demographic information is made. Mortality is analysed using
Kaplan-Meier estimate and the statistical comparison between
the groups is done by Cox-regression. Adverse health effects are
assessed by the health care use and pharmacological use, and are
compared between the two groups by t-test, linear and logistic
regression depending on the variables.
Results The study is under conduction, results will be presented.
Conclusions Widowhood in old age has been associated to an
increased risk of mortality and adverse health effects. This study
assesses the outcome of this in a nationwide register-based sample.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0772
Case report of treatment issues in the
management of dementia with
parkinsonism
N. Manusheva ∗ , S. Bajraktarov , S. Arsova , V. Vujovic
1 University Psychiatry Clinic, Psychophysiology, Skopje, FYR
Macedonia
2 University Psychiatry Clinic, Department for affective disorders,
Skopje, FYR Macedonia
3 University Psychiatry Clinic, Day hospital, Skopje, FYR Macedonia
4 University Psychiatry Clinic, Psychotherapy, Skopje, FYR Macedonia
∗ Corresponding author.
Background Parkinsonism as a clinical syndrome needs to be
diagnosed multidisciplinary. Cognition problems and behavioural
symptoms together with the neurologic symptomatologymake the
treatment very complicated.
Aims To emphasize the importance of effective management
strategies that may extend quality of life and independence.
Methods This is a case report of 59 year old male with com-
plicated clinical presentation of dementia with parkinsonism last
two years treated with levodopa. Admitted with symptoms of
fluctuating cognition, memory problems, visual hallucinations and
depression and also generalized rigidity after introduction of atyp-
ical antipsychotic. Medical history: epilepsy in the last 15 years,
trauma 7 years ago. After admission he was examined clinically and
the brain computed tomography (CT) and electroencephalography
(EEG) were done.
Results We analyzed possible etiologies and differential diag-
nosis of presented symptoms–extrapyramidal signs, mental
confusion with hallucinations which are the three most com-
mon clinical features of Parkinson’s disease dementia (PDD).
CT reveals diffuse cortical atrophy with encephalopathy in the
white matter combined with dilatation of lateral ventricles. EEG
was with theta disrhythmic activity. After consultation with
neurologist the patient was given Carbamazepine for epilepsy
and Levodopa/Carbidopa to control parkinsonism. Donepezil was
introduced. Two weeks after admission the patient was discharged
with given advice to be treated in geriatric clinic.
Conclusion After thorough clinical examination with proper
diagnostic procedures with imaging modalities we should try
cholinesterase inhibitors because they might improve cognition
and can be beneficial for reduction of the hallucinations and
behaviour disturbances combined with proper management of the
surroundings.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0773
The evolution of mania in the elderly:
A case study
I. Martinez Perez ∗, F. García Sánchez ,
A.L. Gonzalez Gáldamez , A. Belmar Simo ,
M.D. Piqueras Acevedo , C.J. Garcia Bri˜nol , B. Perez Molina ,
I. Bello Pombo Lopez Eugenio
1 Residencia Psicogeriatrica Virgen del Valle, Psiquiatría, Murcia,
Spain
2 Hospital Universitario de Elda, Anestesiología, Elda, Spain
3 Hospital Universitario Santa Lucia, Psiquiatria, Murcia, Spain
4 Hospital Universitario Santa Lucía, Psiquiatria, Murcia, Spain
5 CSM Yecla, Psiquiatria, Murcia, Spain
6 Hospital Universitario Santa Lucia, Psicologia, Murcia, Spain
7 CAP Ramonete, Atención Primaria, Murcia, Spain
∗ Corresponding author.
Introduction Bipolar disorder in elderly patients may present as
an evolution of the disease initiated in younger stages or as an entity
newly emerging. In addition, mania in the elderly, has character-
istics that make it different from the adult. These disorders can be
correlated with underlying vascular or degenerative disorders
Methods Review of the relevant literature by searching PUBMED,
limited to studies of greater scientific hierarchy.
Results The existence of changes in the manic phase motivated
by the influence of vascular disease, as well as the importance of the
changes experienced in therapy at the rate of underlying organic
disease described. The useful pharmacotherapeutic approach in
this case is discussed.
Conclusion The most recent research points in the direction of a
more organic for mania late age-related substrate. The diverse eti-
ology requires differential diagnosis for addressing the underlying
causes he clinic does not dim with age, but increases the ten-
dency to develop rapid cycling as age progresses. It is also more
frequent occurrence of paranoid and aggressive traits, especially
in situations of confrontation, along with increased dysphoria
The therapeutic management by neuroleptics require very care-
ful attention, because of the vulnerability of this group to develop
adverse effects. Mood stabilizers use has been demonstrated as
effective as in young