European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S645–S709 S659
Among reasons leading to early identification, memory complaints
(76.4%) was the most mentioned by GPs surveyed. the Mini Men-
tal State was the most used (34.5%) by general practitioners.
Twenty-nine point one percent (29.1%) of physicians conducted a
comparative assessment 6 to 12 months later if the initial evalua-
tion was normal and 83.6% send the patient to a specialist in case
of a detected disorder. For GPs, in 58.2% of the cases, the major
impediment is the lack of time, in 32.7% of the cases it is patient’s
and family’s denial and in 23.6% of the cases it is the absence of
effective medical treatment. A cross analysis shows that GPs who
have had further training in geriatrics have a better approach.
Conclusion Our study shows a lack in the early identification of
cognitive impairment in the elderly by GPs. Develop simple cog-
nitive tests, reinforce training of doctors and promote research to
develop new drugs would improve early diagnosis and manage-
ment of dementia.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0780
Cardiac issues raised by an
examination of the antipsychotic
prescribing practices in the elderly of
St. James’s hospital (SJH), Dublin
B. McCarthy ∗, C. Power , B. Lawlor , E. Greene
1 St Vincent’s University Hospital, Dept of Old Age Psychiatry, Dublin,
Ireland
2 St James Hospital, Mercers Institute of Successful Ageing, Dublin,
Ireland
∗ Corresponding author.
Background Antipsychotic medication use may be associated
with prolongation of the QTc interval, increasing the risk of poten-
tially fatal arrhythmias This is particularly pertinent in the
elderly due to comorbid cardiovascular disease and polypharmacy.
Attention to the ECG and co-prescribed medications is essential to
minimise cardiac risk when prescribing antipsychotics.
Methods On 23rd February 2016 all inpatients aged over 65 who
were prescribed antipsychotic medications were identified as part
of a hospital-wide survey. Data was collected from medical and
electronic patient notes and medication kardexes.
Results Complete data was obtained for 36 patients aged over 65
who were newly-prescribed an antipsychotic or had their antipsy-
chotic changed. Of these, 39%(n = 13) had a cardiac history. One
quarter did not have an ECG in the 12 months preceding antipsy-
chotic initiation. Of the 28 patients with an ECG, 57% (n = 16) had
a QTc > 450ms before starting antipsychotic treatment. Only 11%
(n = 4) had an ECGwithin 24 hours of starting the antipsychotic. The
average change of the QTc interval in those with a repeat ECG was
30msecs. 42% (n = 15) were co-prescribed another QTc-prolonging
medication.
Conclusion Current monitoring of QTc interval in an elderly pop-
ulation newly prescribed antipsychotic medications is inadequate
and a cause for significant safety concerns. Education and clear
guidance is warranted to improve safety and minimise risk in this
population.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Reference
[1] Alvarez PA, Pahissa J. QT alterations in psychopharmaco-
logy: Proven candidates and suspects. Current Drug Safety
2010;5(1):97–104.
EV0781
Acute catatonic syndrome associated
with hyponatraemia
E. McGuire∗, D.M. Yohanathan , D.L. Lally , D.G. McCarthy
Sligo Leitrim Mental Health Service, Psychiatry of Old Age, Sligo,
Ireland
∗ Corresponding author.
Introduction A 71 year old gentleman presented with two dis-
crete episodes of delirium with prominent psychotic features and
catatonia, over a 3-year period. Symptomatically, he was suffering
from fluctuating consciousness, paranoid ideation and both audi-
tory and visual hallucinations. He went on to develop catatonia,
demonstrating negativism and mutism and he also exhibited pseu-
doseizures. His symptoms resolved entirely after three weeks. He
re-presented 3 years later with profound psychosis and hypona-
traemia. On this occasion, he exhibited catalepsy, negativism,
echolalia and mutism, which resolved when his sodium was cor-
rected.
Objectives/aims To illustrate 2 episodes of acute catatonia tem-
porally associated with hyponatraemia in an otherwise healthy
elderly gentleman.
Methods This is a case study. Consentwas sought fromthe patient
to write up his case and distribute it for educational purposes.
His medical inpatient notes, psychiatric inpatient notes, correspon-
dence and bloods pertaining to both admissions were reviewed and
analysed. A literature review was carried out using Pubmed.
Results Low sodium levels were a common factor in his presen-
tations and normal sodium levels were associated with a return to
normal consciousness.
Conclusions While medical issues confounded his first pre-
sentation of hyponatraemia associated catatonia, his second
presentation was directly related to hyponatraemia. Given the
coincidence of hyponatraemia during his first admission, it would
strongly suggest that low sodium levels were an important factor in
this gentleman’s presentation. Importantly, this is the first case in
the literature to demonstrate catatonia related to hyponatraemia
on two separate occasions in the same individual.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0782
Psychological and physical problems
in elderly people with problems of
falls
M. Mentis ∗, M. Gouva , E. Antoniadou , K. Mpourdoulis ,
I. Kesoudidou , C. Marneras , E. Panagiotopoulos
1 University of Patras, Rehabilitation Clinic Spinal Cord Injury,
“Demetrios and Vera Sfikas”, Patras, Greece
2 Technological Educational Institute of Epirus, Research Laboratory
Psychology of Patients Families and Health Professionals, Ioannina,
Greece
∗ Corresponding author.
Introduction Falls of the elderly to a degree been associated with
poor mental health, poor social support and poor physical health.
Objectives To investigate the falls of elderly people in relation to
their mental and physical healthy.
Aims To compare the effects of falls in the elderly in the areas of
mental and physical health.
Methods The current study used purposive sampling compro-
mised from 48 people that visited the emergency department at
the Patras University Hospital in 2016. The inclusion criterion for
participation was age (> 65 years). Data was collected using WHO’s
questionnaire, the WHOQUOL-BREF. Finally, data was analyzed
using the test t test for independent samples.