European Psychiatry - Volume 41 - April 2017

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S662 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S645–S709
EV0789
Parkinson psychosis: A complex
interaction of disease and medication
related factors
S. Petrykiv ∗, L. de Jonge , M. Arts
1 University Medical Center Groningen, Department of Clinical
Pharmacy and Pharmacology, Groningen, The Netherlands
2 Leonardo Scientific Research Institute, Department of Geriatric
Psychiatry, Department of Geriatric Psychiatry, Groningen, The
Netherlands
3 University Medical Center Groningen, Department of Old Age
Psychiatry, Groningen, The Netherlands
∗ Corresponding author.
Introduction Psychotic symptoms are the most important non-
motoric symptoms of the Parkinson disease (PD). The quality of life
of those patients can be significantly improved with an appropri-
ate therapy. In this article we provide evidence about the etiology,
differential diagnosis and therapeutic possibilities with a work-up
for the clinics.
Objectives & aims To provide a case report of patient with PD
who developed a paranoid psychosis after administration of lev-
odopa/carbidopa, followed by a literature review on psychotic
symptoms evoked by psychotropicmedication by patients with PD.
Methods An English-language literature search was conducted
using Pubmed, EMBASE searching for case reports and observa-
tional studies reporting iatrogenic psychotic symptoms by patients
with PD.
Results Ms. C. was a 65-year old woman with PD who was
observed in a polyclinic setting andwho used a levodopa/carbidopa
combination. She developed paranoid psychosis with a following
admission to the psychiatric ward. We have gradually lowered
the dose of anti-Parkinson medication. Subsequently, treatment
with clozapine was initiated and the psychotic symptoms resolved
within five months.
Conclusion Parkinson psychosis is due to a complex interaction of
neurodegenerative changes and pharmacological therapy. There-
fore, the role of iatrogenic factorsmust be always carefully assessed.
Psychosis inducting agents should be lowered or stopped before the
treatment with antipsychotic medication.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0790
The strategy to combat dementia in
Russia
L. Pishchikova
Federal State Budgetary Institution “V. Serbsky” Federal Medical
Research Center for Psychiatry and Narcology, Ministry of Health,
Moscow, Russia
The 139th Executive Committee WHO was held in May 2016. The
Russian delegation took part in its work. The main issue on the
agenda was the report on “Dementia”. It was noted that each year
dementia develops in 8 million people in the world. It is expected
that this figure will increase to 145 million by 2050. In Russia the
national plan to combat dementia is missing. In the resulting meet-
ing, all the WHO country-members voted for immediate action
on the adoption of the strategy for the fight against dementia by
2017. We developed a strategy for dementia, which includes the
following tasks;
– The need of epidemiological research in the field of dementia;
– Research on etiology, prevention, early diagnosis and treatment
of dementia;
– The expansion of the network of specialized stationary and non-
stationarny facilities for patients with dementia;
– Development of programs of psychological care to patients with
dementia and to caregivers;
– Development of palliative care for patients with dementia;
– Cross-sectoral cooperation and multidisciplinary approach in
assistance to patients with dementia;
– Training in the field of geriatric psychiatry, denomination of the
specialty of geriatric psychiatrist;
– Fighting stigma of patients with dementia, protection of their
rights, including in psychiatry and forensic psychiatry.
The solution of these objectives requires foundation of the Rus-
sian observatory on dementia, the WHO cooperating center. The
tasks of such an Observatory will be: centralization and coordi-
nation of actions concerning strategic planning, implementation of
mechanisms of amultispectral cooperation, assessment of services,
monitoring and providing reports on dementia issues in Russia.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0791
Evolutionism and involutionism in
the ontogenesis of ɑ late age
L. Pishchikova
Federal State Budgetary Institution “V. Serbsky Federal Medical
Research Center for Psychiatry and Narcology”, Ministry of Health-
Russia, Moscow, Russia
Individual human development frombirth to death is defined as the
ontogenesis. The ability of the human psyche to development and
to system acquisition of mental and social functions is called evolu-
tionism. The psyche property, causing a gradual loss in the process
of ontogenesis of biological, psychological and social functions is
defined as involutionism.
Involutivitionism of higher mental functions manifests in their
folding in the sequence reverse to the formation. Process of invo-
lution is uneven and abrupt. This is caused by their constant
interaction with the evolution processes, that are struggling with
age-related destruction and disruption and are responsible for the
ongoing adaptation, although at a lower ontogenetical level.
In the event of critical psycho traumatic situations, which are
related to the impact of jet-psychological, somatoneurological fac-
tors, there is a failure of adaptation mechanisms, decompensation
develops, the action of the involutive mechanisms increases, which
leads to a lower level of social functioning. In this interaction
biological and social factors act in their unity and predetermine
disadaptation options, while the latter, in their turn, determine
intensification of involutive processes.
Because of the interaction of these processesmental aging unevenly
affects higher mental functions with the advent of favorable
(adamantix) and unfavorable forms, determined by the devel-
opment of mental disorders and dementia. Favorable aging can
manifest itself by specific quantitative somatoneurological and
mental changes that do not lead to the loss of adaptation. Under
favorable aging life experience, professional skills, biological, social,
adaptive resources are preserved, evolutionary development of the
older person continues.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0792
Antipsychotics in dementia
A. Poc¸ as ∗, S. Almeida
Centro hospitalar Leiria, Psiquiatria e Saúde Mental, Leiria, Portugal
∗ Corresponding author.
Behaviour disorders and psychosis may represent a greater
challenge in patients with dementia. There are evidence-based