European Psychiatry - Volume 41 - April 2017

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S814 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S772–S846
Most of them had nonspecific symptoms of anxiety, emotional
lability, irritability, etc. In half of the cases were reported weight
loss, insomnia and several variations of the usual behavior in
recent days.
Discussion The most important variable is to analyze the reason
for consultation. Moreover, substance abuse and a combination of
prodromal symptoms including positive and other nonspecific are
detected. Furthermore, at the profile with possible demands, we
believe it is appropriate not to delaymental health assessment after
making the appropriate intervention.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1250
First acute psychotic episode: Factors
associated with evolution to
schizophrenia
N. Halouani ∗, F. Guermazi , K. Yaich , R. Ennaoui , S. Chouayakh ,
J. Aloulou , O. Amami
Hédi Chaker University Hospital, psychiatry, Sfax, Tunisia
∗ Corresponding author.
Introduction The acute psychotic episode have often a dramatic
expression. Although it is easily diagnosed, it is not easy to predict
the evolution and much less the prognosis that are of concern both
for the therapist and the patients’ families.
Aims To describe the profile of a population of patientswith a first
psychotic episode. To identify factors correlated with evolution to
schizophrenia.
Methods This is a retrospective study conducted among 55
patients hospitalized for a first acute psychotic episode, in the psy-
chiatry B department during the period extending between January
2010 and December 2015.
Results The average age of patients was 26.5. The majority was
single male. The prodromal phase was present with predominantly
psychotic symptoms (80%). Schizophrenia was the most frequently
encountered scalable diagnosis (38%). Some factors are associ-
ated with the evolution to schizophrenia. We can mention male
gender ( P= 0.004) and premorbid schizoid personality (P = 0.047).
About correlated clinical factors, we have found an initial sym-
ptomatology dominated by loss of interest (P = 0.05), withdrawal
and isolation (P = 0.017), impulsivity ( P= 0.011), breaking with
the usual functioning (P = 0.04), mental automatism (P = 0.033),
the delusions of persecution (P = 0.025) and intuitive mechanism
(P = 0.023).
Conclusion When a first acute delusional experience occurs in
a young adult, it is always a test of uncertain outcome. How-
ever, schizophrenia remains the most feared evolutionary. A better
understanding of poor prognosis and early and appropriate man-
agement seem paramount to reduce the prevalence of this dreaded
evolution.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1251
Combined pharmacotherapy
involving aripiprazole and clozapine
for controlling the positive symptoms
refractory to other antipsychotic
treatments in a patient with
schizophrenia
G. Hernandez Santillan (Psychiatry resident doctor) ∗,
K. Lazo-Chávez (Psychiatry resident doctor) ,
M. Blanco-Prieto (Psychiatry resident doctor)
Mental Health, Madrid, Spain
∗ Corresponding author.
Introduction Treatment resistance is considered a challeng-
ing problem of antipsychotic pharmacotherapy in schizophrenia,
especially, when it is associated with other factors, such as cul-
tural aspects, diverse clinical presentation, furthermore functional
impact. Then, combination approaches are commonly used, for
instance, the add-on of aripiprazole to clozapine; which allows
increasing of efficacy and safety.
Objective Assess the response to clozapine–aripiprazole combi-
nation treatment in the management of resistant schizophrenia.
Aim Treatment of resistant schizophrenia.
Method Analysis of a clinical case.
Result A 27-year-old male resident in an Iberian country two
years ago, is from a Latin American country, lives with his mother,
his sister and his nephew. Their parents were separated. Eight years
ago, his father died and shortly thereafter, he started impaired
behavior, auditory and visual hallucinations, delusions about ref-
erentiality, persecution and prejudice, which required a brief
hospitalization in their country. Upon arrival, he is included in
the network of Mental Health, with positive symptoms, significant
behavioral and cognitive disorganization and he needed hospi-
talization again. Then, treatment is instituted in different lines
with risperidone, quetiapine, olanzapine, haloperidol, amisulpride,
without results. Then, combined clozapine therapy is initiated up
to 400mg/day, more aripiprazole 20mg/day, which switch after to
pattern injectable depot, with informed consent. Six months after,
he presents encapsulated delirium and improvement of disorgani-
zation, allowing the patient to retake studies.
Conclusion Clozapine–aripiprazole combination was associated
with 22% reduction of clozapine dose. There was improvement in
positive and negative symptoms, social functions and amelioration
in their metabolic profile.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1252
Reducing diabetes type 2 risk in
non-selected outpatients with
schizophrenia, a thirty-month
program
P. Hjorth
University of Southern Denmark, Psychiatry, Kolding/Vejle, Silkeborg,
Denmark
Introduction Diabetes type 2 is 2–3 foldmore common in patients
with schizophrenia compared to the general population. A lifestyle
with focus on diet, exercise and medication is required to prevent
complications from diabetes type 2.
Objectives Patients may have trouble complying with a well-
structured and healthy lifestyle because of factors related to their
illness e.g. cognitive disturbances, negative/positive symptoms and
treatment with psychotropic medication.
Aims To measure and reduce diabetes type 2 risk factors in
patients and examine characteristics associatedwith a positive out-
come.
Methods A naturalistic intervention study through 30 months of
clinical work with individual guidance, group sessions and treat-
ment as usual.
Results At index, the newly diagnosed patients had a high con-
sumption of soft drinks and low physical activity. Over time, the
newly diagnosed patients worsened their physical profile with
increased weight, waist circumference, visceral adiposity index
(P = 0.030) and HbA1c (P= 0.010). HbA1c increased for newly diag-
nosed male patients with 0.24m.mol/L ( P = 0.007). The long-term
patient’s physical activity level was low. After the intervention,