European Psychiatry - Volume 41 - April 2017

843 / 916

25th European Congress of Psychiatry / European Psychiatry 41S (2017) S772–S846 S839
EV1324
Delayed post-hypoxic
leukoencephalopathy: Case report
M. Solerdelcoll Arimany ∗, M. Garriga , E. Parellada
1 Institute of Neuroscience- Hospital Clínic de Barcelona- Barcelona-
Spain, Department of Psychiatry and Psychology, Manlleu, Spain
2 Institute of Neuroscience, Hospital Clinic Barcelona, IDIBAPS,
CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain,
Bipolar Disorders Unit, Barcelona, Spain
3 Institute of Neuroscience, Hospital Clinic Barcelona, IDIBAPS,
CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain,
Barcelona Clinic Schizophrenia Unit BCSU, Barcelona, Spain
∗ Corresponding author.
Introduction Delayed post-hypoxic leukoencephalopathy (DPHL)
is an underrecognized syndrome of delayed demyelination, where
patients manifest neuropsychiatric symptoms after a period of
2–40 days of apparent recovery from a cerebral hypo-oxygenation
episode.
Objectives We report a case of a patient who successfully recov-
ered froman overdose of heroin, but then suffered a delayed abrupt
neurological deterioration.
Aims To improve assessment and recognition of DPHL.
Methods An adequate retrospective collection of clinical data and
nonsystematic review of the literature was performed.
Results A 43-year-old male with schizoaffective disorder who
attempted suicide with an overdose of heroin, was successfully
revived and return to his previously mental status, but 3 weeks
after, he abruptly developed progressive cognitive impairment
with akinetic mutism and ataxia. He was admitted to our acute
psychiatric unit after brain CT and chemistry analyses were unre-
markable. Brain MRI showed diffusely symmetric hyperintensity
in the white matter (WM), pronominally the periventricular WM,
on FLAIR and T2 weighted sequences. At 16 weeks postoverdose,
he presented improvement both cognitive and motor symptoms,
lasting deficits in frontal-executive functions.
Discussion DPHL is characterized by similar clinical and neu-
roimaging features regardless of the initial insult. The mean
lucid interval coincides with the replacement half-life for myelin
related lipids and proteins. Prolonged mild-to-moderate hypo-
oxygenation of WM is thought to disrupt myelin turnover. It
appears probable that these were responsible for DPHL in our
patient rather than a direct toxicity.
Conclusion DPHL can be diagnosed when clinical history, labora-
tory assessments and MRI findings are concordant. DPHL requires
extensive support care and carries a relatively good prognosis.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1325
When schizophrenia leads to
terrorism: A case report
N. Staali
Razi hospital, psychiatry ward G, Tunis, Tunisia
Background Some have suggested that terrorists are mentally
ill and have used labels such as psychopathic or sociopathic, nar-
cissistic, paranoid, are schizophrenic types, or passive–aggressive.
Others have argued that although terrorist actions may seem irra-
tional or delusional to society in general, terrorists in fact, act
rationally, and there is no evidence to indicate that they are
mentally ill/disordered, psychopathic or otherwise psychologically
abnormal.
Objective and method Here we present the case of Mr. A, a 32 year
old man diagnosed with schizophrenia, who travelled to Egypt and
Syria in attempt to join the ISIS terrorist organization, and discuss
the clinical features, treatment processes and two years follow-up
of this particular case.
Conclusion As described in some studies, most terrorists do not
demonstrate serious psychopathology and there is no single per-
sonality type. Thus, the relationship between terrorism and mental
illness mostly refers to the question about pathological travel as
part of a religious and messianic delirium.
Keywords Schizophrenia; Terrorism; Pathological travel;
Religion
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV1326
Impairment of visual working
memory among patients with
paranoid schizophrenia
M. Stoimenova-Popova ∗, I. Veleva , P. Chumpalova ,
L. Tumbev , A. Todorov , M. Valkova , V. Valtchev
1 Medical University-Pleven, Faculty of Public Health-Psychiatry and
Medical psychology, Pleven, Bulgaria
2 Medical University-Pleven, Neurology and Neurosugery, Pleven,
Bulgaria
3 National Sports Academy, Biochemistry and Physiology, Sofia,
Bulgaria
∗ Corresponding author.
Introduction Schizophrenia is associated with working memory
(WM), executive dysfunction and access visual WM dysfunctions
among patients with paranoid schizophrenia (PSz).
Material and methods We examined 89 patients (41.35 ±11.52
years old, 65 males, 24 females, 15 with basic, 52 with middle and
22 with high formal education) with PSz (65% with prevalence of
positive and 31 of negative syndromes) by Benton visual retention
test (BVRT, var.A and E).
Results The average number of correct performed items was
3.12± 1.1.83, the average errors, 13.04 ±3.70 (6.51 ±3.05 at left
and 5.35 ±2.30 at right visual field (VF)). Females had more cor-
rects (P = 0.0256). Education is associated with less errors and more
corrects. Patients with prevalence of negative syndromes showed
more errors at left VF than those with positive, although the total
number of errors and corrects were similar. Ageing was not directly
associated with total number of corrects and errors. Twenty-three
percent of our patients had addictions, 52% had omissions, 96% dis-
tortions (average 4.12± 2.31), 78% perseverations, 79% rotations,
83% misplacements and 61% size errors. Horizontal displacements
were obtained from 42%.
Conclusions Visual WM dysfunction is frequent among patients
with PSz. Female sex and high education are associated with better
test performances. Negative syndromes are related with high num-
ber of errors at left VF, but not with total numbers of corrects and
errors. We suggest horizontal displacement as specific error among
patients with PSz.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1327
Hypothyroidism in psychiatric
patients
I. Melatto , M.D.L. Pequeno , A. Santos , H. Gilberto ,
D. Malheiros , F.J. Ropero Peláez , G. Taniguchi Rodrigues ,
J. Magalhães , S. Taniguchi ∗
1 Albert Einstein Hospital, Basic Sciences, Santo André, Brazil
2 CAPS II Jardim Lídia, Psychiatry, São Paulo, Brazil
3 Albert Einstein Hospital, Health Economics, São Paulo, Brazil