European Psychiatry - Volume 41 - April 2017

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S842 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S772–S846
EV1331
Antipsychotics in chronic
schizoaffective disorder: A naturalistic
study
B. Tsygankov ∗, A. Ryzhukhinskaya , K. Evgeny , A. Pavlichenko
Moscow State Medical Dental University, Department of psychiatry,
narcology and psychotherapy, Moscow, Russia
∗ Corresponding author.
In spite of the beneficial effects of antipsychotics (AP) on the course
of schizoaffective disorder (SAD) in general, there is an evidence
for some negative aspects of their application. The objective of the
study was to investigate the clinical manifestations and the course
of resistant SAD while treated by the different AP. At present, the
research includes 63 patients with SAD and duration of psychotic
and/or affective symptoms more than six months. The research
was naturalistic follow-up. The first group of patients (n = 18)
were treated with SGA. An average duration of hospitalization was
61.2 days. After a reduction of acute psychotic condition, subthres-
hold psychotic and anxiety symptoms were still remaining. The
total PANSS score was 71 ± 8. The second group (n = 24) was treated
with a combination of FGA and SGA. An average duration of hos-
pitalization was 53.8 days, the total PANSS score was 79 ±6. It has
been prevailed subthreshold bipolar symptoms. The third group
of patients (n = 21) were treated with FGA. An average duration of
hospitalization was 45.5 days; the total PANSS score was 63 ±10.
The negative symptoms and subthreshold depressions have been
prevailed among the patients.
To conclude, the treatment of SAD by the SGA and combination
of SGA and FGA are more likely associated with persistence of sub-
threshold psychotic and/or bipolar disorder and the longer duration
of hospitalizations. On the other hand, application of FGA in SAD is
more likely associated with negative symptoms and depressions
after a reduction of acute psychotic condition.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1332
The emergence of psychosis in a
patient with severe hypothyroidism:
A case report and literature review
M.L. Turk ∗, J. Rosen
University of Virginia Health System, Psychiatry, Charlottesville, USA
∗ Corresponding author.
Hypothyroidism is associated with changes in mental state that
can range from mild cognitive impairment to depression to florid
myxedema coma. A few cases have linked the occurence of psy-
chotic symptoms in the context of severe hypothyroidism, an event
referred in the literature as “myxedema madness”. We describe
the case of a 48-year-old male with no past psychiatric history
and a past medical history of hypertension and hypothyroidism
who presented to the psychiatric unit for management of new-
onset psychosis, particularly paranoid delusions. On basic medical
screening, the patient was found to have severe hypothyroidism
manifested by a TSH level of 51.85 and a free T4 level less than
0.4. The patient was treated with both an antipsychotic and thy-
roid hormone replacement, after which his hypothyroid symptoms
and his psychosis improved. Liothyronine was also prescribed to
speed up the recovery course, as his delusions were thought to be
due to his hypothyroidism. The aim of this poster is to shed light
on the possibility of development of psychosis concomitantly with
severe hypothyroidism, given the rarity of such events, as well as to
illustrate the importance of treating the underlying medical cause
rather than only focusing on the treatment of the psychiatric symp-
toms. The use of Liothyronine proved to be beneficial in this case,
as the patient’s symptoms drastically improved after its adminis-
tration. This could potentially illustrate the importance of using
Liothyronine particularly in the treatment of delusional disorder in
severe hypothyroidism.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1333
Adjunctive minocycline in clozapine
and amisulpride treated
schizophrenia patients with
persistent symptoms
E. Tzavellas∗, D. Karaiskos , J. Konstantinou , E. Oikonomou ,
R. Soldatos , T. Paparrigopoulos
Eginition Hospital Of Athens, Psychiatry, Athens, Greece
∗ Corresponding author.
Objective Clozapine and amisulpride are two effective antipsy-
chotic and their combination often is used for treatment refractory
people with schizophrenia, yet many patients partially respond.
Clinical data and the recent literature suggest benefitswithminocy-
cline. in our study we adjunct minocycline in five schizophrenic
patients and we observed them for a period of 6 months.
Methods Our patients received adjunct minocycline (100mg oral
capsule twice daily).
Results Using the PANSS, we identified a statistically significant
(P < 0.05) clinical improvement from the fourth week of treat-
ment for positive mainly, and less for negative symptoms in all
our patients. Global cognitive function did not differ, although
there was a significant improvement in working memory favoring
minocycline. Moreover there was a marked reduction of anxiety
and depressive symptoms.
Minocycline was well tolerated and no patient presented side
effects.
Conclusion Minocycline seems to help significantly schizo-
phrenic patients who do not respond fully to their medication
consisted of clozapine and amisulpride. Larger studies are needed
to validate these findings.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1334
Major psychotrauma and social
stress–risk factors for the unfavorable
course of paranoid schizophrenia
T. Udristoiu ∗, I. Udristoiu , F. Militaru , S. Ristea , A.G. Vilcea ,
M.C. Pirlog
1 University of Medicine and Pharmacy of Craiova, Psychiatry,
Craiova, Romania
2 University Clinic of Psychiatry Craiova, Psychiatry, Craiova,
Romania
∗ Corresponding author.
Introduction Recent studies in the neurobiology of schizophrenia
highlighted the role of neuropsychoendocrine activations as a con-
sequence of psychostress followed by the activation of the HPA axis
with an excess of endogenous cortisol. The relation endogenous
cortisol–glutamatergic hyperactivation enhances the excito-toxic
mechanisms and the cortical-subcortical alterations in schizophre-
nia.
Method We conducted a retrospective study on 40 patients, with
ages between 25 and 55 years, admitted in the university clinic
of Craiova between January 1, 2015 and December 31, 2015 for
paranoid schizophrenia according to ICD-10 criteria and with pos-
itive history of psychotrauma and physical abuse in childhood and
adolescence.