Research Paper on ADHD history, causes, treatment, prevention, cross cultural issues and christian worldview perspective on ADHD.

S790 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

entering university, however, few treatment options are available. The aim of this study is to investigate the effectiveness of group therapy in university students with ASD. Methods A one-group, pre-intervention-post-intervention design was adapted for this study. All patients with ASD were recruited from Shizuoka University. The group therapy programs consisted of cognitive behavioral therapy and recreational activity. Outcome measures were Beck Depression Inventory-Second Edition, Quality of Life Inventory, State Trait Anxiety Inventory and Rosenberg Self-Esteem Scale. Results There were 14 participants, 7 males and 7 females. Their ages were from 19-years-old to 23-years-old. All participants had over 80% of attendance in the six-month group therapy. Conclusions These preliminary results suggest that the group therapy can improve symptoms of depression and anxiety for some students with ASD. More research is needed to draw more sturdy conclusions, especially with respect to improvements in quality of life. Disclosure of interest The authors have not supplied their decla- ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2370

EV1386

Disruptive behaviour’s treatment with paliperidone in autistic disorder: Review and case report M. García Moreno 1,∗, A. De Cós Milas 2, L. Beatobe Carreño 2, B. Poza Cano 3 1 Hospital Universitario Puerta de Hierro Majadahonda, CSM Majadahonda, Madrid, Spain 2 Hospital Universitario de Móstoles, CSM Móstoles, Madrid, Spain 3 Hospital Universitario El Escorial, CE San Carlos El Escorial, Madrid, Spain ∗ Corresponding author.

Introduction Autistic disorder (AD) is a neuropsychiatric disor- der that often presents significant disruptive symptoms such as irritability, aggression and self-injury in addition to impairment of social skills and communication. These symptoms interfere both individuals with AD and their families and social environment. Objective Show paliperidone effect in behavioural symptoms in AD. Methods Literature review about behavioural symptoms in AD and paliperidone effect in its treatment, followed by a case report of clinical improvement after treatment with paliperidone in a patient with autism. Agitation subscale Aberrant Behavior Checklist (ABC-I) scores was compared prior and 4 weeks after paliperidone treat- ment, and clinical improvement was assessed with Clinical Global Impression-Improvement Scale (CGI-I). Results Although risperidone has been one of the most stud- ied atypical antipsychotic to treat this symptoms, its use should be limited in order to avoid extrapyramidal and metabolic symp- toms. Paliperidone – the major metabolite of risperidone – has shown effectiveness in the treatment of behavioral symptoms in patients with autism, even in subjects with a prior ineffective trial of risperidone. Our patient, 21-years-old male with AD and significant disruptive symptoms was treated with paliperidone 9 mg/day. We observed a 20-points reduction in ABC-I scores 4 weeks later, with most significant improvement in items like auto-agression, het- eroaggressivity, irritability and slams. CGI-I scores showed a much better improvement, and no significant adverse effects appeared. Conclusions Paliperidone is an effective and safe treatment in behavioral symptoms associated to AD, with reduction in ABC-I subscale scores. More studies are needed to confirm our data. Disclosure of interest The authors have not supplied their decla- ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2371

EV1387

Does community care works? Evaluate the effectiveness of mental health services M. Giacomin Psychiatrist Director of Semiresidential Day Center in Mental Health Center of Villorba (Tv), Italy

Introduction Improving quality require the capability to evaluate clinical and operational processes and improve patients outcomes. Just in the view of evidence-based practise (EBP) it’s used HONOS rating Scale, adopted since May 2012, by Mental Health Center of Villorba (Treviso-Italy) There are 3 package treatments: rehabili- tative, territorial and clinical. Objectives To identify which variables are positively correlated to HONOS improvement in patients group who frequented Mental Health Centre along 36 months. All patients present severe mental illness. Aims Evaluate the effectiveness of interventions and correlate to treatment package and individual feature. Analyze treatment process for quality improvement. Method A psychiatric team (4 nurses, 1 psychiatrist) adminis- tered Honos Rating Scale along 3 years: on starting point and 6, 12 and 36 months later: T 0,1,2,3,4. Patients are also described by diagnosis, mental, social and autonomy skill, time, utilization of MHC and anagraphic information. Results All 15 groups’ patients realize lower scoring, after 36 months’ treatment. Seven have got reliable improvement (i.e. = > 8- point lowering T3–T4) and positively correlate with: (1) 36 months’ treatment, at 12 months in rehabilitative Package; (2) days in residential/semi-residential community from 82 to 311 days. Related tables are included in paper. Discussion and conclusion HONOS score correlates directly with clinical and riabilitation improvement, i.e. mental, social capacity, and personal autonomy. It needs more investigation to clear which other factors are involved with improvement. Disclosure of interest The author has not supplied his/her decla- ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2372

EV1388

Diagnosis and treatment of ADHD in young adults C. Glod Merrimack College, Academic Affairs, North Andover, USA

Introduction ADHD is one of the most common psychiatric disor- ders, affecting 6–10% of children. Recent studies have shown that the illness persists into adolescence and adulthood. Objectives The purpose of this session is to review the state of the science of the diagnosis and treatment of ADHD in young adults and college students. This population poses unique developmental challenges in evaluation of symptoms and adherence to treatment. Aims The aim of this presentation is to promote a better under- standing of the differential diagnosis and effective treatment options specific to this age group. Methods Review of the literature. Results Young adults diagnosed with ADHD in childhood demon- strate symptoms of inattention and hyperactivity that continue. In addition, this age group may present for the first time with previously undiagnosed symptoms that interfere with functioning. Further complicating evaluation and treatment may be the emer- gence of mood disorders or alcohol/substance abuse. Left untreated, ADHD symptoms affect functioning in several key areas including self-esteem, repeated academic failures, poor occupational per- formance, propensity for motor vehicle incidents, instability in relationships, alcohol/substance misuse and abuse, and overall suc- cessful transition to adulthood. Psychopharmacological studies of

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S791

adults reveal the efficacy of several classes of medication including psychostimulants, non-stimulants, and some antidepressants. Conclusions Young adults with ADHD present a unique set of diagnostic challenges along with comorbid conditions, such as depression or alcohol/drug abuse. Accurate diagnosis and early intervention can prevent the development of significant problems into adulthood, reduce morbidity and promote healthy relation- ships and career/educational success. Disclosure of interest The author has not supplied his/her decla- ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2373

EV1389

An approach to neuroleptic malignant syndrome from a clinical case A. Gomez Peinado ∗, P. Cano Ruiz , M.D. Sanchez Garcia , S. Cañas Fraile , M. Gonzalez Cano , G.E. Barba Fajardo Hospital Nuestra Señora del Perpetuo Socorro, Mental Health, Albacete, Spain ∗ Corresponding author.

Introduction Neuroleptic malignant syndrome (NMS) takes place in patients in treatment with neuroleptics and it is poten- tially lethal, being important an early diagnostic and therapeutic approach. Objectives To analyze from a clinical case the clinical and epi- demiological features, and therapeutical approach to NMS. Method Review of some articles in Mental Health journals and analysis of the following clinical case: 68-year-old woman with bipolar disorder, hospitalized in manic phase. Usual treatment: lithium, trazodone, quetiapine and asenapine. During the admis- sion to hospital, the patient started presenting hyperthermia, sweating, electrolyte disturbances, limb rigidity, and elevation of CPK levels. The suspicion was NMS, so neuroleptics were stopped and fluids and dantrolene were initiated, with favorable evolution. Results The discharge diagnosis was NMS. Neuroleptics were gradually reintroduced under vigilance. The patient is stable and has not had new complications. NMS is an uncommon (0.02% to 3% among patients taking neuroleptic agents), but life-threatening condition. Its symptoms are hyperthermia, autonomic nervous system dysfunction, limb rigidity, altered consciousness. . . The attendant infections, consume of lithium, dehydration, iron defi- ciency and sharp changes in neuroleptic treatment are predisposing factors. The withdrawal of neuroleptics is the key of the treatment. Benzodiazepines can improve the prognosis, and electroconvul- sive therapy can be necessary if there is no response to previous measures. Conclusions Neuroleptic malignant syndrome is a life- threatening medical complication we should try to avoid by a correct and careful use of neuroleptics. Additionally, it is impor- tant the early treatment, taking withdrawal of neuroleptics as the key starting point. Disclosure of interest The authors have not supplied their decla- ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2374

EV1390

Erotomania and mood disorder: A case report and literature review V. Guillard 1,∗, J. Mallet 2, F. Limosin 3 1 Charcot hospital, Psychiatry, Plaisir, France 2 Louis-Mourier hospital, Psychiatry, Colombes, France 3 Corentin-Celton hospital, Psychiatry, Issy-les-Moulineaux, France ∗ Corresponding author.

Introduction Erotomania is a rare delusional disorder. De Cleram- bault, a French psychiatrist, was the first who advanced the concept of pure erotomania, one of the “passionate psychosis”, as a distinct

disorder. However, some authors tend to consider this syndrome as related to other psychiatric disorders. Objectives To describe the case of a female patient with ero- tomanic delusion with no remission under an antipsychotic and to review the links between erotomania and other psychiatric dis- orders. Methods Literature review and a case report. Results We report the case of a 32 year-old epileptic woman, hos- pitalized for a delusional erotomanic disorder. Initially, the patient was treated with an antipsychotic, with partial effectiveness. In fact, it appeared that the conviction of being loved began while she was depressed. After one month of combined antipsychotic and antide- pressive medication, she became euthymic and her erotomanic delusions disappeared. Major depressive disorder with psychotic symptoms was diagnosed. After reviewing the literature we found that erotomanic symptoms frequently appear secondarily in other psychiatric disorders. Several publications indicate a frequent asso- ciation between erotomania and mood disorder, especially bipolar affective disorder and major depression, and describe the efficacy of antidepressant and mood stabilizers. Numerous theories may explain the link between erotomania and mood disorder: from narcissistic needs, to the capacity of empathy and emotional pro- cessing. Further studies are needed to clarify the nature of this link. Conclusion In clinical practice, a mood disorder must system- atically be searched for and treated in a patient with erotomanic delusions. Disclosure of interest The authors have not supplied their decla- ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2375

EV1391

Practical teaching of behavioral sciences to medical students M. Hammouda Al-Azhar Faculty of Medicine, Cairo, Egypt

Introduction The teaching of behavioral sciences was in form of lectures to the medical students in the 2nd year of the college, because the lecture is the least beneficial method of teaching. As I have noticed also that students were more interested to practice behavioral skills. So I suggested to the authority of the faculty to teach part of the behavioral sciences in a practical way and pro- posal of that was introduced and accepted to teach in that way and to give 20% of marks to this practical part, this in addition to the same theoretical lectures. Method The students were divided into groups of 30, every group present one day only through their 2nd year. This day divided into two parts each is 2 hours and in between have an hour break. The 1st part includes group discussion about communication, group dynamics, group leading and scientific way of problem solving. The 2nd part is dividing students into small groups of 10 students, to practice the previous skills in group interaction to solve one prob- lem in a scientific way. All groups collected again to see what they have done. Results The results revealed more interest and more enthusiasm to learn in that way and make it easy to practice in their daily life. Conclusion We have to change into more practice in our teach- ing of medical students especially skills of human communication, group leading group dynamics as well as problem solving. Disclosure of interest The author has not supplied his/her decla- ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2376

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