{"paper_id":"bfea8778-5c31-477e-8d9d-6cee58548f56","body_text":"Regarding the PANSS scale – all score in the interval 75-100 points\nbefore initiation as opposed to the scores marked after the initiation\nof the medication that vary in the interval 34-48 points with definite\ndistinctions in P and G items. Regarding the PSP scale – all\nparticipants score between 50 and 70 points before the initiation\nof the treatment as opposed to the scores of 89-95 points after the\ninitiation. During the regular check-ups the patients report of\nsubjective improvement, coupled with reports of objective and\npositive improvement by family.\nConclusions: Treatment with LAIs – Xeplion and Trevicta has an\nunquestionable positive and lasting effect in the treatment of\nschizophrenia. Proof of that is the definite improvement of the\nsymptoms, the increased social engagement and interpersonal\ncommunication. Everything mentioned is a valid reason to direct\nthe treatment of schizophrenia in the direction of preservation of\nthe personality of the patients.\nDisclosure of Interest: None Declared\nEPV0911\nCT OF THE ENDOCRANIUM IN THE FIRST\nEPISODES OF PSYCHOTIC DISORDERS\nA. Tomcuk*, J. Dedovic and A. Macic\nSpecial Psychiatric Hospital Kotor, Kotor, Montenegro\n*Corresponding author.\ndoi: 10.1192/j.eurpsy.2023.2210\nIntroduction: CT of the endocranium is an indispensable step in\nthe differential-diagnostic evaluation of a patient with the first\nepisode of psychotic disorder. In this context, the main goal of this\ndiagnostic procedure is to “exclude” the so-called organic disorders\nof the brain tissue, which could be manifested by psychotic phe-\nnomenology. However, during the past decades, pathological\nchanges in the brain parenchyma have been found during neuroi-\nmaging studies of psychiatric patients.\nWith the group of schizophrenic psychoses, the following are most\noften associated: Expansion of the ventricular system, cortical\nreductive changes, agenesis of the corpus callosum, a higher fre-\nquency of some congenital anomalies of the brain, such as cavum\nseptum pellucidum and cavum verga.\nObjectives: Consequently, the main goal of our study is to dem-\nonstrate the possibility of diagnosing these changes and examine\nthe frequency of cases of so-called secondary psychotic syndromes,\nwhere psychotic phenomenology arose on the basis of some other\nillness.\nMethods: Data were collected for 145 patients from the Acute Male\nDepartment, who were treated in the period 2011-2019. CT scan of\nthe endocranium was performed as part of the diagnostic evalu-\nation during the first psychiatric hospitalization.\nResults: Out of the total number of examinations (145), 20.7% of\npatients had a pathological finding, with the following structure: In\n6.9% of the age group up to 45 years, moderately expressed (dis-\nproportionate for the age) cortical reductive changes were found.\nConcomitant occurrence of cavum septi pellucid et cavum vergae\nwas observed in 3.4% and isolated septum pellucidum cyst in 1.3%\nof patients. Post-stroke changes, post-contusion foci, and benign\ncongenital brain tumors were found with a frequency of 1.3%,\npronounced cortical reductive changes and pathological\ncalcifications with a frequency of 3%, while in individual cases\n(0.68%) the presence of a subarachnoid cyst and atrophy of the\ncerebellar cortex was recorded\nConclusions: CT of the endocranium represents a significant aid in\nthe evaluation of a patient with the first episode of psychotic\ndisorder. However, its use in order to analyze more complex\nchanges in psychiatric patients is significantly limited compared\nto more modern neuroimaging modalities.\nDisclosure of Interest: None Declared\nEPV0912\nGnRh agonists as precipitating components of\npsychiatric pathology. A case report.\nA. Guerrero Medina *, J. S. García Eslava, A. C. Martín Rodriguez,\nL. Martinez Salvador, M. J. Alvarez Alonso and M. Aubareda\nMagriña\nPsychiatry, Consorci Hospitalari de Vic, Vic, Spain\n*Corresponding author.\ndoi: 10.1192/j.eurpsy.2023.2211\nIntroduction: GnRh agonists are drugs used in various\ngynecological pathologies, among which is endometriosis. They\nact by stimulating GnRh receptors in the pituitary gland. This\nsustained and continuous stimulation of GnRh, will initially gen-\nerate an increase in the release of luteinizing hormones and follicle-\nstimulating hormones, subsequently losing sensitivity to the recep-\ntors, internalizing them, and thus suppressing the release of these\nhormones, which would entail an ovarian suppression, thereby\ninhibiting the release of estrogens and progesterone. Psychiatric\nadverse effects have been described. Gonzalez-Rodriguez et al\n(Front Psychiatry 2020; 11:479), described this association with\nchanges in mood, and the presence of a series of cases where the\nlink between GnRh agonist and the possibility of presenting psych-\notic symptoms is observed. Wieck (Curr Top Behav Neurosci\n2011;8:173-87), Frokjaer (J Neurosci Res 2020;98(7):1283-1292),\nBrzezinski-Sinai et al (Front Psychiatry 2020;11:693) reported that\nthis association could be related with the relationship of the\nhypothalamic-pituitary-gonadal axis, hormonal fluctuation and\nits relationship with the dopaminergic regulation, a genetic com-\nponent that would increase the predisposition to trigger psychiatric\npathology in patients with greater sensitivity to hormonal fluctu-\nations, and the loss of neuroprotection generated by the decrease of\nestrogens in the central nervous system. All of this in the context of\nmultiple environmental and genetic factors that participate\ntogether in the appearance of the disease.\nObjectives: To describe the importance of detecting the risk factors\nthat can precipitate a psychotic episode, including the use of certain\ndrugs, such as GnRh agonists.\nMethods: We describe a case of a 45 year old patient with endo-\nmetriosis with multiple organ involvement who went to the emer-\ngency room due to behavioral changes in the context of a brief\npsychotic disorder with “ad-integrum” recovery.\nResults: A retrospective analysis of the case is conducted, observing\nan association between the introduction of GnRh agonists and the\npresentation of a first psychotic episode.\nConclusions: The importance of this case lies in the limited evi-\ndence of this association in the literature, and the implication of\nS1042 E-Poster Viewing\n\nthese drugs in the triggering of psychiatric pathology, being an\naspect to be considered by psychiatrists in their patient’s follow-up.\nDisclosure of Interest: None Declared\nEPV0913\nRelation between stressful life events and psychosis\nA. Osca Oliver 1*, R. Pérez Iglesias 2, M. V. López Rodrigo 1, V. Ros\nFons1, Y. D´Hiver 1, G. Sánchez 1 and M. Pérez Fominaya 1\n1Hospital Nuestra Señora del Prado, Talavera de la Reina and2Hospital\nUniversitario Valdecillas, Santander, Spain\n*Corresponding author.\ndoi: 10.1192/j.eurpsy.2023.2212\nIntroduction: Numerous studies establish clear connections\nbetween traumatic childhood experiences and the risk of develop-\ning psychosis. According to the study carried out by Filippo Varese,\nchildhood traumas, understanding by; physical, psychological or\nsexual abuse, abandonment, death of the parent and “bullying”,\nincrease up to three times the risk of suffering from psychosis.\nObjectives:\n- Determine the prevalence of traumatic events in the sample\nstudied.\n- Determine which traumatic event has a greater relationship\nwith the risk of presenting a psychotic episode.\n- To determine whether traumatic events may be more strongly\nassociated or not with gender differences, age at onset and\nfamily story.\nMethods: A descriptive study is carried out in which the traumatic\nevents are evaluated (through the CAVE questionnaire) of\n98 patients who have been treated for a psychotic episode in the\nlast two years in the Early Intervention Unit for Psychosis\n(ITPCan).\nThe stressful life history questionnaire (CAVE) consists of 52 ques-\ntions divided into blocks: school stage, work, partner, family, health\nand other stressful events. All of them focused on those stressful\nevents prior to the onset of psychotic symptoms. Stressful events\nhave been considered to be those events in which the patients\nstudied have scored 10 (maximum score) on the anxiety scale.\nInclusion criteria:\n- Older than 18 years-old\n- Having presented a first psychotic episode.\nExclusion criteria:\n- Intellectual disabilities\nResults: For now, the data studied in this sample are similar to those\ndescribed in most of the studies reviewed: more than half of the\npatients present at least one traumatic event before the onset of\npsychotic symptoms and a third of these have had any traumatic\nexperience before the age of 18.\nThe percentage of the presence of at least one traumatic event\nwithin the categories of the CAVE questionnaire would be:\n14.2% in the school stage\n26.7% in the workplace\n26% in relationships\n24.3% in family relationships\n12.1% in events related to the patient ’s own health problems\nConclusions: We continue to increase the sample to have a more\nsignificant result.\nDisclosure of Interest: None Declared\nEPV0914\nElectroconvulsive Therapy for Neuroleptic Malignant\nSyndrome: A case report\nA. Osca Oliver1*, M. V. López Rodrigo 2, V. Ros Fons 2, M. Palomo\nMonge2, A. Osca Oliver 1 and M. F. Tascón 2\n1Unidad de Psiquiatría and 2Hospital Nuestra Señora del Prado,\nTalavera de la Reina, Spain\n*Corresponding author.\ndoi: 10.1192/j.eurpsy.2023.2213\nIntroduction: Neuroleptic malignant syndrome (NMS) is a rare\nsyndrome observed in around 0.2% of psychiatric patients. This\nsyndrome consists of the presentation of muscular rigidity, tachy-\ncardia, hyperpyrexia, leukocytosis and elevated levels of CPK. Any\nantipsychotic drug, including atypical ones, can cause this syn-\ndrome. This being an idiosyncratic response to dopamine receptor\nantagonist medications.\nThe use of ECT in patients suffering from NMS is very effective,\nseeing the progressive resolution of the picture in the first sessions.\nObjectives: The patient was a 43-year-old man, whose somatic\nhistory only highlights hypothyroidism, and according to his psy-\nchiatric history, he was diagnosed of mental retardation and para-\nnoid schizophrenia. He was a resident of a group home. And he was\nrecently admitted to a mid-stay psychiatric unit. During this admis-\nsion, the responsible doctor added haloperidol to his medication\nregimen. His other medications at the time were; valproic acid,\nrisperidone and trazodone. A few days later, the patient began to\npresent a dysthermic sensation (presenting a temperature of 39ºC)\nand drowsiness. A laboratory tests and a chest X-ray was per-\nformed, highlighting: leukocytosis and an increase in elevated\ncreatine phosphokinase (CPK).\nDue to his recent exposure to 2 different antipsychotics, with fever,\nrigidity, and elevated CPK, we considered NMS. Antipsychotics\nwere withdrawn and supportive measures were started. Within the\nnext 2 days, his CPK level began to decline and the fever and\nleukocytosis resolved. But without resolving muscle rigidity. At\nthe same time, he began to exhibit staring, negativism and prejudice\ndelusions. Therefore, electroconvulsive therapy sessions were\nstarted.\nMethods: .\nResults: After the third session, his catatonic symptoms increased\nto better; he became more verbal, with less negativism and the\npsychotic symptomatology ceased. After the fifth session of ECT, he\nreturned to his initial level and was able to walk to the bathroom\nwithout assistance and perform other activities of daily living.\nConclusions: It is extremely important that professionals special-\nized in psychiatry become familiar with ECT and consider this\ntechnique as treatment in cases of neuroleptic malignant syndrome.\nDisclosure of Interest: None Declared\nEuropean Psychiatry S1043","source_license":"CC0","license_restricted":false}