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.
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.
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 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.