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IntroductionSkin-Picking Disorder (SPD) is psychiatric condition characterized by recurrent and excessive picking of the skin. There are several attempts to stop the behavior and it causes negative consequences such as dermatological complications and functional impairment.ObjectivesThe aim of this study is to describe a case report of SPD.MethodsData was collected retrospectively from case notes.ResultsA 30 year-old male, married with 2 children, currently on sick leave, was admitted to the Day Hospital at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) with worsen skin-picking behaviour and functional impairment. During childhood the patient would “cut my toe nails the wrong way so that I could fix them”. By adolescence the patient suffered from acne and felt the need to “solve” them and take out the pus. Over the years the skin-picking behaviour spread to other areas of the body, mainly dorsal and chest areas. Before being admitted to the Day Hospital the episodes were daily and had 2-3 hours duration, using scissors and tweezers and evolving his family, asking his wife’s help with picking. He is being treated with fluoxetine 80 mg, risperidone 2 mg and N-acetylcysteine 1200 mg and Cognitive Behavioural Therapy. He is also participating in the Day Hospital activities that include occupational therapy, movement therapy, psychoeducation. After 2 months he has a few 20 minutes episodes per week, spends more time with his children and thinks about coming back to work.ConclusionsSPD is a severe and debilitating illness that benefits from a multidisciplinary approach.DisclosureNo significant relationships.

The psychiatric conditions secondary to substance use (whether legal or illegal drugs) are well characterized and include psychosis, mania, depression and behavior changes. We present a case of metformin-induced psychosis in a 79 years-old patient without any previous psychiatric history. She was brought to emergency room after suicide attempt by hanging. She had a one-month history of altered behavioral and presented paranoid delusional though. Hallucinations were excluded. A detailed clinical evaluation excluded dementia, late-onset chronic psychosis and primary mood disorders with psychotic symptoms and revealed that symptoms initiate few days after the introduction of metformin to treat her diabetes. After Metformin suspension, total remission of psychotic symptoms was obtained in one week and patient return to previous functionality. Psychosis secondary to metformin use is a very rare complication of oral antidiabetic drugs use but the awareness of this condition can lead to an earlier recognition and diagnosis.

Introduction Paraphrenia is a disorder similar to paranoid schizophrenia characterized by phantastic, paralogical and extraordinary imaginative delusions, with better-preserved affect and rapport and much less personality and cognitive deterioration. Most affected patients are women, with onset of symptoms in late adulthood. It was firstly systematically described by Kraepelin in 1913 in order to define a group of psychotic patients who exhibited characteristic symptoms of dementia praecox, but with minimal disturbances of emotion and volition, and marked delusions. Later, it was considered to be unfounded and the term paraphrenia was not included in the current DSM-IV-TR and ICD-10 diagnostic criteria. However, several authors suggest that the concept of paraphrenia has not lost its usefulness and it seems to be that some psychiatrists recognize the illness, but labelled it as atypical psychosis or delusional disorder for the lack of a better diagnostic category. Objectives/aims The aim of this poster is to underline the modernity of Kraepelin's paraphrenia concept, suggesting that it could be possible to define and recognize the illness if practitioners would be induced to use a viable diagnostic entity. Methods Herein we report a case of a 51-year-old woman who presented three years ago with a psychotic disorder whose clinical features resemble de classical description of paraphrenia. Results/conclusion Very few systematic studies on paraphrenia have been carried out in the past 70 years. Further research in this field is needed in order to recognize the viability of this diagnosis and provide patients a better care and therapeutic management.

IntroductionOlfactory reference syndrome (ORS), first described by Pryse-Phillips in 1971, is a rare psychiatric condition whose defining characteristic is a preoccupation with the belief that one emits a foul or offensive body odor, which is not perceived by others. Although the existence of ORS is now widely accepted, current classifications do not explicitly mention ORS as an independent category, but consider it as a delusional disorder, somatic type. Nonetheless, given this syndrome's consistent description along time and cultures, and the associated substancial distress and disability, many authors debate the possibility of a new classification in order to establish its nosological status.Objectives/aimsThe aim of this paper is to show and discuss some troublesome and complex issues of diagnosis and management of patients with ORS.MethodsHerein we report a case of a 38-year-old woman who presented with ORS.Results/conclusionsImprovement in ORS can take place, in some extent, with a variety of different modalities of treatment, with the disorder responding to antidepressants and psychotherapy more frequently than to neuroleptics. Data on ORS are still limited and more research in this field is needed. Awareness of this particular diagnosis allows appropriate treatment to be administered.