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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237



In patients withmajor depressive disorder resilience

were associated with a good self-perception of physical and men-

tal health, higher self-esteem levels and problem-focused/emotion

focused coping strategies. In schizophrenic patients, sample there

was no positive correlation between resilience and perceived qual-

ity of life. Further implications will be discussed.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Systematic evaluation of

dose-escalation strategies after initial

non-response to standard-dose

pharmacotherapy in schizophrenia

M. Dold

1 ,

, G. Fugger


, M. Aigner


, R. Lanzenberger


, S. Kasper



Medical University of Vienna, Department of Psychiatry and

Psychotherapy, Vienna, Austria


Karl Landsteiner University, Department of Psychiatry, Tulln,


Corresponding author.


This meta-analysis investigates if dose increase of

an antipsychotic drug (high-dose treatment, dose escalation) is

advantageous for schizophrenic patientswho failed to respond ade-

quately to standard-dose treatment with the same antipsychotic.


Within a systematic literature survey, we identified all

randomized controlled trials (RCTs) comparing a dose increase

directly to standard-dose continuation treatment in schizophrenic

subjects with initial non-response to prospective standard-dose

pharmacotherapy with the same antipsychotic. The primary out-

come was mean change in the Positive and Negative Syndrome

Scale (PANSS) total score. Secondary outcomes were dichotomous

response and attrition rates. Study selection and data extraction

were conducted independently by two authors. We calculated

effect sizes (Hedges’s


and risks ratios) using the Mante–Haenszel

random-effects model. Meta-regression analyses were performed

to explore the influence of the degree of the dose increase on effect



Five trials (


= 348) examining quetiapine (


= 2,


= 191), ziprasidone (


= 1,


= 75), haloperidol (


= 1,


= 48),

and fluphenazine (


= 1,


= 34) were included. We found no signif-

icant between-group differences for the mean PANSS/BPRS total

score change, even not when itemized according to the individual

antipsychotic agents. There were no between-group differences for

response and dropout rates. The non-significant meta-regressions

indicate no impact of the different amounts of dose increments on

effect sizes.


We found no evidence for the efficacy of a dose

escalation after initial non-response to standard-dose pharma-

cotherapy as general advisable treatment strategy. As the high-dose

treatment was not accompanied by significant increased attrition

rates, appropriate tolerability and acceptability of this pharmaco-

logical option can be assumed.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Cognition in schizophrenia: Selective

impairment and factors that influence


N. Petrova

1 ,

, M. Dorofeikova



Saint Petersburg State university, Medical faculty, Saint-Petersburg,



Saint-Petersburg V.M. Bekhterev psychoneurological research

institute, Department of geriatric psychiatry, Saint-Petersburg, Russia

Corresponding author.

Currently it is well known that schizophrenia is associated with

cognitive impairment. Still there are many unresolved questions,

such as whether cognitive deficit is total, what are the relation-

ships of cognitive impairment with clinical features, demographic

characteristics and different biomarkers, which could shed light

on its pathogenesis. The aim of our study was to characterize

cognitive impairment in schizophrenia and to find factors that

may contribute to it. Sixty patients with paranoid schizophrenia

were examined. BACS, Rey-Osterreith complex figure and correc-

tion task were used to assess cognitive functioning. Only 14.3%

of patients had BACS score in the normal range. The vast major-

ity of them showed impaired motor function, verbal and visual

memory. Cognitive functioning did not worsen with time. Work-

ing memory impairment was influenced by genetic predisposition

to schizophrenia and age of disease onset. Residual positive symp-

toms led to a decrease in the speed of skill development. Symptoms

of anxiety and depression contributed to the impairment of accu-

racy. Hypomania was associated with impaired planning. Planning

and problem-solving behavior did not correlate with other cogni-

tive functions, which makes them isolated domains. Higher levels

of NSE had been found in patients with more severe memory

impairment. S100B level was associated with safer construc-

tive abilities. In general, cognitive impairment in schizophrenia,

although present in themajority of patients, varies a lot and appears

selective and dependent on certain clinical features.

The study was supported by RSCF 14-50-00069 grant.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Testing decision-making competency

of schizophrenia participants in

clinical trials. A meta-analysis and


H. Sorin


, M.C. Rusu


, N. Ionut


, E. Drima

4 ,


Carol Davila University of Medicine and Pharmacy, Legal Medicine

and Bioethics, Bucharest, Romania


Carol Davila University of Medicine and Pharmacy, Anatomy,

Bucharest, Romania


Carol Davila University of Medicine and Pharmacy, Surgery,

Bucharest, Romania


Clinical Hospital Of Psychiatry “Elisabeta Doamna”, Psychiatry,

Galati, Romania

Corresponding author.


The primary purpose of this study is to evaluate the degree of

impairment of decision-making capacity in schizophrenia patients

compared to non-mentally-ill controls, as determined by the

MacCAT-CR instrument.

Materials and methods

We analyzed the results obtained from

three databases: ISI Web of Science, Pubmed, and Scopus. Each

database was scrutinized using the following keywords: “MacCAT-

CR + schizophrenia”, “decision-making capacity + schizophrenia”,

and “informed consent + schizophrenia.”

Results and discussions

We included ten studies in the analy-

sis. Even if schizophrenia patients have a significantly decreased

decision-making competence compared to non-mentally-ill con-

trols, they should be considered as competent unless very severe

changes are identified during the clinical examination. Using

enhanced informed consent techniques significantly decreased

the difference between schizophrenia patients and non-mentally-

ill controls (except for the reasoning dimension), and should be

employed whenever the investigators want to include more severe