European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237 S193
Conclusions 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.
EW0256
Systematic evaluation of
dose-escalation strategies after initial
non-response to standard-dose
pharmacotherapy in schizophrenia
M. Dold ∗, G. Fugger , M. Aigner , R. Lanzenberger , S. Kasper
1 Medical University of Vienna, Department of Psychiatry and
Psychotherapy, Vienna, Austria
2 Karl Landsteiner University, Department of Psychiatry, Tulln,
Austria
∗ Corresponding author.
Objectives 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.
Methods 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 g 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
sizes.
Results Five trials (n = 348) examining quetiapine ( n = 2,
n = 191), ziprasidone (n = 1, n = 75), haloperidol (n = 1, n = 48),
and fluphenazine (n = 1, n = 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.
Conclusions 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.
EW0257
Cognition in schizophrenia: Selective
impairment and factors that influence
it
N. Petrova ∗, M. Dorofeikova
1 Saint Petersburg State university, Medical faculty, Saint-Petersburg,
Russia
2 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.
EW0258
Testing decision-making competency
of schizophrenia participants in
clinical trials. A meta-analysis and
meta-regression
H. Sorin , M.C. Rusu , N. Ionut , E. Drima ∗
1 Carol Davila University of Medicine and Pharmacy, Legal Medicine
and Bioethics, Bucharest, Romania
2 Carol Davila University of Medicine and Pharmacy, Anatomy,
Bucharest, Romania
3 Carol Davila University of Medicine and Pharmacy, Surgery,
Bucharest, Romania
4 Clinical Hospital Of Psychiatry “Elisabeta Doamna”, Psychiatry,
Galati, Romania
∗ Corresponding author.
Aim 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