European Psychiatry - Volume 41 - April 2017

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S194 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237
patients in their clinical trials. Older age, an increased percentage of
men gender or inpatient status tend to escalate the score difference
of decision-making competence compared to non-mentally-ill sub-
jects in various dimensions of the decision-making capacity. The
main limitations of the study are: (1) a decreased number of stud-
ies included in the analysis is small (2) only three studies included
data about enhanced ways of informing potential subjects.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0259
Diagnostic stability in the first episode
of psychosis
M. Duarte ∗, A. Batista , J. Maia
Centro Hospitalar de Leiria, Psychiatry, Leiria, Portugal
∗ Corresponding author.
Introduction Early intervention programs in psychosis have
demonstrated efficiency in reduction the duration of untreated
psychosis, relapse prevention, socio-professional integration and
prognosis improvement. In daily practice, it is evident the clinical
heterogeneity of the first episodes of psychosis (FEP), as well as the
difficulty in initially assigning a specific diagnosis, being difficult to
do the differential diagnosis and verifying, during follow-up, very
different clinical outcomes among patients.
Objectives/aims Two years after the start of specific consulta-
tion for FEP, the authors intended to characterize the followed
patients and their evolution, comparing socio-demographic and
clinical parameters, with emphasis on diagnosis at the first visit
and after two years assessing their variability/stability.
Methods Data research from a 48 patients sample followed up on
the FEP consultation.
Results The diagnostics on the first consultation were 79% psy-
chosis with no other specification (NOS), followed by cannabinoids
addiction in 35%. After two years, in 29% of cases, there was a diag-
nostic change being actually 46% Psychosis NOS, 21% cannabinoids
addiction and 17% schizophrenia. Initially, only 39% did not have
previous history of toxic substances use, being 75% the current
percentage. Six percent abandoned the consultation.
Conclusions The authors conclude that, in this specific psychi-
atry consultation, it is important to initially keep an unspecified
diagnostic, with further progressive evaluation allowing a more
accurate diagnostic, since the initial diagnostic specification is often
found to be incorrect, with adverse consequences for the patient.
It would be useful to compare the results with a sample of patients
under “as usual” treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0260
Auditory verbal hallucinations in first
episode psychosis – an fMRI symptom
capture study
T. Dunne ∗ allikarjun Broome arma
K. Heinze Reniers ood yebode
R. Upthegrove
1 University of Birmingham, College of Medical and Dental Sciences,
Birmingham, United Kingdom
2 University of Birmingham, Barberry, Birmingham and Solihull
Mental Health NHS Foundation Trust, Birmingham, United Kingdom
3 University of Oxford, Department of Psychiatry, Oxford, United
Kingdom
4 Worcester Health and Care NHS Trust, Psychiatry, Worcester,
United Kingdom
5 University of Birmingham, School of Psychology, Birmingham,
United Kingdom
6 University of Melbourne, Department of Psychiatry, Melbourne,
Australia
∗ Corresponding author.
Introduction Neurobiological models of auditory verbal halluci-
nation (AVH) have been advanced by symptom capture functional
magnetic resonance imaging (fMRI), where participants self-report
hallucinations during scanning. To date, regions implicated are
those involvedwith language, memory and emotion. However, pre-
vious studies focus on chronic schizophrenia, thus are limited by
factors, such as medication use and illness duration. Studies also
lack detailed phenomenological descriptions of AVHs. This study
investigated the neural correlates of AVHs in patients with first
episode psychosis (FEP) using symptom capture fMRI with a rich
description of AVHs. We hypothesised that intrusive AVHs would
be associated with dysfunctional salience network activity.
Methods Sixteen FEP patients with frequent AVH completed four
psychometrically validated tools to provide an objective measure
of the nature of their AVHs. They then underwent fMRI symptom
capture, utilising general linearmodels analysis to compare activity
during AVH to the resting brain.
Results Symptom capture of AVH was achieved in nine patients
who reported intrusive, malevolent and uncontrollable AVHs. Sig-
nificant activity in the right insula and superior temporal gyrus
(cluster size 141mm3), and the left parahippocampal and lingual
gyri (cluster size 121mm3 ), P < 0.05 FDR corrected, were recorded
during the experience of AVHs.
Conclusions These results suggest salience network dysfunction
(in the right insula) together withmemory and language processing
area activation in intrusive, malevolent AVHs in FEP. This finding
concurs with others from chronic schizophrenia, suggesting these
processes are intrinsic to psychosis itself and not related to length
of illness or prolonged exposure to antipsychotic medication.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0261
QTc Interval in individuals with
schizophrenia receiving antipsychotic
as monotherapy or polypharmacy
A. Elliott ∗, M. Højlund , T.J. Mørk , T. Christensen ,
R. Jeppesen , N.J. Madsen , A.G. Viuff , P. Hjorth , J.C. Nielsen ,
P. Munk-Jørgensen
1 Aarhus University Hospital, Department of Affective Disorders,
Risskov, Denmark
2 Psychiatric Research Academy, Psychiatric Hospital and University
of Southern Denmark, Odense, Denmark
3 Regional Psychiatry Services West, Department of Psychiatry,
Herning, Denmark
4 Region of Southern Denmark, Department of psychiatry,
Kolding/Vejle, Denmark
5 Aarhus University Hospital, Skejby, Department of Cardiology,
Skejby, Denmark
∗ Corresponding author.
Introduction Antipsychotics are associatedwith the polymorphic
ventricular tachycardia, Torsade’s de pointes, which in worst case
can lead to sudden cardiac death. The QTc interval is used as a
clinical proxy for Torsade’s de pointes. QTc interval is prolonged
by monotherapy with antipsychotic, but it is unknown if the QTc
interval is prolonged further with antipsychotic polypharmacy.
Objectives To investigate the associations between QTc inter-
val and antipsychotic mono- and polypharmaceutical treatment,
respectively, in schizophrenic patients.
Aims To learn more about the impact of antipsychotics on the
QTc interval.