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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.


Diagnostic stability in the first episode

of psychosis

M. Duarte

, A. Batista , J. Maia

Centro Hospitalar de Leiria, Psychiatry, Leiria, Portugal

Corresponding author.


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.


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.


Data research from a 48 patients sample followed up on

the FEP consultation.


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.


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.


Auditory verbal hallucinations in first

episode psychosis – an fMRI symptom

capture study

T. Dunne

1 ,

, P . M


2 , M.


3 , B. F


h 4 ,

K. Heinze

5 , R.


5 , S. W


5 , 6 , F . O


2 ,

R. Upthegrove



University of Birmingham, College of Medical and Dental Sciences,

Birmingham, United Kingdom


University of Birmingham, Barberry, Birmingham and Solihull

Mental Health NHS Foundation Trust, Birmingham, United Kingdom


University of Oxford, Department of Psychiatry, Oxford, United



Worcester Health and Care NHS Trust, Psychiatry, Worcester,

United Kingdom


University of Birmingham, School of Psychology, Birmingham,

United Kingdom


University of Melbourne, Department of Psychiatry, Melbourne,


Corresponding author.


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.


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.


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 141mm


), and the left parahippocampal and lingual

gyri (cluster size 121mm




< 0.05 FDR corrected, were recorded

during the experience of AVHs.


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.


QTc Interval in individuals with

schizophrenia receiving antipsychotic

as monotherapy or polypharmacy

A. Elliott

1 , 2 ,

, M. Højlund

1 , 2

, T.J. Mørk


, T. Christensen



R. Jeppesen


, N.J. Madsen


, A.G. Viuff


, P. Hjorth


, J.C. Nielsen



P. Munk-Jørgensen

1 , 2


Aarhus University Hospital, Department of Affective Disorders,

Risskov, Denmark


Psychiatric Research Academy, Psychiatric Hospital and University

of Southern Denmark, Odense, Denmark


Regional Psychiatry Services West, Department of Psychiatry,

Herning, Denmark


Region of Southern Denmark, Department of psychiatry,

Kolding/Vejle, Denmark


Aarhus University Hospital, Skejby, Department of Cardiology,

Skejby, Denmark

Corresponding author.


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.


To investigate the associations between QTc inter-

val and antipsychotic mono- and polypharmaceutical treatment,

respectively, in schizophrenic patients.


To learn more about the impact of antipsychotics on the

QTc interval.