European Psychiatry - Volume 41 - April 2017

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S196 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237
Conclusion EPSmay influence functional remission at several lev-
els starting from the neurobiological to the social stigmatization
and the treatment adherence levels. Further research in this matter
is required.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0265
Concomitant psychotropic
medications and functional remission
in schizophrenia patients
B. Ghajati ∗, C. Leila , L. Raja , C. Majda
1 Razi Hospital, Psychiatry Department “C”, Tunis, Tunisia
2 Razi Hospital, Psychiatry Department “E”, Tunis, Tunisia
∗ Corresponding author.
Along with the rise of symptomatic and functional remission
concepts in schizophrenia, multiple aspects of the disease treat-
ment have been explored in their link to vocational prognosis.
Although antipsychotics are the corner stone treatment, monother-
apy is seldom. In fact, concomitant psychotropicmedications (CPM)
use during treatment of schizophrenia has dramatically increased
worldwide.
Aim To examinewhether concomitant psychotropicmedications
use is associated to functional remission in schizophrenia patients.
Methods A cross-sectional, retrospective and descriptive study
was conducted in the psychiatry department “C”, in Razi hospi-
tal (Tunis), between October 2014 and March 2015. Sixty patients
suffering from schizophrenia spectrum disorder (DSM IV-R) were
included. Functional status was explored with the Global Assess-
ment of Functioning Scale (GAF), the Social and Occupational
Functioning Assessment scale and the Social Autonomy Scale (EAS).
Sociodemographic and therapeutic characteristics have been col-
lected during a semi-structured interview.
Results Rates of functional remission were respectively: 63.30%
at theGAF scale, 48.30% at the SOFAS and51.70% at the SAS. Antipsy-
chotics were prescribed alone in more than half patients (56.70%),
mood stabilizers in 40% and antidepressants in 1.7% of the cases.
Benzodiazepines were prescribed in 40% of the patients. There was
no association between CPM use and functional remission, using
three scales (GAF: P = 0.091; SOFAS = 0.125; EAS = 0.728).
Conclusion Largely used, concomitant psychotropic medica-
tions can increase side effects, cause drug interactions, escalate
treatment costs, and lead to non-adherence. That is said, their ther-
apeutic effectiveness should be thoroughly investigated, aiming to
recovery not only symptoms control.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0266
Functional connectivity of the ventral
tegmental area and avolition in
schizophrenia: A resting state
functional MRI study
G.M. Giordano ∗ Stanziano ucci Papa
S. Galderisi
1 University of Naples SUN, Department of Psychiatry, Largo
Madonna delle Grazie, 80138, Napoli, Italy
2 University of Naples SUN, Laboratory of Neuronal Networks,
Department of Mental and Physical Health and Preventive Medicine,
Via Luciano Armanni 5, 80138, Napoli, Italy
∗ Corresponding author.
Introduction Impaired motivation is considered a fundamental
aspect of the Avolition domain of negative symptoms. The ventral
tegmental area (VTA) contains the highest number of DA neurons
projecting to the brain areas involved in motivation-related pro-
cesses.
Aim The aimof our studywas to investigate by functionalMRI the
resting-state functional connectivity (RS-FC) of the VTA in patients
with schizophrenia and its relationships with real-life motivation
and avolition.
Method The RS-FC was investigated in 22 healthy controls (HC)
and in 26 schizophrenia patients (SCZ) treated with second gen-
eration antipsychotics only and divided in high (HA = 13) and low
avolition (LA = 13) subgroups. We used the Quality of Life Scale and
the Schedule for the Deficit Syndrome to assess real-life motivation
and avolition, respectively.
Results HA, as compared to LA andHC, showed a reduced RS-FC of
VTA with the right ventrolateral prefrontal cortex (R VLPFC), right
posterior insula (R pINS) and right lateral occipital cortex (R LOC).
The RS-FC for these regions was positively correlated with motiva-
tion in the whole sample and negatively correlated with avolition
in schizophrenia patients.
Conclusion Our findings demonstrate that motivational deficits
in schizophrenia patients are linked to reduced functional connec-
tivity in the DA circuit involved in retrieval of the outcome values of
different actions to guide behavior. Further characterization of the
factors modulating the functional connectivity in this circuit might
foster the development of innovative treatments for avolition.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0267
The impact of cannabis in the early
stages of schizophrenia: A 3-year
longitudinal study on cannabis
influence on relapse rates
M. Gomez Revuelta ∗ Juncal Ruiz Porta Olivares
V. Gajardo Galan Pardo de Santayana Jenaro
L. Sanchez Blanco Abejas Diez andera Rodriguez
L. Garcia Ayal . Nu˜nez Morales Fernandez Rodriguez
1 Hospital Universitario de Álava-Sede Santiago, Vitoria, Gasteiz,
Psychiatry, La Penilla, Spain
2 Hospital Universitario Marques de Valdecilla, Psychiatry,
Santander, Spain
∗ Corresponding author.
Introduction The first five years after the onset of a first episode
of psychosis (FEP) are crucial for long term outcome. In this period,
the risk of relapse is particularly high. Consequences of relapse
include an increased risk of neurotoxicity, chronicity, hospitaliza-
tion, decreased response to treatment, increased economic burden
and functional impairment.
Objectives To discern the influence of cannabis on relapse as it
may contribute to adopt specific measures in patients during early
stages of the illness.
Material and methods PAFIP is an early intervention program for
patients with a FEP. Between January 2005 and January 2011, 163
patients were recruited for this study. They were followed-up dur-
ing 3 years at intervals of three months. The sample was divided
into three groups: (1) those non-cannabis users neither before the
FEP nor during follow-up (nn), (2) consumers before the FEP and
during follow-up (ss) and (3) consumers before the FEP that gave
up consumption during follow-up (sn).
Results No statistically significant differences between the three
groupswere observed but a trend ( P = 0.057) towards amore endur-
ing survival in Group 3 (sn). (Kaplan–Meier curve and detailed Log
Rank Test results will be included in the final poster).
Conclusions Cannabis has a detrimental effect on schizophrenia.
The interruption of its use could contribute to improve the outcome
of the disease, as the results of our study suggest.