European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237 S197
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0268
Diagnostic stability in first psychotic
episode after 5 years follow-up
M. Mota-Oliveira J. Peixoto erraz ereira
R. Guedes ∗ orton ilveira
1 Centro Hospitalar de São João, Clínica de Psiquiatria e Saúde
Mental, Porto, Portugal
2 Hospital Magalhães Lemos, Hospital Magalhães Lemos, Porto,
Portugal
∗ Corresponding author.
Introduction The diagnosis of psychosis is based on the presence
or absence of characteristic symptoms. The presence of such symp-
toms varies during the course and treatment, raising the question
of diagnostic stability after a first psychotic episode.
Aims and objectives The aim of this study is to evaluate the diag-
nostic stability after a first psychotic episode in the long term (five
years after the first inpatient admission).
Methodology A retrospective study that included patients with
first psychotic episode between 2007 and 2011 admitted to the
inpatient unit of the psychiatry and mental health clinic of São João
hospital center, Oporto, Portugal and re-evaluation of the diagnosis
after five years.
Results We included 60 patients with a first psychosis episode,
22 of which were drop-outs after five years. Of the 38 patients
evaluated, it was possible to see that after 5 years 68.4% (n = 26)
maintained the same diagnosis during follow-up. In particular, the
diagnosis of schizophrenia was kept in 83.3% of patients after 5
years (n = 15, 18 patients with the diagnosis of schizophrenia after
first admission). Diagnosis of acute and transient psychotic disor-
der and psychosis not otherwise specified were the least stable
diagnosis after 5 years.
Conclusions The diagnosis after a first psychotic episode has
important therapeutic and prognostic implications. The presence
of characteristic symptomatology, with periods of partial or total
remission between subsequent episodes emphasizes the need for
regular monitoring, since this group of patients appears to be more
vulnerable to changes in diagnosis over time.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0269
Side effects of clozapine and their
relationship with clinical variables in
patients with schizophrenia
G. Gürcan ∗, S¸ . Hun S¸ enol , A.E. Anıl Ya˘gcıo˘glu , A. Ertu˘grul
Hacettepe University Faculty of Medicine, Psychiatry, Ankara, Turkey
∗ Corresponding author.
Introduction The side effects of clozapine may affect the treat-
ment process negatively, and increase the disability.
Aims We aimed to assess the side effects of clozapine, and their
relationship with the clinical variables in schizophrenia patients,
and study the predictors of disability.
Methods Consecutive 122 outpatients who met DSM-IV criteria
for schizophrenia, and were on clozapine treatment were included
in the study. Information about sociodemographic characteristics,
past and current clinical status were gathered through a clinical
interview and review of the medical records, and physical meas-
ures and laboratory tests, including clozapine plasma levels, were
recorded. The patients were assessed with SCID-I, Positive and
Negative Syndrome Scale, UKU-Side Effect Rating Scale, WHO-
Disability Assessment Schedule-II.
Results Hypersalivation, weight gain, sedation and constipation
were the most common side effects of clozapine. Although the
mean plasma clozapine levels were high (828.11 ± 445.5 ng/mL),
no significant effect of clozapine dose and plasma levels were
detected on the severity of side effects, except for constipation.
Metabolic syndrome prevalence was found to be 50% according to
ATP IIIA criteria. Duration of clozapine treatment, clozapine dose
and plasma levels were not significantly different between patients
with andwithoutmetabolic syndrome. Regression analysis showed
that the severity of schizophrenia psychopathology and the number
of side effects predicted the severity of disability.
Conclusions Side effects of clozapine increase the disability of
patients with schizophrenia and should be monitored regularly. On
the other hand, clozapine dose and plasma levels do not determine
the severity of most of the common side effects.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0270
Effect of clozapine on psychiatric
comorbidities in patients with
schizophrenia
G. Gürcan∗, S¸ . Hun S¸ enol , A.E. Anıl Ya˘gcıo˘glu , A. Ertu˘grul
Hacettepe University Faculty of Medicine, Psychiatry, Ankara, Turkey
∗ Corresponding author.
Introduction Clozapine has superior efficacy in treatment-
resistant schizophrenia, and has various effects on psychiatric
comorbidities, which may affect the illness course.
Aims We aimed to assess the past and current psychiatric comor-
bidities in schizophrenia patients treated with clozapine, and study
their relationship with clinical variables.
Methods Consecutive 122 outpatients who met DSM-IV criteria
for schizophrenia receiving clozapine were included. Information
about past and current clinical status were gathered through a
clinical interview and review of the medical records, along with
laboratory test results. Patients were assessed with structured
clinical interview for Axis-I Disorders for DSM-IV, Clinical Global
Impression Scale, Positive and Negative Syndrome Scale (PANSS),
Calgary Depression Scale, Yale-Brown Obsessive Compulsive Scale
(Y-BOCS), Panic and Agoraphobia Scale (PAS), WHO-Disability
Assessment Schedule-II.
Results There was a significant decrease in the diagnosis of
depression, alcohol and substance use disorder, number of suicide
attempts, and an increase in the diagnosis of obsessive compul-
sive disorder (OCD) after clozapine initiation. Clozapine related de
novo OCD appeared in 48.4% of the patients, and there was a pos-
itive correlation between Y-BOCS total scores and clozapine dose
and plasma levels. In the de novo OCD group, compulsion scores
were higher than obsession scores with checking most prevalent
among compulsions. Total PANSS, Y-BOCS, PASscores were posi-
tively correlated withtotal disability score.
Conclusions Clozapine seems to decrease comorbid depression,
alcohol and substance use and number of suicide attempts and
increase OCD. Assessment and treatment of psychiatric comorbidi-
ties in clozapine using schizophrenia patients is vital to decrease
disability.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.