European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237 S209
Introduction Prior studies have indicated that both high and low
school achievement are associated with development of bipolar
disorder (BD). We believe that the latter association may be due
to the confounding effect of family history of mental disorder.
Objective To further investigate the association between school
achievement and subsequent development of BD by adding adjust-
ment for family history of mental disorder.
Methods We are conducting a historical prospective cohort study
based on data from nationwide Danish registers. The cohort con-
sists of all individuals born in Denmark 1986–97 of Danish-born
parents, who were alive and living in Denmark at age 16 years, and
who have completed final examinations in 9th grade between 2002
and 2014 (n = 578,247). The cohort members will be followed until
death, emigration, development of bipolar disorder, or end of study,
whichever comes first. Hazard rate ratios for bipolar disorderwill be
calculated in a Cox model using the z-score for examination grades
as unit of exposure. The regression analyses will be adjusted for a
series of potential confounders including family history of mental
disorder.
Results We expect to find a positive association between high
school achievement and development of BD. In contrast, we expect
to demonstrate that the association between low school achieve-
ment and BD detected in prior studies is due to confounding by
family history of mental disorder. The results will be shown at the
conference.
Conclusions By further testing the potential link between emi-
nence and BD, we hope to contribute to amore balanced perception
of BD.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0303
Emotional deficits in remitted bipolar
and schizoaffective patients
R.S. Romosan ∗ . Romosan , L.M. Ienciu , L. Dehelean ,
A.C. Bredicean
“Victor Babes” University of Medicine and Pharmacy, Neuroscience,
Timisoara, Romania
∗ Corresponding author.
Introduction Both bipolar and schizoaffective patients have defi-
cient social skills persisting even during the remission of the clinical
symptoms. These deficitsmay represent impediments for the social
reintegration and recovery of these patients.
Objectives The purpose of the study was to assess and compare
emotion recognition abilities of schizoaffective and bipolar patients
during remission.
Methods The study was conducted between 2014 and 2016
on remitted outpatients, diagnosed with either bipolar disorder
(n = 38) or schizoaffective disorder (n = 32), according to ICD 10
criteria, and a healthy control group (n = 65). In order to evalu-
ate patients’ ability of understanding the emotional expressions of
other people, we used the revised version of the “Reading the Mind
in the Eyes” test (“Eyes test”).
Results The patient group consisted of 41 (58.6%) women and
29 (41.4%) men, with a mean age of 43.57 years (SD = 10.56). The
control group was comprised of 25 males (38.5%) and 40 females
(61.5%), with a mean age of 42.03 years (SD = 11.07). We found
statistically significant differences (P = 0.003) between the patient
groups and the control group regarding emotion recognition abil-
ities (poorer emotion recognition skills than the control group in
both bipolar and schizoaffective patients). Patients with schizoaf-
fective disorder gave significantly more incorrect answers in the
“Eyes test” than bipolar patients (P = 0.015). Although not statisti-
cally significant, women had better emotion recognition abilities
than men, both in the patient sample and the control group.
Conclusions Schizoaffective patients havemore severe emotional
deficits than bipolar patients during euthymic periods.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0304
Lurasidone adjunctive to lithium or
valproate for prevention of recurrence
in patients with bipolar I disorder
J. Calabrese ikalov ∗ ucchiaro ao Loebel
1 Case Western Reserve University, University Hospitals Case Medical
Center, Cleveland, USA
2 Sunovion Pharmaceuticals Inc., Medical Affairs, Fort Lee, USA
∗ Corresponding author.
Introduction Information is not available on the maintenance
efficacy of lurasidone in bipolar disorder.
Objectives/aims To evaluate the recurrence prevention efficacy of
lurasidone plus lithium (Li) or valproate (VPA) for the maintenance
treatment of bipolar disorder.
Methods Patients with bipolar I disorder received up to 20 weeks
of open-label lurasidone (20–80mg/d) plus Li or VPA. Patients
who achieved consistent clinical stability were randomized to
28weeks of double-blind treatment with lurasidone (20–80mg/d)
or placebo, plus Li or VPA.
Results A total of 496 patients met stabilization criteria and were
randomized to adjunctive lurasidone vs. placebo. Fewer patients
in the lurasidone group had recurrence of any mood episode com-
paredwith the placebo group, with a hazard ratio of 0.71 (P = 0.078).
In pre-planned secondary analyses, recurrence rates were sig-
nificantly lower for the lurasidone group treated with a modal
open-label dose of 80mg/d (hazard ratio [HR], 0.35; P = 0.020);
when patients presented with an index episode of depression
(HR = 0.57; P = 0.039); and when outcome was time-to-all-cause
discontinuation (HR = 0.72; P = 0.034), or time-to-recurrence based
on symptom severity criteria (HR = 0.53; P = 0.025).
Conclusions In patients stabilized on lurasidone plus Li or VPA,
continued treatmentwas associatedwithnon-significant reduction
in risk of recurrence of any mood disorder (primary). Consistent
with dose-response effects observed during acute treatment of
bipolar depression, risk of recurrence on lurasidone was signifi-
cantly reduced after open-label treatment with the 80mg/d dose,
and in the 20–80mg/d dose in patients presenting with an index
episode of depression.
Clinicaltrials.gov: NCT01358357.
Sponsored by Sunovion Pharmaceuticals Inc.
Disclosure of interest Drs. Pikalov, Cucchiaro, Mao, and Loebel
are employees of Sunovion Pharmaceuticals IncDr. Calabrese has
received research support from Abbott, AstraZeneca, Bristol-Myers
Squibb, Cephalon, Cleveland Foundation, Eli Lilly, GlaxoSmithKline,
Janssen, Lundbeck, NARSAD, Repligen, Stanley Medical Research
Institute, Takeda, and Wyeth. Dr. Calabrese consulted to or served
on advisory boards of Abbott, AstraZeneca, Bristol-Myers Squibb,
Cephalon, Dainippon Sumitomo, Elan, EPI-Q, Inc., Forest, France
Foundation, GlaxoSmithKline, Hoffman LaRoche, Janssen, Johnson
and Johnson, Lundbeck, Merck, Neurosearch, OrthoMcNeil, Otsuka,
Pfizer, Repligen, Servier, Solvay, Sunovion, Supernus, Synosia,
Takeda, Teva, and Wyeth. Dr. Calabrese has provided CME lectures
supported by AstraZeneca, Bristol-Myers Squibb, France Foun-
dation, GlaxoSmithKline, Janssen, Johnson and Johnson, Merck,
Sanofi-Aventis, Schering-Plough, Pfizer, Solvay, Sunovion, and
Wyeth.