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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52

prevention program focusing not only stress and symptom man-

agement, but also social cognitive domains.

Disclosure of interest

Consultant to Boehringer Ingelheim lecture

fees by Boehringer Ingelheim, Otsuka travel grant by Servier.


Intervention in early psychosis -

Current status and future perspectives

S. Galderisi

, D. P

ietrafesa , D. Palumbo

University of Campania “Luigi Vanvitelli”, department of psychiatry,

Naples, Italy

Corresponding author.


The delay between psychosis onset and initiation

of treatment (duration of untreated psychosis, DUP) is associated

with a poorer treatment response and overall functional outcome.

In Europe several early detection and intervention programs have

been developed to reduce the DUP and promote Phase-specific

Treatments (PsTs).


To review the evidence of a) the effectiveness of European

Early Interventions (EEIs) in reducing DUP; b) an impact of PsTs on

clinical and social outcomes; and c) EEIs cost-effectiveness.


A literature search in PubMed, PsychInfo, Cochrane and

individual journals through cross-referencing was performed. All

European Randomized Controlled Trials (RCTs) designed to reduce

DUP and/or to implement PsTs for people with first-episode psy-

chosis were included in the review.


Studies examining early detection programs compared

with Standard Care (SC) reported discrepant findings as to their

impact on the DUP. PsTs generally reduce hospitalizations and

improve service engagement when comparedwith SC; their impact

on other clinical variables, e.g. symptomatology and social func-

tioning, is unclear. Studies assessing EEIs cost-effectiveness in

comparison with SC consistently report an advantage for EEIs in

the long run.


EEIs, as compared to SC, show several advantages

that seem to result in an overall reduction in the cost of care. There-

fore, the development of EEI is recommended.

On the other hand, some inconsistencies in the reported results

suggest that EEIs should include psychosocial interventions tar-

geting unmet needs of schizophrenia patients, such as cognitive

dysfunction and negative symptoms.

Disclosure of interest

SG received honoraria or Advisory

board/consulting fees from the following companies: Lund-

beck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf,

Otsuka, Pierre Fabre and Gedeon-Richter. All other authors have


Symposium: Childhood trauma across

psychopathology: mediators and outcome in

clinical samples and molecular mechanistic



Childhood trauma in bipolar

disorders: Familial and individual

mediators for predicting occurrence

and outcome

B. Etain

University Paris Diderot, psychiatry and addictology, Paris, France

Childhood trauma is highly prevalent in patients with bipolar dis-

order (BD) and has been associated to a more severe/complex

expression of the disorder. Little is known about the familial

and individual factors that can mediate the occurrence of trauma

within families but also influence the outcomes of BD. We will

present data from two independent samples of patients with BD

in order to identify the potential mediators for occurrence and

severity/complexity. In a first sample of 371 patients with BD, 256

relatives and 157 healthy controls, we will show that there is a

familial resemblance for emotional and physical abuses. Patients’

level of physical abuse was associated with their parental levels

of physical abuse, but also with their father’s history of alcohol

misuse (


< 0.05). Second, in a sub-sample of 270 normothymic

patients, we have performed a path-analysis to demonstrate that

emotional and physical abuses interacted with cannabis misuse

to increase the frequency of psychotic features and delusional

beliefs. Finally, in an independent sample of 485 euthymic patients

from the FACE-BD cohort we used path-analytic models to show

that emotional abuse increased all the assessed affective/impulsive

dimensions (


< 0.001). In turn, affect intensity and attitudinal

hostility were associated with high risk for suicide attempts



< 0.001), whereas impulsivity was associated with a higher risk

for presence of substancemisuse (


< 0.001). These results illustrate

that childhood trauma might derive from parental characteristics

(own childhood trauma and psychopathology) and increase the

severity/complexity of BD through individual dimensions of psy-


Disclosure of interest

The author has not supplied his declaration

of competing interest.


Childhood trauma and structural and

functional brain mechanisms linked

to psychopathology

M. Aas

Oslo university hospital, Norment- KG Jebsen center for psychosis

research- division of mental health and addiction, Oslo, Norway


Childhood trauma increases the risk of a range of

mental disorders including psychosis. Whereas the mechanisms

are unclear, previous evidence has implicated atypical processing

of emotions among the core cognitive models, in particular sug-

gesting altered attentional allocation towards negative stimuli and

an increased negativity bias. Here we tested if childhood trauma

was associated with differentiation in brain responses to negative

and positive stimuli. We also tested if trauma was associated with

emotional ratings of negative and positive faces.


We included 101 patients with a DSM schizophre-

nia spectrum or bipolar spectrum diagnosis. History of childhood

trauma was obtained using the Childhood Trauma Question-

naire (CTQ). Brain activation was measured with functional MRI

during presentation of faces with negative or positive emo-

tional expressions. After the scanner session, patients performed

emotional ratings of the same faces. Structural MRI was also



Higher levels of childhood trauma were associated with

stronger differentiation in brain responses to negative compared

to positive faces in clusters comprising the right angular gyrus,

supramarginal gyrus, middle temporal gyrus, and the lateral occip-

ital cortex (Cohen’s d = 0.72-0.77). In patients with schizophrenia,

childhood trauma was associated with reporting negative faces as

more negative, and positive faces as less positive (Cohen’s d > 0.8).


Along with the observed negativity bias in the

assessment of emotional valence of faces, our data suggest stronger

differentiation in brain responses between negative and positive

faces in patients with childhood trauma.