European Psychiatry - Volume 41 - April 2017

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S48 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52
Disclosure of interest The authors declare that they have no com-
peting interest.
Symposium: Cognitive remediation and
integrated treatments in the psychoses: Clinical
effects and biological correlates
S131
Cognitive dysfunctions in the
psychoses and their impact on
patients’ social functioning
A. Mucci ∗, S. Galderisi
University of Campania “Luigi Vanvitelli”, Department of Psychiatry,
Naples, Italy
∗ Corresponding author.
Introduction Impairment of neurocognitive functions, such as
attention, memory or executive functions, as well as of social
cognition, particularly of affect recognition and theory of mind,
are frequently observed in people with Schizophrenia or other
psychotic disorders. These dysfunctions are associated with poor
real-life functioning. Social cognition deficits mediate in part the
impact of neurocognitive dysfunction on functional outcome.
Aims To review literature findings on prevalence, severity and
association with functional outcome of neurocognitive and social
cognitive deficits in schizophrenia and other psychotic disorders.
Methods We searched PubMed for English/Italian or French full-
text publications with the keywords.
schizophr*/psychosis/psychot*/AND neurocogni-
tive/cognitive/neuropsychological/memory/attention/”executive
function”/learning/”social cognition”/”theory of mind”/”affect
recognition”/”acial emotion recognition”/”emotional intelli-
gence”/”emot* recognition”. Furthermore, we manually searched
the reference lists of relevant papers, systematic reviews and
meta-analyses.
Results In people with schizophrenia, schizoaffective disorder or
bipolar disorder with psychotic features, neurocognitive and social
cognition deficits were observed in all phases of the disorders, even
after symptom remission. Some of these deficits were observed
in subjects at high-risk to develop schizophrenia before psychotic
onset. In all these subjects, cognitive deficits are associated with
worse psychosocial functioning and poor quality of life. Pharma-
cological treatments do not alleviate cognitive deficits, which can
also limit the benefit of other psychological or psychosocial inter-
ventions.
Conclusions Neurocognitive and social cognition deficits need to
be targeted by specific interventions to improve real-life function-
ing and quality of life of people with schizophrenia or psychotic
disorders.
Disclosure of interest AM received honoraria or advisory
board/consulting fees from the following companies: Janssen
Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.
SG received honoraria or advisory board/consulting fees from
the following companies: Lundbeck, Janssen Pharmaceuticals,
Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and
Gedeon-Richter.
S132
Biological correlates of the effects of
cognitive remediation in the
psychoses
R. Penades
Hospital Clinic Barcelona, Department of Psychiatry and Clinical
Psychobiology, Barcelona, Spain
Cognitive Remediation Therapy (CRT) deals with the cognitive
impairment, which is one of the most disabling symptoms of
schizophrenia. Unfortunately, the understanding of its neurobio-
logical correlates is far from complete. Neuroimaging studies have
shown that CRT is able to induce neurobiological changes although
the results have not always been enough replicated. The most
commonly reported changes were those that involved the pre-
frontal and thalamic regions. Additionally, structural changes were
described in both the grey and white matter, suggesting a neuro-
protective effect of cognitive remediation. Neuroimaging studies
of cognitive remediation in patients with schizophrenia suggest
a positive effect on brain functioning in terms of the functional
reorganisation of neural networks. From a different perspective,
some changes in serum levels of Brain derived neurotrophic factor
(BDNF) have been described. However, our replication of this trial
has not been able to find any significant differences. So, nowadays
the status of BDNF as a biomarker of cognitive recovery is possibly
premature. One possible explanation can be the role of genetics and
their different polymorphisms. COMT and BDNF polymorphisms
could be accounting for the different outcomes of CRT. Moreover,
some studies suggested a role of genes affecting dopamine modu-
lation on outcomes of cognitive remediation.
Disclosure of interest The author declares that he has no compet-
ing interest.
S133
Impact of Cognitive remediation on
the use of psychiatric services and
patterns of care of patients with
psychoses
A. Vita
University of Brescia, Clinical and Experimental Sciences, Brescia,
Italy
Cognitive remediation (CR) has proved to be effective in improving
cognition, symptoms and psychosocial functioning in schizophre-
nia and other psychoses, but its impact on the use of psychiatric
services and patterns of care of patients suffering from these
diseases is still scarcely known. In fact, it would be particularly rel-
evant to know if such intervention may have any modifying effect
on use of services and costs of treatments. There is preliminary
evidence that such an impact does exist, with possible reduction
of number and duration of hospitalizations and of long-term resi-
dential stays and consequent reduced costs of inpatient treatment.
On the other hand, community treatment costs could be increased
as an effect of a shift of psychiatric and psychosocial interven-
tions from inpatient to outpatient activities. A critical review of
the existing literature on the issue will be provided, together with
a discussion of the impact of this shift towards the attainment of
increased functional and social recovery in the individual patient.
Disclosure of interest The author declares that he has no compet-
ing interest.