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

Symposium: Subtypes of schizophrenia


Characterization of different subtypes

of schizophrenia: Premorbid

functioning, neurophysiological

differences, functional outcomes

S. Galderisi

, A. Mucci , P. Bucci , M. Maj

University of Campania “Luigi Vanvitelli”, Department of Psychiatry,

Naples, Italy

Corresponding author.


Although not included in current diagnostic sys-

tems, deficit versus non-deficit and resistant versus non-resistant

schizophrenia subtypes look more promising than traditional

schizophrenia subtypes in terms of stability across time, clinical

utility and interest for research.


To critically analyze evidence supporting the validity of two

schizophrenia subtypes: Deficit Schizophrenia (DS) and Treatment

Resistant Schizophrenia (TRS).


Empirical data supporting the validity of DS and TRS

subtypes will be critically reviewed.


DS, in comparison with non-deficit schizophrenia, is

characterized by poorer premorbid functioning, more insidious

onset, lower prevalence of dysphoria, hostility, suicidal ideation,

depressive symptoms and substance abuse, different neurobiolog-

ical abnormalities, and poorer response to treatment. The diagnosis

of DS shows high reliability and stability across time. However,

research based on this approach has proven difficult, especially in

first-episode schizophrenia, and findings have not been as homo-

geneous as expected.

TRS patients, as compared to non-TRS ones, show persisting

psychotic symptoms, greater severity of negative symptoms,

more severe cognitive dysfunctions, poorer premorbid func-

tioning, longer duration of untreated psychosis, more frequent

co-morbidity with personality disorders, earlier illness onset and

poorer social functioning.


Future research should consider a) refining diagnos-

tic criteria for DS and identifying valid DS endophenotypes; b)

dissecting TRS based on psychopathological characteristics (e.g.

presence of primary and persistent negative symptoms or persis-

tently severe positive symptoms), and underlying neurobiological

mechanisms (e.g. dopamine synthesis capacity and glutamatergic


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



Genetics and neurophysiological

characterization of first episode and

deficit schizophrenia

J. Samochowiec

1 ,

, P. Bienkowski


, D. Frydecka


, B. Misiak



J. Kucharska-Mazur


, J. Pelka Wysiecka



Pomeranian Medical University, Psychiatry, Szczecin, Poland


Department of Psychiatry, Warsaw Medical University, Warsaw,



Department of Psychiatry, Medical University of Wroclaw,

Wroclaw, Poland

Corresponding author.

The deficit subtype of schizophrenia (DS) is hypothesized to con-

stitute a pathophysiologically distinct subgroup of schizophrenia

patients suffering from enduring, idiopathic negative symptoms.

The aim of the present study was to assess a relationship between

the deficit/non-deficit dichotomy and various markers. We tested

a hypothesis that stem cells and factors that modulate their traf-

ficking may be biological markers of acute psychosis.


The DS was identified using the SDS. The MMP-9, BDNF,

and COMT gene polymorphisms were genotyped. DNAmethylation

of the human endogeneous retrovirus type K (HERV-K) sequences

was determined. Smell identification test was performed using the

Sniffin’ Sticks test. For the assessment of executive function we

used the Wisconsin Card Sorting Test, the Trail Making Test, Verbal

Fluency Test Phonemic, Stroop Color Word Test and Go/No Go task.

Results and Discussion

There was no association between the

examined functional gene polymorphisms, methylation levels and

DS. Similarly, there was no relationship between overall odor iden-

tification abilities and the deficit/non-deficit dichotomy. The results

tended to indicate specific problems in the identification of few

odors in DS. DS, compared with the non-deficit group, obtained

lower scores in the WCST and TMT and exhibited greater interfer-

ence within concept formation and non-verbal cognitive flexibility.

Furthermore, in patients with the first schizophrenia-like episode,

the number of circulating Lin (-)/CD45 (-)/CD34 (+) very small

embryionic like stem cells (VSELs) and the S1P plasma level were

the best predictors of risk and are proposed as novel markers for

the first “schizophrenic” episode of psychosis.

Disclosure of interest

The authors declare that they have no com-

peting interest.


From identification of

neurofunctional systems to

individualization of treatment for

schizophrenic disorders

P. Falkai

Medical University, Munich, Germany

Schizophrenia is a severe brain disorder characterized by positive,

negative, affective and cognitive symptoms and can be viewed as a

disorder of impaired neural plasticity. Schizophrenia leads to live-

long disability in a substantial proportion of the sufferers and it still

connected with an unfavorable outcome. Therefore, it is inevitable

to find and apply interventions to reduce the risk of psychosis

and/or prevent a further chronification of the illness. There are two

major obstacles translational schizophrenia research has to face:

One is the introduction of easy to measure and reliable biomark-

ers; the second are add-on treatments to improve the residual

symptoms of this illness. To reach the first goal, subgroups must

be identified utilizing biomarkers in order to induce specifically

targeted treatments. For the long-term prognosis and outcome it

is necessary for biomarkers to constitute easy measurable clini-

cal routine parameters. Studies will be summarized using clinical

(GAF, PANSS, CGI) and imaging data in order to accurately predict

the outcome in the first week, for 4 and for 52 weeks. This will help

to subdivide these groups into a god, an intermediate and a fair

outcome group. Future clinical studies will benefit enormously if it

was possible to focus on the intermediate group, where recovery

could be reached by targeted treatment as most of those subjects

are showing partial recovery or remission.

Disclosure of interest

The author declares that he has no compet-

ing interest.