European Psychiatry - Volume 41 - April 2017

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S52 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52
Symposium: Subtypes of schizophrenia
S145
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.
Introduction 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.
Aims To critically analyze evidence supporting the validity of two
schizophrenia subtypes: Deficit Schizophrenia (DS) and Treatment
Resistant Schizophrenia (TRS).
Methods Empirical data supporting the validity of DS and TRS
subtypes will be critically reviewed.
Results 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.
Conclusions 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
transmission).
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
declared.
S146
Genetics and neurophysiological
characterization of first episode and
deficit schizophrenia
J. Samochowiec ∗, P. Bienkowski , D. Frydecka , B. Misiak ,
J. Kucharska-Mazur , J. Pelka Wysiecka
1 Pomeranian Medical University, Psychiatry, Szczecin, Poland
2 Department of Psychiatry, Warsaw Medical University, Warsaw,
Poland
3 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.
Methods 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.
S147
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.