European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S772–S846 S819
EV1265
Remission and recovery from
first-episode psychosis in adults:
A systematic review and meta-analysis
of long-term outcome studies
J. Lally ∗, O. Ajnakina , B. Stubbs , M. Cullinane ,
K.C. Murphy , F. Gaughran , R.M. Murray
1 Royal College of Surgeons in Ireland, Department of Psychiatry,
Dublin 9, Ireland
2 Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, Department of Psychosis Studies, London, United Kingdom
3 Institute of Psychiatry, Psychology and Neuroscience IoPPN, King’s
College London, Health Service and Population Research Department,
London, United Kingdom
4 Young Adult Mental Health Services, St. Fintan’s Hospital,
Portlaoise, Ireland
∗ Corresponding author.
Introduction Remission and recovery rates for people who have
had a first episode psychosis (FEP) remain uncertain.
Objectives We conducted a systematic review and meta-analysis
to assess pooled prevalence rates of remission and recovery in FEP
in longitudinal studies and conducted meta regression analyses to
investigate potential moderators.
Methods A systematic literature search of major electronic
databases without language restrictions was conducted from
database inception until July 1, 2016. Longitudinal studies with
follow up greater than 1 year reporting data on remission or recov-
ery rates in FEP were included.
Results Seventy-nine studies were included representing 19,072
FEP patients (mean age = 26.9 years, male = 59.5%). The pooled rate
of remission among 12,301 individuals with FEP was 57.9% (95%CI:
52.7–62.9, Q = 1536.3, P < 0.001, n = 60 studies, mean follow up = 5.5
years). Restricting the analysis to studies, which used the remission
in schizophrenia working group (RSWG) criteria (n = 25 studies,
n = 6909 patients), the pooled remission rate was 56.9% (95%CI:
48.9–64.5, Q = 656.9). Higher remission rates were moderated by
studies from more recent years. The pooled prevalence of recov-
ery among 9642 individuals with FEP was 37.9% (95%CI: 30.0–46.5,
Q = 1450.8, studies = 35, P = 0.006, average follow up = 7.2 years).
Recovery rates were higher (P < 0.05) in North America compared
to other regions.
Conclusions Our data suggest that remission and recovery rates in
FEP may be more favorable than previously thought. We observed
stability of recovery rates after the first two years, suggesting that
a progressive deteriorating course of illness is not typical. While
remission rates have improved over time, recovery rates have not,
raising questions about the effectiveness of specialist early inter-
vention services in achieving improved recovery.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1266
Neural modulations in processing of
natural information in patients with
schizophrenia and their unaffected
siblings
Y. Lerner ∗, M. Bleich-Cohen , W. Madah , S. Solnik ,
G. Yogev-Seligmann , I. Kremer , T. Hendler
1 Tel Aviv Sourasky Medical Center, Center for Brain Functions,
Tel-Aviv, Israel
2 Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv, Israel
3 Tel Aviv University, Sagol School of Neurosceince, Tel Aviv, Israel
4 Mazra Mental Health Center, Mental Health Center, Akko, Israel
5 Tel Aviv University, School of Psychological Sciences, Tel Aviv, Israel
∗ Corresponding author.
Recent studies in healthy populations have shown a hierarchical
network of brain areas to process information over time. Specif-
ically, we revealed that the capacity to accumulate information
changes gradually from the early sensory areas toward high-order
perceptual and cognitive areas. Previous research in schizophre-
nia pointed to impairment in comprehension of information. Yet,
the neural mechanisms underlying the breakdown of information
processing are poorly known. Better understanding of the neural
circuits involved in information processingmay assist in early iden-
tification of predisposition to the disease. Using fMRI, we examined
different levels of information comprehension elicited by natu-
rally presented stimuli. Healthy participants, patients with first
episode schizophrenia and their undiagnosed siblings listened to
a real-life narrated story and scrambled versions of it. To estimate
the level of synchronization in response time courses, we calcu-
lated inter-subject correlation (inter-SC) across the entire stimuli
within each group. The time-scale gradients found in healthy
and siblings groups were consistent with our previous findings.
Within the schizophrenia group, the reliability patterns obtained
for the shortest and intermediate temporal scales were similar
to patterns observed in healthy groups. However, the analysis of
responses to story condition (long temporal scale) revealed robust
andwidespreaddisruptionof the inter-SC. In comparison tohealthy
groups, the response time courses to the story were highly variable
within the schizophrenia group, although some significant inter-
SCs in the TPJ and precuneus were found. The hierarchical temporal
deficit is a fundamental trait thatmay be a better target for the study
of the etiology and pathophysiology of the disease.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1267
Heterogeneous effectiveness patterns
of amisulpride in chinese patients
with schizophrenia: A cluster analysis
of ESCAPE study
Y. Liang∗ u
National Clinical Research Center for Mental Disorders, Peking
University Sixth Hospital, Institute of Mental Health, and the Key
Laboratory of Mental Health, Ministry of Health, Peking University,
Beijing, China
∗ Corresponding author.
Introduction Rare research was reported about assessing the
effectiveness and safety of amisulpride in Chinese patients with
schizophrenia before we performed the ESCAPE, a multicenter,
single-arm, phase IV study (NCT01795183). This study is a cluster
analysis of ESCAPE study.
Objective To identify the effectiveness patterns of amisulpride in
Chinese patients with schizophrenia.
Aim To examine baseline characteristics of patients as potential
predictors of effectiveness.
Methods Time-series cluster analysis was performed to identify
effectiveness trajectories bases on Positive and Negative Syn-
drome Scale (PANSS) scores in Chinese patients with schizophrenia
received amisulpride for 8 weeks. Baseline characteristics of
patients were examined.
Results Overall, 295 patients were included for efficacy analysis.
Four response trajectories based on positive PANSS were identified
(1) rapid response (cluster 1); (2) gradual response (clus-
ter 2); (3) sustained low level (cluster 3); (4) poor response (cluster
4). Age in cluster 4was significantly higher than that in cluster 1 and
cluster 3 P= 0.0025 and 0.0032, respectively). Similarly,
four response trajectories based on negative PANSS were gener-
ated (1) rapid response (cluster 1); (2) gradual response
(cluster 2); (3) poor response with moderate PANSS (cluster 3); (4)
poor response with high PANSS (cluster 4). Male to female ratio in