- Email: [email protected]
267 – The national register of antipsychotic medication in pregnancy (NRAMP)
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199 266 – NEUROLOGICAL SOFT SIGNS: CAN THEY PREDICT THE OUTCOME? M.O. Krebs 1,2, A. Ouali 1, M.C. Bourdel 1, F. Mouaffak 1,2, O. Canceil 1,2, J.P. Olie 1,2. 1 2
Inserm U796, University Paris Descartes Service Hospitalo Universitaire, Centre Hospitalier Sainte-Anne
Presenting Author details: [email protected] 7 rue Cabanis, 75014 PARIS, France, Tel.: +33 1 45658646; fax: +33 1 45658160. Background: Neurological Soft signs (NSS) are frequent in schizophrenia. They reflect minimal brain dysfunction but their predictive value remain unclear. Data mining tools could be useful to help to decipher complex phenotypes and multifactorial clinical situations. Methods: This analysis included 336 patients with schizophrenia (DSM-IV). Response to treatment was determined using both prospective and retrospective assessments and was rated with the scale of May et al. This scale classifies the overall response to treatment in 6 levels, grouped in three: 1) responders: clinical remission within 6 months; 2) resistant: no clinical remission, day care or hospitalization required and 3) intermediate. We excluded patients where duration of disease was not long enough to assess the response to treatment with confidence. Analysis was conducted using data mining tools. Results: Among the selected 30 variables, the 6 most relevant variables were extracted from association rules: disorganization score, NSS score, premorbid schizoid/schizotypy, age at first treatment (reflecting the first seek for help), tolerance of treatment, initial clinical form. Then Bayesian network models were built, which show the relations between the variables. Bayesian Networks also allow inference and follow how the information modifies the distribution. In the initial sample, 57.7% of the patients were good responders, 38.2% were bad responders. While 44% of the patients with high NSS scores were bad responders, 68% of the patients with high NSS + premorbid schizoid or schizotypical personality and 70% of the patients with high NSS + Age at first treatment before the age of 18 were bad responders. Conclusions: NSS associated with other early clinical features could help to anticipate the predicted response to treatment of a given individual and to propose adapted treatment algorithms. Those results should now be tested in prospective studies. doi:10.1016/j.schres.2007.12.333
The Alfred Hospital, Level One, Old Baker Building, Commercial Road, 3004 Melbourne, Australia, Tel.: +61 3 9076 6924; fax: +61 3 9076 6588. Background: Current data on the use of antipsychotic medication in pregnancy is limited. The aim of this research is to establish a National Register of Antipsychotic Medication in Pregnancy, to provide evidencebased clinical guidelines for the best use of antipsychotic medication during pregnancy. Methods: This is an ongoing, observational study, with a target of 100 participants Australia-wide. Participants include women with a history of mental illness, who are taking antipsychotic medication, and become pregnant. Following provision of informed consent, data will be gathered via telephone and/or face to face interviews during pregnancy, following delivery and for the first year of the baby's life. Information will include demographics, medical, psychiatric, medication and obstetric history and information on the general health and wellbeing for both mother and baby. Results: Preliminary results include: Twelve participants taking Seroquel, resulting in 12 live births [including 1 prematurity (28 weeks) and 1 maternal tachycardia]. Six participants taking Risperidone, resulting in 6 live births (with 1 participant reporting both gestational diabetes and prematurity at 36 weeks). Four participants taking Clozapine, resulting in: 1 abortion (neural tube defect), gestational diabetes (2 participants) and partial craniosynostosis (1 infant). Two participants taking Aripiprazole had first trimester abortions with high neural tube defects, one participant taking aripiprazole had her medication discontinued at 8 weeks, with no ill effect on the baby. Conclusions: The collection of ongoing data and the resulting guidelines, have the potential to provide regular contemporary updates to clinical treating teams, for the evidence-based management of women in this vulnerable population group. Acknowledgements: This research is supported by AstraZeneca, Janssen-Cilag, Mayne Pharmaceuticals and the Australian Rotary Health Research Fund; plus ethics approvals from 18 health care sites across Australia. doi:10.1016/j.schres.2007.12.334
268 – COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA: THE IMPACT ON OVERALL SEVERITY OF ILLNESS IN A CLINICAL SAMPLE J. Moamai 1,2, D. Boisvert 2. 1 2
267 – THE NATIONAL REGISTER OF ANTIPSYCHOTIC MEDICATION IN PREGNANCY (NRAMP) J. Kulkarni 1, K. McCauley 1,2, H. Gilbert 1, C. Gurvich 1, A. De Castella 1, P. Ftizgerald 1. 1
Alfred Psychiatry Research Centre, The Alfred Hospital and the School of Psychology, Psychiatry and Psychological Medicine 2 School of Nursing and Midwifery, Monash University Presenting Author details: [email protected]
143
Montreal University Hospital Centre, Montreal, Quebec, Canada Pierre Janet Hospital, Gatineau, Quebec, Canada
Presenting Author details: [email protected] 20, Pharand St, J9A 1K7 Gatineau, Quebec, Canada, Tel.: +1 819 7768010; fax: +1 819 7768002. Background: Kraepelin's conceptualization of dementia praecox had been mainly based on a “decline of cognitive processes”. Cognitive Dysfunction (CD) is still viewed as a core feature of schizophrenia, linked to lower quality of life and poor overall functioning. However, its clinical magnitude remains relatively unstudied. The purpose of this study was to measure the prevalence of CD in present-day schizophrenia and to investigate how overall severity of illness is affected by CD.
Inserm U796, University Paris Descartes Service Hospitalo Universitaire, Centre Hospitalier Sainte-Anne
Presenting Author details: [email protected] 7 rue Cabanis, 75014 PARIS, France, Tel.: +33 1 45658646; fax: +33 1 45658160. Background: Neurological Soft signs (NSS) are frequent in schizophrenia. They reflect minimal brain dysfunction but their predictive value remain unclear. Data mining tools could be useful to help to decipher complex phenotypes and multifactorial clinical situations. Methods: This analysis included 336 patients with schizophrenia (DSM-IV). Response to treatment was determined using both prospective and retrospective assessments and was rated with the scale of May et al. This scale classifies the overall response to treatment in 6 levels, grouped in three: 1) responders: clinical remission within 6 months; 2) resistant: no clinical remission, day care or hospitalization required and 3) intermediate. We excluded patients where duration of disease was not long enough to assess the response to treatment with confidence. Analysis was conducted using data mining tools. Results: Among the selected 30 variables, the 6 most relevant variables were extracted from association rules: disorganization score, NSS score, premorbid schizoid/schizotypy, age at first treatment (reflecting the first seek for help), tolerance of treatment, initial clinical form. Then Bayesian network models were built, which show the relations between the variables. Bayesian Networks also allow inference and follow how the information modifies the distribution. In the initial sample, 57.7% of the patients were good responders, 38.2% were bad responders. While 44% of the patients with high NSS scores were bad responders, 68% of the patients with high NSS + premorbid schizoid or schizotypical personality and 70% of the patients with high NSS + Age at first treatment before the age of 18 were bad responders. Conclusions: NSS associated with other early clinical features could help to anticipate the predicted response to treatment of a given individual and to propose adapted treatment algorithms. Those results should now be tested in prospective studies. doi:10.1016/j.schres.2007.12.333
The Alfred Hospital, Level One, Old Baker Building, Commercial Road, 3004 Melbourne, Australia, Tel.: +61 3 9076 6924; fax: +61 3 9076 6588. Background: Current data on the use of antipsychotic medication in pregnancy is limited. The aim of this research is to establish a National Register of Antipsychotic Medication in Pregnancy, to provide evidencebased clinical guidelines for the best use of antipsychotic medication during pregnancy. Methods: This is an ongoing, observational study, with a target of 100 participants Australia-wide. Participants include women with a history of mental illness, who are taking antipsychotic medication, and become pregnant. Following provision of informed consent, data will be gathered via telephone and/or face to face interviews during pregnancy, following delivery and for the first year of the baby's life. Information will include demographics, medical, psychiatric, medication and obstetric history and information on the general health and wellbeing for both mother and baby. Results: Preliminary results include: Twelve participants taking Seroquel, resulting in 12 live births [including 1 prematurity (28 weeks) and 1 maternal tachycardia]. Six participants taking Risperidone, resulting in 6 live births (with 1 participant reporting both gestational diabetes and prematurity at 36 weeks). Four participants taking Clozapine, resulting in: 1 abortion (neural tube defect), gestational diabetes (2 participants) and partial craniosynostosis (1 infant). Two participants taking Aripiprazole had first trimester abortions with high neural tube defects, one participant taking aripiprazole had her medication discontinued at 8 weeks, with no ill effect on the baby. Conclusions: The collection of ongoing data and the resulting guidelines, have the potential to provide regular contemporary updates to clinical treating teams, for the evidence-based management of women in this vulnerable population group. Acknowledgements: This research is supported by AstraZeneca, Janssen-Cilag, Mayne Pharmaceuticals and the Australian Rotary Health Research Fund; plus ethics approvals from 18 health care sites across Australia. doi:10.1016/j.schres.2007.12.334
268 – COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA: THE IMPACT ON OVERALL SEVERITY OF ILLNESS IN A CLINICAL SAMPLE J. Moamai 1,2, D. Boisvert 2. 1 2
267 – THE NATIONAL REGISTER OF ANTIPSYCHOTIC MEDICATION IN PREGNANCY (NRAMP) J. Kulkarni 1, K. McCauley 1,2, H. Gilbert 1, C. Gurvich 1, A. De Castella 1, P. Ftizgerald 1. 1
Alfred Psychiatry Research Centre, The Alfred Hospital and the School of Psychology, Psychiatry and Psychological Medicine 2 School of Nursing and Midwifery, Monash University Presenting Author details: [email protected]
143
Montreal University Hospital Centre, Montreal, Quebec, Canada Pierre Janet Hospital, Gatineau, Quebec, Canada
Presenting Author details: [email protected] 20, Pharand St, J9A 1K7 Gatineau, Quebec, Canada, Tel.: +1 819 7768010; fax: +1 819 7768002. Background: Kraepelin's conceptualization of dementia praecox had been mainly based on a “decline of cognitive processes”. Cognitive Dysfunction (CD) is still viewed as a core feature of schizophrenia, linked to lower quality of life and poor overall functioning. However, its clinical magnitude remains relatively unstudied. The purpose of this study was to measure the prevalence of CD in present-day schizophrenia and to investigate how overall severity of illness is affected by CD.