357 – Appraisals, psychotic symptoms and affect in daily life

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ABSTRACTS / Schizophrenia Research 98 (2008) 3–199

patients with psychosis and its effects on the clinical picture of the subsequent illness. In this study we aimed to examine in a sample of patients already diagnosed with a psychotic disorder, the predictors and consequences of: (1) pre-psychotic cannabis abuse, (2) early cannabis abuse and (3) current cannabis abuse. Methods: Pre-psychotic characteristics included sociodemographic variables, childhood and adolescence adjustment. Phenotypic measures included age of illness onset, psychopathology (OPCRIT) and a short neuropsychological battery. These characteristics were then compared according to patients' pre-psychotic and current history of cannabis abuse. Results: A sample of 337 patients with psychosis was included. It was found that pre-psychotic cannabis abuse was associated with better social but worse school premorbid adjustment. Early cannabis abuse predicted an earlier age of illness onset and more negative and cognitive symptoms. Finally, current cannabis abuse was associated with more severe positive, manic and depressive symptoms. Conclusions: While psychotic patients who comorbidly abuse cannabis may have more prominent positive and affective symptoms, those who started abusing cannabis during their early adolescence have poor adolescent school adjustment, early onset of illness and more prominent negative symptoms and cognitive abnormalities. doi:10.1016/j.schres.2007.12.422

generates three dimensions: cognitive–perceptual, interpersonal and disorganized. Results: In all BS factors, patients presented the highest scores, parents' intermediate values and siblings the lowest ones. Anova posthoc tests showed that: i) parents had significant lower scores than patients in F1, F3 and F4 (p b 0.05) but presented similar scores in F2, ii) siblings differed significantly from patients in all factors (p b 0.01). BS factors and disorganized dimension were significantly correlated in the three groups (p b 0.01). Conclusions: A gradient of BS along schizophrenic patients and their first-degree relatives is observed supporting the idea that BS could constitute a trait of an underlying schizotaxia. A healthy group control and larger samples are needed to address this question in the future. Acknowledgement: Supported by the Fundació La Marató de TV3 (014430/31). doi:10.1016/j.schres.2007.12.423

357 – APPRAISALS, PSYCHOTIC SYMPTOMS AND AFFECT IN DAILY LIFE E. Peters 1, I. Myin-Germeys 2, S. Williams 1, K. Greenwood 1, E. Kuipers 1, J. Scott 3, P. Garety 1. 1

356 – BASIC SYMPTOMS AND SCHIZOTYPY IN FIRST-EPISODE SCHIZOPHRENIA PATIENTS AND THEIR FIRST-DEGREE RELATIVES S. Miret 1, M. Fatjó-Vilas 2, V. Peralta 3, L. Fañanás 2. 1

Centre de Salut Mental de Lleida, Servei de Psiquiatria i Drogodependències, Hospital Santa Maria, Lleida, Spain 2 Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia. Universitat de Barcelona, Barcelona, Spain 3 Unidad de Psiquiatría, Hospital Virgen del Camino, Pamplona, Spain Presenting Author details: [email protected] Avda Rovira Roure, 44, 25198 Lleida, Spain, Tel.: +34 973727060; fax: +34 973248157. Background: Basic Symptoms (BS) consist of abnormal subjective experiences hypothesized to be closer to the neurobiological substrate (Huber 1983). From the schizotaxia (Meehl 1989) and the vulnerability to schizophrenia framework (Zubin and Steinhauser 1981), BS could constitute an expression of liability to schizophrenia. The aims of the study were to examine: i) the BS profiles in patients and their healthy first-degree relatives; ii) the relationship between BS and schizotypy profiles, in all individuals. Methods: The sample consisted of 26 stable patients with a firstepisode schizophrenia spectrum disorders (DSM-IV-TR), 68 healthy first-degree relatives (45 parents, 23 siblings). All answered i) the Frankfurt Complaint Questionnaire (FCQ, Süllwold 1986) that generates four factors: Central cognitive disturbances (F1), Perception and motility (F2), Depressivity (F3) and Internal and external overstimulation (F4) and ii) the Schizotypal Personality Questionnaire – Brief (SPQ-B, Raine and Benishay 1995) that

King's College London, Institute of Psychiatry, Psychology University of Maastricht 3 King's College London, Institute of Psychiatry, Psychologica Medicine 2

Presenting Author details: [email protected] PO77, Psychology, Institute of Psychiatry, De Crespigny Park, SE5 8AF London, United Kingdom, Tel.: +44 207 8480347; fax: +44 207 8485006. Background: Experience Sampling Method (ESM) is a structured diary technique permitting ‘on-line’ measurement of daily psychotic experiences. Methods: This study assessed appraisals of symptoms, content of spontaneous thoughts, characteristics of key symptoms and affect. 534 datapoints were obtained from 12 psychotic outpatients. Individuals were signaled by a bleeping wrist watch to complete an ESM booklet at 10 random times of day for 6 consecutive days. Results: Hallucinations were rated as present on 73% of observations and delusions on 67%. However only 3.6% of spontaneous thoughts were psychosis related, which were predictive of more negative and less positive affect. Intensity of hallucinations was correlated with distress and interference, and intensity of delusions with distress, interference and preoccupation, but not conviction. Delusional conviction was highly variable from moment to moment, as were ‘insight’ (“my problems are due to an illness”) and ‘decentring’ (“my problems are something to do with the way my mind works”) appraisals. Multilevel linear regressions showed that appraisals about power of voices, but not control, were related to negative affect and symptom-related distress, with higher power ratings leading to more distress. ‘Decentring’ appraisals for delusions, but not hallucinations, were related to negative affect and symptom-related distress, with higher decentring ratings leading to less distress. ‘Insight’ appraisals were not related to distress for either symptom.

ABSTRACTS / Schizophrenia Research 98 (2008) 3–199 Conclusions: This study demonstrates that ESM is a useful methodology to capture ‘on-line’ variability in psychotic phenomenology and in determining complex relationships between appraisals, symptoms and affect. Results showed that despite psychotic symptoms being present a majority of the time, people are not engulfed by them. However intensity and presence of psychosis-related thoughts lead to more distress and interference with functioning. Delusional convictions are not stable, nor are appraisals about symptoms. Power appraisals are central to predicting distress about voices, while ‘decentring’ from your delusions predicts less distress. In contrast, having traditional ‘insight’ into symptoms does not influence distress. doi:10.1016/j.schres.2007.12.424

358 – NEURODEVELOPMENTAL MARKERS AND CLUSTER ANALYSIS IN FIRST EPISODE NON-AFFECTIVE PSYCHOSIS M. Ruiz-Veguilla 1, M.L. Barrigon 2, M. Ferrin 3, E. Gordo 2, A. Brañas 2, M. Anguita 2, M. Gurpegui 4, J. Cervilla 4. 1 Complejo Hospitalario Jaen. First Episodes of Psychosis Unit (Jaén), Spain 2 Complejo Hospitalario Jaén.Child and Adolescent Unit 3 Hospital Clinico Granada 4 Instituto de Neurociencias, University of Granada, Spain

Presenting Author details: [email protected] Carretera Bailen-Motril sn, 23009 Jaen, Spain, Tel.: +34 958 171583. Background: The term schizophrenia includes a group of clinical entities with a variety of phenomenological presentations and etiological factors . The main aim of this study was to explore whether specific groups of patients with first episode psychosis can be identified on a psychopathologically basis and whether such identified groups can be validated by exploring their correlation with a variety of neurodevelopmental markers. Methods: This study included 87 patients in their first episode of nonaffective psychosis. Psychopathology (PANSS), age onset of psychosis, premorbid adjustment (Premorbid Adjustment Scale, PAS), Obstetrics complications (OCs, Lewis–Murray Scale), Neurological assessment (NES) and Cannabis use (CIDI), family history, were assed at the first contact with mental health services. Results: Principal component analysis was applied to PANSS, obtaining 4 factor (eigenvalue above 1.5) that explained 54% of the variance: Negative Factor, Disorganization Factor, Positive Factor and Paranoid Factor. The cluster analysis of the four factors produced three clusters of patients: negative, low score and paranoid psychotic subtypes. After adjusted by gender and age, the negative cluster is associated with poor social premorbid adjustment (3.9 ± 6 vs. 3.8 ± 6 vs. 9.2 ± 9; p b 0.05), low score in verbal fluency (18.4 ± 4vs. 17 ± 7vs. 12.2 ± 2, p b 0.05), more presence of Neurological soft signs (21.6 ± 9 vs. 17.3 ± 8 vs. 29.2 ± 1; p b 0.05) and more OCs (16% vs. 4% vs. 29%; p b 0.05). Conclusions: The negative cluster presents a profile of abnormal neurodevelopmental. doi:10.1016/j.schres.2007.12.425

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359 – NEGATIVE AND POSITIVE SYNDROMES IN FIRST EPISODE SCHIZOPHRENIA H. Soliman 1,2, S. Rabie 2, R. Mahfouz 2. 1 2

Kent and Medway NHS & Social Care Partnership Trust, Kent, UK Department of Psychiatry, Minya University, Egypt

Presenting Author details: [email protected] St Bartholomew's Hospital, New Road, ME1 1DS Rochester, Kent, United Kingdom, Tel.: +44 7 900220645; fax: +44 163 4810972. Background: Most of the phenomenological studies examining the two versus three syndrome concepts of schizophrenia classified symptoms rather than patients. The objectives of this study were to investigate the structure of positive and negative syndromes at the first episode of the illness in groups of patients. Correlation between negative and positive symptoms, on the one hand and depression, on the other, was also studied. Methods: Of 65 patients presenting to the Department of Psychiatry, Minya University Hospitals, Egypt, 43 (20 females and 23 males) met the diagnosis of schizophrenia (ICD-10). Clinical interviews using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and Positive and Negative Syndrome Scale (PANSS) were conducted. Cluster analysis was carried out using a matrix of scores on individual symptoms of PANSS. Comparison between the resulting groups of patients was carried out, using T-test for independent sample, as well as nonparametric Mann–Whitney test. The same tests were used in the comparison between the two genders. Spearman rank correlation coefficients between negative, positive and depressive symptoms were calculated. Results: 75% of the patients suffered moderate to severe degree of negative symptoms. Cluster analysis revealed that a two-cluster model fit better the data than the three-cluster model. 27 (62.8%) patients belonged to the first cluster, characterized by the preponderance of positive symptoms, while 16 (37.2%) belonged to the second, with preponderance of negative symptoms. There was some overlap between cluster membership and the typological assessment of the PANSS. Negative correlation was found between negative and positive symptoms. No correlation was found between negative symptoms and depression. No gender differences in negative symptoms were elicited, but females had a higher age of onset. Conclusions: The study supports the primary nature of negative symptoms, as well as the two-syndrome model of schizophrenia.

doi:10.1016/j.schres.2007.12.426

360 – THEMES AND PREVALENCE OF IDEAS/DELUSIONS OF REFERENCE IN EARLY PSYCHOSIS G.H.Y. Wong 1, C.P.Y. Chiu 2, C.W. Law 2, E.Y.H. Chen 1. 1 Department of Psychiatry, University of Hong Kong, Hong Kong 2 Department of Psychiatry, Queen Mary Hospital, Hong Kong