- Email: [email protected]
Use of long acting injectables in mentally disordered offenders
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P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical)
Conclusions: The literature review data suggest that the gender might play an important role in the course of acute psychosis. However, gender differences in antipsychotic reponses have been less systematically pursued. Gender-related effects may play a role in antipsychotic treatment [4,5]. The results of our study show that the female gender is a protective factor for re-hospitalization but the results in terms of the number of prescribed antipsychotics are not significant, though possibly this can be solved by increasing the sample size. The aim of the RETO study was to determine the relationship between the number of readmissions and the number of prescribed antipsychotics in these patients and it din not focus on detection of gender differences. There are biological, psychological, sociological and functional factors, which could explain these gender differences, according to some of the studies reviewed [3]. Therefore, it seems logical to think that psychotic disorders should be expressed differently in both sexes. A greater understanding of the gender differences presents in acute psychosis can help us design more effective preventive and intervention actions. References [1] Montemgni, C., Frieri, T., Blandamura, A., Villari, V., Rocca, P, 2015. Gender differences in 353 inpatients with acute psychosis: The experience of one Psychiatric Emergency Service of Turin. Psychiatry Research 227, 192–197. [2] Usall, J., Suarez, D., Haro, JM, 2007. Gender differences in resonse to antipsychotic treatment in outpatients with schizophrenia. Psychiatry Research 153, 225–231. [3] Ochoa, S., Usall, J., Cobo, J., Labad, X., Kulkarni, J, 2012. Gender Differences in Schizophrenia and First-Episode Psychosis: A comprehensive Literature Review. Schizophrenia Research and Treatment. Article ID 916198. [4] Ceskova, E., Prikryl, R., Libiger, J., Svancara, J., Jarkovsky, J, 2015. Gender differences in the treatment of first-episode schizophrenia: Results from the European First Episode Schizophrenia Trial. Schizophrenia Research 169, 303–307. [5] Seeman, M.V, 2004. Gender differences in the prescribing of antipsychotic drugs. Am. J. Psychiatry 161, 1324–1333.
P.3.b.044 Quality of life, mental health status and service utilization in a sample of outpatients from a mental health service in northern Italy G. Cerveri1 ° , C. Gesi1 , V. Venturi1 , V. Tricarico1 , C. Mencacci1 Psychiatric Service, Dept of psychiatry, Milan, Italy
1 Fatebenefratelli
Introduction: Quality of life (QOL) has developed as an important integration to the concepts of health and functioning. QOL comprises physical, emotional, social, and behaviour-related components of subjective well-being [1]. Psychotic disorders are among the most severe and resource consuming mental illnesses [2]. However, data about QOL in this patients group compared to other mentally ill subjects and with regard to Community Mental Health Service (CMHS) utilization are lacking. Aims: The aim of the present report was to assess quality of life, mental health status and CMHS utilization in a sample of outpatients from a CMHS in northern Italy and the associations among these dimensions. Methods: 74 outpatients with a broad range of psychiatric disorders were recruited from the CMHS of the Azienda Ospedaliera Fatebenefratelli e Oftalmico in Milan (Italy). Subjects were administered the Brief Psychiatric Rating Scale (BPRS) and
they were asked to fill the World Health Organization Quality of Life (WHOQOL-BREF). Data about CMHS utilization (namely: attendance to rehabilitation programs (RP), number of acesses to the CMHS and number of rehabilitation sessions (RS) per year) were collected. Statystical analyses included Pearson’s correlation analysis, T test and Chi2 test. A multivariate analysis of covariance (MANCOVA) was used to evaluate the impact of clinical variables on the domains of WHOQOL-BREF. Results: Out of 74 subjects (mean age ±SD 48.8±14.4), 17 had schizophrenia or schizoaffective disorder, 1 delusional disorder, 4 psychotic disorder NAS, 27 had a mood disorder, 9 a personality disorder and 16 an anxiety disorder. A positive correlation between BPRS total score and the number of RS per year (r = 0.325; p = 0.009) was found. No correlations were found between BPRS total score and number of accesses per year to the CMHS. Only Environment domain score of the WHOQOL-BREF correlated with BPRS total score (r = 0.258; p = 0.040). No correlations were found between WHOQOL-BREF domains score and BPRS depression score, number of accesses to the CMHS or number of RS. After splitting the sample in two groups (psychotic disorders: PD, non psychotic disorders: NPD), PD subjects were shown to have greater BPRS total scores that NPD subjects (50.5±15.4 vs 38.9±12.2; p = 0.005), while the latter group showed higher BPRS depression scores (1.64±1.0 vs 1.16±0.4; p = 0.005). NPD subjects were more likely to attend a RP (40.9% vs 7.7%; p = 0.001). The MANCOVA analysis showed that PD subjects showed higher self-rated QOL in all WHQOL-BREF domains but Social one (Physical: F = 6.668, p = 0.012; Psychological: F = 6.743, p = 0.012; Environment: F = 6.635, p = 0.013) controlling for BPRS total and depressive score and attendance to RP. Conclusions: Te severity of psychiatric symptoms is positively correlated with utilization of RP and negatively with QOL. Individuals with PD show greater symptom severity and larger utilization of RPs than subjects with NPD and they score higher in most domains of the QOL, even when the effects of symptom severty and RP utilization have been controlled for. References [1] The World Health Organization, 1998. Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med 46, 1569−85. [2] Byford S., Barber J.A., Fiander M., Marshall S., Green J., 2001. Factors that influence the cost of caring for patients with severe psychotic illness: report from the UK 700 trial. Br J Psychiatry 178, 441−7.
P.3.b.045 Use of long acting injectables in mentally disordered offenders C. Tsopelas1 ° , G. Tzeferakos2 , I. Kotsiouba2 , G. Kalemi2 , A. Douzenis2 1 Psychiatric Hospital of Attica, 5th Dept. of Acute Admissions, Athens, Greece; 2 2nd Dept. of Psychiatry- National and Kapodistrian University of Athens - “Attikon” General Hospital, 2nd Dept. of Psychiatry, Athens, Greece Objective: Psychiatric disorders are often associated with aggression and violence. Mentally ill patients that commit criminal acts often have history of poor compliance to psychiatric treatment and violence. These patients have poor therapeutic outcomes, low quality of life, poor social functioning, more frequent relapses of the mental disorder and frequent involuntary admissions [1−3]. Aim: The present research aims to assess the long term compliance of this difficult to engage mental health patients group [4,5].
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical) Methodology: Data was collected during the operation of long acting injectables clinic at the 2nd Psychiatry Department, Attikon hospital. Patients who were seriously mentally ill, with a history of poor compliance or poor response to treatment were admitted to this outpatient service which was part of an outpatient forensic mental health service. The follow up period covered 28 months (July 2013 to November 2015) Psychopathological assessment was completed using the Structured Clinical Interview for DSM-IV axis-I disorders (SCID-I/P). The statistical program SPSS was used for the data analysis. Results: Our sample consisted of 90 patients, 60.0% were males, 40.0% females, aged 18−65. Mean age of men was 36 (SD = 13.3) and of women 43 (SD = 11.5). The mean age of mental disorder onset was 31.2 years (SD = 13.1). They were mostly single (75.6%). The diagnoses were: Schizophrenic spectrum disorders 63.3%, bipolar disorder 10.8%, and other (psychotic spectrum) diagnoses 20.8%. Upon admission to the study 98% had a history of poor compliance and were often involved in aggressive acts (80%) and a high percentage of them have committed criminal acts (usually murder) (67.7%). 68.9% had good compliance in the depot outpatient clinic for the period of 28 months. Although overall compliance was 68.9%, men were more compliant than women but this difference hasn’t reached statistically significant level. Upon admission atypical long acting antipsychotics were used in 91.3% of the patients and typical in 9.7% of them. In detail atypical were used as follows: 51.6% long acting Olanzapine, 20.9% Risperidone long acting, 17.7% long acting Paliperidone. All other per os medication was eventually tapered off. There were no statistically significant differences between the different atypical long acting antipsychotics in compliance, average PANSS scores and akathesia. Patients receiving long acting Olanzapine had more weight increase in the first year. There were few adverse events, and only one (informal) psychiatric admission. Conclusions: Poor compliance to treatment result to relapse of mental disorder. This is of major importance for patients who have a history of being violent were they relapse. Outpatient clinics provide a safe environment for close monitoring and enhancing good compliance. New atypical long acting antipsychotics can promote compliance, close contact with mental health services and continuous monitoring of this difficult to engage population of mentally ill patients. References [1] Leucht, C., Heres, S., Kane, J.M., Kissling, W., Davis, J.M., Leucht, S., 2011. Oral versus depot antipsychotic drugs for schizophrenia − a critical systematic review and meta-analysis of randomised long-term trials. Schizophr Res. Apr;127(1−3):83−92. Epub 2011 Jan 22. [2] Burns, T., 2009. Knowledge about antipsychotic long-acting injections: bridging that gap. Br J Psychiatry Suppl. Nov;52:S5−6. [3] Bond, D.J., Pratoomsri, W., Yatham, L.N., 2007. Depot antipsychotic medications in bipolar disorder: a review of the literature. Acta Psychiatr Scand Suppl. (434):3−16. [4] Kane, J.M., 2001. Improving treatment adherence in patients with schizophrenia. J Clin Psychiatry. Sep;72(9):e28. [5] Goff, D.C., Hill, M., Freudenreich, O., 2011. Treatment adherence in schizophrenia and schizoaffective disorder. J Clin Psychiatry. Apr;72(4):e13.
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P.3.b.046 Environmental predictive factors of cognition in first episode psychotic patients E. Rodr´ıguez-Toscano1 ° , D. Fraguas2 , B. Cabrera3 , A. GonzalezPinto4 , I. Corripio5 , A. Lobo6 , M. Bernardo3 , M. Cuesta7 , M. Parellada2 1 Hospital General Universitario Gregorio Mara˜no´ n, Madrid, Spain; 2 Hospital General Universitario Gregorio Mara˜no´ n, Child and Adolescent Psychiatry Department, Madrid, Spain; 3 Clinic Hospital, Psychiatry Department, Barcelona, Spain; 4 University Hospital of Alava, Psychiatry ´ Department, Alava, Spain; 5 Hospital de la Santa Creu i Sant Pau, Psychiatry Department, Barcelona, Spain; 6 Hospital Cl´ınico Universitario Miguel Blesa, Psychiatry Department, Zaragoza, Spain; 7 Complejo Hospitalario de Navarra, Psychiatry Department, Pamplona, Spain Background: In recent years, evidence for the influence of environmental factors on the development of schizophrenia and other psychoses has become well-established. Indeed, schizophrenia patients have demonstrated greater sensitivity and increased manifestations of psychotic symptoms in response to mild stressors [1]. Certain environmental conditions have already been identified as risk factors for psychosis, including history of obstetric complications (OC) and low parental Socioeconomic status (SES) [2,3]. Despite the established role of these factors in the development of a first episode psychosis (FEP), their potential to predict specific phenotypes such as cognitive impairment remains to be studied. In the present study we aim to investigate the role of OC, SES and their interaction in predicting cognitive functioning in FEP. Methods: FEP diagnosed of schizophrenia, schizophreniform and schizoaffective disorders and con controls were included in the study. History of OC and parental SES were recorded using the LewisMurray Scale (only items related to events around delivery) and the Hollingshead–Redlich Scale respectively. The two variables were coded dichotomously (one of the groups indicating the presence of risk): Any versus no OC and low versus high parental SES. A global cognitive (GC) index was estimated using the means of 7 cognitive domains calculated by the z scores of neuropsychological tests based on the performance of controls. The independent relationships between GC and CO or SES were assessed by means of bivariate comparison (t-test) and in order to measure the predictive value of their interaction on GC a general linear model was run (using GC as the dependent variable, CO, SES and their interaction as fixed factors and sex, age and GAF as covariables). Results: 228 FEP (156 males [68.4%], mean age 23.24, SD = 5.85) and 194 controls (126 males [64.9%], mean age 23.66, SD = 5.90) were included in the study. FEP patients had significantly higher proportion of subjects with a history of OC (c2 = 11.12, p = 0.001) and lower SES (c2 = 12.99, p < 0.001) compared to controls. A significant main effect for SES was found in patients (F1,227 = 13.86, p < 0.001) and in controls (F1,193 = 6.64, p = 0.011), with subjects with lower SES demonstrating worse cognitive performance than those with higher SES. No significant main effects were found on GC for OC (in patients:F1,227 = 0.71, p = 0.401; in controls:F1,193 = 0.020, p = 0.889). However, this effect became significant (F1,116 = 4.83, p = 0.030) when only FEP patients with a diagnosis of schizophrenia were included, with worse GC observed in subjects with OC (−1.17(0.65)) than without (−0.93(0.54)).
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical)
Conclusions: The literature review data suggest that the gender might play an important role in the course of acute psychosis. However, gender differences in antipsychotic reponses have been less systematically pursued. Gender-related effects may play a role in antipsychotic treatment [4,5]. The results of our study show that the female gender is a protective factor for re-hospitalization but the results in terms of the number of prescribed antipsychotics are not significant, though possibly this can be solved by increasing the sample size. The aim of the RETO study was to determine the relationship between the number of readmissions and the number of prescribed antipsychotics in these patients and it din not focus on detection of gender differences. There are biological, psychological, sociological and functional factors, which could explain these gender differences, according to some of the studies reviewed [3]. Therefore, it seems logical to think that psychotic disorders should be expressed differently in both sexes. A greater understanding of the gender differences presents in acute psychosis can help us design more effective preventive and intervention actions. References [1] Montemgni, C., Frieri, T., Blandamura, A., Villari, V., Rocca, P, 2015. Gender differences in 353 inpatients with acute psychosis: The experience of one Psychiatric Emergency Service of Turin. Psychiatry Research 227, 192–197. [2] Usall, J., Suarez, D., Haro, JM, 2007. Gender differences in resonse to antipsychotic treatment in outpatients with schizophrenia. Psychiatry Research 153, 225–231. [3] Ochoa, S., Usall, J., Cobo, J., Labad, X., Kulkarni, J, 2012. Gender Differences in Schizophrenia and First-Episode Psychosis: A comprehensive Literature Review. Schizophrenia Research and Treatment. Article ID 916198. [4] Ceskova, E., Prikryl, R., Libiger, J., Svancara, J., Jarkovsky, J, 2015. Gender differences in the treatment of first-episode schizophrenia: Results from the European First Episode Schizophrenia Trial. Schizophrenia Research 169, 303–307. [5] Seeman, M.V, 2004. Gender differences in the prescribing of antipsychotic drugs. Am. J. Psychiatry 161, 1324–1333.
P.3.b.044 Quality of life, mental health status and service utilization in a sample of outpatients from a mental health service in northern Italy G. Cerveri1 ° , C. Gesi1 , V. Venturi1 , V. Tricarico1 , C. Mencacci1 Psychiatric Service, Dept of psychiatry, Milan, Italy
1 Fatebenefratelli
Introduction: Quality of life (QOL) has developed as an important integration to the concepts of health and functioning. QOL comprises physical, emotional, social, and behaviour-related components of subjective well-being [1]. Psychotic disorders are among the most severe and resource consuming mental illnesses [2]. However, data about QOL in this patients group compared to other mentally ill subjects and with regard to Community Mental Health Service (CMHS) utilization are lacking. Aims: The aim of the present report was to assess quality of life, mental health status and CMHS utilization in a sample of outpatients from a CMHS in northern Italy and the associations among these dimensions. Methods: 74 outpatients with a broad range of psychiatric disorders were recruited from the CMHS of the Azienda Ospedaliera Fatebenefratelli e Oftalmico in Milan (Italy). Subjects were administered the Brief Psychiatric Rating Scale (BPRS) and
they were asked to fill the World Health Organization Quality of Life (WHOQOL-BREF). Data about CMHS utilization (namely: attendance to rehabilitation programs (RP), number of acesses to the CMHS and number of rehabilitation sessions (RS) per year) were collected. Statystical analyses included Pearson’s correlation analysis, T test and Chi2 test. A multivariate analysis of covariance (MANCOVA) was used to evaluate the impact of clinical variables on the domains of WHOQOL-BREF. Results: Out of 74 subjects (mean age ±SD 48.8±14.4), 17 had schizophrenia or schizoaffective disorder, 1 delusional disorder, 4 psychotic disorder NAS, 27 had a mood disorder, 9 a personality disorder and 16 an anxiety disorder. A positive correlation between BPRS total score and the number of RS per year (r = 0.325; p = 0.009) was found. No correlations were found between BPRS total score and number of accesses per year to the CMHS. Only Environment domain score of the WHOQOL-BREF correlated with BPRS total score (r = 0.258; p = 0.040). No correlations were found between WHOQOL-BREF domains score and BPRS depression score, number of accesses to the CMHS or number of RS. After splitting the sample in two groups (psychotic disorders: PD, non psychotic disorders: NPD), PD subjects were shown to have greater BPRS total scores that NPD subjects (50.5±15.4 vs 38.9±12.2; p = 0.005), while the latter group showed higher BPRS depression scores (1.64±1.0 vs 1.16±0.4; p = 0.005). NPD subjects were more likely to attend a RP (40.9% vs 7.7%; p = 0.001). The MANCOVA analysis showed that PD subjects showed higher self-rated QOL in all WHQOL-BREF domains but Social one (Physical: F = 6.668, p = 0.012; Psychological: F = 6.743, p = 0.012; Environment: F = 6.635, p = 0.013) controlling for BPRS total and depressive score and attendance to RP. Conclusions: Te severity of psychiatric symptoms is positively correlated with utilization of RP and negatively with QOL. Individuals with PD show greater symptom severity and larger utilization of RPs than subjects with NPD and they score higher in most domains of the QOL, even when the effects of symptom severty and RP utilization have been controlled for. References [1] The World Health Organization, 1998. Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med 46, 1569−85. [2] Byford S., Barber J.A., Fiander M., Marshall S., Green J., 2001. Factors that influence the cost of caring for patients with severe psychotic illness: report from the UK 700 trial. Br J Psychiatry 178, 441−7.
P.3.b.045 Use of long acting injectables in mentally disordered offenders C. Tsopelas1 ° , G. Tzeferakos2 , I. Kotsiouba2 , G. Kalemi2 , A. Douzenis2 1 Psychiatric Hospital of Attica, 5th Dept. of Acute Admissions, Athens, Greece; 2 2nd Dept. of Psychiatry- National and Kapodistrian University of Athens - “Attikon” General Hospital, 2nd Dept. of Psychiatry, Athens, Greece Objective: Psychiatric disorders are often associated with aggression and violence. Mentally ill patients that commit criminal acts often have history of poor compliance to psychiatric treatment and violence. These patients have poor therapeutic outcomes, low quality of life, poor social functioning, more frequent relapses of the mental disorder and frequent involuntary admissions [1−3]. Aim: The present research aims to assess the long term compliance of this difficult to engage mental health patients group [4,5].
P.3.b. Psychotic disorders and treatment − Psychotic disorders (clinical) Methodology: Data was collected during the operation of long acting injectables clinic at the 2nd Psychiatry Department, Attikon hospital. Patients who were seriously mentally ill, with a history of poor compliance or poor response to treatment were admitted to this outpatient service which was part of an outpatient forensic mental health service. The follow up period covered 28 months (July 2013 to November 2015) Psychopathological assessment was completed using the Structured Clinical Interview for DSM-IV axis-I disorders (SCID-I/P). The statistical program SPSS was used for the data analysis. Results: Our sample consisted of 90 patients, 60.0% were males, 40.0% females, aged 18−65. Mean age of men was 36 (SD = 13.3) and of women 43 (SD = 11.5). The mean age of mental disorder onset was 31.2 years (SD = 13.1). They were mostly single (75.6%). The diagnoses were: Schizophrenic spectrum disorders 63.3%, bipolar disorder 10.8%, and other (psychotic spectrum) diagnoses 20.8%. Upon admission to the study 98% had a history of poor compliance and were often involved in aggressive acts (80%) and a high percentage of them have committed criminal acts (usually murder) (67.7%). 68.9% had good compliance in the depot outpatient clinic for the period of 28 months. Although overall compliance was 68.9%, men were more compliant than women but this difference hasn’t reached statistically significant level. Upon admission atypical long acting antipsychotics were used in 91.3% of the patients and typical in 9.7% of them. In detail atypical were used as follows: 51.6% long acting Olanzapine, 20.9% Risperidone long acting, 17.7% long acting Paliperidone. All other per os medication was eventually tapered off. There were no statistically significant differences between the different atypical long acting antipsychotics in compliance, average PANSS scores and akathesia. Patients receiving long acting Olanzapine had more weight increase in the first year. There were few adverse events, and only one (informal) psychiatric admission. Conclusions: Poor compliance to treatment result to relapse of mental disorder. This is of major importance for patients who have a history of being violent were they relapse. Outpatient clinics provide a safe environment for close monitoring and enhancing good compliance. New atypical long acting antipsychotics can promote compliance, close contact with mental health services and continuous monitoring of this difficult to engage population of mentally ill patients. References [1] Leucht, C., Heres, S., Kane, J.M., Kissling, W., Davis, J.M., Leucht, S., 2011. Oral versus depot antipsychotic drugs for schizophrenia − a critical systematic review and meta-analysis of randomised long-term trials. Schizophr Res. Apr;127(1−3):83−92. Epub 2011 Jan 22. [2] Burns, T., 2009. Knowledge about antipsychotic long-acting injections: bridging that gap. Br J Psychiatry Suppl. Nov;52:S5−6. [3] Bond, D.J., Pratoomsri, W., Yatham, L.N., 2007. Depot antipsychotic medications in bipolar disorder: a review of the literature. Acta Psychiatr Scand Suppl. (434):3−16. [4] Kane, J.M., 2001. Improving treatment adherence in patients with schizophrenia. J Clin Psychiatry. Sep;72(9):e28. [5] Goff, D.C., Hill, M., Freudenreich, O., 2011. Treatment adherence in schizophrenia and schizoaffective disorder. J Clin Psychiatry. Apr;72(4):e13.
S521
P.3.b.046 Environmental predictive factors of cognition in first episode psychotic patients E. Rodr´ıguez-Toscano1 ° , D. Fraguas2 , B. Cabrera3 , A. GonzalezPinto4 , I. Corripio5 , A. Lobo6 , M. Bernardo3 , M. Cuesta7 , M. Parellada2 1 Hospital General Universitario Gregorio Mara˜no´ n, Madrid, Spain; 2 Hospital General Universitario Gregorio Mara˜no´ n, Child and Adolescent Psychiatry Department, Madrid, Spain; 3 Clinic Hospital, Psychiatry Department, Barcelona, Spain; 4 University Hospital of Alava, Psychiatry ´ Department, Alava, Spain; 5 Hospital de la Santa Creu i Sant Pau, Psychiatry Department, Barcelona, Spain; 6 Hospital Cl´ınico Universitario Miguel Blesa, Psychiatry Department, Zaragoza, Spain; 7 Complejo Hospitalario de Navarra, Psychiatry Department, Pamplona, Spain Background: In recent years, evidence for the influence of environmental factors on the development of schizophrenia and other psychoses has become well-established. Indeed, schizophrenia patients have demonstrated greater sensitivity and increased manifestations of psychotic symptoms in response to mild stressors [1]. Certain environmental conditions have already been identified as risk factors for psychosis, including history of obstetric complications (OC) and low parental Socioeconomic status (SES) [2,3]. Despite the established role of these factors in the development of a first episode psychosis (FEP), their potential to predict specific phenotypes such as cognitive impairment remains to be studied. In the present study we aim to investigate the role of OC, SES and their interaction in predicting cognitive functioning in FEP. Methods: FEP diagnosed of schizophrenia, schizophreniform and schizoaffective disorders and con controls were included in the study. History of OC and parental SES were recorded using the LewisMurray Scale (only items related to events around delivery) and the Hollingshead–Redlich Scale respectively. The two variables were coded dichotomously (one of the groups indicating the presence of risk): Any versus no OC and low versus high parental SES. A global cognitive (GC) index was estimated using the means of 7 cognitive domains calculated by the z scores of neuropsychological tests based on the performance of controls. The independent relationships between GC and CO or SES were assessed by means of bivariate comparison (t-test) and in order to measure the predictive value of their interaction on GC a general linear model was run (using GC as the dependent variable, CO, SES and their interaction as fixed factors and sex, age and GAF as covariables). Results: 228 FEP (156 males [68.4%], mean age 23.24, SD = 5.85) and 194 controls (126 males [64.9%], mean age 23.66, SD = 5.90) were included in the study. FEP patients had significantly higher proportion of subjects with a history of OC (c2 = 11.12, p = 0.001) and lower SES (c2 = 12.99, p < 0.001) compared to controls. A significant main effect for SES was found in patients (F1,227 = 13.86, p < 0.001) and in controls (F1,193 = 6.64, p = 0.011), with subjects with lower SES demonstrating worse cognitive performance than those with higher SES. No significant main effects were found on GC for OC (in patients:F1,227 = 0.71, p = 0.401; in controls:F1,193 = 0.020, p = 0.889). However, this effect became significant (F1,116 = 4.83, p = 0.030) when only FEP patients with a diagnosis of schizophrenia were included, with worse GC observed in subjects with OC (−1.17(0.65)) than without (−0.93(0.54)).