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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S72–S115

S111

FC95

Decreased interhemispheric resting

state functional connection in

schizophrenic patients with auditory

hallucinations

H. Wang

1 ,

, G. Wang

2

1

Renmin Hospital of Wuhan University, Wuhan, China

2

Renmin Hospital of Wuhan University, Department of Psychiatry,

Wuhan, China

Corresponding author.

Introduction

Auditory hallucination (AH) has been always con-

cerned as a main core symptom of schizophrenia. However, the

mechanisms of AH are still unclear.

Objectives

The aim of this study is to further explore the compli-

cated neuroimagingmechanismof AHs froma new insight by using

voxel-mirrored homotopic connectivity (VMHC).

Methods

Forty-two patients with AH (APG), 26 without AHs

(NPG) and82normal controls (NC) participated in resting state fMRI

scan. Correlation analyses were used to assess the relationships

between VMHC and Hoffman scores. Additionally, ROI analysis was

used to further knowabout the functional connectivity between the

brain areas with changed interhemispheric FC and the whole brain.

Results

APG showed reduced VMHC in the parahippocapus,

fusiform gyrus, rolandic operculum, insula, heschl’s gyrus and

superior temporal gyrus (STG). Hoffman score of APG group had

negative correlation with VMHC in these regions. Besides, ROI

analysis supported decreased interhemispheric FC in schizophre-

nia with AH and verified functional connectivity abnormalities in

schizophrenia.

Conclusions

These findings suggest impairment of interhemi-

spheric coordination and whole brain FC in schizophrenia with

AH, which may be implicated to the neuroimaging mechanism of

auditory hallucination. Furthermore, this research highly support

dysconnectivity hypothesis that schizophrenia related to abnor-

malities in neuronal connectivity.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.099

FC96

Efficacy and safety of brexpiprazole in

schizophrenia: Meta-analysis of three

double-blind, randomized,

placebo-controlled phase 3 studies

C. Weiss

1 ,

, P. Zhang

2

, M.J. Hakala

3

, A. Skuban

4

, E. Weiller

5

1

Otsuka Pharmaceutical Development & Commercialization Inc.,

Global Medical Affairs, Princeton, USA

2

Otsuka Pharmaceutical Development & Commercialization Inc.,

Biostatistics, Princeton, USA

3

H. Lundbeck A/S, ICR Psychiatry, DK, Valby, Denmark

4

Otsuka Pharmaceutical Development & Commercialization Inc.,

Global Clinical Development, Princeton, USA

5

H. Lundbeck A/S, Medical Affairs, Valby, Denmark

Corresponding author.

Introduction

Brexpiprazole is a serotonin-dopamine activity

modulator that is a partial agonist at 5-HT1A and dopamine D2

receptors at similar potency, and an antagonist at 5-HT2A and nor-

adrenaline alpha1B/2C receptors.

Objectives

To evaluate the efficacy, safety, and tolerability of

brexpiprazole in patients with acute schizophrenia in a meta-

analysis of three phase 3 studies with brexpiprazole.

Aim

The primary endpoint was change from baseline to week 6

in PANSS total score.

Methods

Data from the 3 clinical studies in patients with

acute schizophrenia were combined and analyzed using individ-

ual patient data meta-analysis. In two similarly designed studies

(NCT01396421; NCT01393613), patients with acute schizophre-

nia were randomized to fixed-doses of brexpiprazole 2mg/day,

4mg/day or placebo (a low-dose treatment group was included

in each study [0.25mg and 1.0mg]; not included in the meta-

analysis). In the third study (NCT01810380), patients were

randomized to flexible dosing of brexpiprazole (2 to 4mg/day),

placebo, or an active reference (quetiapine extended release).

Changes from baseline for brexpiprazole vs. placebo were analyzed

using an MMRM approach.

Results

Brexpiprazole 2–4mg (

n

= 868) was superior to placebo

(

n

= 517) in change from baseline in PANSS total score (

20.1 vs.

14.3; estimated treatment difference to placebo:

5.8 [95% CI:

8.0;

3.6];

P

< 0.001). The proportions of patients reporting TEAEs

were similar between the brexpiprazole and placebo treatment

groups (57.9% vs. 57.5%). No unexpected safety concerns were

observed.

Conclusion

This meta-analysis supports evidence from three

individual trials that brexpiprazole is efficacious and safe in treating

patients with acute schizophrenia.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.100

Sleep disorders and stress

FC97

Sleep disturbances and substance use

disorders: An international study of

primary care and mental health

specialty care patients

L. Fortuna

1 ,

, N . N

oyola

2 , B. C

ook

3 , A.

Amaris

2

1

Boston Medical Center, Psychiatry, Child and Adolescent Psychiatry,

Boston, USA

2

Massachusetts General Hospital, Disparities Research Unit, Boston,

USA

3

Cambridge Health Alliance and Harvard Medical School, Health

Equity Research Lab, Cambridge, USA

Corresponding author.

Introduction

There is no comprehensive evidence on the influ-

ence of sleep disturbances (SD) on substance use disorders (SUD) or

treatment use patterns of individuals with comorbid disturbances.

Objective/aim

To better understand comorbidities and treatment

use patterns of individuals with SD and SUD.

Methods

We combine 2010–2012 electronic health record (EHR)

data from healthcare system in Boston (

n

= 131,966 person-years)

and Madrid, Spain (

n

= 43,309 person-years). Patients with sleep

disturbances (SD) were identified in the EHR through ICD-9 codes

and medical records and substance use disorders (SUD) identified

by documented treatment for drug or alcohol abuse or depend-

ence. Rates of SUD are compared between individuals with and

without SD. Among those with both, adequacy of mental health

treatment (defined as eight or more outpatient visits or four or

more outpatient visits with a psychotropic prescription) and ER

use is compared.

Results

Among the individuals, 21.1% with SD also report SUD,

compared to only 10.6% of individuals without SD (

P

< .01). Those

with comorbidities weremore likely than their specialty care coun-

terparts without comorbidities to be seen in the ER (57.1% vs. 36.6%,

respectively,

P

< .05). Limiting the sample to only those with both

SD and SUD in specialty mental health care (

n

= 268 in Boston and

n

= 28 in Madrid), 49.2% of Boston patients received adequate care