European Psychiatry - Volume 33 - March 2016

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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 ∗, G. Wang
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.
FC96
Efficacy and safety of brexpiprazole in
schizophrenia: Meta-analysis of three
double-blind, randomized,
placebo-controlled phase 3 studies
C. Weiss ∗, P. Zhang , M.J. Hakala , A. Skuban , E. Weiller
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.
Sleep disorders and stress
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Sleep disturbances and substance use
disorders: An international study of
primary care and mental health
specialty care patients
L. Fortuna ∗ oyola ook Amaris
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