European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348 S267
EW436
Dysfunctional meta-cognitive beliefs
across psychopathology:
A meta-analytic review
X. Sun ∗, S.H.W. So , C. Zhu , P.W.L. Leung
The Chinese University of Hong Kong, Department of Psychology,
Hong Kong, China
∗ Corresponding author.
Introduction It is assumed that dysfunctional meta-cognitive
beliefs about one’s thoughts increase problematic appraisals and
coping behaviors, which further contribute to the development
of mental disorders (Wells and Matthews, 1994; Wells, 2000).
Although this research interest originated around generalized anx-
iety disorder (GAD), recent studies have begun to examine similar
meta-cognitive processes in other disorders. The majority of stud-
ies using Meta-cognitions Questionnaire (MCQ; Cartwright-Hatton
& Wells, 1997) and its variants to assess meta-cognitive beliefs.
Objectives We conducted a meta-analysis to integrate empirical
findings on group differences in meta-cognitive beliefs between
healthy individuals and patients with various psychiatric disorders.
Methods We followed the PRISMA guideline (Liberati et al.,
2009). A systematic literature search was conducted. We included
studies that involved a diagnosed psychiatric group and healthy
controls (aged 18 or above), reported group comparisons of
metacognition, and were published during the period of 1990–27
August 2015. Effect sizes were computed.
Results A final set of 43 studies was included. Large combined
effect sizes were found on each subdomain of the MCQ, indicating
increased levels of dysfunctional meta-cognitive beliefs in patients.
Subgroup analyses were carried out based on psychiatric diagnosis
(i.e. psychosis, n = 10; GAD, n = 7; obsessive-compulsive disorder,
OCD, n = 15; anorexia nervosa, n = 5). All patient groups were more
dysfunctional on each subtype of meta-cognitive beliefs than con-
trols. Effect size of U/D was particularly large for GAD, and that of
CSC was particularly large for OCD.
Conclusions Dysfunctional meta-cognitive beliefs are evident
across several psychiatric disorders, with specific types of beliefs
being more marked in certain diagnoses.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW437
Catatonia in acute psychiatric patients
R. Takacs ∗, M. Asztalos , G. Gazdag
1 Szent Istvan and Szent Laszlo Hospitals, Centre for Psychiatry and
Addiction Medicine, Budapest, Hungary
2 Semmelweis University, School of Doctoral Studies, Budapest,
Hungary
∗ Corresponding author.
Introduction Over the past years, catatonia received increas-
ing attention. The concept of catatonia has been decoupled from
schizophrenia and broadened.
Aim The aim of our prospective study was to determine the
prevalence of catatonia in patients admitted to an acute psychiatric
ward.
Material and methods We examined all patients acutely admit-
ted to the Centre for Psychiatry and Addiction Medicine (CPAM)
of Szent István and Szent László Hospitals, from 01/04/2015 to
31/07/2015. We used Bush Francis Catatonia Screening Instrument
(BFCSI) for the assessment of catatonic signs. In case of presence of
2 or more symptoms on BFCSI, the severity of catatonia was rated
with Bush Francis Catatonia Rating Scale (BFCRS). After detailed
clinical examination, we used Structured Clinical Interview for
DSM-IV, Mini Mental State Examination and Clock Drawing Test
in setting up a diagnose.
Results In the study period, altogether 338 patients were admit-
ted to CPAM. Catatonia could be diagnosed in 8.55% of them,
according to BFCRS and in case of 5.02% the diagnosis of catato-
nia could be set up according to DSM-5 diagnostic criteria. Female
patients were present in 58.62%. The mean age was 57.62 years.
Schizophrenia spectrum disorder was diagnose in 41.3%, demen-
tia in 27.5%, affective disorder in 6.89%, alcohol, drug withdrawal
syndrome, Down syndrome and mental retardation in 3.44% each,
other organic disease in 10.34% of all catatonia cases.
Conclusion Catatonia can be present in a variety of psychiatric
conditions. Its specific therapy gives a special importance to the
recognition of this syndrome.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Psychopharmacology and pharmacoeconomics
EW438
Hematological safety of olanzapine
A. Alageel ∗, E. Gaffas
1 Imam University, Psychiatry Dep., Riyadh, Kingdom of Saudi Arabia
2 Alamal Complex for Mental Health, Psychiatry Department, Riyadh,
Kingdom of Saudi Arabia
∗ Corresponding author.
Introduction Olanzapine is an atypical antipsychotic medication,
previously expected to be safe in terms of hematological side effects
and an alternative choice to clozapine in patients who develop
hematotoxicities. However, since olanzapine was introduced to the
market, a lot of cases reports have been published revealing it could
cause hematoxicity. Some of them indicate that olanzapine induces
agranulocytosis. Because of that, it raises the concerns about hema-
tological safety of olanzapine.
Objective To date, no review discusses this topic specifically, so
we conducted a systemic review to explore and address this issue.
Methods We searched Pubmed, Google Scholar, Ovid and Med-
line databases for articles between 1998 and 2015 that include
keywords olanzapine, leukopenia, neutropenia, and agranulocyto-
sis.
Results A total of 38publicationswere identified. The case reports
included patients aged 16 to 83 years. Doses ranged from 2.5 to
30mg. After starting treatment, onset of hematotoxicity varied
from the first day to 2–3 years, but most commonly within the first
month. Also, olanzapine could induce leukopenia in patients who
have never developed drug-related leukopenia.
Conclusion Among antipsychotic medications, olanzapine is the
third leading cause of neutropenia and the second leading cause
of atypical antipsychotic medication. Because of the small body of
literature regarding the hematotoxic side effects of olanzapine, we
encourage further research to understand themechanismbywhich
olanzapine causes granulocytopenia. The identification of risk fac-
tors could facilitate the development of newsurveillance guidelines
in patients taking olanzapine. We recommend that the guidelines
of using and monitoring olanzapine need to be reconsidered.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.