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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.554

EW437

Catatonia in acute psychiatric patients

R. Takacs

1 ,

, M. Asztalos

2

, G. Gazdag

1

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.555

Psychopharmacology and pharmacoeconomics

EW438

Hematological safety of olanzapine

A. Alageel

1 ,

, E. Gaffas

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.556