European Psychiatry - Volume 33 - March 2016

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S272 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
stay of 15.7 days, as compared to 18.24 days of average hospital
stay due to schizophrenia in Spain. The direct costs of hospitaliza-
tion stays due to psychiatric reasons decreased from 162,071.88
Euros to 74,282.95 Euros (P < 0.001).
Conclusions This observational study shows us that the treat-
ment with PAP reduced the average length of the hospital stay, and
resulted in a decreased percentage of re-admissions as compared
to oral treatments for schizophrenia. These data led to savings of
more than 50% of the direct costs of hospitalization.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW450
Hyperuricemia in children and
adolescents with autism spectrum
disorders treated with risperidone:
The risk factors for metabolic adverse
effect
C. Sukasem ∗, N. Vanwong
Faculty of Medicine Ramathibodi hospital, Pathology, Bangkok,
Thailand
∗ Corresponding author.
Introduction The prevalence of hyperuricemia in ASDs pediatric
patients including the association of serum uric acid and metabolic
adverse effect in ASDs pediatric patients treated with risperidone
have never been examined.
Objective To determine the prevalence of hyperuricemia in ASD
pediatric patients treated with risperidone and the relationships
between serum uric acid level and risk factor components of
metabolic syndrome.
Methods This cross-sectional study recruited 127 Thai ASDs chil-
dren and adolescents, which age 3–20 years and had received
risperidone for more than 4 weeks. The condition of hyperuricemia
was defined as a high level of uric acid in the blood > 5.5mg/dL.
Results Hyperuricemia was observed in 73 of 127 (57.48%) sub-
jects. Serum uric acid level were statistically significant positively
associated with age, risperidone dose, duration of treatment, BMI,
waist circumference, triglycerides (TG), TG/HDL cholesterol ratio,
insulin, homeostatic model assessment index (HOMA-IR), leptin,
and high-sensitivity CRP (hs-CRP). Furthermore, serum uric acid
was statistically significant negatively associated with HDL choles-
terol and adiponectin level. In multiple regression, only age, BMI,
TG/HDL-C, and adiponectin level remained significant associated
with serum uric acid level (P < 0.0001).
Conclusions High level of serum uric acid related with adoles-
cence. Serum uric acid level correlated with most of the risk factors
of metabolic syndrome, except blood glucose and LDL-C levels.
The information might encourage the clinicians for aware to the
possible consequences of hyperuricemia, in order to verify possi-
ble complications of early metabolic syndrome in ASDs pediatric
treated with risperidone.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW451
Development and validation of liquid
chromatography/tandem mass
spectrometry analysis for therapeutic
drug monitoring of risperidone and
9-hydroxyrisperidone in pediatric
patients with autism spectrum
disorders
C. Sukasem ∗, S. Prommas
Faculty of medicine Ramathibodi hospital, pathology, Bangkok,
Thailand
∗ Corresponding author.
Objectives The sensitive, accurate and specific LC-MS/MS
method, which a small-volume injection has been developed and
validated for simultaneous quantification of RIS and 9-OH-RIS
plasma concentrations in ASD pediatric patients.
Methods Plasma samples were extracted by using the protein
precipitation extraction technique and were separated on an Agi-
lent, USA C18 column (4.6 cm ×50mm; 1.8 m particle size).
Detection was by MS-MS with an analytical run time of 6minutes.
Results The recoveries were in the range of 95.01-112.62% for
RIS and 90.27-114.00% for 9-OH-RIS. The method was applied in
the therapeutic drug monitoring (TDM) of ASD pediatric patients
treated with oral RIS. This study was to investigate the relationship
between RIS dosageswith RIS plasma levels including to investigate
the correlations between RIS plasma levels and serum prolactin
levels in ASD pediatric patients. Risperidone doses were signifi-
cantly positively related with the concentration of RIS, 9-OH-RIS
and active moiety. Moreover, the result indicates that the higher
concentrations of RIS and itsmetabolite have a tendency to produce
prolactin elevations than the lower RIS concentrations.
Conclusion The determination of RIS and its metabolites in
individual patient could be clinically useful for prediction andmon-
itoring of treatment response to RIS. Therefore, we recommend the
determination of RIS and its metabolites as part of an ongoing study
in which routinely monitored for compliance and to adjust the RIS
dose to achieve the optimum clinical outcome as well as to aware
of the adverse drug reaction.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW452
9-hydroxyrisperidone induced
hyperprolactinemia in Thai children
and adolescents with autism
spectrum disorder
C. Sukasem ∗, M. Chamnanphon
Faculty of medicine Ramathibodi hospital, pathology, Bangkok,
Thailand
∗ Corresponding author.
Introduction Although our previous study has revealed associ-
ation between prolactin level and risperidone dosage, data on
plasma drug concentration of risperidone therapy was lacking.
Objectives Therefore, the aim of this study was to investigate the
associationbetweenplasma drug concentrations of risperidone and
serum prolactin level in Thai children and adolescent with autism
spectrum disorders (ASD).
Methods The subjects were 103 children and adolescent with
ASD (90 males and 13 females). Blood sample were collected 12
hours after the last drug administration. Serum prolactin levels,
plasma risperidone and 9-hydroxyrisperidon level were measured.
The clinical data of patients collected from medical records–age,
weight, height, body mass index, dose of risperidone, and duration
of treatment–were recorded.
Results Serum prolactin level was significantly positively cor-
related with plasma 9-hydroxyrisperidone levels (rs = 0.355,
P < 0.001). The median of 9-hydroxyrisperidone level in group
of hyperprolactinemia (7.59 ng/mL IQR; 4.86-15.55) significantly
higher than non-hyperprolactinemia (5.18 ng/mL; IQR 2.10-8.99)
after risperidone treatment (P = 0.006).
Conclusion The results of this study showed that serum prolactin
levels, especially autism with hyperprolactinemia during risperi-
done treatment, were significantly correlated with level of the