European Psychiatry - Volume 33 - March 2016

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S312 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348
Introduction Sarcosine - glycine transporter inhibitor - increases
glycine concentration around NMDA (N-methyl-D-aspartate)
receptors. Function of the glutamatergic system in the prefrontal
cortex and hippocampus is impaired in schizophrenia, which may
lead to negative and cognitive symptomatology.
Aims We evaluated the influence of sarcosine therapy on the
concentration of metabolites (NAA, N-acetylaspartate; Glx, com-
plex of glutamate, glutamine and -aminobutyric acid (GABA); mI,
myo-inositol; Cr, creatine; Cho, choline) in the left dorso-lateral
prefrontal cortex (DLPFC) and left hippocampus in patients with
stable schizophrenia.
Methods Fifty patients with schizophrenia, treatedwith constant
antipsychotics doses, in stable clinical condition were randomly
assigned (25 patients in each group) to administration of sarcosine
(2 g) or placebo for sixmonths. 1H-NMR spectroscopy (1.5 T) in both
localisations and clinical evaluation (PANSS) was performed before
and after sarcosine addition.
Results Initiallywe noted no differences inmetabolite concentra-
tions between groups. In the left DLPFC, NAA/Cho, mI/Cr andmI/Cho
ratios were significantly higher in the sarcosine than the placebo
group after six months. In the sarcosine group, NAA/Cr, NAA/Cho,
mI/Cr, mI/Cho ratios also increased compared to baseline values.
In the placebo group, only the NAA/Cr ratio increased. In the left
hippocampus Glx/Cr and Glx/Cho decreased in sarcosine group at
the end of our study.
Conclusions The addition of sarcosine to antipsychotic therapy
for six months caused increase of neurons viability (NAA) and
neurogilal activity (mI) markers in the left DLPFC and decrease
of hyperglutamatergic overstimulation parameters in the left hip-
pocampus with simultaneous improvement of clinical parameters
including negative symptoms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW559
Selected metabolites of kynurenine
pathway and response to
antipsychotic treatment in
schizophrenia
K. Szymona ∗, H. Karakuła-Juchnowicz , M. Flis , T. Kocki ,
A. Urbanska , R. Kloc , Z. Szymona , W. Rosa , E.M. Urba ´nska
1 Medical University of Lublin, Mental Health Outpatient Clinic-
Children’s University Hospital, Lublin, Poland
2 Medical University of Lublin, Department of Clinical
Neuropsychiatry Department of Psychiatry- Psychotherapy and Early
Intervention, Lublin, Poland
3 Medical University of Lublin, Department of Psychiatry-
Psychotherapy and Early Intervention, Lublin, Poland
4 Medical University of Lublin, Laboratory of Cellular and Molecular
Pharmacology- Department of Experimental and Clinical
Pharmacology, Lublin, Poland
5 Medical University of Lublin, Department of Psychiatry and
Psychiatry Rehabilitation, Lublin, Poland
6 PZ Cormay SA, Orphee Group, Lomianki, Poland
7 Lublin University of Technology, Faculty of Fundamentals of
Technology- Department of Applied Mathematics, Lublin, Poland
∗ Corresponding author.
Introduction Deficit of glutamatergic transmission and aberrant
function of kynurenine pathway, with disturbed synthesis of gluta-
mate receptors antagonist, kynurenic acid (KYNA) and neurotoxic
metabolite of kynurenine, 3-hydroxykynurenine (3-OH-KYN) have
been implicated in the pathogenesis of schizophrenia.
Objectives Demonstrated by others higher level of KYNA in the
brain may cause relative deficiency of glutamate-mediate trans-
mission with resulting behavioural and cognitive changes.
Aims Search for predictors of satisfactory response to antipsy-
chotic treatment based on the analysis of KYNA and 3-OH-KYN
serum levels.
Methods Fifty-three patients with chronic schizophrenia and 46
healthy individuals were enrolled in the study. Quantitative analy-
ses of KYNA and 3-OH-KYN were performed using high-pressure
liquid chromatography (HPLC) and electrochemical detection,
respectively. Clinical assessments (PANSS, SANS, SAPS) and blood
analyses were conducted at 3 time-points: during the active phase
of disease, after 4 weeks of modified pharmacotherapy, and after
reaching remission.
Results In schizophrenia group, lower levels of KYNA (P = 0.002)
and non-altered levels of 3-OH-KYN (p = 0.195), as compared to
control, were detected during active phase of disease. Despite clin-
ical improvement, no significant changes in the level of studied
metabolites were observed later on. The initial level of 3-OH-KYN
correlated negatively (r= –0.368; Spearman’s rank) with clinical
improvement (negative symptoms) (P < 0.05).
Conclusions 1. The peripheral dysregulation of kynurenine path-
way metabolites in chronic schizophrenia manifests as relative
increase in the ratio between neurotoxic 3-OH-KYN and neuropro-
tective KYNA. 2. The higher serum level of 3-OH-KYNduring relapse
of schizophrenia seems to predict poor response to antipsychotic
treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW560
Obsessive-compulsive symptoms
interact with disorganization in
influencing social functioning in
schizophrenia
M. Tonna∗ ttoni , F. Paglia , P. Ossola , C. De Panfilis ,
C. Marchesi
University of Parma, Neuroscience, Parma, Italy
∗ Corresponding author.
Objective Recent research has suggested a dual impact of
obsessive-compulsive dimension on functioning in schizophre-
nia with a gradual transition from an improving to a worsening
effect depending on obsessive-compulsive symptoms (OCS) sever-
ity (frommild tomoderate-severe). Aimof the present studywas to
investigate whether this varying effect of OCS on functioningmight
be mediated or moderated by schizophrenia symptom dimensions
or occur independently.
Method Seventy-five patients affected by schizophrenia were
administered the Structured Clinical Interview for DSM-IV Disor-
ders, the Positive and Negative Syndrome Scale, the Yale-Brown
Obsessive-Compulsive Scale and the Social and Occupational Func-
tioning Assessment. The sample was divided into two groups
according to the severity of OCS (absent/mild and moderate/high
OCS group).
Results In both groups, the effect of OCS on functioning was not
mediated by their effect on positive, negative or disorganization
symptoms. Conversely, a significant interaction between OCS and
disorganization dimension was found: the dual effect of OCS on
functioning occurred only among patients with low disorganiza-
tion symptoms while it was no more apparent at high levels of
disorganization.
Conclusion Data suggest that in patients with schizophrenia,
functioning at least in part depends on the interaction between
disorganization and OCS. Particularly, since mild OCS contribute
to lesser functional decline in patients with low disorganized
psychosis, they may favor the constitution of a subtype of
schizophrenia with a better functioning. In keepingwith the histor-
ical concept of “pseudoneurotic schizophrenia”, we speculate that