European Psychiatry - Volume 33 - March 2016

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S34 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55
future research to get a better understanding of the heterogeneity
of clinical manifestations in severe mental disorders and to map
clinical symptoms to imaging phenotypes.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
S49
Fronto-thalamic dysconnectivity and
cognitive control in schizophrenia
G. Wagne ∗ e la Cruz Güllmar . Schultz
K. Koch . Bär
1 Germany
2 Jena University Hospital, Department of Psychiatry and
Psychotherapy, Jena, Germany
3 Jena University Hospital, Institute of Diagnostic and Interventional
Radiology I, Jena, Germany
4 Klinikum rechts der Isar, TUM, Department of Neuroradiology,
München, Germany
∗ Corresponding author.
Introduction Several lines of evidence suggest that cognitive
deficits represent a core feature of schizophrenia.
Objectives The concept of “cognitive dysmetria” has been
introduced to characterize disintegration at the system level of
frontal-thalamic-cerebellar circuitry which has been regarded as
a key network for a wide range of neuropsychological symptoms
in schizophrenia.
Aims The present multimodal study aimed at investigating effec-
tive and structural connectivity of the frontal-thalamic circuitry in
schizophrenia.
Methods Univariate fMRI data analysis and effective connectiv-
ity analysis using dynamic causal modeling (DCM) were combined
to examine cognitive control processes in 40 patients with
schizophrenia and 40 matched healthy controls. BOLD signal and
parameters of effective connectivity were related to parameters
of corresponding white matter integrity assessed with diffusion
tensor imaging (DTI).
Results In the DTI analysis, significantly decreased fractional
anisotropy (FA) was detected in patients in the right anterior limb
of the internal capsule (ALIC), the right thalamus and the right
corpus callosum. During Stroop task performance patients demon-
strated significantly lower activation relative to healthy controls in
a predominantly right lateralized frontal-thalamic-cerebellar net-
work. An abnormal effective connectivity was observed in the right
lateralized connections between thalamus, anterior cingulate and
dorsolateral prefrontal cortex. FA in the right ALIC was significantly
correlated with the fronto-thalamic BOLD signal, effective connec-
tivity and cognitive performance in patients.
Conclusions Present data provide evidence for the notion of
a structural and functional defect in the prefrontal-thalamic-
cerebellar circuitry, which seems to be the basis of the cognitive
control deficits in schizophrenia.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
S50
Motor symptoms and altered
connectivity in schizophrenia
S. Walther ∗, K. Stegmayer , B. Tobias , A. Federspiel
University Hospital of Psychiatry, Translational Research Center,
Bern, Switzerland
∗ Corresponding author.
Schizophrenia spectrum disorders are frequently associated with
motor abnormalities. Aberrant motor function can be observed in
patients throughout the course of the disorder, in subjects at high
clinical risk and in unaffected first-degree relatives. Schizophrenia
is further characterized by white matter abnormalities in multi-
ple fiber tracts and aberrant resting state cerebral perfusion. In
a series of studies, we investigated the association of objectively
measured motor behavior in terms of activity levels with white
matter microstructure and cerebral perfusion at rest. Patients were
less active than controls at the behavioral level. In the associations
with neuroimaging techniques, we detected that unlike controls,
patients’ activity levels were linked to structure and perfusion
of cortical motor areas as well as the connecting white matter.
In controls instead, motor activity relied on the association of
cortico-subcortical motor loops. Thus, some of the motor signs in
schizophrenia may result from ineffective coupling between cor-
tical and subcortical motor areas. Finally, preliminary data from
functional connectivity analyses support this notion.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Lifespan development of schizophrenia and how
the treatments improve outcome
S51
Antipsychotic medication and
outcomes in schizophrenia from a
lifespan perspective
H. Koponen
Helsinki University and Helsinki University Hospital, Department of
Psychiatry, Helsinki, Finland
Introduction Antipsychotic medications play an important role
in schizophrenia, and their efficacy in the relapse prevention and
treatment of acute psychotic symptoms is clear-cut.
Objectives Data on the long-term use of antipsychotics and
impact on prognostic issues is limited, although some previous
studies noted a high risk of relapse during the first two years after
the first acute psychosis.
Aims Our aimwas to study the characteristics and clinical course
of medicated and unmedicated schizophrenia patients.
Methods The study population consisted of schizophrenia
patients from the Northern Finland 1966 Birth Cohort ( n = 70). Use
of antipsychotics was examined in the follow-up interview by ask-
ing about the subjects’ medication history during the previous
three months. The sample was divided into a non-medicated group
(n = 24) and a medicated group (n = 46).
Results Relapses during the follow-up were equally frequent
between non-medicated and medicated subjects (47% vs. 53%). Not
having been hospitalised during previous five years, but not previ-
ous two years, before the interview predicted long-term successful
antipsychotic withdrawal without relapse. Fifteen of the subjects
in the non-medicated group (63%) and 9 in the medicated group
(20%) were in remission.
Conclusions The present results imply that there are some indi-
viduals with schizophrenic psychoses not using antipsychotic
medication whose psychotic illness and clinical course are so
favourable that they do not necessarily need medication perma-
nently. Changes in the antipsychotic dosing should not bemade too
fast and the patient and relatives should be able to contact without
delay if exacerbation of psychotic symptoms is suspected.
Disclosure of interest The author has not supplied his declaration
of competing interest.