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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55

S35

S52

A life course perspective on familial

and environmental risks for

schizophrenia using a western

Australian E-cohort

V. Morgan

, P. Di Prinzio , G. Valuri , M. Croft , S. Shah , T. McNeil ,

A. Jablensky

The University of Western Australia, School of Psychiatry and Clinical

Neurosciences, Perth, Australia

Corresponding author.

Introduction

Familial risk for psychosis may interact with envi-

ronmental risk factors.

Objectives

We are studying a large birth cohort of children

of mothers with psychotic disorders, themselves at high risk of

developing a psychotic illness, to understand the developmental

aetiology of psychotic illness.

Aims

Our aim is to examine whether exposure to environmental

stressors in childhood, including timing of exposure, is a risk factor

for psychotic illness, independent of familial liability. Specificity to

maternal schizophrenia is explored.

Methods

We used record-linkage across state-wide registers

(midwives, psychiatric, child protection and mortality, among

others) to identify 15,486 offspring born in Western Australia

1980–2001 to mothers with a lifetime history of psychotic illness

(case children) and compared them with 452,459 offspring born

in the same period to mothers with no known psychiatric history

(comparison children).

Results

A total of 4.1% of case children had developed a psy-

chotic illness compared to 1.1% of comparison children. Exposure to

environmental risk factors including obstetric complications, abo-

riginality, lower socioeconomic status, discontinuity in parenting

and childhood abuse significantly increased risk of psychotic illness

in offspring. Length and age at time of discontinuity in parenting

impacted on risk. At the same time, case children were also sig-

nificantly more likely than comparison children to be at risk of

experiencing these adverse life events.

Conclusions

Exposure to environmental stressors is associated

with psychotic illness, and timing of exposure is important. How-

ever, children already at increased familial risk for psychotic illness

are also at increased risk of experiencing these environmental

stressors.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.868

S53

Treatment-resistant schizophrenia

during life span : Epidemiology,

outcomes and innovative M-Health

treatments within M-RESIST Project

K. Rubinstein

1 , 2 , 3 ,

1

Sheba Medical Center, Department of Psychiatry, Tel HaShomer,

Israel

2

Tel-Aviv University, Sackler School of Medicine, Tel Aviv, Israel

3

Gertner Institute of Epidemiology and Health Policy Research, Tel

Aviv, Israel

Correspondence.

Treatment-resistant symptoms of schizophrenia (TRS) complicate

the clinical course of the illness, and a large proportion of patients

do not reach functional recovery (Englisch and Zink, 2012). Out of

the estimated 5million people (0.2–2.6 %) suffering frompsychotic

disorders in the European Union, 30-50 % can be considered resis-

tant to treatment, and 10–20 % ultra-resistant (Essock et al., 1996 ;

Juarez-Reyes et al., 1995). The complexity of standard intervention

within this population, along with the presence of persistent posi-

tive symptomatology, extensive periods of hospital care and greater

risk of multi-morbidity, lead to a high degrees of suffering for the

patients, family and social environment, and a high proportion of

costs to the healthcare system (Kennedy et al., 2014).

At present, a uniformdefinition of treatment resistance in the phar-

macotherapy of schizophrenia is not available (Suzuki et al., 2011),

as well as generally recommendable evidence-based treatment

methods (Dold and Leucht, 2014).

A recent systematic review on the topic showed that TRS is poorly

a studied and understood condition, contrasted to its high preva-

lence, clinical importance and poor prognosis. There is lack of

studies on epidemiology and risk factors of this disorder, as well

as on outcomes and longitudinal course. Most of the available lit-

erature focuses on medication treatments, while very few examine

efficacy of adjunctive therapeutic options (Seppala et al., in prepa-

ration).

Treatments based on information and communication technol-

ogy (ICT) present novel possibilities to improve the outcomes

of schizophrenia. Previous studies have indicated suitability and

promising results of such intervention techniques (Granholm

et al., 2012 ; Ben-Zeev et al., 2013). m-RESIST is an innovative

project aimed to empower patients with resistant schizophrenia,

to personalize treatment by integrating pharmacological and psy-

chosocial approaches, and to further develop knowledge related to

the illness using predictive models designed to exploit historical

and real-time data based on environmental factors and treatment

outcomes.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.869

S54

Somatic comorbidity and its outcomes

in schizophrenia during lifespan

J. Seppala

1 , 2 ,

, H .

Korpela

2 , E. J

ääskeläinen

2 , J. M

iettunen

2 ,

M. Isohanni

2 , J. A

uvinen

2 , T. N

ordström

3 , R. M

arttila

4 ,

S. Keinänen-Kiukaanniemi

2 , M.R

. Järvelin

5 , H.

Salo

2 , N.

Rautio

2

1

Department of Psychiatry, South Savo Hospital District, Mikkeli,

Finland

2

University of Oulu, Center for Life Course Health Research, Oulu,

Finland

3

University of Ouu, Research Unit of Clinical Neuroscience, Oulu,

Finland

4

Oulu University Hospital, Unit of Primary Health Care, Oulu, Finland

5

Imperial College London, Department of Epidemiology and

Biostatistics, London, United Kingdom

Corresponding author.

Background

Studies mainly relied on hospital or case-control

data have well documented that individuals with psychoses, and

especially with schizophrenia have increased rates of physical ill-

nesses. They have two to four-fold higher mortality risk, and about

10 to 25 years shorter life expectancy compared with the general

population. The aim of this study is to evaluate the prevalence of

physical illnesses in individuals with schizophrenia or with other

psychoses and among people without psychoses until the age of

46 years using complete outpatient and inpatient data from birth

cohort.

Methods

The study is based on The Northern Finland 1966

Birth Cohort (NFBC, 1966), which is a population-based prospec-

tive cohort concerning 12.058 live-born children in 1966 in the

provinces of Lapland and Oulu.

The study population consisted of 10,933 individuals, who were

alive at the age of 16-years, and followed serially until the age

of 46-years The study population was divided into three groups:

those having schizophrenia (

n

= 228) and those with other psy-

choses (

n

= 240) while individuals without psychosis (

n

= 10,465)