European Psychiatry - Volume 33 - March 2016

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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.
S53
Treatment-resistant schizophrenia
during life span : Epidemiology,
outcomes and innovative M-Health
treatments within M-RESIST Project
K. Rubinstein ∗
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.
S54
Somatic comorbidity and its outcomes
in schizophrenia during lifespan
J. Seppala ∗ Korpela ääskeläinen iettunen
M. Isohanni uvinen ordström arttila
S. Keinänen-Kiukaanniemi . Järvelin Salo Rautio
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)