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S50

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

totally in agreement with that affirmation, we want to point out

that we often forget there is proven evidence of the preventative

utility of non-pharmacological interventions designed to increase

clinical follow-up and adherence to post-attempt outpatient treat-

ment. It is important to indicate that these interventions are not

aimed at specific disorders or population groups, but rather they

are of a more universal character and are thus more easily gener-

alised. During this presentation, some of these approaches will be

addressed and discussed.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.916

The effects of neuroleptics on the brain

S101

GROUP 6 year outcome data in

relation to antipsychotic medication

W. Cahn

, for GROUP Investigators

UMC Utrecht, Brain center, Utrecht, Netherlands

Corresponding author.

Objective

Genetic risk and outcome of psychoses (GROUP) is a

6 year longitudinal cohort study that focus on gene–environment

vulnerability and resilience in patients with psychotic disorders,

their unaffected familymembers and non-related controls. Itsmain

aim is to elucidate etiological and pathogenetic factors that influ-

ence the onset and course of psychotic disorders. In this substudy,

we will examine medication use over time, its relation with (the

change in) metabolic syndrome status and effects on the brain.

Methods

A consortium of four university psychiatric centers

and their affiliated mental health care institutions, conducted

the GROUP study. At baseline, 1120 patients, 1057 siblings, 919

parents and 590 healthy controls were included. After inclu-

sion, participants, except parents, were evaluated again after

three and six years of follow-up. Extensive assessment of genetic

factors, environmental factors, medication use, metabolic param-

eters and outcome were performed. Moreover, brain imaging

was performed in a subset of participants, using a 1.5 Tesla MRI

scanner.

Results

At baseline 65% of patients used atypical antipsychotics,

16% used conventional antipsychotics and 19% used clozapine. Sib-

lings and controls used no antipsychotics. Forty-three percent of

patients, 21.3% of siblings and 9.1% of controls used antidepres-

sants; 43.9% of patients, 2.1% of siblings and none of the controls

used a mood stabilizer. We are currently analyzing the medication

data over time in relation to (change in) metabolic syndrome status

and the effects on the brain.

Conclusion

GROUP is a longitudinal cohort study in patients with

psychotic disorders, their healthy siblings and controls without

psychosis. This naturalistic substudy examines medication use, its

association with (change of) metabolic status and effects on the

brain in subjects with (high risk of) psychosis.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.917

S102

Discontinuation vs. continuation

treatment with neuroleptics for a

better long-term outcome

L. Wunderink

1 ,

, R. Nieboer

2

, F. Nienhuis

3

, S. Sytema

3

,

D. Wiersma

3

1

Friesland Mental Health Services, University Medical Center

Groningen, Research & Education, Psychiatry, Leeuwarden,

Netherlands

2

Friesland Mental Health Services, Research and Education,

Leeuwarden, Netherlands

3

University Medical Center Groningen, Psychiatry, Groningen,

Netherlands

Corresponding author.

Background

Long-term functional

outcome of dose-

reduction/discontinuation strategies in first-episode psychosis

(FEP) has not been studied before. The present study

compared 7-year outcome of an early antipsychotic dose-

reduction/discontinuation (DR) strategy with maintenance

treatment (MT). Primary outcome was (symptomatic and func-

tional) recovery; relapse rates, functional and symptomatic

remission were secondary outcomes.

Methods

FEP patients (

n

= 128) symptomatically remitted for 6m

during their first treatment year who completed an 18 months trial

comparing MT and DR were followed-up at 7 years. Symptomatic

remission criteria were adopted from Andreasen et al., functional

remission criteria were based on a functioning scale. Recovery was

defined as meeting both criteria sets. MT or DR strategy, and base-

line parameters were entered in a logistic regression analysis with

symptom and functional remission and recovery at 7-years follow-

up as dependent variables.

Results

One hundred and three patients consented to partici-

pate. DR-patients showed twice the recovery-rate of MT-patients

(40% against 18%), odds ratio 3.5 (

P

= .014). Symptomatic remission-

rates were equal (69% and 67%). Better DR recovery-rates were

attributable to higher functional remission-rates (46% vs. 20%) in

DR. Predictors of recovery were DR, baseline living together and

less severe negative symptoms. During the last 2 years of follow-

up the mean daily dose in haloperidol equivalents was 2.20mg in

DR vs. 3.60mg in MT (

P

= .031).

Relapse rates were initially higher in DR but leveled at 3 years;

61.5% relapsed in DR and 68.6% in MT in 7 years.

Conclusion

DR of antipsychotics during early stages of remitted

FEP significantly improved 7-years outcome in terms of recov-

ery and functional remission compared to maintenance treatment.

Though initially relapse rates in GD were higher, these equalled

those inMT from3 years to the end of the study. While the necessity

of immediate antipsychotic treatment in FEP and positive symp-

toms relapse is robustly demonstrated in a great number of studies,

this study suggests thatwe are facedwith a dilemma concerning the

drawbacks of long-term maintenance antipsychotic treatment on

functional capacity. Though antipsychotic discontinuation appears

only feasible without relapse in a substantial minority of patients,

guided dose-reduction as far as positive symptoms remain sub-

sided and allow it, appears a feasible strategy in view of functional

recovery, doing justice to both sides of the dilemma.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.918