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S52

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

Aim

To explore if emotional instability is a useful construct in

adults with autism spectrum disorder (ASD) and intellectual dis-

ability (ID).

Method/approach

The current diagnostic criteria for ASD and ID

will be outlined and related to any relevant literature on emotional

instability in those with ASD or ID. Recent cross-sectional studies in

a clinic and a prison of adultswith ASD and/or IDusing standardised

screening and diagnostic tools will be described.

Findings

Current literature indicates there is little research on

emotional instability in adultswithASD and ID. Studies across clinic

and forensic settings indicate high levels of comorbidity such as

attention-deficit hyperactive disorder (ADHD) and mood disorders

in adults with ASD and ID.

Conclusion

At present emotional instability as a construct may

not have validity for adults with ASD and ID but may do in the

context of other comorbid conditions such as ADHD.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.922

Thought and language disorders: Phenomenology

and neural pathophysiology

S107

How increasing the effect of rTMS in

the treatment of auditory

hallucinations in schizophrenia?

S. Dollfus

1 ,

, C. Nathou

2

, E. Olivier

3

1

CHU de Caen, Department of psychiatry, Caen, France

2

CHU Caen, Department of psychiatry, Caen, France

3

CHU de Caen, Department of neurophysiology, Caen, France

Corresponding author.

Repetitive transcranial magnetic stimulation (rTMS) shows a high

inter-subjects variability in the efficacy of treatment of auditory

verbal hallucinations (AVH) in schizophrenia. The aim of this pre-

sentation is to demonstrate the involvement of several factors in the

efficacy of rTMS such as the frequency of stimulation, the placebo

effect and the brain morphology underlying the target of stimula-

tion.

Methods

A meta-analysis was conducted to determine the effect

sizes of placebo effect in 21 controlled studies on rTMS in the treat-

ment of AVH in schizophrenia. MRI was also acquired in patients

treated by rTMS to evaluate the scalp to cortex distances (SDCs)

and the gray matter densities (GMDs) at the target of stimula-

tion. Finally, we evaluated the efficacy of high (20Hz) frequency

stimulation in a controlled placebo study.

Results

Weak or no placebo effect in the control groups led to

reveal a superiority of active rTMS over sham rTMS in the treatment

of AVH. Clinical efficacy of rTMS was also correlated with the SCD

or the GMD at the region of the target stimulation. Finally, we also

demonstrated that more responders were observed after 2 weeks

in the active group treated by 20Hz than in the placebo group.

Conclusion

We clearly demonstrated that several factors such as

high frequency, the placebo effect, anatomical cortical variations

can impact on the efficacy of rTMS. These results fundamentally

inform the design and the method of further controlled studies,

particularly with respect to studies of rTMS in the treatment of

AVH.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.923

S108

Phenomenology and neural correlates

of formal thought disorder

T. Kircher

Philipps-University, Psychiatry and Psychotherapy, Marburg,

Germany

Speech and language disorders, such as concretism and formal

thought disorder (FTD) are core symptoms of Schizophrenia, but

do occur to a similar extent in other diagnoses such as bipolar dis-

order and major depression. We will review clinical rating scales

of FTD and introduce a new, validated scale, the TALD. Further,

structural and functional brain imaging data will be reviewed and

own novel findings presented, relating speech and language dys-

functions to neural networks, within schizophrenia and across the

“functional psychoses”. The impact of genetic variance and NNDA

receptor blockage on brain functionwill be addressedwith a partic-

ular focus on speech and language (dys-)

function.We

demonstrate,

from the genetic to the brain structural and functional level, that

particular aspects of the neural language system are disrupted in

patients with FTD across traditional diagnoses.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

Further reading

Kircher T, Krug A, Stratmann M, Ghazi S, Schales C, Frauenheim

M, et al. A rating scale for the assessment of objective and subjec-

tive formal Thought and Language Disorder (TALD). Schizophr Res

2014;160(1–3):216–21.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.924

S109

Language, psychosis and the brain:

Novel insights from a dimensional

approach

W. Strik

University of Bern, Psychiatry, Bern, Switzerland

The brain mechanisms related to formal thought disorders (FTD)

and auditory verbal hallucinations (AVH) appear to be closely

linked to structural and functional abnormalities of the language

system.

In particular, functional imaging data indicate that several com-

ponents of the language system are involved in the generation of

both, FTD and AVH. Co-activation of the primary auditory cortex

(Heschl’s gyrus) during verbal thoughts appears to be crucial for

the subjective perception of an externally generated voice, and

DTI studies indicated that the intrahemispheric fronto-temporal

connectivity of the language system is specifically increased in

hallucinating patients. On the other hand, FTD are significantly

correlated to a gray matter reduction in Wernicke’s region along

with a hyperactivation of frontal and temporal components of the

language system.

AVH are intimately related to a dysfunction of the left hemi-

spheric language system, including the primary auditory cortex

and the fronto-temporal fibre tracts connecting Broca’s and Wer-

nicke’s regions. Co-activation of the primary auditory cortex during

verbal thoughts appears to be the basis of the pathological net-

work dynamics during AVH, while FTD are linked to a pathological

hyperactivity of central components of the language system. Both

phenomena are related to functional imbalances of the language

system, and phenomenological differences may depend on the dif-

ferent contributions of the system components.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.925