European Psychiatry - Volume 33 - March 2016

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S722 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV1167
Risk-taking and self-medicating
contribute to the association between
psychometric risk for schizophrenia
and smoking
M. Verwey , C. Ruzibiza , R. Linscott ∗
University of Otago, Department of Psychology, Dunedin, New
Zealand
∗ Corresponding author.
Background There is a robust association between positive symp-
toms of schizophrenia and smoking. This relationship extends
to psychometric risk for schizophrenia (schizotypy). We sought
to determine whether smoking in schizotypy is best under-
stood in terms of self-medicating or risk-taking behaviour.
The self-medication perspective holds that individuals with
schizophrenia smoke to relieve stress. By smoking, cortisol lev-
els increase, stimulating negative feedback circuits that reduce
the hypothalamic-pituitary-adrenal (HPA) axis stress response.
Increased HPA activation also stimulates dopamine release, pro-
moting the expression of positive schizotypal experiences. In
contrast, the risk-taking perspective holds that elevated dopamine
promotes risk-taking behaviour, including substance misuse, by
reducing reward sensitivity and increasing sensation-seeking.
Method Undergraduates (n = 230) reported current and past
nicotine use and completed the Schizotypal Personality Question-
naire and a self-report measure of stress sensitivity.
Results Consistent with risk-taking, positive features of schizo-
typy predicted having ever smoked (OR = 1.02, P < 0.05) but did
not distinguish current smoking from non-smoking (OR = 0.99).
The self-medication hypothesis was examined in two ways. When
smoking status was regressed onto positive schizotypy and stress,
stress was found to predict current smoking (OR = 1.08, P < 0.05)
but not having ever smoked (OR = 1.09). Secondly, stress and cur-
rent smoking interacted to predict positive schizotypy (ß = 0.31,
P < 0.05).
Conclusions Risk-taking and self-medicating each contributed to
the relationbetween smoking and schizotypy, but indifferentways.
Risk-taking seems to contribute to having ever smoked whereas
current smoking seems to reflect self-medicating behaviour.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1168
Clinical effectiveness of Paliperidone
Palmitate in schizophrenia
E. Lyubov
Moscow Research Institute of Psychiatry, Moscow, Russia
Introduction Along with numerous randomized controlled tri-
als, little is known about the clinical effectiveness of Paliperidone
Palmitate (PP).
Aims to evaluate long-term clinical outcomes of PP treatment in
schizophrenia, to assess the reasons of PP treatment, and PP usage
patterns.
Methods Retrospective analysis of 152 outpatients with≥ 1 PP
(in total, 1446) injections for 10.2 (9.2–11.1) months.
Results The average maintenance PP dose was 82 ±1.25 (median
75) mg. PP appointed due to the following reasons: partial insta-
ble remissions in “typical” (i.e., with oral antipsychotics and
long-acting forms of typical ones) therapy (93.4%), full or partial
noncompliance (44.7%), intolerability (27.6%). Doctors take into
account the patient preferences (38.1%). Only 7.2% of the cohort
discontinued treatment, and 4.2% patients by the doctor decision
as “resistant” at PP doses of 75mg (< recommended maximum).
PP reduced the frequency of total adverse action (AEs), especially
extrapyramidal ones (p
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV1169
Specifics of communication with
schizophrenic patient
S. Manojlovic ∗ ikolic-Popovic
University of Nis, Faculty of Medicine, Psychiatry, Nis, Serbia
∗ Corresponding author.
The precondition of communication with schizophrenics is know-
ing and understanding of their fragmented and chaotic world.
Communication with the schizophrenics should respect their fear
of fusion and disintegration, as well as the fear of abandoning. In
communication with the schizophrenic two facts are important:
the real support is accepting the bizarre existence of the patient,
and the other side of the support is the capacity of the psychi-
atrist to understand and withstand the patient. This capacity is
determined through the consistency of therapist’s behavior, possi-
bility to accept the patient’s right on regression, but also the ability
to offer the constancy of himself, too. The therapist is the repre-
sentative of the reality whose consequence and constant presence
enables him to grow up from the internal mixture of the mental
presentations into an authentic, independent person, dedicated to
the patient. The therapist is expected to tolerate the patient’s alien-
ation due to the fears from fusion or disintegration. A constant
activity of reestablishing of contact and respect of a specific cog-
nitive style are needed. Communication with the schizophrenics
implies an explicit calling to a verbal communication that has to
be understandable, and searching for the conceptual framework,
which provides understanding. Basic characteristics of the ade-
quate communication are persistence, consequence and simplicity
of instructionswith the normof behavior control, aswell as the clar-
ity of the “here-and-now” situation. The therapist’s understanding
of the schizophrenics justifies his actions and allows taking the
psychotherapeutic attitude.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1170
Psychogenic polydipsia and
schizophrenia
L. Maroto Martín ∗, P. Hervías Higueras
Hospital Doctor Rodríguez Lafora, Psiquiatría, Madrid, Spain
∗ Corresponding author.
Introduction Psychogenic Polydipsia is defined as the desire to
drink liquid in big quantities with an inappropriate activation of the
mechanisms of thirst without loss of liquid for urine. This disorder
is frequent enough and can derive in a water poisoning, a clinical
presentation of high mortality.
Objective Review of the Psychogenic Polydipsia in patients with
schizophrenia and theoretical discussion of a case report.
Methods A case report of a 58-year-old male, admitted in hospi-
tal with a clinical presentation of hyponatremia with severe low
serum osmolarity secondary to Psychogenic Polydipsia. As psy-
chiatric history he has a diagnosis of Paranoid Schizophrenia for
forty years in treatment with Paliperidone 6mg: 1-0-0, Haloperi-
dol 10mg: 0-0-0.5, Quetiapina 300mg: 0-0-1, Trazodona 100mg:
0-0-1, Ketazolam 30mg: 0-0-1, Diazepam 10mg: 0-0-1.
Discussion Psychogenic Polydipsia is not included in any sec-
tion of current psychiatric classifications as specific diagnosis.
There are several psychiatric disorders that may present with psy-
chogenic polydipsia; however, the most common cause appears to
be schizophrenia.