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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2152

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2153

EV1169

Specifics of communication with

schizophrenic patient

S. Manojlovic

, J. N

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2154

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.