European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S56–S71 S69
Objectives The objectives were to investigate how this research
tool can be implemented for detecting suicide risk in depressed
patients.
Aims The aims were to find a base for the objective test of electro-
dermal reactivity to be used as support in suicidal risk assessments
in depressed patients.
Methods More than ten published studies on electrodermal
hyporeactivity and suicide were reviewed subsequent to the appli-
cation of an untraditional statistical approach. Gender, age,
subdiagnoses and depressive depth were considered. All subjects
were tested in a habituation experiment of the electrodermal
response to a moderately strong tone stimulus.
Results The percentage of electrodermally hyporeactive
depressed patients who later committed suicide was 86–97%.
The percentage of electrodermally reactive patients that did not
commit suicide was 96–98%. Hyporeactivity seems to be stable in
at least 1–2 years in remission.
Conclusions It was considered favorable to test for hyporeactivity
as early as possible, i.e. already in the primary care. That enables
right treatment of right patients very early. The number of referrals
to psychiatric specialists could be expected to decrease. Possible
causes of hyporeactivity begin to be revealed, giving ideas of several
treatment approaches.
Disclosure of interest The author has not supplied his declaration
of competing interest.
The assessment of negative symptoms:
Achievements and perspectives
W43
Self-assessment instruments:
Development and validation
S. Dollfus
CHU de Caen, Department of psychiatry, Caen, France
Introduction Negative symptoms are found in many patients
with schizophrenia, but their assessment remains delicate. Stan-
dardized assessments are therefore needed to facilitate their
identification. Many tools have been developed but most of them
are assessments based on observer rating. Nevertheless, patient
subjective evaluation can provide an additional outcome measure
and allow patients to be more engaged in their treatment. There-
fore, the aim of this study is to present past and recent tools
assessing the subjective experience of negative symptoms; we will
particularly focus on a novel tool, the Self-evaluation of Negative
Symptoms (SNS).
Methods Forty-nine patients with schizophrenia and schizoaf-
fective disorders (DSMIV) were evaluated in order to demonstrate
three components of the scale’s validity: face and content validities
and reliability.
Results Cronbach’s coefficient showed good internal consistency.
Factor analysis extracted 2 factors (apathy and emotional). SNS was
significantly correlated with the Scale of Assessment of Negative
Symptoms and the Clinician Global Impression on severity of neg-
ative symptoms supporting good convergent validity. SNS scores
were not correlated with level of insight, Parkinsonism, or with
BPRS positive sub-scores in favor of good discriminant validity.
Intra-subject reliability of SNS revealed excellent intraclass corre-
lation coefficients.
Conclusion This study shows good psychometric properties of
SNS as well as quite satisfactory acceptance by patients. It also
demonstrates the ability of patients with schizophrenia to accu-
rately report their own experience. Self-assessments of negative
symptoms should be usedmore in clinical practice since theymight
allow patients with schizophrenia to develop appropriate coping
strategies.
Disclosure of interest The author has not supplied his declaration
of competing interest.
W44
Evolution of negative symptom
assessment instruments
M.P. García-Portilla Gonzalez
University of Oviedo, Psychiatry, Oviedo, Spain
In this talk we will review the psychometric evolution of available
instruments for assessing the negative syndrome of schizophrenia,
describing their strengths and weaknesses.
Current instruments were classified into two categories accord-
ing to their content validity and assessment approach as first- or
second-generation instruments. The BPRS, SANS, the SENS and the
PANSS belong to the first generation while the BNSS, the CAINS
and the MAP-SR belong to the second generation. The NSA can
be considered a transitional instrument between the two. First-
generation instruments have more content validity problems than
second-generation instruments do, as they do not accurately reflect
the currently accepted negative syndrome (they do not include all
negative symptoms and signs or they include symptoms fromother
dimensions). They also have more problems relative to the use
of behavioral referents instead of internal experiences of deficits
when assessing symptoms, which may lead to measuring function-
ing instead of negative symptoms.
Further research needs to be done in this area in order to ensure the
evaluation of primary negative symptoms and internal experiences
involved in negative symptoms rather than external behaviors.
Disclosure of interest The author has not supplied his declaration
of competing interest.
W45
Assessment of negative symptoms
beyond schizophrenia
S. Kaiser
Psychiatric Hospital, University of Zurich, Department of Psychiatry,
Psychotherapy and Psychosomatics, Zurich, Switzerland
Introduction Negative symptoms have long been recognized as
a hallmark of schizophrenia. Newer evidence suggests that nega-
tive symptoms can be observed in persons with other disorders or
even innon-clinical populations. However, most negative symptom
scales are designed to identify clinically relevant symptoms, which
might lead to underappreciation of subclinical symptom expres-
sion.
Objectives The aim of the present study was to establish distri-
butional properties of well-established negative symptom scales in
comparison with the newly developed Zurich Negative Symptom
Scale, which employs a fully dimensional and continuous approach.
Methods We included participants with established schizophre-
nia (n = 65), first-episode psychosis (n = 25), schizotypal personality
traits (n = 29) and remitted bipolar disorder (n = 20). Assessment
of negative symptoms was conducted with the Zurich Negative
Symptom Scale and compared to establish rating scales.
Results In this broad sample, measurement of negative symp-
toms with established negative symptom scales lead to a highly
skewed distribution. In other words, established negative symptom
scales were able to identify negative symptoms in some partici-
pants in the non-schizophrenia spectrum, but a differentiation of
negative symptom severity in the subclinical range was not possi-
ble. In contrast, the distribution of negative symptoms measured
with the Zurich Negative Symptom scale approached normality.