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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S729

Introduction

As programs for prodromal states of psychosis

emerge, part of our focus naturally shifts from first psychotic

episodes and early course psychotic disorders. Clinical practice

will, however, always confront us primarily with psychosis after its

onset, and ample evidence still confirms specificity and importance

of early stages of psychosis.

Aim

Authors aim to present experience and data from Zagreb

First Psychosis Unit, only such unit in Croatia and one of rare units

of that type in the region, discussing wider role of stationary units

in integrative care of first and early psychoses.

Methods

Ten-year data from the unit is analyzed. Demograph-

ics and illness specificities are presented, along with duration of

hospitalization, involuntary treatment rates, diagnoses, rehospital-

ization rates, subsequent treatment and other variables. Examples

of organic causes and specific clinical presentations are presented

in the context of necessaryfirst psychotic episodes differential diag-

nostic process.

Results

In the 10-year period Zagreb First Psychosis Unit had over

2000 hospitalizations, 61% of which were first psychotic episodes

and the rest cases in early stages of psychosis; 6.8% of first episode

cases required involuntary hospitalization; 71.4% of first psychotic

episode cases were not re-hospitalized following the diagnostic

process and treatment.

Conclusion

First psychotic episodes present especially vulnerable

periods that might determine following stages of illness and func-

tioning. It is vital to consider role of specialized first psychosis units

that initiate structured specific diagnostic, evaluation, and treat-

ment protocols for first episode patients requiring hospitalization,

and present a bridge towards equally specialized and congruent

outpatient programs.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2174

EV1190

What do we know about

treatment-resistant schizophrenia? –

A systematic review

A. Seppälä

1 ,

, J. Miettunen

1

, N. Hirvonen

2

, M. Isohanni

3

,

J. Moilanen

3

, H. Koponen

4

, J. Seppälä

5

, E. Jääskeläinen

1

1

University of Oulu, Center for Life-Course Epidemiology and

Systems Medicine, Oulu, Finland

2

University of Oulu, Information Studies, Faculty of Humanities,

Oulu, Finland

3

University of Oulu and Oulu University Hospital, Research Unit of

Clinical Neuroscience, Department of Psychiatry, Oulu, Finland

4

University of Helsinki and Helsinki University Hospital, Psychiatry,

Helsinki, Finland

5

South-Savo Hospital District, Department of Psychiatry, Mikkeli,

Finland

Corresponding author.

Introduction

Treatment-resistant schizophrenia (TRS) is a severe

form of schizophrenia. From one fifth to one third of all patients

with schizophrenia are resistant to treatment.

Objective

To determine the knowledge on TRS and to find out the

extent and the quality of research on TRS.

Aims

To conduct a systematic review of the current literature on

TRS.

Methods

Original studies and reviews on TRS were system-

atically collected from PubMed and Scopus databases. The

following search strategy was used as a title search; (“ultra-

resistant” OR “treatment-refractory” OR “treatment-resistant”)

AND (schizophrenia). The searchwas restricted to English language

articles.

Results

The literature search identified 403 studies. After abstract

and title review, 324 studies were included. The included stud-

ies considered medication (

n

213), electroconvulsive therapy and

repetitive transcranial magnetic stimulation (15), prognosis (15),

genetics (15), studies on neurobiology (15), definitions (14), psy-

chotherapy (12), brain structures and functioning (10), cognition

(7) and other miscellaneous studies (6) on TRS. Definitions of TRS

varied notably and in most of the non-pharmacological studies,

the samples were fairly small. Regarding treatments, clozapine,

ECT, and cognitive-behavioral therapy have shown effectiveness,

though the quality of research on interventions is limited. Very little

is known about risk factors and predictors of outcome in TRS.

Conclusions

Our findings suggest TRS is poorly studied and

understood condition contrasted to its high prevalence, clinical

importance and poor prognosis. There is a lack of studies on epi-

demiology, for example risk factors of TRS, as well as on outcomes

and longitudinal course. Most of the studies consideredmedication.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2175

EV1191

Psychiatric social work intervention

program for “high expressed

emotion” among the caregivers of

persons with schizophrenia in India –

a feasibility study

K. Setty

1 ,

, J. Navaneetham

1

, S. Bada Math

2

, P. Marimuthu

3

1

National Institute of Mental Health & Neurosciences, Psychiatric

social work, Bangalore, India

2

National Institute of Mental Health & Neurosciences, Psychiatry,

Bangalore, India

3

National Institute of Mental Health & Neurosciences, Department of

Biostatistics, Bangalore, India

Corresponding author.

Introduction

Schizophrenia is a severe mental illness that creates

various psychosocial problems among family members. In addi-

tion, the family also contributes to psychosocial issues such as,

expressed emotion. Expressed emotion (EE) has been found to pre-

dict relapse. Literature indicated that psychosocial interventions

along with medicines would helps in mainstreaming the persons

with illness. However, there is paucity of culturally sensitive inter-

ventions for EE in India.

Methodology

The objective of the study is to test the feasibility

of cultural sensitive psychiatric social work intervention package

to reduce expressed emotion among the caregivers of persons

with schizophrenia in India. Ten caregivers of inpatients with

schizophrenia from National Institute of Mental Health and Neu-

rosciences, India, participated in the study. MINI 6.0 was used

as screening tool. Socio-demographic profile collected. The Fam-

ily Emotional Involvement and Criticism Scale was used to elicit

the expressed emotion. A standardized 10 session spread over 10

days psychiatric social work package was given to the caregivers.

Intervention package included methods of Social work and various

techniques.

Results and conclusion

Mean score of family income (M= 3200,

SD = 1.98), onset of illness (M= 26.0, SD = 6.56), illness duration

(M= 3.10, SD = 1.41), duration of care giving (M= 2.3, SD = 1.56).

Overall ill individual’s perception of expressed emotion on

their caregivers was found to be decreased in post-assessment

(M= 29.60, SD = 2.9) when compared to the pre-assessment

(M= 50.0, SD = 1.9). It was found to be statistically significant

(0.000* =

P

< 0.05). The standardized psychiatric social work inter-

ventionwas found to be effective to the caregivers of schizophrenia

in India.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2176