European Psychiatry - Volume 33 - March 2016

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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.
EV1190
What do we know about
treatment-resistant schizophrenia? –
A systematic review
A. Seppälä ∗, J. Miettunen , N. Hirvonen , M. Isohanni ,
J. Moilanen , H. Koponen , J. Seppälä , E. Jääskeläinen
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.
EV1191
Psychiatric social work intervention
program for “high expressed
emotion” among the caregivers of
persons with schizophrenia in India –
a feasibility study
K. Setty ∗, J. Navaneetham , S. Bada Math , P. Marimuthu
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.