European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S731
(DUP) has been described as an important predictor of outcome
in FEP [2].
Aims With this study, we want to know which baseline charac-
teristics and clinical outcomes differ between FEP patients with and
without substance use.
Methods One hundred and seventy-five FEP were consecutively
admitted to Hospital del Mar since January 2008 to September 2014
and entered the FEP programme of the institution. The included
evaluationwas socio-demographic and clinical data at baseline and
1 year follow-up. We studied differences in age, gender, DUP, GAF
scores at baseline and 1 year follow-up and PANSS subscale scores
at base and 1 year follow-up between substance users and non-
users.
Results Cannabis: we found that users were significative younger
(P < 0.01), had a higher proportion of males (P< 0.01) and a signi-
ficative shorter DUP in users (P = 0.008).
Alcohol: we found that users were significative younger (P < 0.009),
had a higher proportion of males (P < 0.003) and a significative
lower PANNS negative scores at baseline (P= 0.01) and 1 year
follow-up (P = 0.03).
Conclusions In our sample of first episode psychosis, cannabis
and alcohol use is linked with a younger age and a high proportion
of males. Moreover, it seems that cannabis use could be associated
with a shorter DUP.
References not available.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1196
Factors associated with schizophrenic
evolution after a first episode
psychosis
M. Turki ∗ Halouani , R. Naoui , I. Gassara , N. Hamza ,
J. Aloulou , O. Amami
Hédi Chaker university hospital, psychiatry department, Sfax, Tunisia
∗ Corresponding author.
Introduction The evolution of a first episode psychosis is a fun-
damental question, despite its unpredictability. It affects the type
of management and drug treatment. In this context, schizophre-
nia, a disabling psychiatric disease, remains the most formidable
evolution.
Objective Assess the frequency and factors associated with
schizophrenic evolution after a first episode psychosis.
Methods We conducted a retrospective, descriptive and analytic
study including 55 patients hospitalized in psychiatry department,
Hédi Chaker Hospital, Sfax, Tunisia, during 7 years (from 2007 to
2013), then managed in the outpatient department. We collected
socio-demographic, clinical and evolutive data from clinical obser-
vations.
Results The mean age was 26.5 years. Sex ratio (M/F) was 2.9.
Among our patients, 74.5%were single and 49.1% had no profession.
A trigger factor of this episode was noted in 43.6% and a break with
the previous functioning in 63.6% of cases. A schizoid personality
was reported in 74.5% of the population. All patients presented pos-
itive symptoms, 96.4% had negative symptoms and 61.8% presented
mood symptoms.
Schizophrenic evolution was reported in 38.2% of patients. Factors
associated with this evolution were: masculine gender (P = 0.004),
social isolation (P= 0.009); absence of mood symptoms (P < 0.001)
and mental automatism (P = 0.043).
Conclusion Our study shows some factors associated with
schizophrenic evolution after a first episode psychosis. The iden-
tification of these factors, as well as other factors reported in the
literature is essential to allow early and adequate support, and
ensure a better social integration.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1197
The aetiology of schizophrenia as
outlined in a treatment-resistant case
D. Vella Fondacaro ∗ alzon Aquilina
1 Mater Dei Hospital, Ministry for Energy and Health, Mosta, Malta
2 Mount Carmel Hospital, Department of Psychiatry, Attard, Malta
∗ Corresponding author.
Introduction The development of treatment-resistant
schizophrenia in a 16-year-old Maltese girl was analyzed in
terms of its biopsychosocial model of disease.
Objectives To highlight the presentation of treatment-resistant
schizophrenia.
To investigate the etiology of treatment-resistant schizophrenia.
Aims To utilize the biopsychosocial model of disease in order to
investigate the aetiology of treatment-resistant schizophrenia.
To highlight the treatment modalities utilized in this case of
treatment-resistant schizophrenia.
Methods Interviewing the patient.
Analyzing all investigations and documentation made during her
admission in an acute psychiatric hospital.
Evaluating the response to various treatment modalities.
Carrying out literature reviews.
Results Image attached.
Conclusions Although the aetiology of treatment-resistant
schizophrenia remains somewhat unclear even after many years
of study, the biopsychosocial model is nevertheless useful in
understanding the development of this condition. The treatment
modalities to which the patient was resistant were also identified.
Figure not available.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1198
Clozapine and aripiprazole
combination
M.M. Vera ∗, C. Garay Bravo , S. Alonso Gutierrez ,
M.D.L.D. Descalzo Cabadés
Hospital universitario general de Valencia, Valencia, Spain
∗ Corresponding author.
A 32 years old female with paranoid schizophrenia diagnosed at 20
years old, admitted for psychotic descompensation althought treat-
ment compliance. She had delusional ideas focused on her family
with suicidal behaviour and functional impairment, refractory to
different antipsychotic treatments so clozapine was initiated. Val-
proic acid was initiated too because of seizure risk. Clinically,
improvement was accomplish at these treatment doses: valproic
acid 1000mg per day; clozapine 300mg per day; and aripiprazole
150mg IM per month.
Discussion The use of clozapine in resistant schizophrenia
patients improves functionality at the long-term and it is specially
indicated for suicidal behaviour. Recent studies show that rehospi-
talization rates for patients treated with clozapine raised 13%.
Other studies show that aripiprazole can be off label used as com-
bination therapy in these situations.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Further readings
Csernansky JC, Schuchart EK. “Relapse rates in patients with
schizophrenia re-admissions effects of second generation antipsy-
chotics”. CNS Drugs 2002;16(7):473–83.