Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384 S269

Discussion: Our results demonstrated that significant disagreement exists

between clinician and patient evaluations of improvement in symptoms

and their relationships with distress and interference with life. To under-

stand the long-term course of AVH, we need to consider perspectives of

patients as well as clinician.

Poster #M217

A NETWORK APPROACH TO THE PSYCHOPATHOLOGY OF PSYCHOSIS

Johanna Wigman1, Jim van Os2, Dina Collip2, Catherine Derom3,

Evert Thiery4, Nele Jacobs5, Tineke Lataster2, Inez Myin-Germeys2,

Philippe Delespaul6, Marieke Wichers6

1Maastricht University and Groningen University; 2Maastricht University;3Catholic University Leuven; 4Association for Scientific Research in Multiple

Births, Ghent; 5Maasstricht University; Open University; 6Maastricht UMC

Background: Manuals of psychiatric disorders distinguish separate classes

of mental illness. Although clinically useful, these labels are not very helpful

in understanding the true nature and development of psychopathology and

mental disorders. Recently, it has been proposed that mental disorders

should not be seen as latent constructs giving rise to different sets of

symptoms. Rather, mental disorders are better represented as networks of

symptoms. In this theory, symptoms do not flow from an underlying con-

struct, but exist per se, as causal, independent actors. Following from this

idea, it can be hypothesized that the network connectivity of mental states

is increased in individuals with mental disorder compared to network con-

nectivity in individuals without mental disorder. A second hypothesis is that

networks of mental states are expected to differ between individuals with

different types of mental disorder. In three separate studies, I investigated

the application of this network approach to the field of psychopathology.

Methods: In several large samples of healthy controls, individuals with

depression, individuals with psychosis and their siblings, longitudinal net-

works of moment-to-moment effects between momentary affective states

were visualized and different aspects of network connectivity were ex-

plored.

Results: Network connectivity between mental states was shown to in-

crease with increasing levels of psychopathological severity. In addition,

networks of mental states showed both overlap and (quantitative as well as

qualitative) differences in network characteristics between different groups

(eg healthy controls vs individuals with mental disorder, or individuals with

psychotic disorder vs individuals with depressive disorder). Furthermore,

mental state connectivity was shown to be dependent on affective and

environmental factors.

Discussion: A network approach to mental disorder may prove valuable

to complement current diagnostic practice and may help us to better

understand both phenomenology and development of psychopathology. It

may also offer explanations for clinical aspects such as comorbidity. These

studies represent first explorations of the network approach to mental state

connectivity in the field of psychopathology.

Poster #M218

PATHWAYS TO CARE FOR YOUNG INDIVIDUALS WITH A FIRST-EPISODE

PSYCHOSIS IN SOUTH LONDON: USE OF PRODROMAL SERVICES

Olesya Ajnakina1, Craig Morgan2, Sherifat Oduola3, François Bourque4,

Lucia Valmaggia5, Paola Dazzan6, Robin M. Murray2, Anthony S. David5

1Department of Psychosis, Institute of Psychiatry, KCL; 2IOP; 3Centre for Public

Mental Health, Health Service and Population Research Department, Institute

of Psychiatry, King’s College London, UK; 4Department of Psychosis Studies,

Institute of Psychiatry, King’s College London, UK; 5Institute of Psychiatry,

King’s College London; 6Psychological Medicine, Institute of Psychiatry, King’s

College London

Background: The onset of schizophrenia (SZ) may be preceded by a

prodromal phase, also termed as At Risk Mental State (ARMS), which

is characterised by presence of either “attenuated” psychotic symptoms,

brief and self-limiting psychotic symptoms, or a significant decrease in

functioning in the context of a genetic risk. Estimates of transition rates

to schizophrenia spectrum disorders of people presenting with the ARMS

range from approximately 20-40% in the following 12 months after onset.

The Outreach and Support in South London (OASIS) service is a large and

well-established prodromal psychosis service and currently covers four

boroughs in South East London, UK, a region with high prevalence rates

of psychosis. This study sought to a) establish what proportion of the

total number of individuals with a first episode of psychosis (FEP) who

present to catchment area mental health services provided by the South

London Maudsley NHS Foundation Trust come via OASIS (which covers

the same catchment) and b) examine differences in socio-demographic

characteristics and pathways to care between those who entered mental

health services via OASIS and those who did not.

Methods: Data on demographic characteristic, first presentation to mental

health services and pathways to care for all individuals with FEP over a

one-year period (aged 18-35 years) were extracted from electronic records

obtained from the Maudsley Biomedical Research Centre (BRC) Case Regis-

ter Interactive Search (CRIS) system for which secondary data analysis has

been ethically approved. All analyses were performed in STATA (11).

Results: During the study period, 150 patients with FEP presenting to

services for the first time were identified. Of these, 25 (16.7%) had had

a prior contact with OASIS. The mean age in the OASIS groups was 24

years (sd=4.12) compared with 26 years (sd=4.75) in the non-OASIS group

(p=0.05). There groups did not differ in gender (χ2=14, df=1, p=0.71), living

arrangements (χ2=2.80, df=2, p=0.25), level of educational achievement

(χ2=0.21, df=1, p=0.90), occupational (χ2=1.24, df=2, p=0.54), relationship

status (χ2=5.1, df=2, p=0.25), and cannabis use (χ2=0.96, df=1, p=0.33) at the

time of presentation. The entire FEP sample included a higher proportion

of individuals of black ethnicity (n=59; 39.6%) compared with white British

(n=38, 25.5%) (p<0.001). A higher number of individuals of back ethnicity

had prior contact with family practitioners (GPs) (n=49; 44.1%) compared

to white British (n=23; 20.7%) (χ2=10.79, df=2, p=0.005). However, this

group was less likely to have had a prior contact with OASIS (black: 16.7%;

white British 54.2%; χ2=13.28, df=2, p<0.001). Individuals from black ethnic

minority groups had somewhat higher rates of an acute onset of psychotic

symptoms (n=23, 39%) compared to white British (n=10, 26.3%), though this

difference was not significant (p=0.34). Those who accessed OASIS were

primarily referred by GPs, nurses and other health professionals (χ2=12.87,

df=1, p<0.001).

Discussion: In the area of SE London studied, only a small proportion

of individuals who present with a first episode of psychosis to the main

secondary mental health provider have previously been in contact with

prodromal services. Those who do are more likely to be white British.

Individuals of black ethnicity appear to actively seek help, but gain access

to services by other routes. Further work is needed to establish whether

prodromal services fail to reach prodromal patients and/or the proportion

of FEP which presents acutely without a prodrome.

Poster #M219

THE ASSOCIATION OF AUTISTIC TRAITS AND PSYCHOSIS PRONENESS IN

CHINESE EARLY ADULTS: THE TWINS SCAN CHINA STUDY

Shelly Leung1, Phoebe Kong1, Cecilia Leung1, Emma Li1, Francesca

A. Cotier1, Winifred Mark1, Lu Hua Chen1, Jim van Os2,

Timothea Toulopoulou1

1The University of Hong Kong; 2Maastricht University Medical Centre/King’s

College London

Background: Autism and Psychotic Disorder are both spectrum disorders

that include a range of symptom severity from mild to severe. Studying the

sub-clinical or prodromal symptoms can help the conceptualization and

distinction of the two disorders. The current study aims to replicate Hurst

et al. (2007) in studying the relationship between psychotic experiences or

symptoms and autistic traits in a non-clinical Chinese adolescent sample. It

was hypothesized that 1) when the domains of autistic traits and psychotic

traits are compared, positive correlation will be observed. Specifically, we

predicted a stronger association between communication and social skills,

two of the main features of autism, and psychosis proneness, and 2) autistic

traits would predict psychosis proneness.

Methods: The study included 148 Chinese healthy participants aged 15-21.

Self-report questionnaires of autistic traits and psychotic experiences and

symptoms, including Autism Spectrum Quotients (AQ), Community Assess-

ment of Psychic Experiences (CAPE) and Symptom Checklist 90-Revised

(SCL-90-R), were administered.