S346 Abstracts of the 3rd Biennial Schizophrenia International Research Conference / Schizophrenia Research 136, Supplement 1 (2012) S1–S375

baseline BMI for women was 25.2 and rose to 26.9 at 6 months which washighly significant (t=-4.32, p=0.00). For men baseline BMI rose from 25.8to 27.2 at 6 months, again highly significant (t=-3.62, p=0.00). Mean waistcircumference in women significantly increased from 86.6cm at baseline to90.1cm at 6 months (t=-3.26, p=0.00). For males, mean waist circumferenceincreased significantly from 91.2 cm at baseline to 94.3 cm at 6 months(t=-2.7, p=0.00). There was no significant increase in fasting glucose orlipids over this period.Discussion: By 6 months 46% of our sample gained 7% or more of their totalbody weight and there were statistically significant increases in waist cir-cumference in men and women. The rates of metabolic syndrome increasedand 1 person developed type 2 diabetes. These rapid metabolic changessuggest a need to use metabolically neutral antipsychotics when availableand tolerated. Further study is needed on the use of adjunctive metforminto prevent or mitigate weight gain when weight neutral medication is nottolerated. Guidelines for early intervention programs should recommendcollaboration with family physicians, dieticians and recreation and occu-pational therapists to manage endocrine pathology with medication andlifestyle changes.

Poster #181PREDICTORS OF REAL-WORLD OUTCOMES IN SCHIZOPHRENIA PATIENTS,THEIR FAMILY MEMBERS AND CONTROL SUBJECTS

Katya Rubinstein1, Abraham Reichenberg4, Daniella Margalit3,Michael Davidson1,2, Mark Weiser1,21Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel; 2Sackler School ofMedicine, Tel-Aviv University, Tel-Aviv, Israel; 3Department of RehabilitationPsychology, Ariel University Center of Samaria, Ariel, Israel; 4Institute ofPsychiatry, King’s College, London, United Kingdom

Background: Characterising predictors of real-world outcomes inschizophrenia is important for patients, family members and clinicians,who need this information when assessing the prognosis of first episodepatients and designing suitable interventions. In addition, it is conceptu-ally important to look at these predictors, to see if they are specific forschizophrenia, or predict real-world outcome of people in general. Thispaper is unique in that it we looked at predictors of real-world out-comes in control subjects and unaffected relatives of patients diagnosedwith schizophrenia, as well as patients. The specific objectives of the cur-rent study were: 1. To describe the patterns of real-world functioning ofschizophrenia patients, compared to their unaffected family members andcontrol subjects. 2. To explore the role of social and cognitive functioningin adolescence in predicting different aspects of real-world outcomes (workproductivity, independent living and self care, available social networkrelationships and a composite functioning score) in schizophrenia patients,compared to their family members and controls. 3. To explore the jointeffect of severity of illness in schizophrenia patients (other psychiatricsymptoms in relatives and controls) and premorbid factors on real-worldoutcomes. To the best of our knowledge, this is the first attempt to conducta comparison on these domains within the three groups.Methods: As part of an NIMH funded study, 123 patients diagnosed withschizophrenia, 101 family members of these patients, and 272 healthy con-trols were assessed with Diagnostic Interview for Genetic Studies (DIGS),Wide Range Achievement Test (WRAT-3), Wechsler Adult Intelligence Scale(WAIS-III) subtests and Premorbid Social Functioning (PSF) scale. WRATscores were used as an estimate of premorbid cognitive functioning, PSFscores at the age 16 - 18 were used to assess estimated premorbid socialfunctioning. WAIS verbal and performance IQ scores were used as measuresof current cognitive abilities. Real world functioning scores were derivedfrom the narrative section of the DIGS, using the Role Functioning Scale(RFS) ratings.Results: As expected, we found that the level of real-world functioningof schizophrenia patients is lower compared to their relatives and healthycontrols, with the relatives of schizophrenia patients functioning betterthen their ill siblings but significantly lower compared to controls. Inaddition, we found that social functioning in adolescence significantly pre-dicted several aspects of real-world outcome both in patients, their familymembers, and in controls. Furthermore, we found that social functioningat adolescence buffers the affect of psychiatric symptoms on real-worldoutcome among relatives of schizophrenia patients and control participants.

Discussion: These results emphasise the centrality of social functioningand social abilities in adolescence in determining vocational, interpersonaland independent living outcomes in life, for patients, and also for normalcontrols. Clinical implications of these findings and suggestions for futureresearch are presented, and the centrality of social functioning in patientsand controls is discussed.

Poster #182CHANGE IN DELUSIONAL DIMENSIONS, REASONING BIASES ANDEMOTIONS IN THE FIRST 8 WEEKS OF ANTIPSYCHOTIC TREATMENT

Suzanne H. So, Philippa A. Garety, Emmanuelle R. Peters, Shitij KapurInstitute of Psychiatry, King’s College London, London, United Kingdom

Background: Delusions are characterised by dimensions such as conviction,preoccupation, distress and disruption. Depression, anxiety and reasoningbiases, “jumping to conclusions” (JTC) style and lack of belief flexibility inparticular, have been shown to be important in the development and main-tenance of delusions. This study examined changes of delusional dimen-sions, affect, and reasoning biases at the initial phase of antipsychotic treat-ment. The major hypotheses were as follows: Delusional distress, preoccu-pation and impact on functioning will reduce before delusional convictionDepression, anxiety and subjective distress will reduce alongside improve-ments in delusional dimensions Belief flexibility (but not JTC) will improveBaseline reasoning biases will moderate changes in delusional conviction.Methods: Patients with delusions were interviewed five times in the first 8weeks of their antipsychotic treatment - baseline, 1 week, 2 weeks, 4 weeks,and 8 weeks. Measures included interview-based and self-reported ques-tionnaires, Beads task and Cards task. Changes in delusional dimensionsand affect were analysed using mixed modelling approach.Results: The sample consisted of 40 individuals with a high level (80%)of delusional conviction. All four delusional dimensions improved togetherover 8 weeks of antipsychotic treatment. The hypothesis that conviction re-duces in a slower or lesser degree was not supported. Change in dimensionswas the greatest in the earlier weeks, and reduction in the first 2 weekspredicted subsequent improvement. There was an improvement in beliefflexibility and cognitive biases, but not in “jumping to conclusions” (JTC)style. Anxiety, depression, and subjective distress did not change. Baselinereasoning biases did not predict change in conviction, although individualswith belief flexibility at baseline had a lower level of conviction.Discussion: In contrast with the traditional view that delusions are per-sistent and unchanging, our findings suggest that delusional dimensionsand cognitive biases underlying delusions, including belief flexibility andappraisals, are capable of improving after only 8 weeks of antipsychotictreatment, despite JTC remaining prevalent.

Poster #183PREDICTORS OF DISENGAGEMENT FROM TREATMENT IN AN EARLYPSYCHOSIS PROGRAM

Jacqueline Stowkowy1, Donald Addington1, Lu Liu1, Brett Hollowell2,Jean Addington11Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary,Calgary, Alberta, Canada; 2Faculty of Medicine, University of Calgary, Calgary,Alberta, Canada

Background: Disengagement from treatment is a major concern in psychi-atry with as many as half of all individuals with schizophrenia not currentlyreceiving care. This is of particular concern for those presenting for careat their first episode of psychosis (FEP) as it has been demonstrated thatlong term treatment can improve symptoms and functioning in individualsexperiencing an FEP as well as reduce the likelihood of relapse. There islittle research published to date on this topic, and what is published hasrevealed a range of different predictors and characteristics of disengage-ment from treatment. The purpose of this study is to determine the rateof disengagement from a three year comprehensive treatment programfor individuals with a FE of psychosis and the potential predictors of thatdisengagement.Methods: We used a longitudinal cohort design. The sample consisted of286 (191 males, 95 females) individuals that were admitted to a specialized