Desiree Castillo

The reliability and validity of the Test of Adaptive Behavior in Schizophrenia (TABS)

Performance-based tests of functional capacity are important to utilize in schizophrenia where global measures may underestimate community functioning in the context of impoverished environments and disincentives to return to work. The Test of Adaptive Behavior in Schizophrenia (TABS) is a performance-based measure of adaptive functioning designed to address limitations of other available measures including limited assessment of the ability to initiate and of the ability to identify problems that occur in the course of performing functional activities. The TABS and a variety of symptom, functional outcome, and cognitive measures were administered to 264 outpatients with schizophrenia/schizoaffective disorders at an initial assessment. At 3 months, 110 subjects received a follow-up assessment. Results indicated that the TABS had very good test-retest reliability (0.80) and inter-item consistency (0.84). Moreover, TABS scores were moderately to strongly correlated with other measures of functional outcome, negative symptoms and neuropsychological test scores (convergent validity). Measures of positive symptoms were not found to be related to TABS performance (discriminate validity). The data provide preliminary evidence for the reliability and validity of the TABS. Further studies of the psychometric properties of the TABS including those examining the sensitivity of the TABS to treatments with different pharmacological agents or psychosocial treatments are encouraged.

FRI0485 Long-Term Efficacy of Rituximab in Systemic Sclerosis. A Spanish Multicentric Analysis

Background It has been proved in several studies with a small number of patients that Rituximab (RTX) can prevent worsening of interstitial lung disease (ILD) and improve skin fibrosis in patients with Systemic Sclerosis (SSc). Recently, a multicentre case-control study of the EUSTAR cohort has confirmed these favorable results (Jordan S, et al. Ann Rheum Dis 2014 Jan 17[Epub ahead of print]). Moreover, RTX may be effective on calcinosis. However, little is known about its long-term effect. Objectives To assess the efficacy of RTX on skin involvement, ILD and calcinosis in patients with SSc. Methods Patients with SSc treated with RTX were recruited from 3 hospitals. At baseline, the following data were collected: gender, age, type and duration of the SSc, clinical features, modified Rodnan skin score (mRSS), HRCT, pulmonary function tests (PFTs), walking test, sPAP (measured by echo), previous and present treatments, and indication and dosage of RTX. Throughout the follow up, clinical changes, as well as changes in HRCT and PFTs, were registered. We also recorded the changes in the dosage of corticosteroids, number of RTX cycles, duration of treatment, and withdrawals. The package SPSS 17.0 was used for descriptive statistics, and quantitative variables were compared using the t-test for paired samples. Results Thirty SSc patients treated with RTX were included in the analysis. The majority were women (86.7%), with a mean age of 54 years, and a mean of 9.4 years of evolution of the disease. Subtypes: DSSc 50%, LSSc 37%, and Overlap syndromes 13.3%. The baseline mean mRSS was 15. Clinical features: ILD 80% (NSIP 67%), calcinosis 37%, pulmonary hypertension 10%, joint disease 49%. The baseline mean FVC, DLCO and TLC values were 70%, 47% and 73%, respectively. The indication for RTX was: ILD (73.4%), arthritis (36.6%), calcinosis (33.3%) and severe skin involvement (19.7%). The most used previous treatments were cyclophosphamide (50%) and mycophenolate (46.6%). RTX was always used in a RA dosage, mainly in monotherapy (46.7%), or in association with mycophenolate (40%). When data were collected, patients had received a mean of 1.7 cycles (1-5) of RTX, with a dosing interval which ranged from 6 to 15 months, and a mean of 12.8 months (1-43) of treatment. The mean mRSS was significantly reduced at follow-up (17.2±10.9 vs. 14±9.8; p=0.012), without significant changes of the HRCT (76.9%) and/or PFTs in patients with ILD. The 40% of patients with calcinosis reported improvement. There was also a good response, in terms of TJC and SJC, in patients with arthritis (p=0.024 and 0.019, respectively). The dose of corticosteroids was significantly reduced (10.1±8.8 vs. 5.3±2.9 mg, p=0.003). Two patients with severe ILD died despite RTX, and there were 3 withdrawals for various reasons. Conclusions RTX is an effective long-term therapy in SSc which can improve skin fibrosis, arthritis and calcinosis, and also prevent deterioration of ILD. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5629

Tools for mental health agencies to evaluate research protocols

Research involving community mental health center clients, resources, or both can affect clinical care, administrative processes, and costs. To help agencies identify and quantify these effects, a stakeholder group examined and discussed a range of protocols and then developed questionnaires and rating scales for agency use. The purpose of these materials is to make explicit the risks, costs, and benefits of a research protocol so an agency can make informed decisions about protocol approval and implementation. The goal of this work was to promote the conduct of appropriate research in community mental health settings while reducing risks to the agency and its clientele.