F. Seminerio

F99. FIRST EPISODE PSYCHOSIS PATIENTS WHO USED CANNABIS DEVELOP THEIR ILLNESS AT A SIGNIFICANTLY YOUNGER AGE THAN THOSE WHO NEVER USED CONSISTENTLY ACROSS EUROPE AND BRAZIL

Abstract Background Patients presenting to psychiatric services with their first episode of psychosis (FEP) report higher rates of previous cannabis use than the general population (Donoghue et al., 2011; Myles, Myles and Large, 2016). Evidence suggested that patients suffering from psychosis with a history of cannabis use have an earlier age of onset of psychosis (AOP) than those who never used it (Di Forti et al., 2013). We aim to investigate if the reported association between use of cannabis and AOP is consistent across different countries, once having taken into account different patterns of cannabis use (i.e. frequency of use and age at first use). Methods We analysed data on patterns of lifetime cannabis use and AOP from FEP=1,149 (61.7% males) from 5 European countries and Brazil part of the European network of national schizophrenia networks studying European Gene-Environment-Interaction (EUGEI) study. Patients met ICD-10 criteria for psychosis, ascertained by using OPCRIT (McGuffin et al., 1991). The CEQmv (Di Forti et al., 2009) further modified for the EUGEI study, was used to collect data on lifetime frequency of cannabis use (never used/used at least once but less than daily/ everyday use) and age at first use in years (then dichotomized according to mean age at first use ≤15 years or ≥16 years). We used two ANOVAs: age of onset was used as the outcome variable and frequency of cannabis use and age of first use were respectively entered as independent predictors, along with country, gender and self-ascribed ethnicity. Results 63.3% of our sample used cannabis at least once in lifetime. Among those who used cannabis in their lifetime, mean age at first use was 16.8 years (sd=4.6) and median age was 16 years, 42.3% tried first time cannabis at 15 years or before, 57.7% at 16 years or older. Patients who smoked cannabis on a recreational basis (mean age 29.0; contrast=5.8, CI 95% 4.3, 7.2, p<0.001) and on a daily basis (mean age 26.6; contrast=2.4, CI 95% 0.9, 3.9, p=0.001) had lower age of onset than not users patients (mean age 34.8) across all countries, once have taken into account gender and ethnicity Only, those who started using cannabis ≤15 years had an earlier age of onset (25.5 years) than those who started at their 16 years or later (29.5 years), (F(1,683)=37.3, p<0.001). This relationship was the same across different countries (p=0.968), and independently influenced by ethnicity (F(5, 683)=2.3, p=0.03) but not by gender (p=0.057). Discussion Our results suggest a generalizable across country and specific effect of frequency of use and early age at first cannabis use on significantly anticipate age of psychosis onset in First episode Psychosis patients.

S77. JUMPING TO CONCLUSIONS AND FACIAL EMOTION RECOGNITION IMPAIRMENT IN FIRST EPISODE PSYCHOSIS ACROSS EUROPE

Abstract Background Jumping to conclusions (JTC) is a well-established reasoning and data gathering bias found in patients with psychosis even at illness onset (First Episode Psychosis, FEP). Preliminary work in this field focused primarily on the association with delusions, although jumping to conclusions has also been found in non-deluded schizophrenia patients after remission, and in individual with at risk mental state. Moreover, psychotic patients tend to show impairments in social cognition, struggling in identifying, processing and interpreting social clues. Deficits in facial emotion recognition (FER) – a key component of the construct – represent a well-replicated finding in schizophrenia. Furthermore, deficits in global facial affect recognition have been found in FEP with the same severity as at further stages, especially for anger recognition. The present study aims to measure JTC and FER bias in a sample of FEP recruited across 5 European countries, compared with healthy controls. Methods Data on JTC (Beads task 60:40), FER (Degraded Facial Recognition task – DFAR) and socio-demographics have been analysed in a sample of 643 FEP and 1019 population controls recruited as part as the EU-GEI study across UK, Netherlands, France, Spain, and Italy. IQ scores were used to exclude cases and controls with current IQ<70 (N=171) from JTC analysis and a score <41 (N=384) on the Benton Facial Recognition test for the analysis on DFAR. Logistic regression model was applied to predict case/control status using 1) JTC and 2) DFAR as predictive variables controlling for age, gender and country. Results We showed that the presence of JTC bias varies across different countries both in cases (χ2=23.77 p<0.001) and controls groups (χ2=14.01 p=0.007). Logistic regression analyses revealed JTC to be a significant predictor of case/control status (Adj OR=1.88 CI 95%=1.43–2.29 p<0.001). As well as JTC, FER differed over Europe in both groups (FEP, total: F=17.37, p<0.001; neutral: F=12.4, p<0.001; happy: F=25.62, p<0.001; frightened: F=8.78, p<0.001; angry: F=5.48, p<0.001. Controls, total: F=23.06, p<0.001; neutral: F=21.72, p<0.001; happy: F=21.74, p<0.001; frightened: F=14.14, p<0.001; angry: F=12.49, p<0.001). Logistic regression analyses revealed all DFAR scores, except for happy emotions, to be negatively associated with case/control status (total: B=-.0182 p=0.001; neutral: B=-.054 p=0.003; happy: B=-.0196 p=0.2; frightened: B= -.065 p<0.001; angry: B=-.030 p=0.04). Discussion This study supports the evidence that 1) FEP patients are more likely to present JTC and FER impairments than controls; 2) cognition and social cognition might represent transcultural features of psychotic disorders.

Pathological gambling in adolescence: a narrative review

Pathological gambling is an emerging and increasing phenomenon in Western counties. This work is aimed at reviewing the existing literature on this topic, paying special attention to its development, course and outcome in adolescence. We will explore epidemiological data, the instruments for the diagnostic and clinical assessment, the course and the outcome of the disorder, the comorbidity with other psychiatric syndromes and disorders. The main risk factors will be described at individual, social and community level. We provide an overview of the available pharmacological and psychological treatments and we report a clinical vignette in order to describe the psychological and psychopathological features of pathological gambling in adolescence.

Cumulative social disadvantage and psychosis: findings from a southern Italy case-control study

IEPA 10th International Conference on Early Intervention in Mental Health – “Looking Back, Moving Forward” Milan, Italy, 20th – 22nd October 2016

Working Memory, Jumping to Conclusions and Emotion Recognition: a Possible Link in First Episode Psychosis (Fep)

Introduction A large body of literature has demonstrated that people affected by psychotic disorders show deficits in working memory, in Emotion Recognition (ER) and in data-gathering to reach a decision (Jumping To Conclusions – JTC). Aims To investigate a possible correlation between working memory, JTC and ER in FEP. Methods 41 patients and 89 healthy controls completed assessments of working memory using WAIS shortened version, JTC using the 60:40 Beads Task and ER using Degraded Facial Affect Recognition Task. Results According to the literature, cases had poorer performance in working memory tasks (Digit Span: μ7,72 [ds=2,98] vs μ10,14 [ds=3,10], U=865,00, p=0,00; Digit Symbol: μ5,36 [ds=2,43] vs μ10,05 [ds=3,10], U=455,50, p=0,00; Arithmetic: μ5,46 [ds=2,76] vs μ8,74 [ds=3,24], U=865,50, p=0,00; Block Design: μ4,82 [ds=2,72] vs μ7,60 [ds=3,18], U=912,00, p=0,00), in Beads Task (81,6% vs 51,1%, χ 2 =10,27, p=0,001, μ2,53 [ds=3,57] vs μ4,23 [ds=4,77], U=1171,00, p=0,006) and in DFAR (total errors: μ21,62 [ds=7,43] vs μ16,58 [ds=8,69], U=554,50, p=0,002). Furthermore working memory tasks in cases group correlated significantly with JTC (Digit Span: r rho =0,276, p=0,003; Digit Symbol: r rho =0,275, p=0,002; Arithmetic: r rho =0,265, p=0,003; Block Design: r rho =0,292, p=0,001), but only Digit Span with ER (r rho =-0,239; p=0,021). In addition, we found that JTC and ER were significantly associated (r rho =-0,281; p=0,004). Conclusions Data show that working memory impairments, JTC style and dysfunctions in the facial emotions recognition are phenomena strongly correlated in the group of patients. Preliminary results suggest the importance of early rehabilitation as the impairments detected may lead to difficulties in social and relational adaptation in psychotic patients.

EPA-0874 – Social disadvantage and psychosis: a case control study on italian first-episodes of psychosis

Introduction A growing body of literature suggests that people affected by psychotic disorders are more likely to be unemployed, tend to live alone, have a poor social network, and are not able to establish long-term relationships (Morgan et al., 2008). Aims To investigate social disadvantage in a sample of first-episode of psychosis patients and geographically matched controls. Methods The study sample consists of 52 healthy controls and 37 FEP who were assessed using the MRC Sociodemographic Schedules. Results Preliminary results suggest that, consistently with the literature, cases are more exposed than controls to social disadvantage. They tend to reach a lower education degree (OR 6.66; CI 95%, 1.67–26.50, p 0.005) and to have an underpaid job 5 years before the onset (OR 2.84; CI 95%, 1.08–7.45, p 0.03). Furthermore, cases are more likely to live longer with their parents rather than independently (OR 3.33; CI 95%, 1.25–8.86, p 0.01) and are more exposed to house overcrowding (OR 3.92; CI 95%, 1.03–14.93, p 0.05). It was also found that an higher percentage of cases have never been in a stable relationship in the previous 5 years (OR 2.61; CI 95%, 1.08–6.27, p 0.03). Conclusions In line with the previous literature, we found that lower educational and occupational status and poor relationship status are associated to risk for psychosis. However, in contrast with North European cases, Italian FEP are more likely to live with their family rather than alone and, therefore, to be exposed to house overcrowding.