differential 3-year effects of first vs. second-generation antipsychotics on subjective wellbeing in...

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(SF-36) as well as specific of their pathology (Sevilla and IBDQ, respectively). An external assessment of functioning is performed. Additionally, schizophrenia patients quality of life is assessed by clinician through Heinrichs-QLS. Insight is scored through SUMD scale. Treatment compliance is evaluated by Morisky Geen test. This study is approved by Ethics Committe and all subjects sign informed consent prior to participation. Results: Schizophrenia subjects have been assessed a poorer social and working functioning by clinician in comparison with IBD group. However, subjective measures have not been so different between both groups. In the schizophrenia group, patients with better insigh show a better quality of life. Both groups have shown good treatment adherence. Discussion: Schizophrenia subjects with higher insight show better quality of life, subjective and objective, in contrast with previous literature when depresion was linked to insight improvement. With less insight, there is an important difference between objective and subjective measures. It is recommended to measure insight assessment in research and in routine practice. It is recommended to facilitate insight improvemet through psico- social therapiees. doi:10.1016/j.schres.2010.02.465 Poster 238 DIFFERENTIAL 3-YEAR EFFECTS OF FIRST VS. SECOND-GENERATION ANTIPSYCHOTICS ON SUBJECTIVE WELLBEING IN SCHIZOPHRENIA USING MARGINAL STRUCTURAL MODELS (MSMS) Martin Lambert 1 , Benno G. Schimmelmann 2 , Alexander Schacht 3 , David Suarez 4 , Josep M. Haro 4 , Diego Novick 5 , Peter M. Wehmeier 3 , Christian G. Huber 1 , Hans P. Hundemer 3 , Ralf W. Dittmann 6 , Dieter Naber 1 1 Psychosis Center, Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf Hamburg Germany; 2 University Hospital of Child and Adolescent Psychiatry Bern Switzerland; 3 Lilly Deutschland GmbH Bad Homburg Germany; 4 Sant Joan de Déu-SSM, Fundació Sant Joan de Déu, Sant Boi, Barcelona Spain; 5 Eli Lilly and Company Windlesham, Surrey United Kingdom; 6 Central Institute of Mental Health Mannheim Germany Background: This study examined the differential effects of first (FGA) versus second-generation antipsychotics (SGA) on subjective wellbeing in patients with schizophrenia. Methods: Data were collected in an observational 3-year follow-up study of 2,224 patients with schizophrenia. Subjective wellbeing was assessed with the Subjective Wellbeing under Neuroleptics scale (SWN-K). Differential effects of FGAs vs. SGAs were analyzed using marginal structural models (MSMs) in those patients taking antipsychotic monotherapy. Results: The MSM, which analyzed the differential effect on the SWN-K total score, revealed that patients on SGAs had significantly higher SWN-K total scores, starting at 6-month (3.02 points; p = .0061; d = 0.20) and remaining significant thereafter (end- point: 5.35 points; p = .0074, d = 0.36). Discussion: Results of this large observational study are consistent with a small but relevant superiority of SGAs over FGAs in terms of subjective wellbeing extending previous positive findings of differential effects on quality of life. doi:10.1016/j.schres.2010.02.466 Poster 239 SUBJECTIVE WELL-BEING IN PSYCHOTIC DEPOT-TREATED PATIENTS IS RELATED TO PERSONALITY TRAITS Scott McGreal 1 , Tim J. Lambert 2 1 Psychology Dept, University of Sydney Camperdown, NSW, Australia; 2 BMRI, University of Sydney Camperdown, NSW, Australia Background: Previous research has found that schizophrenia patients treated with atypical oral antipsychotics experience greater subjective well-being (SWN) compared to patients treated with typical medications. The present study aimed to examine if this finding is applicable to patients treated with depot medications. Additionally, the relationship between SWN and personality characteristics was examined. Methods: 34 patients, 25 with schizophrenia and 9 with schizoaf- fective disorder, taking depot antipsychotic medication were assessed on SWN, personality traits, negative affect, insight, cognitive functioning, and psychopathology (PANSS) symptoms. 16 patients received an atypical depot medication (risperidone), the rest received a variety of typical medications. 28 of these patients were additionally taking oral antipsychotic medications. Results: T-tests revealed no differences between depot groups in SWN, cognitive functioning, and schizophrenia symptoms. SWN total score was significantly positively correlated with extraversion (r= .66) and agreeableness (r = .56), and negatively correlated with neuroticism (r=-.62). There were a number of significant correlations between several of the SWN subscales and with extraversion, agreeableness and neuroticism. Openness to experience was significantly positively correlated with the SWN mental subscale (.82). SWN was negatively correlated with depression (-.67), anxiety (-.61), stress (-.55), and with side-effect severity (-.57). SWN was negatively correlated with the Affective factor of the PANSS (-.46), but had no other significant correlations with the remaining PANNS factors. Insight was negatively correlated with SWN total score (-.58) and with three SWN subscales. Additionally, insight was positively correlated with depression (.47) and stress (.62). Side-effect severity was negatively correlated with extraversion (-.49) and agreeableness (-.61) and positively with neuroticism (.53). Insight was negatively correlated with extraversion (-.58) and positively with neuroticism (.54). Discussion: Preliminary result of this study found no evidence that type of depot medication influences SWN. However, patients who were higher on extraversion and agreeableness, and lower on neuroticism, reported higher levels of SWN and lower side-effect severity. Additionally, higher SWN is associated with lower levels of distress, but also with poorer insight into one's mental illness. Furthermore, more extraverted patients had poorer insight, while more neurotic patients had better insight. Patients' SWN and hence perceived quality of life seems to be strongly related to stable features of their personality as well as current distress levels and side-effect severity. SWN may have a stable trait-like character due to its relationship with personality features. doi:10.1016/j.schres.2010.02.467 Poster 240 PREVENTION OF MOTHERS' MENTAL ILLNESS DETERIORATION: A RETROSPECTIVE REVIEW OF 34 JAPANESE PATIENTS Keiko Akimoto 1 , Masaru Taira 2 , Motoo Watanabe 2 , Takeshi Hashimoto 2 , Kiyoshi Maeda 2 1 Kobe City Medical Center West Hospital Kobe, Hyogo, Japan; 2 Graduate School of Medicine, Kobe University Kobe, Hyogo, Japan Abstracts 284

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Page 1: DIFFERENTIAL 3-YEAR EFFECTS OF FIRST VS. SECOND-GENERATION ANTIPSYCHOTICS ON SUBJECTIVE WELLBEING IN SCHIZOPHRENIA USING MARGINAL STRUCTURAL MODELS (MSMS)

(SF-36) as well as specific of their pathology (Sevilla and IBDQ,respectively). An external assessment of functioning is performed.Additionally, schizophrenia patients quality of life is assessed byclinician throughHeinrichs-QLS. Insight is scored through SUMDscale.Treatment compliance is evaluated by Morisky –Geen test. This studyis approved by Ethics Committe and all subjects sign informed consentprior to participation.Results: Schizophrenia subjects have been assessed a poorer socialand working functioning by clinician in comparison with IBD group.However, subjective measures have not been so different betweenboth groups. In the schizophrenia group, patients with better insighshow a better quality of life. Both groups have shown goodtreatment adherence.Discussion: Schizophrenia subjects with higher insight showbetter quality of life, subjective and objective, in contrast withprevious literature when depresion was linked to insightimprovement. With less insight, there is an important differencebetween objective and subjective measures. It is recommended tomeasure insight assessment in research and in routine practice. Itis recommended to facilitate insight improvemet through psico-social therapiees.

doi:10.1016/j.schres.2010.02.465

Poster 238DIFFERENTIAL 3-YEAR EFFECTS OF FIRST VS.SECOND-GENERATION ANTIPSYCHOTICS ON SUBJECTIVEWELLBEING IN SCHIZOPHRENIA USING MARGINAL STRUCTURALMODELS (MSMS)

Martin Lambert1, Benno G. Schimmelmann2, Alexander Schacht3,David Suarez4, Josep M. Haro4, Diego Novick5, Peter M. Wehmeier3,Christian G. Huber1, Hans P. Hundemer3, Ralf W. Dittmann6,Dieter Naber11Psychosis Center, Department of Psychiatry and Psychotherapy, Centerfor PsychosocialMedicine,UniversityMedical CenterHamburg-EppendorfHamburg Germany; 2University Hospital of Child and AdolescentPsychiatry Bern Switzerland; 3Lilly Deutschland GmbH Bad HomburgGermany; 4Sant Joan de Déu-SSM, Fundació Sant Joan de Déu, Sant Boi,Barcelona Spain; 5Eli Lilly and Company Windlesham, Surrey UnitedKingdom; 6Central Institute of Mental Health Mannheim Germany

Background: This study examined the differential effects of first(FGA) versus second-generation antipsychotics (SGA) on subjectivewellbeing in patients with schizophrenia.Methods: Data were collected in an observational 3-year follow-upstudy of 2,224 patients with schizophrenia. Subjective wellbeingwas assessed with the Subjective Wellbeing under Neurolepticsscale (SWN-K). Differential effects of FGAs vs. SGAs were analyzedusing marginal structural models (MSMs) in those patients takingantipsychotic monotherapy.Results: The MSM, which analyzed the differential effect on theSWN-K total score, revealed that patients on SGAs had significantlyhigher SWN-K total scores, starting at 6-month (3.02 points;p=.0061; d=0.20) and remaining significant thereafter (end-point: 5.35 points; p=.0074, d=0.36).Discussion: Results of this large observational study are consistentwith a small but relevant superiority of SGAs over FGAs in terms ofsubjective wellbeing extending previous positive findings ofdifferential effects on quality of life.

doi:10.1016/j.schres.2010.02.466

Poster 239SUBJECTIVE WELL-BEING IN PSYCHOTIC DEPOT-TREATEDPATIENTS IS RELATED TO PERSONALITY TRAITS

Scott McGreal1, Tim J. Lambert21Psychology Dept, University of Sydney Camperdown, NSW, Australia;2BMRI, University of Sydney Camperdown, NSW, Australia

Background: Previous research has found that schizophreniapatients treated with atypical oral antipsychotics experience greatersubjective well-being (SWN) compared to patients treated withtypical medications. The present study aimed to examine if thisfinding is applicable to patients treated with depot medications.Additionally, the relationship between SWN and personalitycharacteristics was examined.Methods: 34 patients, 25 with schizophrenia and 9 with schizoaf-fective disorder, taking depot antipsychotic medication wereassessed on SWN, personality traits, negative affect, insight,cognitive functioning, and psychopathology (PANSS) symptoms.16 patients received an atypical depot medication (risperidone), therest received a variety of typical medications. 28 of these patientswere additionally taking oral antipsychotic medications.Results: T-tests revealednodifferences betweendepot groups in SWN,cognitive functioning, and schizophrenia symptoms. SWN total scorewas significantly positively correlated with extraversion (r=.66) andagreeableness (r=.56), and negatively correlated with neuroticism(r=-.62). There were a number of significant correlations betweenseveral of the SWNsubscales andwith extraversion, agreeableness andneuroticism. Openness to experience was significantly positivelycorrelated with the SWN mental subscale (.82). SWN was negativelycorrelated with depression (-.67), anxiety (-.61), stress (-.55), andwith side-effect severity (-.57). SWN was negatively correlated withthe Affective factor of the PANSS (-.46), but had no other significantcorrelationswith the remaining PANNS factors. Insight was negativelycorrelated with SWN total score (-.58) and with three SWN subscales.Additionally, insight was positively correlated with depression (.47)and stress (.62). Side-effect severity was negatively correlated withextraversion (-.49) and agreeableness (-.61) and positively withneuroticism (.53). Insight was negatively correlated with extraversion(-.58) and positively with neuroticism (.54).Discussion: Preliminary result of this study found no evidence thattype of depot medication influences SWN. However, patients whowere higher on extraversion and agreeableness, and lower onneuroticism, reported higher levels of SWN and lower side-effectseverity. Additionally, higher SWN is associated with lower levels ofdistress, but also with poorer insight into one's mental illness.Furthermore, more extraverted patients had poorer insight, whilemore neurotic patients had better insight. Patients' SWN and henceperceived quality of life seems to be strongly related to stablefeatures of their personality as well as current distress levels andside-effect severity. SWN may have a stable trait-like character dueto its relationship with personality features.

doi:10.1016/j.schres.2010.02.467

Poster 240PREVENTION OF MOTHERS' MENTAL ILLNESS DETERIORATION: ARETROSPECTIVE REVIEW OF 34 JAPANESE PATIENTS

KeikoAkimoto1,MasaruTaira2,MotooWatanabe2, TakeshiHashimoto2,Kiyoshi Maeda21Kobe City Medical Center West Hospital Kobe, Hyogo, Japan;2Graduate School of Medicine, Kobe University Kobe, Hyogo, Japan

Abstracts284