Biological
Psychiatry
with risk for psychopathology and furthers the evidence that
certain types of maltreatment and the timing of exposure are
crucial factors in development of psychopathology.
Supported By: NIDA R01 DA01784606
Keywords: childhood maltreatment, Personality, Personality
disorder, neuroticism
486. Longitudinal Recovery Trajectories of Patients
with First Episode Psychosis
Mei-Hua Hall1, Kristina Holton2, Thomas Chittenden3,
Dost Ongur1, Kevin Eklund4, Debra Montrose4, and
Matcheri Keshavan5
1
McLean Hospital/Harvard Medical School, 2Department of
Research Computing, Harvard Medical School, 3Boston
Children's Hospital, Harvard Medical School, 4University of
Pittsburgh School of Medicine, 5Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA
Background: There is a large variability in the recovery
trajectory of rst episode of psychosis [FEP] patients. The
goal of this study was to examine outcome differences among
FEP patients using an unsupervised data driven clustering
approach, and explore the diagnosis, cognitive function, and
demographic characteristics of patients within each cluster.
Methods: A total of 129 FEP patients (93% anti-psychotic
naive) with schizophrenia (SZ) (n5 82) or non-SZ psychoses
(n5 47) were included in the baseline assessments and
followed-up at 1-month, 6-months, and 1 year. The Scale for
the Assessment of Negative Symptoms, Scale for the
Assessment of Positive Symptoms, Wisconsin Card Sorting
Test, and Neurological sign were used as predictors against
Global Assessment of Functioning Scale (GAS) scores. We
used an R package, K-means Longitudinal 3D (kml3d), to
identify clustering trajectories and predict functional outcome.
Results: Four distinct functioning trajectories emerged:
poor, intermediate, good and catch-up. Patients with cohort
the good outcome trajectory showed least baseline
symptoms and were likely to be Caucasian, having higher
SES and better premorbid functioning. Patients in the poor
trajectory showed severe baseline symptoms and were more
likely to be with SZ diagnosis, male, and having lower SES.
Patients in the catch-up trajectory had severe baseline
symptoms but were able to show good functioning recovery
a year later. These patients were likely to be with SZ diagnosis,
male Caucasian, and with low schizotypal personality disorder.
Conclusions: Patients at greatest risk of poorer recovery
trajectories could be targeted for more aggressive treatment
interventions to reduce function deterioration and improve recovery.
Supported By: NIMH R01
Keywords: rst episode of psychosis, recovery trajectory,
longitudinal, K-means clustering
487. Clinical and Morphometric Predictors of Quality of
Life at Three Year Longitudinal Follow up of a First
Episode Psychosis Cohort
Shane McInerney1, Cathy Scanlon2, John McFarland2,
Heike Anderson-Schmidt3, Dara Cannon2,
S198 Biological Psychiatry May 15, 2017; 81:S140S276 www.sobp.org/journal
Friday Abstracts
Peter McCarthy2, Joanne Kenney2, Brian Hallahan2, and
Colm McDonald2
1
St Michael's Hospital, 2NUI Galway, 3Universittsmedizin
Gttingen
Background: First episode psychosis (FEP) patients were
followed up after a minimum of three years in order to
determine the extent of progression of clinical and
morphometric indices and their relationship with Quality of
Life (QoL). While QoL has been explored with respect to
clinical parameters, investigation into the role of brain regional
decits and QoL is less understood.
Methods: 45 FEP patients (18 non-affective psychosis) were
recruited into the study and a proportion of these (n532)
underwent clinical and neuroimaging investigations 3 years
later. Detailed clinical assessments were conducted including
SCID, GAF, PANSS and QLS.
Results: To identify clinical and morphometric independent
predictors of QoL at baseline, we used linear regression
modelling. Lower quality of Life (QoL) was predicted clinically
by higher baseline negative symptoms (t5 -2.3, p,0.03) and
improvement in negative symptoms (1.28, p,0.004) predicted
higher QoL 3 years later. From a neuroimaging perspective,
left lateral ventricular volume enlargement over the follow up
period was predicted lower QoL (t522.29, p,0.03).
Conclusions: This study demonstrated that it was the
trajectory of clinical and morphometric measures over time,
particularly with respect to negative symptoms and left lateral
ventricular volume respectively, that are most associated with
QoL as an outcome measure. Such measures are likely to be
markers of a neuroprogressive process that ultimately
determines the functional outcome after the onset of
psychotic illness.
Supported By: Health Research Board
Keywords: First-Episode Psychosis (FEP), Quality Of Life,
Negative Symptoms, Longitudinal Brain Imaging, longitudinal
488. Sign-Tracking is Difcult to Extinguish and Resis-
tant to Multiple Cognitive Enhancers
Christopher Fitzpatrick, Justin Creeden, Trevor Geary, and
Jonathan Morrow
University of Michigan
Background: Sign-tracking is a type of Pavlovian conditioned
approach (PCA) behavior that is thought to underlie some
aspects of addictive behavior, due to evidence that sign-
tracking is difcult to suppress or control, and that animals
prone to sign-track also display more robust addiction-related
outcomes such as cue-induced reinstatement of drug self-
administration. We aimed to determine whether sign-tracking
responses are resistant to extinction. We also tested whether
extinction of sign-tracking could be facilitated by different
classes of cognitive enhancers known to facilitate extinction of
other learned behaviors.
Methods: We measured the effects of extinction training on a
PCA procedure that exploits individual differences, such that