Primary Health Care (PHC) has an essential role in the early detection of people with cognitive impairment (CI). Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive test, appropriate for people with minimum completed level of education and easily adaptable to multicultural contexts. For these reasons it could be a good instrument for dementia screening in PHC. It comprises the following areas: recent memory, body orientation, praxis, executive functions and language.

The objective of this study was to analyse the viability of RUDAS, as an instrument for the screening of CI in PHC. RUDAS viability in PHC was checked, and it's psychometric properties assessed: Reliability, Sensitivity, Specificity, Positive and Negative Predictive Value were studied. RUDAS was compared to Mini Mental State Exam (MMSE) as a “gold standard”.

RUDAS was administered to 150 participants older than 65 years, randomly selected from seven PHC physicians’ consultations in O Grove Health Center. The test battery also included Katz, Barthel and Lawton Indexes, MMSE and the Geriatric Depression Scale. For each instrument administration time, difficulties perceived while administration and participant's collaboration were recorded. RUDAS was administered again within one month to assess test-retest reliability. For dementia clinical diagnosis, patients were classified following the Clinical Dementia Rating (CDR) scale based on clinicians’ criteria and health records.

RUDAS application was brief (7,58±2,10 minutes) and well accepted. RUDAS’ area under Receiver Operating Characteristic (ROC) curve was 0.965 (95% Confidence Interval (CI) = 0.91-1.00) for an optimal cut-off point of 21.5, with sensitivity of 90.0%, and a specificity of 94.1%. RUDAS did not correlate with depression. Education, socioeconomic status and urban or rural context did not contribute any variance to RUDAS total score.

RUDAS is a valid instrument to assess CI in PHC. It is easily applicable and appears to be culturally fair and free from educational level and language interference in bilingual contexts. However, longitudinal studies to determine its sensitivity to change in cognitive function over time are needed.

This study was performed to identify the predictive factors of functional capacity assessed by the Spanish University of California Performance Skills Assessment (Sp-UPSA) and real-world functioning assessed by the Spanish Personal and Social Performance scale (PSP) in outpatients with schizophrenia.

Naturalistic, 6-month follow-up, multicentre, validation study. Here, we report data on 139 patients with schizophrenia at their baseline visit. Assessment: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), Sp-UPSA and PSP. Statistics: Pearson's correlation coefficient (r) was used to determine the relationships between variables, and multivariable stepwise linear regression analyses to identify predictive variables of Sp-UPSA and PSP total scores.

Functional capacity: scores on the PSP and PANSS-GP entered first and second at P < 0.0001 and accounted for 21% of variance (R2 = 0.208, model df = 2, F = 15.724, P < 0.0001). Real-world functioning: scores on the CGI-S (B = −5.406), PANSS-N (B = −0.657) and Sp-UPSA (B = 0.230) entered first, second and third, and accounted for 51% of variance (model df = 3, F = 37.741, P < 0.0001).

In patients with schizophrenia, functional capacity and real-world functioning are two related but different constructs. Each one predicts the other along with other factors; general psychopathology for functional capacity, and severity of the illness and negative symptoms for real-world functioning. These findings have important clinical implications: (1) both types of functioning should be assessed in patients with schizophrenia and (2) strategies for improving them should be different.

Schizophrenia is not only a mental disorder but also has other components affecting the physical part of the body. Several studies have suggested that neuroinflammatory processes may play a role in schizophrenia pathogenesis, at least in a subgroup of patients.

This poster reported the preliminary results of a project aiming to find schizophrenia biomarkers. We present biological parameters and clinical variables of patients with schizophrenia according to the lab results and the clinical assessments.

Cross-sectional, naturalistic study. Inclusion criteria: DSM-IV diagnosis of schizophrenia; age >17 years; and written informed consent given.

123 patients with schizophrenia. Mean age 40.75 (10.37), 67.5% males. There is relationship between homocysteine(oxidative stress) and psychopathology: PANSS [negative subscale 0.27 (p=0.003), general subscale 0.21 (p=0.028) and Marder factor 0.28 (p=0.003)], NSA [global score 0.24 (p=0.010), and some factors: communication 0.26 (p=0.005), affect 0.28 (p=0.002), motivation 0.30 (p=0.001) and motor retardation 0.27 (p=0.004)]; Functioning [(PSP total score -0.24 (p=0.011) and some PSP factors: work 0.30 (p=0.001), self-care 0.21 (p=0.022)]. However, there is no relationship between C-reactive protein(inflammation) and any clinical variable. On the other hand, there is relationship between: glucose and cognitive impairment; cholesterol and NSA motivation score, cognitive impairment and PSP (total score, self-care and work); triglycerides and HDRS (total score, melancholia factor and vitality factor), NSA motivation score and cognitive impairment.

The negative dimension of schizophrenia is associated with high homocysteine levels, which means an oxidative stress state. As well, a worse functioning level is associated with high homocysteine level.

Some coping strategies might serve as protective functions by regulating the negative emotions associated with stress, whereas others may exacerbate the effects of stress and contribute to maladaptation.

To examine the distribution of the Beck Depression Inventory II (BDI-II) scores in the Spanish sample of adolescents from the “Working in Europe to Stop Truancy among Youth” Project (WE-STAY) and study the differences according to the coping style.

Sample: 1409 pupils from 23 schools sited in Asturias (Spain) [48.55% males; mean age(SD) = 15.16(1.22)]. Instruments:

1. (1) Coping Across Situations Questionnaire (CASQ);

2. (2) BDI-II.

7.3% of the sample scored in mild depression, while 4.9% did so in moderate (BDI-II criteria). Significant differences were found by gender in BDI-II scores, females scoring higher in severe, moderate and mild depression (p< .005). Regarding to the coping style, 65.4% of the sample showed internal style. The least representative was the withdrawal style (13.9%). Significant differences were found in the coping style by gender, females scoring higher in both active and withdrawal styles (p< .050). Regarding to the relation between BDI-II scores and coping style, pupils with withdrawal style score higher in severe, moderate and mild depression (p< .000).

Although ideally would be an active style, pupils showed mainly an internal coping style (which includes assessing a situation and looking for a compromise). Coping style was related with the severity of depression. Withdrawal style (which includes denial) is related to a worsening of depression. Thereby, training coping skills may be important.

People with schizophrenia and bipolar disorder are more likely to smoke, smoke more cigarettes per day and have greater mortality from smoking-related disease than those in the general population.

To describe the sample and to identify the relationship between the pattern of tobacco use and psychopathology.

Multicenter, observational, prospective, 12-month follow up study to assess the clinical efficacy of a multicomponent smoking cessation program specifically designed for patients with severe mental illness.

65 patients from 3 Mental Health Centers sited in Spain [64.6% males; mean age (SD) = 44.63 (8.93)].

1. (1) Pattern of tobacco use: Fargerstrom Test for Nicotine physical Dependence; Glover-Nilsson Test for Nicotine psychological Dependence; expired carbon monoxide (CO); n° cigarettes/day; n° smoking years.

2. (2) Psychopathology: PANSS; Hamilton; Young; CGI-G.

Schizophrenia 64.6% and bipolar 26.2%; suicide attempts 36.9% (2.83 mean of suicide attemps); economically active 7.7%. There is no differences: in psychopatology severity between “heavy smokers” (ppm ≥ 26 or n° cigarettes/day ≥ 30) and “non heavy smokers” (ppm < 26 or n° cigarettes/day < 30) and in the pattern of tobacco use between schizophrenia and bipolar patients. There is no relationship between psychopatology severity and the pattern of tobacco use in schizophrenia patients. Finally, there is relationship between depressive symptoms (Hamilton) and nicotine psychological dependence (Glover-Nilsson Test) in bipolar disorder patients (r = 0.72, p = 0.004).

In bipolar disorder patients, there is relationship between the severity of depressive symptoms and the dependence of nicotine.

The self-medication hypothesis suggests that patients diagnosed with schizophrenia might smoke as an attempt to self-medicate theirsymptoms. As a consequence, smoking cessation could worsen their clinical status.

To assess the clinical changes associated with tobacco cessation in a sample of smoking outpatients with schizophrenia.

Sample: 63 smoking outpatients with DSM-IV Schizophrenia from three Mental Health Centers located in Northern Spain [77.0% males; mean age (SD) = 43.90 (8.72); average daily cigarette use (SD) = 27.99 (12.55)]. Instruments: (1) Clinical symptoms: Positive and Negative Symptoms Scale (PANSS), Hamilton Depression Rating Scale (HDRS), Clinical Global Impression (CGI). (2) Pattern of tobacco use: n° cigarettes/day; Expired carbon monoxide (CO ppm). Design: A quasi-experimental design with two groups was implemented: control group (GC − 18 patients not willing to stop smoking), and treatment group [TG − 45 patients in smoking cessation supported by nicotine patches or vareniclina (12 weeks)]. Patients were evaluated at baseline and at week 11 (end of program). Paired sample t-test was used to detect changes in clinical symptoms from baseline to follow-up.

23.1% stopped smoking (from TG). No significant differences were found between baseline and follow-up scores (p>.05) among smokers and abstinent in PANSS subscales, HDRS and CGI.

Tobacco cessation did not have a significant effect on the clinical symptoms of this group of patients. Further studies should analyze the stability of these outcomes at longer follow-ups to confirm our results.

The treatment of anxiety disorders is subject to multiple factors (biological and environmental), this creates a complex situation while trying to achieve effective treatment of anxiety disorders.

This is the reason why in the current study, we decided to evaluate the effectiveness of specific relaxation techniques as an additional therapeutic measure.

To determine whether there is therapeutic benefit in the application of relaxation techniques among patients undergoing Pharmacological and psychological anxiety disorder treatment in comparison with patients with anxiety disorders receiving only the latter.

Firstly the process involved a pre and post intervention assessment using a psychometric equipment the Hamilton rating Scale for -HARS anxiety (HARS), the anxiety Inventory-STAI State (STAI-S) and Trait (STAI-T), which allowed us to perform an objective assessment of anxiety levels

Significant reductions in post intervention levels were obtained in comparison with pre anxiety levels, in HARS (30.56 and 22.75), in STAI-S (64.93 and 46.62) and in STAI-T (83.75 and 63.56).

Additionally the size effect (SE) was considerable, in the HARS (SE= 0,70), en STAI-S (SE=0.59) and STAI-T (SE =0.69).

From the obtained results, we can affirm there are benefits of introducing therapeutic relaxation techniques as a complement to pharmacological / psychological treatment in patients with anxiety disorders.

However more studies should be carried out to evaluate the maintenance of these results in the Long-term.

Information about the perception of suicide attempters regarding prevention of their suicide attempt may be helpful in implementing preventive strategies.

To examine:

1. (i) sociodemographic profile,

2. (ii) distribution of the Suicide Intent Scale, and

3. (iii) differences according to the gender in the sample of participants in a controlled study to determine the effectiveness of case management programme in the prevention of recurrent suicidal behaviour.

106 suicide attempters who attended the Emergency Room of the Hospital of Asturias from July- 2011 to October- 2012 were included in the study [33% males; mean age (SD)= 41.82 (13.16)]. Instruments: Ad hoc Sociodemographic- Questionnaire; Suicide Intent Scale (SIS); SAD-PERSON Scale; Medical Damage Scale; List of Threatening Experiences; Hamilton Depression Rating Scale.

Profile: 45-54 years old (30.4%), married (34%), with bachelor's degree (42.5%), unemployed (29.2%), with children (61.3%) and living with partner (34.9%). 36.2% of the sample had the intention to repeat at the time of the suicide attempt (SA), while 22.6% actually repeated it. The intention to repeat the SA was associated with the commission of SA at 12-months follow-up (p=.002). SIS data: mean total score (SD)=15.99(4.71); mean objective score (SD)=5.69(2.48); mean subjective score (SD)=10.28(3.29). Significant differences in SIS scores were found by gender (p=.007), men scoring higher. Repetition of the SA was related with higher scores (p=.002).

SA severity and its repetition at 12-months follow-up was related with the intention of repetition; nevertheless we didn’t find relation between the SA severity and the repetition of SA one year later.

The self-medication hypothesis proposes that schizophrenia patients may smoke as an attempt to reduce their cognitive deficits, their symptoms or the antipsychotic side-effects.

to identify the relationship between the smoking topography and psychopathology among outpatients with DSM-IV schizophrenia.

The sample included 26 smoking outpatients with DSM-IV schizophrenia from a Mental Health Center sited in the North of Spain [65.5% males; mean age (SD) = 44.66 (7.83)]. Instruments: (1) Psychopathology: Positive and Negative Syndrome Scales (PANSS); Clinical Global Impression of Severity (CGI-S); n° antipsychotic. (2) Pattern of tobacco use: n° cigarettes/day; Fargerstrom test for nicotine physical dependence; Glover-Nilsson test for nicotine psychological dependence; Expired carbon monoxide (CO ppm).

prevalence was 59.3% for non-heavy smokers [<30 cigarettes/day; Mean CO (SD)= 24 ppm (9.70)] and 40.7% for heavy smokers [≥30 cigarettes/day; Mean CO (SD) = 36 ppm (16.06)]. PANSS mean score (SD) = 54.07 (12.45); CGI-G mean score (SD) = 3.50 (1.17); Mean number of antipsychotic (SD) = 1.79 (0.88). No significant differences were found between the severity of the psychopatology (PANSS, CGI-S, n° antipsychotic) and all the variables of the pattern of tobacco use (n° cigarettes/day; expired carbon monoxide; Fargerstrom; Glover-Nilsson).

In this sample of schizophrenia patients, there is no relation between the severity of psychopathology and the dependence of nicotine. However, the sample of this study is small.

Several adolescents engaging in suicidal behavior represent a hidden population who do not receive professional help. Aim: to increase understanding of adolescents who were screened as being at high risk of suicide.

Sample: 1,409 pupils from 23 schools sited in Asturias (Spain) participants in the ‘Working in Europe to Stop Truancy among Youth’ Project (WESTAY) (48.55% males; mean age=15.16 years). Emergency cases: those with severe suicide ideation and/or suicide attempt (SA) in the past 2 weeks. 45 pupils identified as emergency cases (46.7% males; mean age=15.02 years).

Evaluation: Beck Depression Inventory II (BDI-II), Deliberate Self-Harm Inventory (DSHI), Strengths and Difficulties Questionnaire (SDQ), Well Being Index (WHO-5), Paykel Suicide Scale (PSS).

3.2% (n=45) of the sample self-reported acute suicidality (22 attended the clinical interview, 5 were referred to mental health services). More girls than boys were identified as cases, attended the interview and were referred to services. Emergency cases scored significantly higher (p=0.000) in SDQ total scores, emotional symptoms, conduct problems, hyperactivity and peer relationship problems, however, no significant differences were found in the prosocial scale. Emergency cases also manifested significant (p=0.000) higher level of depressive symptoms (BDI-II) and lower well-being. Emergency cases were more likely to have a history of DSH (p=0.000). No significant differences were found between those who attended the interview or not.

There is a high rate of self-reported acute suicidality among adolescents; however, their suicide risk after a clinical assessment was considered as low.

Tobacco use has been associated with more excitement and agitation symptoms, greater severity of global psychopathology as measured by the Clinical General Impression (CGI) Scale, and psychotic symptoms in patients with schizophrenia.

To assess the effects of nicotine abstinence versus nicotine maintenance on the clinical symptoms of a sample of outpatients smokers diagnosed with schizophrenia.

Sample: 81 outpatients with schizophrenia [72.8% males; mean age (SD) = 43.35 (8.82)] currently smoking tobacco [no. of cigarettes (SD) = 27.96 (12.29)]. Desing: non-randomized, open-label, 6-month follow-up and multi-center study conducted at 3 sites in Spain (Oviedo, Santiago de Compostela and Orense). Instruments: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression for Schizophrenia (CGI-SCH), Hamilton Depression Rating Scale (HDRS). Antropometric measures: Body mass index (BMI) and waist circumference. Vital sings: heart rate. Procedure: Patients were assigned to 2 conditions:

– control group = patients continuing their tobacco use;

– experimental group = patients participated in vareniclina or nicotine patches treatment for smoking cessation.

Patients were evaluated at baseline (all patients smoking) and after 3 and 6 months.

No significant differences (P>.05) were found between groups at baseline evaluation. Likewise, there were no significant differences between smokers and non-smokers after treatment (3 and 6 months follow-up) in their clinical symptomatology (according to PANSS, HDRS and CGI-SCH), anthropometric measures and heart rate.

No significant differences were found in the clinical symptoms after a period of nicotine abstinence. Therefore, clinicians should motivate and help their patients to quit smoking (CIBERSAM - FIS PI11/01891).

The authors have not supplied their declaration of competing interest.

The concept of schizophrenia as a systemic disease includes, not only psychosis, but an increase in somatic comorbidity and cardiovascular risk [1]. Furthermore, it is known the implication of inflammation in the pathogenesis of schizophrenia [2].

To determinate potential inflammatory/metabolic biomarkers of schizophrenia's dimensions.

Sample: 36 outpatients with schizophrenia for less than 11 years, under stable maintenance treatment (mean age [32.25], males [63.9%]) and their 36 matched controls (age [32.53 ± 6.63]; males [72.2%]).

PANSS, Clinical Assessment Interview for Negative Symptoms(CAINS), Calgary Scale(CDS), CGI, Personal and Social Performance Scale(PSP). Biomarkers: C-reactive protein (CRP), homocysteine, glucose, insulin, HOMA-IR (insulin resistance), cholesterol, HDL, LDL, triglycerides.

Biomarkers differences between groups are shown in Table 1. Table 2 shows the correlations found after controlling for Body Mass Index [patients(28.61 ± 5.69);controls(24.64 ± 3.80);p = 0.001] and Smoking [patients(52.8%-yes);controls(5.6%-yes);p = 0.000].

1. CRP, a potential inflammatory biomarker in schizophrenia, is related to depression severity. Homocysteine, representing an oxidative stress, is related to positive, negative, cognitive and depressive symptoms severity, and worse functioning. 2. Patients with schizophrenia have lower HDL–related to negative and cognitive symptoms severity and worse functioning–and insulin resistance – related to worse cognition –.

The authors have not supplied their declaration of competing interest.

The level of high-risk alcohol consumption WHO is estimated at more than 40 mg for women and 60 mg for men.

Nalmefene is a new treatment that breaks the cycle of continued use of alcohol.

A sample of 18 patients of a Mental Health Centre in the province of Leon alcohol dependent and high consumption They received nalmefene 18 mg daily continuous treatment for 6–9 months is selected. We appreciate the adherence of patients and the efficacy, tolerability and impact on physical health.

We appreciate reduction in the amount of alcohol ingested observed by both the patient and their relatives without any cases of neglect and few side effects.

We got two patients leave the alcohol completely and an average decline in consumption over 9 Basic Units of Drink.* (90 g).

We observed improvement in the quality of life in patients with multiple pathologies and difficult social situation.

The authors have not supplied their declaration of competing interest.

Immune-inflammatory processes have been implicated in schizophrenia (SCH), but their specificity is not clear.

To identify potential differential intra-/intercellular biochemical pathways controlling immune-inflammatory response and their oxidative-nitrosative impact on SCH patients, compared with bipolar disorder (BD) patients and healthy controls (HC).

Cross-sectional, naturalistic study of a cohort of SCH patients (n=123) and their controls [BD (n=102) and HC (n=80)].

ANCOVA (or Quade test) controlling for age and gender when comparing the three groups, and controlling for age, gender, length of illness, cigarettes per day, and body mass index (BMI) when comparing SCH and BD.

Pro-inflammatory biomarkers: Expression of COX-1 was statistically higher in SCH and BD than HC (P<0.0001; P<0.0001); NFκB and PGE2 were statistically higher in SCH compared with BD (P=0.001; P<0.0001) and HC (P=0.003; P<0.0001); NLRP3 was higher in BD than HC (P=0.005); and CPR showed a gradient among the three groups. Anti-inflammatory biomarkers: BD patients had lower PPARγ and higher 15d-PGJ2 levels than SCH (P=0.005; P=0.008) and HC (P=0.001; P=0.001). Differences between SCH and BD: previous markers of SCH (NFκB and PGE2) and BD (PPARγ and 15d-PGJ2) remained statistically significant and, interestingly, iNOS and COX-2 (pro-inflammatory biomarkers) levels were statistically higher in SCH than BD (P=0.019; P=0.040).

This study suggests a specific immune-inflammatory biomarker pattern for established SCH (NFκB, PGE2, iNOS, and COX-2) that differentiates it from BD and HC. In future, their pharmacological modulation may constitute a promising therapeutic target.