and similarly for theories of violence and aggression. One suchpotential risk factor is childhood adversity which has been linked topsychosis onset and to violence and offending amongst youngmales. Therefore this study sought to examine whether there wererelationships between specific forms of childhood adversity andantisocial behaviour in an epidemiological sample of first episodepsychosis patients. These associations were also explored for genderdifferences.Methods: Data were available on 171 individuals recruited as part ofthe Aetiology and Ethnicity of schizophrenia and other Psychoses(AESOP) study who had presented to services for the first time with apsychotic disorder. Self reports of adversity prior to 17 years of agewereobtained from the Childhood Experiences of Care and Abuse (CECA),whilst historyof antisocial andoffendingbehaviour aswell as aggressionor violence at presentation to serviceswas retrieved fromclinical recordsand the Psychiatry and Personal History Schedule (PPHS).Results: Logistic regression analysis revealed a significant associationbetween violent offending pre-onset and paternal separation (OR 3.5,95% C.I 1.06-11.54). When explored by gender this finding onlyremained significant for the male participants (OR 3.75, 95% C.I 1.07-13.14) compared with females (OR 1.03, 95% C.I 0.97-1.09). Addition-ally violence at first presentation was found to be significantlyassociated with paternal physical abuse (OR 3.75, 95% C.I 1.23-11.46).When explored by gender this finding remained only for males andwas markedly stronger (OR 6.7, 95% C.I 1.48-30.19) than for females(OR 1.93, 95% C.I 0.34-11.17). No significant associations were evidentbetween other forms of childhood adversity and antisocial behaviour.Discussion: Experiencing separation from the biological father andsevere physical abuse from a father figure appeared to be associatedwith a history of violent offending and aggression at presentation toservices in this first onset sample. This pattern was only evidentamongst men. These results lend support to previous findings thatspecific forms of childhood adversity are associated with the onsetof psychosis and with aggression and violence, particularly inmales. Identification and subsequent treatment of inter-personaldifficulties associated with exposure to adverse experiences inchildhood may potentially reduce violent behaviour amongst malepsychosis patients.

doi:10.1016/j.schres.2010.02.962

Poster 202PREVALENCE OF THE METABOLIC SYNDROME AMONGSCHIZOPHRENIA PATIENTS ON ANTIPSYCHOTICS IN NIGERIA

Bawo O. James1, Ambrose A. Lawani1, Modupe Okolo1,Olufemi Morakinyo21Federal Psychiatric Hospital Benin City, Edo, Nigeria; 2University ofBenin Benin City, Edo, Nigeria

Background: The metabolic syndrome has been implicated in theincreasing incidence of cardiovascular morbidity. The syndrome iscommoner among patients with schizophrenia compared to thegeneral population. Morbidity and mortality in schizophrenia mayarise due to co-morbid cardiovascular disorders. The prevalence ofthe metabolic syndrome has not been studied in psychiatric out-patient populations in Nigeria.Methods: A cross sectional survey of schizophrenics attending out-patient clinics at a Nigerian hospital was undertaken. Anthropo-metric measures, clinical variables and lifestyle patterns ofrespondents were assessed.Results: About 19% met the criteria for the metabolic syndrome.About half had a BMI in the overweight category. Poor lifestylehabits were observed, comprising lack of exercise and poorknowledge on weight reduction techniques.

Discussion: Schizophrenic patients in Nigeria are at risk for car-diovascular morbidity and warrant better attention from psychia-trists.

doi:10.1016/j.schres.2010.02.963

Poster 203ANTIPSYCHOTICS AND HAEMATOLOGICAL TOXICITY

Evangelos G. Neroutsos1, George N. Vagionis2, Markella P. Fiste3,Afroditi C. Retziou1, Aikaterini D. Roupaka1,Konstantoula G. Ouzonidou1

1General Hospital of Elefsina Thriasio Elefsina, Athens, Greece; 2GeneralHospital of Chania Chania, Crete, Greece; 3Psychiatric Hospital ofAthens Dromokaition Athens, Athens, Greece

Background: Atypical antipsychotics are associated with superiortolerability, adherence and relapse prevention and have led toimproved treatment for patients with serious mental illness.However, they are also associated with haematological adverseeffects [1]. Complete blood count before treatment, weekly for6 months of treatment, biweekly for months 6–12 and every4 weeks thereafter is the common practice for the treatment withClozapine worldwide.Methods: Presentation of a clinical case. Medline research forarticles published from 1990 to the present, using the terms"antipsychotic", "antipsychotic agents", "leucopenia".Results: Caucasian male, age 30, with diagnosis of schizophrenia,was hospitalized because of psychotic symptoms in our clinic. Afteradmission, the values of blood cell count, biochemistry andurinalysis were into the normal ranges. 10 days after the first doseof risperidone long-acting injectables (50 mg/15 days) he presentedwhite blood cells (WBC) 1.900/mm3 with an absolute neutrophilcount (ANC) of 1.050/mm3, Red blood cell count (RBC) 4.35 (4.4 –

5.8×10 /μL), Hemoglobin 13,9 (13.0-18.0 g/dl), Haematocrit 38,9%(37.0% - 49.0% of red blood cells) with ESR mm/hr. Physicalexamination was performed by a senior internist without patholo-gical findings. After the infective and autoimmune basis of theleucopenia was excluded, the treatment was interrupted and westarted haloperidol at 10 mg/day. After 10 days the blood valuesreturned to normal values.Discussion: Haematological abnormalities are frequently encoun-tered during treatment with antipsychotic drugs [2]. Most of theseare mild and of no clinical significance [3], but in a small minority ofpatients, hazardous, potentially life-threatening haematologicaleffects, including leucopenia and agranulocytosis, can occur [4].Clinicians should track, maybe more often, the effects of treatmenton physical and biological parameters and should facilitate access toappropriate medical care. However, with the prescription ofantipsychotic drugs comes the responsibility for monitoringpotential drug-induced haematological abnormalities. A coordi-nated action of psychiatrists and hematologists, but also, generalpractitioners, endocrinologists, cardiologists, nurses and the familyis certainly a key determinant to ensure the optimal care of thesepatients.

References

[1] S. Mazaira, S. 2008. Haematological adverse effects caused by psychiatricdrugs. Vertex 19 (82), 378–386 Nov-Dec.[2] C. Cowan, C., C. Oakley, C. 2007. Leukopenia and neutropenia induced byquetiapine. Prog. Neuropsychopharmacol. Biol. Psychiatry 31 (1), 292–294 Jan 30.[3] J.M. Delieu, J.M., R.W. Horobin, R.W., J.K. Duguid, J.K. 2006. Formation ofimmature neutrophil leucocytes in schizophrenic patients treated with various

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antipsychotic drugs: comparisons and predictions. J. Psychopharmacol. 20 (6),824–828 Nov.[4] S.U. Qureshi, S.U., E. Rubin, E. 2008. Risperidone- and aripiprazole-induced leukopenia: a case report. Prim. Care Companion. J. Clin. Psychiatry10 (6), 482–483.

doi:10.1016/j.schres.2010.02.964

Poster 204ALTERATIONS OF GLUCOSE METABOLISM IN PATIENTS TREATEDWITH ZIPRASIDONE VS. CLOZAPINE

Maria A. Rettenbacher1, Christoph Ebenbichler2, Alex Hofer1,Georg Kemmler1, Monika Edlinger1, W. Wolfgang Fleischhacker11University Clinics Psychiatry Innsbruck, Tirol, Austria; 2UniversityClinics Internal Medicine Innsbruck, Tirol, Austria

Background: Alterations of glucose metabolism have been foundduring treatment with novel antipsychotics.Methods: We conducted a prospective, open drug monitoringstudy in schizophrenia patients in order to compare insulin, glucose,Homeostasis Model Assessment index for insulin resistance (HOMAIR) and for beta cell acitivity (HOMA beta cell index) in patients whowere treated with ziprasidone to those who took clozapine.Results: We present preliminary results from 26 patients: 15received clozapine and 11 ziprasidone. Mean age was 39,9 (SD:+//0-9.3). Baseline parameters did not differ significantly between thetwo groups. Patients who were treated with clozapine showedsignificantlyy higher insulin and HOMA beta cell index after week12-16 of treatment as compared to patients who took ziprasidone.After week 12-16HOMA IR was higher in patients who tookclozapine than in those who took ziprasidone at a trend level.Discussion: Our findings indicate that the treatment with ziprasi-done is favourable compared to treatment with clozapine withrespect to the risk to induce alterations of glucose metabolism.

doi:10.1016/j.schres.2010.02.965

Poster 205MALE SEXUAL DYSFUNCTION IN SCHIZOPHRENIA: RELATIONSHIPWITH DRUG TREATMENT, PROLACTIN AND DRD2 GENOTYPE

Gavin P. Reynolds1, XiangRong Zhang1,2, ZhiJun Zhang21Queen's University Belfast Belfast United Kingdom; 2AffiliatedZhongDa Hospital of Southeast University Nanjing China

Background: Sexual dysfunction induced by antipsychotic drugtreatment is under-investigated and under-reported. The under-lying mechanisms are unclear and likely to be multifactorial,although effects of prolactin elevation have been implicated. Weundertook a study to determine the influence of drug treatment andgenetic polymorphisms in two candidate genes with sexualdysfunction in male subjects with remitted schizophrenia, and toassess the possible role of blood prolactin concentrations.Methods: 100 male subjects with schizophrenia and meetingcriteria for remission were assessed for sexual and erectiledysfunction using the Arizona Sexual Experience Scale (ASEX)and the 5-item version of International Index of Erectile Function(IIEF-5). Subjects were married, living with a sexual partner andreceiving antipsychotic drug monotherapy for at least six months.Blood samples were taken for plasma prolactin determination andgenotyping of two polymorphisms each of the D2 dopaminereceptor (DRD2) and eNOS nitric oxide synthase isoform genes.

Results: 30 subjects received typical antipsychotic drugs (primarilychlorpromazine) and 70 received atypical drugs (primarily clozapineand risperidone). Sexual dysfunction determined by ASEX score wassignificantlygreater in thepatients receiving typical antipsychotics thanthose receiving risperidone or clozapine, and threshold criteria forsexual dysfunction and erectile dysfunction were reached significantlygreater proportion of subjects on typical drugs (67% and 60%),compared with the atypical drug group (39% and 39%). Prolactin,significantly higher in subjects receiving risperidone compared withthose receiving clozapine or typical antipsychotics, was only signifi-cantly correlatedwith sexual dysfunctionwithin the risperidone group.Neitherof the eNOSpolymorphisms, G894Tor T-786C,was significantlyassociatedwith sexual or erectile dysfunction. The -141C ins/del, but notTaq1A, polymorphism of the DRD2 gene was significantly associatedwith sexual dysfunctionwith the del allele carriers having significantlylower ASEX scores and being less frequent in subjects meeting sexualdysfunction criteria. Prolactin was also lower in del allele carriers.Discussion: Our findings indicate that the older typical antipsycho-tics are more likely to be associated with sexual dysfunction inmen than the atypical drugs, including risperidone and clozapine,despite the higher blood prolactin concentrations associated withrisperidone. The pharmacogenetic association with a functionalDRD2 polymorphism may, in part, be related to effects on prolactinelevation due to genotype differences in receptor density, althoughother DRD2 mechanisms may contribute. Certainly factors inde-pendent of both prolactin and DRD2 genotype are likely tocontribute to the increase in sexual dysfunction in male patientson typical antipsychotic drugs.

doi:10.1016/j.schres.2010.02.966

Poster 206COGNITIVE IMPAIRMENT FOLLOWING PRENATAL IMMUNECHALLENGE IN MICE CORRELATES WITH PREFRONTALCORTICAL AKT1 DEFICIENCY

Joram Feldon, Byron Bitanihirwe, Urs MeyerSwiss Federal Institute of Technology (ETH) Zurich Schwerzenbach,Zurich, Switzerland

Background: Accumulating evidence indicates that genetically deter-mined deficiency in the expression of the cytoplasmic serine-threonine protein kinase AKT1may contribute to abnormal prefrontalcortical structure and function relevant to the cognitive disturbances inschizophrenia. However, it remains essentially unknown whetherprefrontal AKT1 expression may also be influenced by environmentalfactors implicated in the etiology of this mental illness. One of therelevant environmental risk factors of schizophrenia and relateddisorders is prenatal exposure to infection and/or immune activation.The present study therefore explored whether prenatal viral-likeimmune challenge may lead to prefrontal AKT1 deficiency andassociated changes in cognitive functions attributed to the prefrontalcortex. For these purposes, we used a well-established experimentalmousemodel of prenatal exposure to a viral-like acute phase responseinduced by the synthetic analogue of double-stranded RNA, poly-riboinosinic-polyribocytidilic acid (PolyI:C).Methods: Pregnant C57BL/6 mice on gestation day (GD) 17 weretreated with PolyI:C (5 mg/kg, i.v.) or corresponding vehicle(saline) solution. Adult offspring born to immune-challenged andcontrol mothers were then subjected to cognitive phenotyping andneuroanatomical investigations. Cognitive testing included theassessment of spatial working memory in the cheeseboard mazeand spatial recognition memory in the Y-maze. Following comple-tion of the cognitive phenotyping, the animals were sacrificed for

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