S160 Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384

Methods: The study is a randomised single blind controlled, crossover

design, with 21 participants randomised to SCIT and 15 to treatment as

usual (TAU). SCIT treatment consisted of eight-week therapy sessions twice

per week. Participants were assessed before and after the intervention

period with measures of symptoms, affect recognition, theory of mind

and attributional style. Feasibility was assessed through group attendance.

Participant acceptability was evaluated through post-group satisfaction and

social goals achievement.

Results: The group was well received by all participants and the majority

reported their confidence had improved following the intervention. Almost

two thirds of the SCIT participants agreed they had achieved their social

goal as a result of the intervention. Participants in the SCIT group showed a

significant improvement in affect recognition compared to TAU. However,

the two groups did not differ in theory of mind and attributional style after

therapy.

Discussion: It is feasible to deliver SCIT in forensic ward setting and the

intervention improved affect recognition. Some adaptations may be needed

in order to accommodate for the reduced social contact of forensic wards.

Poster #S194

ROLL-OUT AND IMPACTS OF DJ’S CHOICES WORKSHOPS

Marie-france Demers1,2, Julie Bourbeau1, Claudia Lévesque1,

Lysanne Gauthier1, Marc-André Roy3,1

1Institut universitaire en santé mentale de Québec; 2Centre de recherche de

l’Institut universitaire en santé mentale de Québec; 3Université Laval

Background: Since 2010, in Quebec province, several teams are familiar

with the DJ’s Choices program to promote treatment adherence in pa-

tients suffering from psychosis. In addition to a short introduction to the

program, these teams have expressed a need for support and training to

embrace an interdisciplinary approach combining psychosocial and medical

perspectives. The goal of our communication is to describe our multicenter

project that will assess the impact of DJ’s Choices approach roll-out in

different settings. This project therefore pursues the following objectives:

1) To ensure the roll-out of DJ’s Choices workshops in their current format

as resources for specialized and primary care teams. This means organizing

and supporting the roll-out of such a program for teams caring for people

with mental illness, including specialized and primary care teams from

a representative selection of facilities within the Québec province; 2) To

assess the impact of the distribution of this program on patients, care

providers and the organization, using treatment adherence indicators in

exposed individuals and satisfaction, skill enhancement and cross-sharing

indicators in professionals involved in implementation.

Methods: The roll-out of DJ’s Choices workshops will rely on INSPQ (Institut

national de santé publique du Québec) theoretical model for knowledge

transfer, including its eight stages (production/co-production of the support

and training program content, program adaptation, distribution, reception,

adoption, appropriation, use of knowledge and assessment of results). A

first qualitative phase will be conducted through an initial telephone sur-

vey of key players (care providers already exposed to the program and

individuals targeted to receive training) using a set questionnaire. Analysis

of this data will provide a basis for creating a program targeting training

and support for the DJ’s Choices workshops roll-out. A roll-out kit will then

be developed to support DJ’s kit deployment in these identified settings

Results: The impacts observed in care providers and individuals living with

psychosis exposed to the program will be assessed before, during and after

the program over a 3 years period. Nine sites will be included, some from

university clinics, others, from community settings in the Quebec province.

Several indicators of impact will be collected at three main levels: 1) In

patients: Combined assessment measures for adherence (e.g., self-report

adherence scales, prescription renewal at the pharmacy, overall clinical

assessment according to care providers’ impressions, medication counting

where possible) will be collected before, during and after program roll-out.

2) In health care providers: basic knowledge concerning psychopharma-

cology and facilitation techniques inspired by the motivational approach

and cognitive behavioral therapy will be assessed throughout the three

stages of the project. 3) In organizations: We will carefully describe the

different organizational environments in which the program will roll out

and will identify the factors that promote or restrict program roll-out in

the different settings

Discussion: This project will include systematic assessment of the im-

pacts of the DJ’s Choices roll-out in a representative sample of different

psychiatric care settings in Quebec. In the long term, it aims to improve

the efficiency of the distribution of this innovative treatment adherence

support to all settings in the province

Poster #S195

PREVENTION OFWEIGHT GAIN IN EARLY PSYCHOSIS: A RANDOMIZED

CONTROLLED CLINICAL TRIAL OF 16-WEEK STEPPED BEHAVIORAL

INTERVENTION

Rohan Ganguli1,2, Sabrina Hassan3, Mehreen Bhamani3, Todd Jenking3

1Psychiatry; 2Professor of Psychiatry, University of Pittsburgh; 3CAMH

Background: Patients with serious mental disorders are at higher risk of

being overweight and obese which increases their vulnerability to cardio-

vascular morbidities and mortalities. Along with unhealthy dietary habits

and higher physical inactivity in patients with psychosis, the use of novel

antipsychotic drugs is highly associated with weight gain especially in

early phase of treatment. The degree of weight gain varies by the type

of antipsychotic medications being used, with clozapine and olanzapine

are most likely to cause weight gain, followed closely by risperidone and

quetiapine. The higher prevalence of obesity in patients receiving anti-

psychotic treatment, directs our attention towards developing strategies to

reduce weight gain in this high risk group. The aim of the study therefore,

was to evaluate whether a “stepped behavioral intervention” is effective in

preventing weight gain in early psychotic patients as compared to usual

care.

Methods: This was a parallel group randomized control trial (RCT) in which

sixty participants diagnosed with an early psychotic illness (schizophrenia,

schizoaffective disorder, bipolar disorder, psychosis NOS, within 5 years

of illness-onset) were recruited for a 16-week intervention program. After

providing informed consent, the participants who met the enrollment crite-

ria were randomly assigned to either get a stepped behavioral intervention

(SBI) (n∼30) or treatment as usual (TAU) (routine care, n∼30). The preven-

tion of weight gain (increase over baseline) in two groups, using chi-square

test, was the primary outcome measure, with mean change in weight as a

secondary outcome (t test).

Results: Sixty two percent of the participants were male, most were single

and young with a mean age of 24.5 + 5.8 years. Fifty five percent of the

participants were of European ancestry followed by 22% of African ancestry.

Only 4 of the participants were employed. Out of 60 participants, regardless

of treatment assignment, 12 did not gain any weight. And of these 83%

were in SBI group as compared to only 17% in the control group (P value =

0.034). The mean change in weight was 2.27 + 4.7 in SBI group and 4.61 +

4.6in TAU group (P value= 0.08). Further, all participants gaining more than

20% over baseline weight were in the TAU group. Overall, the participants in

the SBI were significantly less likely to gain weight and their mean weight

gain was also lower (approaching significance) than for the TAU group.

Discussion: The findings of our study have important public health im-

plications. Weight gain in early psychosis, partly associated with the use

of antipsychotic medications make the psychotic individual vulnerable to

obesity related complications which may lead to inferior quality of life

and decrease life expectancy. The SBI, evaluated in this clinical trial, shows

promise in preventing weight gain in these individuals with a serious

mental disorder. Such interventions not only increase the awareness about

the benefits of healthy life style but also motivate the patients to adopt

them as part of their daily routine. Numerous studies of patients with

chronic illness and established obesity have demonstrated that behavioral

interventions can be effective in inducing weight loss. However, prevention

of weight gain is likely to be even more effective in reducing the risk of

both diabetes and cardiovascular diseases in this population, and to also

more effectively reduce disability and premature mortality.