Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384 S287 treatment-resistant (TR) schizophrenia, this drug remains under-used for this group of patients. To evaluate the patterns of clozapine and other antipsychotic drugs prescription to the TR schizophrenia patients in com- munity mental health services of São Paulo, Brazil. Methods: In order to identify the TR schizophrenia patients, a multiple- choice questionnaire was applied to fifteen psychiatrists at five services inquiring about patients’ clinical condition, adherence to oral treatment and current antipsychotic treatment. History of previous and current antipsy- chotic treatment was collected through medical chart review. Obstacles to prescribing clozapine were investigated through an open questionnaire. Results: Out of 442 schizophrenia patients, 103 (23.3%) fulfilled the criteria for TR schizophrenia. Fifty-eight patients (56.3%) were receiving polyphar- macy; 30 (29.1%) were on atypical antipsychotic monotherapy, 14 (13.6%) were on typical antipsychotic monotherapy, and 25 (24.3%) were taking depot antipsychotic medication. Only 22 (21.4%) patients were receiving clozapine and there was no evidence that the drug was ever suggested to the patients. Psychiatrists pointed “blood counts” and “laboratory delays” as the main obstacles to prescribe clozapine. Discussion: Although the Government subsidizes clozapine distribution, the large majority of the TR patients (78.6%) do not receive proper treat- ment. Instead of providing clozapine, the best evidence-based medication for TR schizophrenia, psychiatrists prescribe antipsychotic polypharmacy. Government authorities should make every effort to provide these services with medical training and the necessary equipment and logistic support to adequately serve those patients who could benefit from clozapine treatment. Poster #M264 DIFFERENCES IN CANNABIS-RELATED EXPERIENCES BETWEEN PATIENTS WITH AFIRST EPISODE OF PSYCHOSIS AND HEALTHY CONTROLS Matteo Bonomo 1 , Francesca Bianconi 1 , Marta Di Forti 1 , Arianna Marconi 2,3 , Anna Kolliakou 1 , Simona A. Stilo 3 , Valeria Mondelli 4 , Pedro Gurillo Muñoz 5 , Craig Morgan 6 , Michael T. Lynskey 3 , Robin M. Murray 1 1 Institute of Psychiatry, King’s College London; 2 Department of Pediatrics and Child and Adolescent Neuropsychiatry, Sapienza University of Rome; 3 Institute of Psychiatry, King’s College of London; 4 Psychological Medicine, Institute of Psychiatry, King’s College London; 5 Marina Baixa’s Hospital (Alicante); 6 IOP Background: Many studies have suggested that cannabis use can increase the risk of a first-episode of psychosis (FEP). Until now only a few studies have investigated the nature of cannabis-related experiences in FEP pa- tients, and none has examined whether these experiences are similar in the psychotic and normal populations. The aim of this study, therefore, was to explore the differences between general and FEP populations. Methods: 252 subjects, who met ICD10 criteria for FEP and 217 healthy controls, were selected from the Genetic and Psychosis (GAP) samples, on the basis of their having previously used cannabis. The Medical Research Council Social Schedule and the Cannabis Experience Questionnaire were used to collect socio-demographic data and information about of cannabis use respectively. Results: The following experiences were more commonly reported by the FEP patients than controls: feeling like going mad (χ 2 =13,729; p=0,001), feeling nervous (χ 2 =12,287; p=0,002), feeling suspicious without a reason during (χ 2 =9,556; p=0,002); and after the effect of cannabis worn off (χ 2 =6,737; p=0,034), feeling happy (χ 2 =10,439; p=0,005), feeling full of plans (χ 2 =8,544; p=0,014), hearing voices (χ 2 =10,644; p=0,005), difficulty to concentrate (χ 2 =13,496; p=0,001) and not being able to think clearly after the effect of cannabis had worn off (χ 2 =9,887; p=0,007). Through factor analysis, four components were found (Cognitive Experiences, Pre- Psychotic Experiences, Enjoyable Experiences, Psychotic Experiences) which explained 61,82% of the variance. Linear regression analysis showed that a positive psychotic family history, gender, age of first cannabis use, type and frequency of cannabis use, and genetic susceptibility all contributed to determining both intensity and frequency of these experiences with the exception of Enjoyable Experiences. Discussion: These results suggest a higher sensitivity to cannabis use for people who have First Psychotic Episode; this hypersensitivity is not only for “bad experiences” but also for “enjoyable experiences”. Poster #M265 THE IMPORTANCE OF PHARMACOLOGICAL AND NON-PHARMACO- LOGICAL FACTORS FOR THE DEVELOPMENT OF ORGAN LESIONS AND OCCURRENCE OF “SUDDEN CARDIAC DEATH” IN PATIENTS WITH SCHIZOPHRENIA. APHD PROJECT AS PART OF SURVIVE Anne Bugge 1 ,C.B. Høyer 1 ,L.W. Boel 2 ,G.L. Ottesen 3 ,J. Banner 3 , J.L. Thomsen 1 1 Institute of Forensic Medicine, University of Southern Denmark; 2 Institute of Forensic Medicine, University of Aarhus; 3 Department of Forensic Pathology, University of Copenhagen Background: The mortality of persons diagnosed with schizophrenia is more than doubled and life expectancy reduced by up to 25 years, when compared to the general population. Pharmaceuticals used in the treatment of schizophrenics, such as antipsychotics, have numerous side effects such as weight increase, hyperglycaemia, hypercholesterolemia, and hyperten- sion. Each of these conditions predispose for developing cardiovascular disease. Furthermore, obesity, hyperglycaemia, hypercholesterolemia and hypertension are among the criteria used to diagnose the Metabolic Syn- drome (MetS). The occurrence of MetS is related to increased risk of developing cardiovascular diseases and Type 2-Diabetes; the more of the components of MetS are present, the higher the cardiovascular mortality rate. Numerous studies have documented, that the prevalence of MetS is increased among schizophrenics compared to the general population. The purpose of this PhD project is to identify causes of death among schizophrenics and identify new prognostic markers for MetS and cardio- vascular disease, respectively, among schizophrenics. Methods: “SURVIVE: Let the dead help the living” is a prospective, autopsy- based study. The study is a nation-wide and cross-disciplinary project between the three departments of forensic medicine in Denmark. The overall study includes thorough analysis in each case, such as computed tomography scanning, forensic toxicological analysis, and genetic testing. A detailed algorithm has been developed to ensure autopsies are performed in a strictly standardized way. The project includes all cases of known or suspected mental illness and all cases of known or suspected treatment with antipsychotic pharmaceuticals that are subject to medico-legal au- topsy during the two-year study period. Based on retrospective studies it is estimated, that approximately 500 persons are included. This PhD-project will focus on the detection of organ lesions and their possible association with consumption of antipsychotic pharmaceuticals and lifestyle factors. As some antipsychotics are associated with myocardial fibrosis, thorough examination of the myocardium by stereology will be performed. This includes special histological staining and development and validation of stereological analysis of fibrosis are performed. Results: Inclusion of cases started May 1, 2013 resulting in 140 cases during the first 6 months. If the inclusion rate continues unchanged, approximately 560 cases are included; all cases that will be included in this PhD-study, as it runs for a period of three years, starting November 1, 2013. Discussion: We will contribute towards giving the mentally ill a better and longer life. SURVIVE is a unique research cooperation, we want to identify risk factors for deaths among schizophrenic patients in Denmark using autopsy-based studies. Autopsies of the schizophrenics can clarify a number of conditions including diseases of the heart and liver, obesity and excessive use of medicine by studies that would otherwise be impossible. SURVIVE wants to link autopsy results directly to clinical medicine and disease prevention. Addressing new technologies in a combined genetic, metabolic and toxicologic approach to death on an autopsy material in a “bottom up” method (going from the dead to the living), a new and groundbreaking concept. Poster #M266 CLINICAL CHARACTERISTICS IN EARLY ONSET FIRST-EPISODE PSYCHOSIS WITH CANNABIS USE Radhika Patel 1 , Maria-de-Gracia Dominguez 1 , Helen Fisher 2 , Sonia Johnson 3 , Matthew Hodes 1 1 Centre for Mental Health, Imperial College London, UK; 2 Institute of Psychiatry, King’s College London, UK; 3 University College London, UK Background: Previous studies have demonstrated an association between