Poster 41 PREMORBID FUNCTIONING AND TREATMENT RESPONSE AMONG PATIENTS WITH RECENT ONSET SCHIZOPHRENIA: PROSPECTIVE STUDY WITH RISPERIDONE LONG-ACTING INJECTABLE-PROPEL STUDY Jonathan Rabinowitz 1 , Oleksandr Napryeyenko 2 , Benjaminas Burba 3 , Guadalupe Martinez 4 , Nikolay Neznanov 5 , Tsvi Fischel 6 , BayleFranck Baylé 7 , Giulio Corrivetti 8 , Enrico Smeraldi 9 , Andreas Schreiner 4 1 Bar Ilan University Ramat, Gan, Israel; 2 National Medical University, Kiev, Ukrenia; 3 Kaunas Medical University, Kaunas, Lithuania; 4 Janssen-Cilag EMEA Beerse, Belgium; 5 St. Petersburg State Pavlov's Medical University, St. Petersburg, Russia; 6 Geha Psychiatric Hospital Petach, Tikva, Israel; 7 Université Paris-Descartes, Paris, France; 8 Community Mental Health Center Pontecagnano, Faiano, Italy; 9 San Raffaele Universitary, Milan, Italy Background: Some studies suggest a positive relationship between premorbid functioning and antipsychotic treatment response. Yet these studies were not a priori designed to test this relationship and did not assure drug adherence. This study was designed to test the association between premorbid functioning and antipsychotic treatment response after controlling for drug adherence by using a long acting injectable antipsychotic. Methods: This was a prospective 6-month, open label, multicentre, phase IV trial in subjects with early-onset (< =2 years) schizo- phrenia treated with flexible doses of Risperidone Long-Acting Injectable (RLAI) (25 to 50 mg every 14 days). Premorbid function- ing was assessed at baseline with Premorbid Adjustment Scale- Structured Interview; efficacy was evaluated with clinician rated PANSS, CGI-S, CGI-C, GAF and subject completed SF-36, and tolerability with ESRS and adverse event (AE) reports. Analyses controlled for baseline scores and demographics. Results: Using published PAS scoring criteria subjects were grouped into stable-good (n = 142), stable-poor (n = 116) and deteriorating (n = 36) premorbid functioning. All groups showed significant improvement on the PANSS, CGI, GAF and SF-36. The stable-good group had the most improvement and also best functioning at baseline on most efficacy measures. The PAS Global Assessment of highest level of functioning item (excellent n=75; good n=117; fair n=78 and poor n=31) also showed a strong association with baseline functioning and improvement and had a significant linear association with meeting Remission in Schizophrenia Working Groups PANSS symptom remission criteria at baseline (40.5%; 35.4%; 28.0%; 10.0%, p = .003) and also attaining and sustaining remission for 3 months during study (47.7%; 49.3%; 29.6%; 22.2%, p=.006). Treatment was equally well tolerated with no major differences associated with premorbid functioning. Discussion: In this open label study of early episode psychotic patients treated with RLAI, good premorbid functioning corresponded with greater improvement on both clinician and patient-reported measures. doi:10.1016/j.schres.2010.02.536 Poster 42 IMPRISONMENT AND DIAGNOSTIC DELAY AMONG MALE OFFENDERS WITH SCHIZOPHRENIA Mika Rautanen Psychiatric Hospital for Prisoners Vantaa, Finland Background: Serious crime can lead to a court ordered forensic psychiatric examination of the offender and to a hospitalisation instead of an imprisonment. Regardless of this procedure mentally ill offenders end up in prison due to less serious crimes. They suffer socioeconomic problems and downward drift in the community as well as their mental disorder, and it has been clinically observed that many of these chronic illnesses become diagnosable in custody. The aim of this study was to describe differences between imprisoned schizophrenic patients and schizophrenic patients in general mental health services in Finland. Methods: This was a retrospective descriptive cohort study. We extracted Background information from all male sentenced prisoners in Finland who left the national prison hospital service between 01.01.2003 to 31.12.2006 with a discharge diagnosis of schizophrenia, verified according to ICD-10 criteria (F20.x). The diagnoses were made by clinically experienced psychiatrists working in the hospital. Results: Eighty-three such men were identified over the four-year period. A dual diagnosis of schizophrenia and substance dependence was common in the study group – 59%. On the other hand, even 90% of prisoners may fulfil the criteria for substance dependence according to the preliminary data from the large Prison Health Survey in Finland. Half of the prisoners have hepatitis-C, while the prevalence for schizophrenic patients was 37%. A triple diagnosis stigmatizes 29% of these schizophrenic prisoners. The key findings were that in 3 out of 4 cases schizophrenia was first diagnosed in the prison hospital instead of the community and that the average age at diagnosis was over 30 years, while it is 24 years in the general population in Finland. The sub-group of prisoners who had been diagnosed in the community was also older than the general population at the time of first diagnosis. Discussion: This naturalistic study casts light on the under-recognised and ill-treated subgroup of men whose chronic psychotic illness is difficult to recognise behind drug abuse, personality problems and offending behaviour. The findings support the clinical presumptions and highlight the need to find alternatives to imprisonment with severely ill persons. Further studies are needed to establish methods of shortening the diagnostic gap between forensic and non-forensic schizophrenic patients. doi:10.1016/j.schres.2010.02.537 Poster 43 ARE SOCIAL ANXIETY AND PARANOIA ASSOCIATED, AND WHICH COMES FIRST? Judith Rietdijk 1 , Jim van Os 2,3 , Ron de Graaf 4 , Philippe Delespaul 2,5 , Mark van der Gaag 1,6 1 VU University Amsterdam and EMGO+, Amsterdam, Netherlands; 2 Maastricht University, Maastricht, Netherlands; 3 Institute of Psychiatry, London, United Kingdom; 4 Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands; 5 Mondriaan Institute Maastricht, Netherlands; 6 Parnassia Psychiatric Institute Den Haag, Netherlands Background: Social Phobia (SPh) and Paranoid Symptoms (PS) are associated with each other. They may overlap because they have some psychological and behavioural mechanisms in common such as hyper vigilance, selective attention for social threat, and safety- and avoidance behaviour. Possibly, one leads to the other. Birch- wood et al. (2006) showed that SPh developed after the onset of psychosis as a result of self stigmatisation, while Cunningham Owens et al. (2005) found that situation and social anxiety pre- cedes psychosis. The aim of this study is to explore the etiological relationship between SPh and PS in the general population in a prospective study. Three hypotheses are tested: 1) SPh and sub- clinical PS are associated; 2) SPh emerges after sub-clinical PS; and 3) sub-clinical PS emerges after SPh. Methods: The database of NEMESIS (N =7076 adults from the general population) was used to examine the three hypotheses. The Abstracts 317