Conclusions: This study demonstrates that ESM is a usefulmethodology to capture ‘on-line’ variability in psychotic phenomen-ology and in determining complex relationships between appraisals,symptoms and affect. Results showed that despite psychotic symptomsbeing present a majority of the time, people are not engulfed by them.However intensity and presence of psychosis-related thoughts lead tomore distress and interference with functioning. Delusional convic-tions are not stable, nor are appraisals about symptoms. Powerappraisals are central to predicting distress about voices, while‘decentring’ from your delusions predicts less distress. In contrast,having traditional ‘insight’ into symptoms does not influence distress.

doi:10.1016/j.schres.2007.12.424

358 – NEURODEVELOPMENTAL MARKERS AND CLUSTERANALYSIS IN FIRST EPISODE NON-AFFECTIVE PSYCHOSIS

M. Ruiz-Veguilla1, M.L. Barrigon2, M. Ferrin3, E. Gordo2,A. Brañas2, M. Anguita2, M. Gurpegui4, J. Cervilla4.

1Complejo Hospitalario Jaen. First Episodes of Psychosis Unit(Jaén), Spain2Complejo Hospitalario Jaén.Child and Adolescent Unit3Hospital Clinico Granada4Instituto de Neurociencias, University of Granada, Spain

Presenting Author details: mruizveguilla@yahoo.comCarretera Bailen-Motril sn, 23009 Jaen, Spain,Tel.: +34 958 171583.

Background: The term schizophrenia includes a group of clinicalentities with a variety of phenomenological presentations andetiological factors . The main aim of this study was to explorewhether specific groups of patients with first episode psychosis can beidentified on a psychopathologically basis and whether such identifiedgroups can be validated by exploring their correlation with a variety ofneurodevelopmental markers.Methods: This study included 87 patients in their first episode of non-affective psychosis. Psychopathology (PANSS), age onset of psycho-sis, premorbid adjustment (Premorbid Adjustment Scale, PAS),Obstetrics complications (OCs, Lewis–Murray Scale), Neurologicalassessment (NES) and Cannabis use (CIDI), family history, were assedat the first contact with mental health services.Results: Principal component analysis was applied to PANSS, obtaining4 factor (eigenvalue above 1.5) that explained 54% of the variance:Negative Factor, Disorganization Factor, Positive Factor and ParanoidFactor. The cluster analysis of the four factors produced three clusters ofpatients: negative, low score and paranoid psychotic subtypes. Afteradjusted by gender and age, the negative cluster is associated with poorsocial premorbid adjustment (3.9±6 vs. 3.8±6 vs. 9.2± 9; pb0.05), lowscore in verbal fluency (18.4±4vs. 17± 7vs. 12.2±2, pb0.05), morepresence of Neurological soft signs (21.6±9 vs. 17.3±8 vs. 29.2±1;pb0.05) and more OCs (16% vs. 4% vs. 29%; pb0.05).Conclusions: The negative cluster presents a profile of abnormalneurodevelopmental.

doi:10.1016/j.schres.2007.12.425

359 – NEGATIVE AND POSITIVE SYNDROMES IN FIRSTEPISODE SCHIZOPHRENIA

H. Soliman1,2, S. Rabie2, R. Mahfouz2.

1Kent and Medway NHS & Social Care Partnership Trust, Kent, UK2Department of Psychiatry, Minya University, Egypt

Presenting Author details: hana_soliman2@yahoo.co.ukSt Bartholomew's Hospital, New Road, ME1 1DS Rochester, Kent,United Kingdom,Tel.: +44 7 900220645; fax: +44 163 4810972.

Background: Most of the phenomenological studies examining thetwo versus three syndrome concepts of schizophrenia classifiedsymptoms rather than patients. The objectives of this study were toinvestigate the structure of positive and negative syndromes at the firstepisode of the illness in groups of patients. Correlation betweennegative and positive symptoms, on the one hand and depression, onthe other, was also studied.Methods: Of 65 patients presenting to the Department of Psychiatry,Minya University Hospitals, Egypt, 43 (20 females and 23 males) metthe diagnosis of schizophrenia (ICD-10). Clinical interviews using theSchedules for Clinical Assessment in Neuropsychiatry (SCAN) andPositive and Negative Syndrome Scale (PANSS) were conducted.Cluster analysis was carried out using a matrix of scores on individualsymptoms of PANSS. Comparison between the resulting groups ofpatients was carried out, using T-test for independent sample, as wellas nonparametric Mann–Whitney test. The same tests were used in thecomparison between the two genders. Spearman rank correlationcoefficients between negative, positive and depressive symptoms werecalculated.Results: 75% of the patients suffered moderate to severe degree ofnegative symptoms. Cluster analysis revealed that a two-clustermodel fit better the data than the three-cluster model. 27 (62.8%)patients belonged to the first cluster, characterized by thepreponderance of positive symptoms, while 16 (37.2%) belongedto the second, with preponderance of negative symptoms. There wassome overlap between cluster membership and the typologicalassessment of the PANSS. Negative correlation was found betweennegative and positive symptoms. No correlation was found betweennegative symptoms and depression. No gender differences innegative symptoms were elicited, but females had a higher age ofonset.Conclusions: The study supports the primary nature of negativesymptoms, as well as the two-syndrome model of schizophrenia.

doi:10.1016/j.schres.2007.12.426

360 – THEMES AND PREVALENCE OF IDEAS/DELUSIONS OFREFERENCE IN EARLY PSYCHOSIS

G.H.Y. Wong1, C.P.Y. Chiu2, C.W. Law2, E.Y.H. Chen1.

1Department of Psychiatry, University of Hong Kong,Hong Kong2Department of Psychiatry, Queen Mary Hospital, Hong Kong

181ABSTRACTS / Schizophrenia Research 98 (2008) 3–199

Presenting Author details: gloriawong@hkusua.hku.hkJ2 Lab, Department of Psychiatry, Queen Mary Hospital, Pokfulam, n/a Hong Kong, Hong Kong,Tel.: +00 852 90401937.

Background: Recent emphasis on a symptom dimension andcontinuum approach in understanding psychosis has resulted in aneed for more refined description of common psychotic symptoms.While Ideas/delusions of reference (I/DOR) were reported in two-thirds of schizophrenic patients, not much is known beyond this earlierobservation. This descriptive study provides more details.Methods: Structured interviews were conducted in a consecutivesample of 137 outpatients with early psychosis by trained raters usingan I/DOR scale validated in Hong Kong Chinese. General symptomswere rated by patients' psychiatrists using Positive and NegativeSyndrome Scale (PANSS), Scale for the Assessment of PositiveSymptoms (SAPS), Scale for the Assessment of Negative Symptoms(SANS), Calgary Depression Scale for Schizophrenia and Scale toAssess Unawareness of Mental Disorder.Results: During the study period, I/DOR was present in 43 cases andsubsided in 47, giving a point prevalence of 31.4% and a prevalence of65.7%. It is equally represented in both sexes, across diagnoses andsociodemographic factors. I/DOR is associated with auditory halluci-nation, persecutory delusions and circumstantiality in SAPS (r=0.39,0.28 and 0.34), impersistence at work/school and inability to feelintimacy and closeness in SANS (r=0.26 and 0.25), and depression(r=0.24; all pb0.01). Insight was not affected. The most commonlyreported themes were “being talked/laughed at” (73% of I/DOR cases),“being followed” (30%), “being gazed upon” (29%) and “beingdepicted in mass media” (28%). Of note, 17% (18/106) of remittedpatients (defined using PANSS criteria) were currently experiencingIOR.Conclusions: Our study confirmed previous prevalence findings. I/DOR is a common experience in early psychosis, unexplained byindividual patient characteristics. It covariates with a number ofpositive and negative symptoms, but does not affect insight. Patterns ofassociation between individual I/DOR themes and psychotic symp-toms are explored. This study suggests possible directions for futurepathogenesis studies. Implications of subthreshold I/DOR in remittedpatients despite otherwise adequate disease control also call forattention.

doi:10.1016/j.schres.2007.12.427

361 – IDEAS/DELUSIONS OF REFERENCE: DEVELOPMENTAND VALIDATION OF A NEW RATING SCALE

G.H.Y. Wong1, C.P.Y. Chiu2, C.W. Law2, E.Y.H. Chen1.

1Department of Psychiatry, University of Hong Kong, Hong Kong2Department of Psychiatry, Queen Mary Hospital, Hong Kong

Presenting Author details: gloriawong@hkusua.hku.hkJ2 Lab, Department of Psychiatry, Queen Mary Hospital, Pokfulam,n/a Hong Kong, Hong Kong,Tel.: +852 90401937.

Background: Ideas/delusions of reference (I/DOR) are highly pre-valent in psychosis and in-depth investigation is warranted. However,

tools capturing this symptom are scarce and most do not distinguishit from related concepts such as paranoia, suspiciousness andpersecutory delusion. Definitions of severity also vary, employingdifferent combinations of delusional dimensions such as conviction,frequency and pervasiveness. We propose, from an informationprocessing point of view, that I/DOR can be understood as deviationfrom normal self-information processing and its severity defined byhow strongly and specifically a piece of environmental information istargeting or referring to oneself (i.e. level of self-referentiality).Methods: In the scale development phase, possible contents andsettings of I/DOR were exhausted from the literature andexperiential accounts of patients during pilot interviews. Fifteenthemes were identified and formed items in the new rating scaledesigned for use in structured interviews. Each endorsed item entailsprovision of actual examples for self-referentiality ratings. Related,non-IOR experience is differentiated and excluded. Traditional delu-sional dimensions are also enquired. During the validation phase,two trained raters interviewed a consecutive sample of 137 out-patients with early psychosis, 15 of who entered the interraterreliability study. Subjects also completed the Schizotypal PersonalityQuestionnaire (SPQ) and were independently rated by theirpsychiatrists using the Scale for the Assessment of PositiveSymptoms (SAPS).Results: The scale demonstrated high internal consistency (Cronba-ch's alpha, 0.91) and interrater reliability (intraclass correlationcoefficient, 0.95). Convergent validity with I/DOR ratings in SAPSand SPQ was good (r=0.70 and 0.52, p=0.00).Conclusions: The scale provided a new tool for more comprehensiveunderstanding of I/DOR with a dimensional and continuum approach.It can be administered by trained nonmedical staff with goodreliability. Despite a lack of gold standards for comparison, theinstrument showed adequate agreement with clinicians' observationand patients' self-reports.

doi:10.1016/j.schres.2007.12.428

362 – SOCIAL ANXIETY AND IDEAS/DELUSIONS OFREFERENCE IN EARLY PSYCHOSIS

G.H.Y. Wong1, C.P.Y. Chiu2, C.W. Law2, E.Y.H. Chen1.

1Department of Psychiatry, University of Hong Kong, Hong Kong2Department of Psychiatry, Queen Mary Hospital, Hong Kong

Presenting Author details: gloriawong@hkusua.hku.hkJ2 Lab, Department of Psychiatry, Queen Mary Hospital, Pokfulam, n/a Hong Kong, Hong Kong,Tel.: +852 90401937.

Background: Social anxiety disorder (SAD) is increasinglyrecognized as a comorbid condition in early psychosis. Putativeexplanations include SAD as a psychological response emergingduring recovery, a component per se or vulnerability marker forpsychosis. Alternatively, it could also be an epiphenomenon ofconceptually related symptoms, such as subthreshold suspiciousnessand ideas/delusions of reference (I/DOR). This study describes therelationships between SAD and psychotic symptoms in stablepatients.

182 ABSTRACTS / Schizophrenia Research 98 (2008) 3–199