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ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS I
psycho-educational treatment in McFarlanes multifamily groups and
social skills training. Inclusion was from lst of February 1998 to 31st
of December 2000, 547 patients were included. Patients were
assessed comprehensively at baseline and at 12-month follow-up
with SCAN interview, SAPS, SANS and other validated instruments.
Results and conclusion: Results show that women at baseline have
fewer or Iess severe negative symptoms than men but more positive
symptoms. Age of onset is surprisingly the same for both male and
female, as the DUP (Duration of Untreated Psychosis) was. Male
patients have more social problems than female patients concer-
ning having a job, getting an education or a partner. A larger pro-
portion of the nien have some kind of harm- and dependency diag-
nosis. Since gender differences are marked in first episode psychotic
patients more focus may lead to better understanding of the
schizophrenic syndrome.
S-XVI/1 Friday 15/8,11:00-12:30
Cognitive decline is associated with reduced white
■natter in schizophrenia
MacCabe JH, BSc, MB, BS, MRCPsych, Clinical Researcher, Division of Psychological
Medicine, Inslitute of Psychiatry, P063, Institute of Psychiatry, de Crespigny Park,
London, SE5 8AF. Rossell SL, Chitnis XA, David AS, Murray RM.
j- Maccabe@iop. kcl.ac. uk
Background: There is growing evidence that some schizophrenia
patients decline in IQ over time. We hypothesised that such decline
may have a neural substrate, and consequent neuroanatomical cor-
relates.
Ainis: To use voxel-based morphometry (VBM) of MR images to
investigate neuroanatomical correlates of current IQ and IQ de-
cline in schizophrenia.
Methods: 72 patients with DSM-IV schizophrenia and 32 age,
gender, handedness and IQ matched healthy controls underwent
neuropsychological testing (National Adult ReadingTest (NART),
4 subtests of Weschler Adult Intelligence Scale, Revised (WAIS-
R)) and VBM using S-BAMM. IQ decline was estimated by sub-
tracting NART IQ from WAIS-R full-scale IQ.
Results: Patients had significantly greater IQ decline than controls
(18.7 vs. 6.0, p<0.00005), smaller total brain volume (1235 vs 1300cc,
P<0.005) and smaller total white matter volume (506 vs. 544 cc,
P<0.05). There was no difference in grey matter and CSF volumes. IQ
decline was not related to age, chronicity, age at onset, education or
length of unemployment, but it was related to symptom scores.
ln patients, there was a negative correlation between IQ decline
and total white matter volume (patients: r =-0.26, p<0.05; controls:
r=0.00, p=N.S.). Voxel-based analysis demonstrated that this corre-
lation was marked in three clusters: one in the left frontal and pari-
etal lobe, a second in the left temporal lobe, and a smaller cluster in
the right temporal lobe.
Condusions: Cognitive decline in schizophrenia may be mediated
by reduced white matter in left frontal and bilateral temporal lobes.
S-XVI/2 Friday 15/8, 11:00-12:30
The neuropsychology of anosognosia for memory
impairment in Alzheimer’s disease
Krisfín Hanncsdóttir. PhD Student, Neuropsychology, Institute of Psychiatry, King's
College. University of London, Kjarrvegi 2,108 Reykjavík, Iceland. Morris RG’
Anosognosia or ‘lack of insight’ is a phenomenon frequently not-
iced in Alzheimer’s disease (AD). Although documented in early
clinical observations and often considered a hallmark for the illness,
research remains scare and the condition poorly understood. There
are both theoretical and clinical importance of studying insight.
Theoretically, it makes us wonder about the mechanism that nor-
mally allows people to be aware of their own cognitive functioning.
Clinically speaking, impaired insight may form an obstacle for
rehabilitation, whereas patients may refuse to participate in ‘any
remedial interventions’. It can also result in poor interaction be-
tween patient and caregiver thus, perhaps increasing caregiver
burden. Ninety-two Icelandic AD patients are compared with 92
normal controls for this study. The age of subjects ranges from 65 -
85 years. The research is conducted from a neuropsychological pro-
file approach and by using a thorough neuropsychological test
battery, provides information about memory, executive functioning,
anosognosia, language, and visuospatial perception. Tliree
quantitative measures are used to investigate anosognosia: I) ex-
perimenter rating, 2) objective judgement discrepancy between
actual and estimated performances, and 3) subjective-rating discre-
pancy between subject and informant judgements. It is hypothe-
sised that the level of insight correlates with executive and visuo-
spatial functioning but is relatively independent of degree of
memory impairment. Insight levels are compared between AD
patients and controls as well as correlaled with each neuropsycho-
logical test. The results revealed a highly significant difference
between the AD patients and controls on all measures of insight.
Moreover, the results indicate an association between the Rey
Complex Figure Copy, the Organizational aspect of the Rey Figure
Complex copy, the DEX questionnaire, Fluency Letter and insight.
S-XVI/3 Friday 15/8,11:00-12:30
The prevalence of frontal variant frontotemporal
dementia and the frontal lobe syndrome in a population-
based sample of 85-year-olds
Þorsteinn B. Gíslason, MD, Psychiatrist, Psychiatric Department, University Hospital ot
Iceland, 101 Reykjavík, Iceland. Magnus Sjögren, MD, PhD. Lena Larsson, MD. Ingmar
Skoog, MD, PhD.
thorstgi@landspitali.is
Objectives: To investigate the prevalence of the frontal lobe synd-
rome (FLS) and the frontal variant of frontotemporal dementia
(fvFTD) in a population-based sample of 85-year-olds.
Methods: A representative sample of 451 85-year-olds in Gothen-
burg, Sweden was examined with a neuropsychiatric examination
and a key informant interview performed by an experienced
psychiatrist. A subsample underwent a computerised tomography
(CT) of the head. The Lund-Manchester research criteria were
used as a basis for a symptom algorithm to identify individuals with
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