out of ten patients has enduring OCS symptoms and is diagnosedwith co-morbid OCD. OCS/OCD co-morbidity was not associatedwith a more severe course of psychotic symptoms and relapse,although premorbid functioning and social outcome of patientswith OCD and enduring OCS symptoms is worse.

doi:10.1016/j.schres.2010.02.216

ANALYSES OF PROTECTIVE FACTORS FOR PATIENTS WITH A GOODOUTCOME FIVE YEAR AFTER FIRST EPISODE PSYCHOSIS

Nikolai Albert, Mette Bertelsen, Anne Thorup, Lone Petersen, PiaJeppesen, Gertrud Krarup, Torben Christensen, Merete NordentoftUniversity of Copenhagen Copenhagen Denmark

Background: There is an ongoing debate whether psychosis andschizophrenia is a progressive deteriorating illness or an illnesswith multiple outcome options. Until the development of anti-psychotics the prognosis of schizophrenia were grim. Most long-itudinal studies now conclude that approximately a quarter too onethird of the patients recover, in one way or another, and one third isconsidered chronically ill. It has also been suggested that the courseof illness reaches a natural plateau of psychopathology anddisability early in the course, and that this phase, "the criticalperiod", has a direct effect on the long-term trajectory of thepsychosis. Most studies are mainly occupied with risk factors for achronic outcome. Even though the predictors of a good outcomemight be the inverse of these, this relation is not fully investigated.Methods: The OPUS trial is one of very few long-term prospectivefollow-up studies of first-episode psychotic with multiple follow-uppoints. It offers an important contribution to the literature since thesample has been followed after one, two and five years. This paperaims to investigate the predictors of good outcome after first episodepsychosis. In the OPUS trial 468 first episode psychotic patients wereincluded at baseline, 362 (77.4%)with schizophrenia and 104 (22.6%)with other psychosis in the schizophrenia spectrum. At the five yearfollow up 255 was interviewed, 76 (29.8%) of these were working orstudying and 40 (15.7%) were considered fully recovered. Recoverywas defined as working or studying, having a GAF- score of 60 orabove, no hospitalisation and living independently for the last twoyears and having stable remission of negative and positive symptomsover the last two years.Results: The analysis was made in two steps, first with the socialand demographic variables and then with the clinical variables. Ofthe socio-demographic variables: premorbid social function, mea-sured with premorbid adjustment scale, social dimension (OR0.009, 95% CI 0.001 to 0.165), growing up with your mother andfather (OR 2.7, 95% CI 1.1 to 6.9), being a parent (OR 9.8, 95%CI 1.8 to55.1), being in a relationship (OR 3.1, 95% CI 1.2 to 7.8) and a highernumber of friends (OR 1.2, 95% CI 1.0 to 1.5), all at baseline, werefound to predict recovery after five years. Strangely however, ahigher number of friends and family contacts (OR 0.81, 95% CI 0.68to 0.98) decreased chances for recovery. In the multivariate analysisof the clinical variables only a higher severity of negative symptoms(OR 0.60, 95% CI 4.3 to 8.7) were significant associated withdecreased change of recovery.Discussion: The rate of recovery (15.7 %) and working or studying(29.8%) contradicts the presumption that psychosis or schizophre-nia is a chronic or progressive deteriorating illness. The predictorsare consistent with earlier findings, which suggest that a stablesocial life with a normal level of social functioning (a partner,friends, kids) have a predicative value on good outcome. Thesemeasures might be a pseudo measurement of negative symptoms

and thus not having a protective value in their own. But in themultivariate analysis with negative symptoms included they stillstand out.

doi:10.1016/j.schres.2010.02.217

LONG TERM FOLLOW UP OF AN ULTRA HIGH RISK("PRODROMAL") GROUP

Barnaby Nelson, Alison R. Yung, Hok Pan Yuen, DanielaSpiliotacopoulos, Ashleigh Lin, Annie L. Bruxner, Christina M.Broussard, Magenta B. Simmons, Patrick D. McGorryUniversity of Melbourne Parkville, Vic, Australia

Background: Criteria have now been developed that identifyindividuals at "ultra high risk" (UHR) or clinical high risk (CHR)of psychotic disorder. That is they are thought to be in theprodromal stage. These individuals have been found to have a rateof "transition" to psychotic disorder of about 35% over 1 year, withrisk decreasing over the next 2.5 years. The longest follow up todate of a UHR cohort has been 3.5 years. In this study we sought todetermine the longer term (5-15 year) outcome of a UHR sample.Methods: An extensive tracking procedure was followed to traceindividuals who had previously participated in research studies atthe PACE UHR Clinic in Melbourne Australia (n=416). At the timeof the original research studies (conducted between 1994 and2006) participants had given consent for long term follow up. TheCAARMS (Comprehensive Assessment of At Risk Mental States) wasused to determine whether transition to a previously definedpsychosis threshold had occurred, and if so the date of onset.Results: 311/416 individuals (74.8%) were directly assessed byinterview. Taking into account all sources (interview, clinicaldatabase, past research), data on transition status was availablefor 411 subjects (98.8%). Rates of transition to psychotic disorderwere: within the first year after entry: 17.1%, within 2 years afterentry: 20.9%, within 3 years after entry: 25%, within 5 years or moreafter entry: 29.3%. Rates of transition tailed off after 5 years. Theoverall transition rate was lower than expected. Thus we thenassessed whether year of recruitment affected transition rate, as wehave previously found that transition rates are decreasing over time.It was found that the participants recruited earlier, between 1994and 2000, had a significantly higher transition rate than latercohorts, recruited between 2001 and 2006.Discussion: This long tern follow up study suggests that UHRindividuals continue to be at risk of psychosis even 5 years andmore after initial presentation. However the risk is greatest in theearly years after recruitment. The transition rate appeared to havedecreased over the past 15 years. This may be partly because latercohorts have not yet moved through the period of greatest risk,especially given the reduced period of time between symptomonset and entry into PACE. For example, previously we had foundthat subjects recruited before 1998 had a significantly highertransition rate compared to those recruited between 1998 and2000. However this longer term follow up found that the transitionrate in the 1998-2000 cohort caught up to the earlier cohort,suggesting a lead time effect. It is also possible that changes inrecruitment and clinical practice over time may have decreased therate of transition to psychotic disorder.

doi:10.1016/j.schres.2010.02.218

Abstracts 179